Tagged with " depression"

A Gift Better Not Given

Most days, I try not to think about how my kids were formed (note: I didn’t say “how they were made;” that was quite pleasant), just like I try not to think about how my husband and I met. The odds are just too astronomical that things worked out the way they should, and on less-good days, it’s hard to believe that the universe has even one good thing in store for me after pulling off those hat tricks.

But every once in a while, especially when I see something of myself or Cam reflected back from them in flawless mirror image, my mind flits across whimsical images. Sometimes, it’s the three fairies from Sleeping Beauty, hovering over their cradles and bestowing gifts. And sometimes, more magical in its own way for being true, I imagine those tiny coded zippers–unfurling, melding pieces of each of us into someone new and unique but so familiar, then coiling again, before doing a little do-si-do and starting the whole thing over again, in the blink of an eye. Amazing, but frankly, it hurts my head a little to contemplate it all.

Of the two boys, Griffin definitely looks more like me, or more correctly, my little brother–he certainly got his uncles’ engineering skills and sheer cussedness from both sides of the family. Connor’s a bit more of a mystery–his looks are changing so much every year–but there’s definitely something of his Auntie Fi in his smile and stubborn little chin. Not to mention his big, enormous head, an inheritance from his father which I had not truly contemplated until hour three of pushing at Connor’s birth.

Personality traits are much easier to spot and attribute. Cam and I are a lot alike, and were as children, and we’d like to think we’ve had a big influence on them as they’ve grown too, so it’s no surprise that both boys are voracious readers–Connor loves adventure stories, comics, and technical manuals; Griffin is my non-fiction kid, and I think we’ve read every book about animals and weather that our local library has. They’re also imaginative storytellers, and immerse themselves in roleplay that folds together Star Wars, Indiana Jones, Doctor Who, James Bond, the Marvel and DC universes, and a host of other settings in what we affectionately call “the Connorverse.” We’re fortunate that Griffin inherited my appreciation for villains; he’s not stuck as the droid, like I always made my sister, to her everlasting bitterness. And of course, there are the senses of humor, as abundantly demonstrated in the last post; like their parents, they riff from the absurd to word play to cultural references and back to the zany again.

Other gifts are more obviously from one or the other of us. To our great relief, both boys inherited my iron stomach for travel–no Dramamine for us, we’ll be here in the back seat, reading quietly through long car trips. Their talent and enjoyment for video games, though, that’s all their dad (and uncles). Connor inherited his father’s ability to produce vast quantities of heat from an internal nuclear reactor. Griffin, much to my chagrin, seems to have inherited my anti-authoritarian streak.

But then there are the gifts that aren’t really gifts, the things that show up that fill you up with regret when they surface in your child. Cam felt horrible the day we learned that Connor needed glasses, much worse than Connor did, in fact. And the first time Connor had a stretch of insomnia, I actually apologized to him for setting that little timebomb in his DNA. The Asperger’s, too, was an unwelcome complication from me and my family, though the relief at understanding what was going on with Connor offset any grief at the diagnosis. Griffin, too, has some sensory issues in common with Connor and me, but so far, no sign of being too far off the neurotypical end of the spectrum.

This has been a weird month for our family. While we’re overjoyed at the release of Marvel Heroic Roleplaying, and the attendant acclaim and delight, even good stress can be very stressful. Then I had my sudden pancreatic mutiny that landed me unexpectedly in the hospital for almost a week, and recovering from surgery for another week after that. Whatever the combination of factors, Connor hasn’t reacted well, and the deepest stretch of depression in almost two years has laid him low. He’s so fragile and off-balance: little things he could normally roll with knock him down into the trenches, and those troughs are so much deeper and hard to escape than even the usual lows that are common among Aspies. We’ve had several violent (toward himself and objects, not anyone else) meltdowns at school, as well as a hair trigger temper toward his brother and more insomnia. Yesterday’s major event, to my furious frustration, was brought on by a teacher who didn’t follow Connor’s IEP, which lets him go to a safe place when he’s overwhelmed at school, and told him that he needed to “stop being a baby” and stay, or he would “lose privileges like free time.” He’s been to the ER twice in two weeks for evaluation.

Guilt is a normal state of existence for mothers everywhere, but seeing the depression that’s derailed whole seasons of my life wrap its sticky, persistent black tendrils around my beautiful boy–it weighs like a stone on my heart. And it’s probably no consolation to him, when he says there isn’t anything good in the world for him, or anything good he can give back to the world, that I can look him straight in the eye and say, “I know exactly how you feel right now.” Sometimes, I do things that fly in the face of my own experience–I don’t particularly like or find comfort in being touched when I’m that depressed, but I hold him so tightly as he weathers hurricanes of emotion too big for his little body, and I hope it brings him calm sooner than he would find alone.

Knowing how much he’s like me in other ways is no consolation. He has my resourcefulness. He has my tendency to predict future events based on scenarios played out, like chess games, entirely in his mind. And he has my impulsiveness. Each, on their own, is harmless–even an asset in many situations. But put them together, and I’m left with the certainty that, if he decided now was the time to hurt himself, the best I could hope would be to find him in time.

