Floating

We went to parent night last night, which helped to alleviate our fears somewhat. We did learn that Brandon is the problem child in the class, but that he's also one of the youngest (if not the youngest). The teacher seems a little more human to me now. We'll meet with her tomorrow morning for a one-on-one conference. I still had a crying fit last night, partially regretting my decision to send him to school instead of homeschooling, and wondering if I've forced myself into a permanent decision because of his excitement over school.

I stayed up late Saturday night and haven't been able to recoup my sleeping pattern (what little it was), so I'm fighting to keep my eyes open. I haven't sewn since last week because I'm so tired and I'm scared that I'm letting it slip. I just can't force myself to the sewing table right now.

I need desperately to do dishes and laundry - Brandon is running out of school clothes and we've begun to eat cereal out of take-along containers since the bowls are all dirty. The living room floor is beginning to look like a confetti pattern from all the lint and crumbs that need to be vacuumed up, and I can't remember the last time I made the bed. At least you don't have to make a path through the living room yet. Maybe I'll perk back up before it gets that bad.

To make matters worse, the mother cat has apparently taken the kittens away. I haven't seen them in days. I was so hoping to befriend them and have pets again. I miss having pets. I haven't had a pet in almost 8 years. I grew up with cats and haven't had one in over 10 years. I'd love to cuddle a cat and hear it purring right now. It would be so wonderful.

The Abyss

Brandon has continued to get worse at school. We're going to meet with the teacher on Tuesday morning. I worry all day what he's doing and how the teacher is treating him. I'm beginning to wonder how this woman's mind works. Of course, that's probably the overprotective mother in me going nuts.

I've spiraled into a slump worse than any I remember. I either want to cry or sleep all the time. I'm exhausted and withdrawn. When I do go to bed, I can't get comfortable, and can't fall asleep. Then when I do manage to fall asleep, I toss and turn and wake up all night. I've been waking up at 5 every morning. What's the point of being exhausted if I get no rest? I go to bed between 9 and 10 and get up at 6:30, but feel like I never slept.

I didn't want to go to church yesterday...I never not want to go to church. I can't sing in worship, and I end up going to the mother's room and rocking in the rocking chair because I can't stand to be in a room of people. I'm trying to force myself to participate in things because in the past that has made me feel better. It doesn't seem to be working, though. Part of me wants to give up and withdraw completely, but I know that will just make it worse. I'm just not into it, though.

The only time I approach anything resembling contentment or happiness is when I'm sewing. I've got to figure out something else to make, though, or Sarah and Bethany will have so many dresses they'll never wear them all. I'm scared to try anything else, though. I'm too afraid I'll screw it up.

My depression has become the "trump card" in arguments now. Once I say anything about being depressed, Michael declares, "you've trumped me" and stops talking. I feel like this depression is taking away my life, and he seems to view it as some sort of excuse I use to get out of accountability. I view it as a straight jacket that nobody has the key to.

Someone mentioned B vitamins yesterday. I'd think that the Prozac and my prenates would have what I need, but I'm going to look into getting a B vitamin complex to start taking. I've known that they are very helpful in depression, but like I said, I figured my prenate had enough in it. I'm getting desparate now, though, so I'm going to try to find some.

I don't know when I'll post again. I had to force myself to do this one.

Abhorrent Behavior

Brandon was atrocious today. He got no less than five spankings, after time-outs. Michael told him he got a black dot for today. There was yelling, backtalk, sticking out his tongue, slamming doors...you name it. I can only hope tomorrow will be okay at school. He's already grounded from DVDs; I guess next will be VHS.

Again, if you're reading this, be praying tomorrow.

Finally!

Brandon got a green dot yesterday! We took away all DVD's and spending the night with Grandma until he got a green dot. We'll see how it goes next week.

The van died Thursday afternoon. We think the motor is shot. I ended up borrowing my mom's truck to take the kids to school and Kids Day Out, and to go to my doctor's appointment. What fun - all day in a gargantuan pickup with no air! My appointment went well, though, and my second glucose screen was fine. I'm considered at high risk for gestational diabetes because my mother has developed Type II diabetes since my last pregnancy. I'm also overweight and my paternal grandmother has had diabetes since childhood. I go back in three weeks - it's getting closer!

