Words to Live and Write by

I am willing to fall Because I have learned how to rise.

I craft Love from heartbreak, Compassion from shame, Grace from disappointment, Courage from failure.

I am among the brave and brokenhearted, and I am rising strong.

(credit to Brene Brown)

Saturday, August 24, 2013

Depression




Depression is a part of my life. Not in a passing way, but a constant one. It has been an active problem since I was seventeen, although I didn't recognize it at the time. Many years later, I've discovered that my depression can be managed by Zoloft. We call it my "happy pill," because it makes me feel more like myself—less prone to fits of irritability, frustration, or full-on meltdowns. That's a sure sign a medication is needed, I think: when it makes you feel like you.

I've had several episodes of serious, sometimes dangerous depression in my life.

The first major one was when my first engagement ended abruptly and brutally. (In hindsight it was for the best; at the time it was devastating.) I lived alone in the apartment we'd leased to move into just a few weeks later. My wedding dress, already fitted, hung in my closet alongside a good portion of my almost-husband's wardrobe, preemptively moved in. It was winter in Utah, and a very cold one at that, but although I trudged through the snow in no more winter gear than a scarf and sometimes gloves, I literally never felt the cold. I was numb even physically. So numb that, frustrated by the calluses on my feet from working long hours in a department store, one night I took a box of matches and burned them off. I don't recall that hurting one bit.

What did hurt was my ex-fiancĂ© jumping back and forth between "I don't want to get married" and "I'm an idiot; please give me another chance." I always gave him another chance, which he always backed out of. I spent many nights awake, afraid of the dark, afraid of my thoughts (which tended towards romantic suicidal scenes), afraid of everything until I couldn't feel fear anymore. Then I felt grief. My mind has blocked out most of those months, but I have one distinct memory of getting out of the shower and being so suddenly overwhelmed that I crumpled to the cold floor in my towel, curled into the fetal position and sobbed—loudly—for hours. No one called to check on me. No neighbors knocked, wondering what the noise was. No one came to visit. My family and friends, and especially my ex-fiancĂ©, had all turned away from me. I stopped going to class, I stopped sleeping, I stopped eating, I stopped going out. Life for me had stopped.

Eventually, I was sent back to my parents' house, where I lived like a zombie, emotionless and uncaring, for months. I don't remember much of those months either. I don't remember what really helped me out of that depression. But I do remember the first time I felt myself again. Back at college, my very patient roommates finally convinced me to go out with them. We went caving, exploring extensive, pitch black caves somewhere outside Provo. It was exhilarating. And when we finally emerged, I breathed in the fresh air and looked up and actually saw the stars. It felt like I'd just done the exact same thing emotionally—crawled out of the darkness, breathed deeply for the first time, and seen light, hope. I was back!

The second major episode with depression was much more subtle. Anthony and I had been trying to conceive for a year, and we'd been on the miserable Clomid cycles for almost eight months. My depression, instead of being abrupt, crept up and slowly loomed larger and larger. Infertility is stressful. (See this previous post for more about that.) I was working too long and hard at my job, and longer and harder at my last college classes. I was getting crippling migraines every day. I'd break down sobbing to Anthony about a Latin passage I couldn't translate. I would snap at my co-workers and boss. I finally told my doctor that I thought the infertility treatments and the major hormonal fluctuations accompanying them were too much. He said, "Oh! Well, here's some Zoloft. See if that helps." As if he should have seen it sooner. Within about a week, as I walked from work to campus, I found myself humming, unable to stop smiling, and turning my face upwards to bask in the sunlight. I was back again! Incidentally, I later got a copy of that doctor's notes and he'd noted on my next visit, "Hannah was actually smiling today. Marked improvement."

Depression attack number three came within another year. I was still on Zoloft, but the cause of this one was beyond what that meds ability to help. After ten weeks of joyful pregnancy (no nausea except around bacon), we had an ultrasound that brought my world crashing down. No heartbeat. No baby. The miscarriage was so painful. On bed rest for two weeks, I sank deeper and deeper into my personal darkness. I blamed all our fertility troubles on myself. I got really angry with God. I can't number the times I cried over news that yet someone else was expecting. I stayed in that darkness, unable to admit to anyone that's where I was. Anthony lost his job, we moved twice, and I played a very convincing "fine." But I wasn't. I hadn't been able to sleep since that miscarriage. I turned to Tylenol PM and then to Ambien to mask the insomnia. Coming out of that depression was so slow. There was no "I'm back!" moment. But it came as I learned to love my Primary class, and then my Seminary class. Teaching Seminary was probably the most healing thing I could have done. Slowly, my spirit strengthened, my heart grew stronger and broader, and I became the me I knew again.