The options for treating juvenile depression aren’t great, or many. We’ll step up the frequency of his visits to the therapist. We’ll work with him for plans to stay safe in every imaginable contingency; he does well with things scripted out in advance. We’ll spend a lot of time just snuggling on the couch, reading and watching TV together. We’ll work a little harder to keep him in touch with friends and family who love him so much. We’ll watch some “It Gets Better” videos. We’ll build little things for him to look forward to on the calendar for the next few months, and I’ll break myself if I have to to make sure they happen, no matter how I’m feeling.

All these plans, though, are no match for one moment of desperate action. Needless to say, I’m not sleeping much or deeply these days. I’m terrified for my baby; I would be even without any personal experience with depression. But I do have experience. When he says it’s hopeless, he’s only saying aloud something I’ve thought a million times. When he says we’d all be better off if he killed himself, he’s giving voice to a feeling etched in a dark corner of my own heart.

This broken piece of my beautiful boy comes from me. It matches a broken piece inside of me. What remains to be seen is whether my broken piece will be any help filling in the jagged edges of his tattered little soul.

Jan 25, 2012 - Physical Ed    11 Comments

Fair Warning

I saw my psychiatrist the other day for my regular check-in. As we went over the list of meds I’m taking, both those prescribed by him and those from other doctors, I said that the anti-depressant I’m on right now is working just fine, and that the only real change since I last saw him was that my pain management docs were having me transition from narcotic pain relievers for my fibromyalgia onto tramadol, a non-narcotic.

He looked up from his notes with a sudden frown, and said, “Oh no. That’s not good.”

Since all I’ve heard from day one of being a fibromyalgia patient is that narcotics are bad, and I’m bad for taking them, and I might as well be a crack addict, his response startled me. “Why isn’t that good?” I asked.

“Have they warned you about serotonin syndrome?”
“No, I’ve never heard of it.”
“Well, it’s a fairly rare thing, but when you take more than one drug that affects your body’s serotonin level, you can get serotonin syndrome. You don’t know you have it until you become symptomatic, and once you’re symptomatic, you’ve reached the point at which there’s a 20% mortality rate.”

“My pharmacist didn’t tell me there were any contra-indications…” I began.

“Oh, no, it wouldn’t show up as a contra-indication because it doesn’t happen all the time. It’s just a possibility,” he replied.

“Yeah, but it’s a possibility that kills 20 percent of the people who get it.”

He nodded, and leaned forward to whisper, somewhat conspiratorially, “Really, the Vicodin is much safer for you to be on.”

I was stunned. Not once in the 12 years I’ve been taking various medications for my fibro and my depression has a single healthcare professional ever even mentioned the existence of this potentially fatal drug interaction.

And when I looked it up, I got even more alarmed, because you don’t even have to be that sick, or taking a bunch of medications, to find yourself at risk for serotonin syndrome. If you take any kind of SSRI or SSNRI anti-depressant or smoking cessation drug, and you take medicine for migraines (the triptans), some pain relievers, even cough syrup containing dextromethorphan, you are at risk. If you take an anti-depressant and anything else–over-the-counter or prescription, regularly or sporadically–I can’t urge you strongly enough to read up on this condition.

If the only way to know you’ve got it is to understand the symptoms when you show up, you kind of need to know the symptoms. If it’s caught early, 80 percent of those who get it survive. But if it’s left untreated for more than 48 hours, you rapidly arrive in that other 20 percent territory.

I don’t expect doctors to know every drug and every symptom and read me chapter and verse on every possible reaction to each drug alone or in conjunction. It’s not like doctors and nurses even have drug books or PDRs sitting around in their offices anymore; the Internet has pretty much put those publications out of the print business. But with drugs as common as the ones I’m talking about, and with a potential reaction with a not-inconsiderable number of deaths attributable to it, you’d think it would’ve come up with at least one of the dozen or so doctors and specialists I’ve seen over the last decade.

And it reminded me, yet again, that some doctors just don’t see a problem with withholding information from their patients. When I started grad school in 1997, I started getting absolutely blinding tension headaches. The doctor who saw me at the student health center prescribed me a tricyclic anti-depressant to manage them; it’s a not-uncommon off-label use. In the six months that followed, I put on somewhere around 45 pounds, at the same time as my husband and I went vegetarian and I was using an elliptical machine every day. I was frustrated and distraught at this inexplicable weight gain, and my self-esteem was devastated.

It wasn’t until two and a half years later when a female CRNP said, “Didn’t the doctor who prescribed it warn you that one of the most common side effects is moderate to severe weight gain?” I gritted out, “No, he most certainly did not.” She sighed sympathetically and asked, “A male doctor?” I nodded. She said, “They do that all the time. They just don’t think it’s a big deal. They don’t understand how women take that sort of thing.”