We're thinking it's time to give up on the van and try to trade it in. A lady from church is going to talk to the board tomorrow morning and ask if the church will help us with a down payment on something. Isn't that sweet?

We're not sure yet if we're going to try to get it fixed or just trade it in. Michael's taking it to a shop Monday to have it looked at. If it's definitely that the motor needs to be completely replaced, we're going to trade it in. Otherwise, we don't know what we'll do yet.

The past couple of days I've been feeling a little better - not as withdrawn as I have been. Of course, I've also been making a concerted effort to take my medicine everyday, so I'm sure that's helped somewhat. I also picked up $125 dollars worth of sewing work yesterday and then found a Moses basket for $15 dollars at a resale shop - that would make anyone happy!

Not so bad

Misty's mother-in-law brought Amber and Courtney over a little after 12. They brought homemade supper with them, then stayed until 4 o'clock. While they were here, Courtney played with the kids, Amber folded and put away all my laundry, and Pearlene did the dishes, cleaned the kitchen, and cleaned the living room. I felt so spoiled - I even got to take a nap!

Sarah never got sick again, and the last time Brandon got sick was around 11 or 11:30. The wonderful people at the doctor's office called in a prescription for prometh gel and pedialyte for Brandon without making us come in. I gave him one dose of gel at 1:00 to make sure he kept everything down, but apparently he didn't need it. We took him to school this morning. Sarah still has some diarrhea, but not as bad as it was, so I think everybody's on the mend or better.

It's amazing how a little tlc from some friends can make you feel better - and all because I just called and asked for Amber to come watch the kids while I slept. I still feel so undeserving, but as I've been reading (and slowly learning), God loves me and wants to show me how much He does. Often, we just have to reach out so that we can grasp the love He offers us.

All in all, yesterday and today so far have been much better. I try not to get too excited, though, because I realize one good day doesn't mean the slump is over. I'll hold on to the good I've got and use it as an impetus to take care of myself in the hopes that I will continue to improve.

Dreading Today

Brandon and Sarah (3) both got sick around 1am and have been sick all night so Brandon's staying home from school today. I'm exhausted and trying to think of someone to come and help me, but I don't know who. Janet lives too far away at these gas prices, and Misty has her 5 still. Maybe she can bring Amber over.

I'm dreading how today will go if I don't find someone to come over. I'm extrememly cranky when I'm so tired, and I have trouble staying awake to care for the kids. If anybody's reading this, please pray for me today.

A Worse Day

Brandon (5) got in trouble today - his second day of kindergarten. Again, the day seemed to be going fine until he got home. Just getting him home today was a nightmare because of the bus and the transportation director not telling me the right information.

I feel like a failure as a mother, and that Brandon is a failure as a student. All this time I thought I was doing the right thing by staying home with him and keeping him out of day care and the like. Only now he doesn't know how to sit still in class and got in trouble not once, but twice today.

The teacher's note says that he "needs to learn control." How do I teach that, and how long is she going to give me? How much trouble is he going to get into while we're trying to teach him? The vagueness of her statement is frustrating...what does she want me to do? I've never done this before and I need direction.

It helped to call my friend and cry to her, but I can't spend my life crying to someone about everything. Sometimes I think my depression stems from my apparent inability to parent my children and that I'd be fine if I'd never had them. But have them I do, so I have to figure this out somehow. I keep thinking if I could get this parenting stuff down, I'd be fine. If only life were that simple...

Child Development Study Following Fetal Expoure to Fluoxetine (Prozac)

Am J Psychiatry. 2002 Nov;159(11):1889-95. : Child development following exposure to tricyclic antidepressants or fluoxetine throughout fetal life: a prospective, controlled study.Nulman I, Rovet J, Stewart DE, Wolpin J, Pace-Asciak P, Shuhaiber S, Koren G.Motherisk Program, Division of Pediatrics and Psychology and the Reseaarch Institute, The Hospital for Sick Children, Toronta, Ont. Canada.