Episode number four is discussed in detail in Our Pregnancy Story. Truthfully, not much detail, but the story seemed so long that I left out a lot. Physically, I was sick and in constant, excruciating pain. No numbness this time, not even on morphine, oxycodone, codene, hydrocodone, etc. It got so severe that my brain turned to survival mode. In my life of plenty, I never expected to experience that; I never want to again. All higher thought ceased: I couldn't read, I couldn't listen to music, I couldn't engage in conversation, and I really couldn't force myself to think positively. There was only pain. My entire world was pain. Nothing else mattered to me but making that pain stop. Anything to make it stop. Literally, anything. Throwing myself down the stairs,  "accidentally" slipping in the shower, taking an entire bottle of painkillers, ramming myself belly-first into the corner of a dresser, finding a knife and bleeding out. Those thoughts were real, and they were forceful. It was the most frightened I have ever been, and I was frightened of myself. Except it wasn't me—not the me I know. Because in survival mode my brain had turned off all the parts that made me me. And I was terrified that I would be stuck that way permanently. Always in the darkest abyss; never able to feel happy, or light, or breathe deeply again. And I lived with that terror for months.

Fortunately, the end came. They cut Lana out of me, and suddenly this tiny person whom I'd hated for eight months became the most perfectly loved person in my universe. Deepest darkness to brightest light in one newborn scream. This time, it was Anthony who looked at me in wonder, about two weeks later after I'd gone off on some random tangent while reading scriptures. With wide eyes, he simply said, "You're back!"

Yes, depression for me is something I get lost in. It's a darkness that settles over my whole soul and binds me so perfectly that I cannot break free. This happens in smaller ways very frequently, especially when I forget to take my "happy pill" regularly. It is a part of my life I have to accept. I'm not broken—that seems too cruel—I just need a little help.

Recently, there has been much news about the risks of taking Zoloft during pregnancy. I never took any while I was pregnant with Lana until after they removed my ovary and through my post-surgery grogginess I heard the doctors confer. "She's been through enough trauma." "She's predisposed." "Let's not risk post-partum depression." So I began taking it for the last month and following delivery. Which meant no PPD, hooray!

Now, however, as we consider adding another Trujillo (seems insane, doesn't it?), I worry about my necessary "happy pill." My OB, one of the best and who was there through the whole mess last time, advised me that the risk of birth defect is very, very small, and given my history she would highly recommend I keep taking Zoloft. But, seeing my concerned look, she added, "If you really want, you can wean yourself off for the first 12 weeks. After that, there's no risk, so go back on it." That sounded like good advice.

So wanting to be free-and-clear of Zoloft for the first trimester—whenever that happens—I've spent the last couple months weaning myself off of Zoloft. I now vividly remember why we call it my "happy pill." I am not me. And I hate it. I'm short-tempered, irritable, lethargic, and seem to fail at every coping strategy I've learned. It's disrupting my ability to be a wife, a mother, a friend, a teacher, or anything else I try to be.

So here's my conclusion. Judge me as you will. I have to do what seems best for my family and for me. I'm going to take that Zoloft—be me—until l see that first positive pregnancy test. THEN I will drop it for three months, trying to do what's best for unborn baby, and hop back on in the second trimester with hopes it can help me cope with the stresses inevitable from motherhood and pregnancy. No one needs me to go back to that dark abyss. No one. (I think I learned that lesson, God. Let's not repeat the test, okay? Seriously. Please?) 

No, my depression's not gone. It never entirely is. I don't know why I drew that straw in life. But if there's a way to manage it, to feel like I have some control, than I am one to adamantly say, "Take it!" God made man to have joy; some trials, too, to learn and grow; but mostly joy. I choose to see Zoloft as God's tool for me to help me experience joy.

I guess I shared all this because I know so many people suffer from depression. In different ways and for different reasons than I do. And it gets lonely down there. There's no room for anyone or anything else in that cave. The best we can do is try to find our way out of the blackness, breathe deeply, and rejoice when you can finally say, "I'm back!"