I’ve never managed to get my weight back down to where it was before I went on that medication, and that struggle takes a daily toll on my feelings toward my body, my self-worth, and my sex life. That a doctor wouldn’t think to warn me of something that major, because he didn’t “think it was a big deal,” makes my head explode. Just like it did the other day, when I was finally been warned of the risk I’ve been exposed to for so long.

I’d like to be able to just brush it off and think that it just didn’t occur to all those professionals that I’d actually be more comforted knowing all of the reasonable risks I’m incurring by following one treatment plan over another. I know it’s not the same for every patient, but it’s probably that way for more patients than they think it is. More and more, information is power, and people believe that doctors aren’t infallible and patients can’t abdicate understanding or control of their conditions.

Once again, I’m reminded and reassured that I really am my own best advocate. Sadly, what I’m most looking for in a physician these days is one who respects my knowledge of my own body, my medical history, and my research skills. It stings to pay someone with a prescription pad to just execute the treatment that I’ve found to be best. The least I can expect is fair warning if something either of us has come up with has potential side effects and risks. And when that warning isn’t given–when you discover the risks on your own or, gods forbid, through a close shave–it erodes your faith in the whole system, and every well-intentioned, well-educated professional who comes after them suffers the consequences of the mistrust that others earned.

Dec 2, 2011 - Psychology    4 Comments

Irish Stubbornness and Sunscreen: Reverb Broads 2011 #2

That's me with the pink hair, blue sundress, and wide ass, back to the camera as I watch a hurley game.

Almost every stupid thing I’ve ever done in my life can be traced back to my stubbornness. I come by it honestly, even genetically — I’m five-eighths Irish, one-quarter German, and one-eighth mule, I think. And this year’s colossally stupid act was no different.

Every year here in Saint Paul, they hold Irish Fair on Harriet Island, which sits in the Mississippi River adjacent to the downtown. It’s around the second or third weekend of August typically, and it’s totally free (well, the entertainment’s free, but they get you coming and going on the food and drink). Of course, there’s music and dancing, but there’s also hurling, wolfhounds, arts and crafts, and lectures on a wide variety of subjects. It’s no Milwaukee Irish Fest, but it’s really quite nice.

We didn’t go in 2010, our first summer here. As a matter of fact, I watched little color pieces about it on the local news from the fifth floor of St. Joseph’s Hospital, which sits¬†within spitting distance of Harriet Island. I was in the hospital because, the previous Thursday, I had emerged from our apartment bedroom and informed my Darling Husband that I had thought of nothing all day but how to kill myself. This certainly wasn’t the first time that summer I’d contemplated means and method, but it was the first day I couldn’t remember thinking anything other than suicide.

This scared the tiny part of my brain that wasn’t yet consumed by the howling storm of depression. The onslaught had begun shortly after we moved to the Cities, and the doctor I’d found before we arrived turned out to have a “policy” about not writing any prescriptions without seeing medical records. The stupidest thing I had done that year, and perhaps in my life, was not come with hard copy in hand, but there was no way I could’ve anticipated the three weeks it took for my doctor’s office just one state away to furnish them. In the meantime, I tapered the doses of my fibromyalgia maintenance medication, my narcotic pain reliever, and my anti-depressant as much as I could, but there came a day when I was off, and I had to stay off for a long time. I finally went to the ER at the end of July, but by that time, the tailspin was irrevocable, compounded by the pain and insomnia that cascaded out of the cover of management, and the loneliness and isolation of being in a completely new, unfamiliar city with no job and few friends, in a brutally hot summer. If there’s a definition of “working without a net,” I’m pretty sure this fits.

So this year, when Irish Fair came around, I was determined to be there, if only to defiantly demonstrate that I wasn’t where I had been a year ago. My dear friend Alan was in town, and he was keen to see the fantastic band The High Kings, scheduled at noon; I had my eye on Altan¬†at 5. It was a glorious day, sunny and warm in a way completely at odds with the celebration of all things Irish, but perfect for an outdoor festival.

The problems began on the car ride there, as my boys announced that they were already tired of this outing. Before we even got there. Clearly, this didn’t bode well. They remained whiny, but more or less compliant for the first hour. The seating for the main stage was smack in the middle of the field, not a gasp of shade for 200 yards, but I was so distracted by my efforts to keep calm and not focus on the kids or the past that I completely miscalculated my need for sunscreen. Even the poor guys in the band appealed to the crowd for “some Factor 15,” after Alan and I had been watching them redden appreciably for the first hour.

My sunburns develop like Polaroids, and I was already in the shade by the time the extent of my scorching became apparent. Meanwhile, the boys’ patience had expired before the High Kings’ set had even finished, and even the dogs and hurley could only distract them for so long. Both my burn (ultimately 2nd degree) and my temper bloomed brighter by the minute, but I was so determined to be there and be having fun (dammit) that I forced everyone to stick it out much longer than any of us were enjoying ourselves. We were exhausted and cranky and sunsick by the time we gave up and left at 4, an hour shy of the concert I’d wanted most to see.

The square tanlines from my sundress, still remarkably clear even now on December 2, remind me that, if I’m going to be stupid and stubborn, I should at least put on another round of sunscreen.

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