OBJECTIVE: Previous work suggested that first-trimester exposure to tricyclic antidepressants or fluoxetine does not affect adversely child IQ and language development. However, many women need antidepressants throughout pregnancy to avoid morbidity and suicide attempts. Little is known about the fetal safety of tricyclic antidepressants and fluoxetine when taken throughout pregnancy. The goal of this study was to assess the effects of tricyclic antidepressants and fluoxetine used throughout gestation on child IQ, language, and behavior.

METHOD: In a prospective study, mother-child pairs exposed throughout gestation to tricyclic antidepressants (N=46) or fluoxetine (N=40) and an unexposed, not depressed comparison group (N=36) were blindly assessed. The three groups were compared in terms of the children's IQ, language, behavior, and temperament between ages 15 and 71 months. The authors adjusted for independent variables such as duration and severity of maternal depression, duration of pharmacological treatment, number of depression episodes after delivery, maternal IQ, socioeconomic status, cigarette smoking, and alcohol use.

RESULTS: Neither tricyclic antidepressants nor fluoxetine adversely affected the child's global IQ, language development, or behavior. IQ was significantly and negatively associated with duration of depression, whereas language was negatively associated with number of depression episodes after delivery.

CONCLUSIONS: Exposure to tricyclic antidepressants or fluoxetine throughout gestation does not appear to adversely affect cognition, language development, or the temperament of preschool and early-school children. In contrast, mothers' depression is associated with less cognitive and language achievement by their children. When needed, adequate antidepressant therapy should be instituted and maintained during pregnancy and postpartum

Full study details found at http://ajp.psychiatryonline.org/cgi/content/full/159/11/1889

Identifying Prenatal Depression & Treatment Options

Depression During Pregnancy
A Public Health Risk & What To Do About It

Pregnant women and their loved ones are becoming more aware of the negative consequences of non-psychotic postpartum depression on infant and child well-being, on the mother's and father's subsequent mental health, and on the quality of their relationship. However, expectant mothers may not be well informed about the negative effects of depression during pregnancy on fetal and newborn development and on their own mental health after the baby is born. A series of studies have shown, for example, that depression during pregnancy is associated with higher anxiety or stress levels that, in turn, predict low birth weight and prematurity.

Further, depression during pregnancy is likely to lead to postpartum depression in the mother. A large number of studies have demonstrated that prenatal depression is one of the strongest predictors of postpartum depression. Once a woman has postpartum depression, she continues to be vulnerable to depression in her childbearing years. Maternal postpartum depression has been found to pose serious risks for the quality of mother-child interaction, interfering with the ability of the mother to bond with the infant and for the infant to form a secure attachment with the mother.

What are the signs of depression during pregnancy? Fleeting moments of feeling sad and blue or depressed are part of the human condition. These mood changes are normal and tell you that something is not quite right in your life and they usually pass. Clinical depression is different. It is persistent, impairing and includes a range of symptoms such as sadness, disturbance in sleep and appetite, changes in weight, agitation or feeling sluggish, a decrease in energy, feelings of worthlessness and guilt, having trouble concentrating or thinking, thoughts of death, feeling life is not worth living, and loss of interest or pleasure in usual activities or things you used to enjoy such as food, sex, work, your family and friends. In addition, depression during pregnancy is usually associated with a great deal of stress.

Evidence suggests that approximately 10% - 26% of women have been found to be depressed during their pregnancy and as poverty increases, so does the rate of depression during this time. Pregnancy is also known to be an opportune time for suggesting health interventions and pregnant women may be unusually open to making changes to improve their mental health before their baby is born. In order to alleviate depression during pregnancy and prevent postpartum depression, it is imperative that patients, doctors, nurse clinicians, and social workers be provided with evidence regarding the effective treatments for depression during pregnancy. The good news is that depression during pregnancy is a treatable medical illness for which there are a number of effective treatments. Depression is not the pregnant woman's fault, but there is something she can do about it, if she seeks help.Antidepressant medications (mainly selective serotonin uptake inhibitors or SSRIs) have been found to be effective for reducing non-psychotic, unipolar depression during pregnancy and have demonstrated relative safety during pregnancy and the postpartum period. On the other hand, many pregnant or breastfeeding women are reluctant to take and doctors are reluctant to prescribe antidepressants because absolute safety (e.g., low risk of birth defects) cannot be assured. Thus, pregnant women may prefer treatment for depression with psychotherapy.

Recent evidence suggests that two types of psychotherapy may be effective for alleviating depression during pregnancy. The first type of psychotherapy, interpersonal psychotherapy, helps the depressed woman feel better by addressing and better managing the interpersonal difficulties most connected to her depression, including 1) learning to identify and take care of her own needs, 2) learning to rely less on an unsupportive boyfriend, 3) increasing her social support from available, reliable people in her network, 4) resolving a dispute with a person important to her, 5) enabling her to talk about her negative (and positive) feelings about the pregnancy without fear of judgment, 6) adjusting to and planning for the upcoming birth.

The second type of psychotherapy, cognitive behavioral therapy, helps the depressed woman feel better by encouraging her 1) to increase pleasurable activities weekly, 2) to give herself credit for her accomplishments, 3) to develop more realistic and helpful thinking, 4) to address and resolve step-by step the problems most currently linked with her depression, and 5) to adjust to and plan for the upcoming birth.
You can feel better before your baby is born! To seek help for depression during pregnancy, talk to your nurse, social worker or your physician, or call your local community mental health center.

Editorial provided by Nancy K. Grote, Ph.D., MSW, Director, Promoting Healthy Families Program, School of Social Work, University of Pittsburgh, Pittsburgh PA.

References: Grote, N.K., Swartz, H.A., Bledsoe, S.E., & Frank, E. (in press). Feasibility of providing culturally relevant, brief interpersonal psychotherapy for antenatal depression in an obstetrics clinic: A pilot study. Research on Social Work Practice.

Article found at http://www.expectantmothersguide.com/library/pittsburgh/depression.htm

Blog Day 1

Today seemed to go well until the kids and I got home this afternoon. I found myself in the usual "get away from me; don't touch me" mood that accompanies my lows. It's during these times that I feel the worst. Generally I am very sanguine, but in my slumps I retreat completely. I don't want anyone near me, and I find it virtually impossible to process information or interactions. People usually get a dazed look from me during these times and have to repeat themselves.

I realized a few days ago that I hadn't been taking my meds regularly. My lows often follow several days of skipping meds. I find that happens when I'm not eating well, since I have to take them in the middle of a meal. When I'm not enticed by the pantry stock, I tend to snack rather than dine and I feel like I'm not eating enough to keep from getting sick if I take them. As a result, I end up going through the day not taking them because by dinner when I actually eat a meal I've forgotten all about it. I need to discipline myself to eat meals, both for my mental health and for Bethany's sake.

Introduction

Why is This Here?
As I have struggled with depression throughout my adult life, I've often wondered if what was going on in my head was familiar to anyone else in the world. Well, technology has once again offered a balm for our vanity, so here I am.

I don't know if anyone will ever read any of this. I don't know that if anyone does read it, it will sound familiar...or at least not completely crazy. Regardless of the outcome, this is here for me to share my life.

Hopefully it will help someone somewhere to know that she is not alone. Maybe it will help a husband better understand what his wife is going through. Maybe a family member or friend.

"Case History"
I am currently pregnant with my third child. This is my first pregnancy to also be on antidepresants. I take 40 mg of fluoxetine (Prozac) daily. Just before I got pregnant, I had begun to wonder if I needed to up my dosage because I seemed to be struggling even more than usual. I've been on the same dosage and medication for almost 3 years.

For me, depression exhibits itself in anger and fatigue - not good when you have a 3 year old and a 5 year old. I am a stay at home mother with a very small business doing website design and graphics design.

Plan of Action
My plan is to try to post each day to journal my experiences with depression during pregnancy. I will share articles, facts, and links that may also benefit.