BIRD IN A HOUSE
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Amanda's Story

Introduction: Counting

6/29/2012

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500, 499, 498, 497 - “Please, just go to sleep.”  Chris’s voice comes through the darkness.  He must have heard me moving, trying to find comfort in this new and unfamiliar hour of wakening.  How many nights have I been up past last call? Too many to count.

The faint smell of spit-up lingers everywhere around me.  My nose is on high alert these days, even more than usual.  Another sense to assault me and make me think.  What’s too much spit-up?  Too little? Next feeding time will undoubtedly turn into a research session on my Nook, which has an Internet history that reads like a woman obsessed.  Five weeks postpartum and I am running out of places online and in print to find information to ease the ever-changing round robin of questions and concerns.

    “I’m doing everything I can here.  It’s not working.” My voice doesn’t even sound like me anymore.  Just some tortured version of myself that’s worn down and lost.

    “Just keep counting.  It always worked for me.  It will work this time, it has to.” He is so upbeat, so hopeful, but there is a just a hint of terror. What if it doesn’t work? What, then? Partners in crime, we always called ourselves, now partners in insomnia.

496, 495, 494 - If only it were that easy.  Why did no one tell me this could happen after I had a baby?

493, 492 -  “Please, I don’t understand this. How can you not be sleeping yet?”

491, 490, 489 - This night will never end.  How am I going to function with no sleep again? It’s been at least five days so far with less than the minimum 5 hours I know I’m supposed to get. Mom’s down the hall, thankfully, so we’ve got backup. Still, though, I am sure she can hear this latest plea.  

488, 487, 486, 485 - “What can I do for you?  Are you hungry, thirsty? Hot, cold? Tell me, I’ll do it. Anything, just please sleep.  Please.”

484, 483, 482, 481 - I don’t even know the answers to those questions. Heart racing, stomach queasy in depths of my body I never knew existed until a few weeks ago.  When will this end? I’ve never wanted to feel the sense of my body relaxing into a pillow quite so much.  I used to love this bed; it’s become the place I dread.

480, 479, 478 - “Please, Amanda, you’ve got to try.  Please.”
The worst part of all is that our baby sleep soundly, at least for a few more hours, while I cannot. The counting is for me, just as the worries, the questions, and the concerns are for me.  Guilt would overwhelm me if I could even think past right now, past this time that is unending, and will never end, I am convinced.  And when that sweet little boy wakes up, I will go to him, if I can, and eventually the sun will come up, bringing what I know will be another day of the walls closing in.  Of not eating, or sleeping, or worse yet, living within a body that is not mine.  My body has been replaced with something completely alien, which starts in the pit of my stomach and rushes out to my fingers and toes. It makes my thoughts cloudy and the tears come.  

“I’m sorry,” I barely manage to say the words.  All I do is apologize lately.  For what, I can’t even begin to describe.

477, 476, 475 - It’s going to be a long night.


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Going Crazy to Get Sane

6/29/2012

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If someone had told me that one of the most important things I would ever learn after the birth of my son was the difference between anti-depressants, I would have literally thought they were crazy.  Now, I was the one struggling to retain my sanity.  After getting on hands and knees at my doctor’s office, shaky from not being able to eat or sleep much at all for over a week now, I had in my hand a new prescription to try for what I was praying would be my miracle.

    The uncontrollable panic attack that the Zoloft had initiated still hadn’t left me; and I was terrified it never would.   Because of that reaction, which had mystified every doctor and pharmacist I had spoken with, I was now officially unable to take any of the class of antidepressants labeled SSRIs, or selective serotonin reuptake inhibitors. This took Paxil, Prozac, and Lexapro, among others, off the list of potential medications.  Since it was agreed upon by everyone involved that I needed some kind of medication to get through this time, my doctor, who had patience I can’t even begin to describe, began doing her research.  I would sit on the examining table, wringing hands, crying, while she very calmly looked through her reference lists, making sure that anything I tried would be safe for breastfeeding.  Of course, the term “safe for breastfeeding” was becoming in my mind something of a misnomer.  I realized early into my many calls to the pediatrician’s lactation consultant, that very few medications or herbal remedies have really been proven safe for breastfeeding mothers. This entire situation fed into my anxiety to a point where I was again online trying to find safe ways to help me sleep.  It was getting out of hand, and by the time I was sleeping soundly again, I would have tried nearly a dozen medications and other remedies, with varied success.

    “Wellbutrin. Have you heard of that one?” Dr. Lloyd interrupted my latest runaway stream of thoughts with her question. No, I hadn’t, I said.

    “Wellbutrin has a different chemical structure from any other antidepressant on the market,” Dr. Lloyd said. “It may work for people who haven’t had success with others.”

    That was putting it mildly.  It’s different, I thought.  Maybe it would work. The side effects of decrease in appetite, dizziness, dryness of mouth, increased sweating, nausea or vomiting, even tremors, all seemed so mild in comparison to my current physical and mental state.  

    “Let’s do it.” With the knowledge and understanding that I would return to Dr. Lloyd in a week, which in itself was a safety net, I took the prescription, and mom and I left her office, for the third time in less than seven days.

On the way home from the doctor, I called my friend Megan.  We had known each other for years, and spent many weekends going to see music, and having a great time. Megan had given birth to a beautiful baby girl just two months before I had Bryce.  She was doing great, legitimately. I wanted to hear her voice; to remind me of my life before all of this madness.   She also had no idea what I was going through, but I knew she was on summer vacation from teaching, so I made the call while mom drove me to the pharmacy for what would end up being one of our many trips there to try different medications.  Today though, I felt a ray of hope through the weight of this dreadful, disturbed place.

    “Megan.  Hi, it’s Amanda.”

    “Amanda, how are you? How’s Bryce? Matt said he was so happy to meet him when he was in town last week.”

    Oh, right. I had almost forgotten.  Megan’s husband, who runs sound for a band I actually used to work for, had been in town recently for a concert. He and our good friend Kyle, who also works for the band, had wanted to get together. I couldn’t get out of bed that day, so Chris got Bryce in the car and met them at their hotel.  They came back to the house, and I managed to make it downstairs for a few minutes.  I don’t remember what we talked about, other than how Megan and Matt’s daughter was sleeping through the night at only a few weeks old. I wouldn’t know that joy for months, but was happy for them.  I remember thinking that if things were different, we’d be going out to eat or for a walk, and I would be so proudly showing off Bryce, that gurgling, chubby-cheeked masterpiece that he was.  Instead, I fumbled down the stairs, a shell, barely able to respond to conversations, and wanting to scream out, “Hey! Things are not OK.  Can you please save Chris, and take him with you when you leave?”  

Chris was a trooper, though.  He must have been so happy to see old friends, and spend some time with them.  When I went upstairs, I could hear them laughing, and telling stories.  Late night stores. Wedding stories. Those were my stories, too, but I wasn’t sharing in the moment.  I couldn’t do it.  So I went upstairs.  I missed the concert, of course.  I was so happy for Chris to go, and reacquaint himself with society, but I was also so jealous, and so frustrated.  Here I was, with mom downstairs taking care of Bryce, and I once again, a prisoner in my bedroom.  We had only lived in that house for a few months, and I worried I would never want to spend time there.  I started plotting for a way to sell the house and buy a new one, free of these horrible memories, and then shocked, remembered that it was only a month or so ago that we had walked with Bryce into this house, floating on the wave of happiness of being a family.  How had things changed so quickly to the point that if I could have managed, we’d be living somewhere else tomorrow?

Bringing myself back to my phone call with Megan, I answered her in a way that was quickly becoming my postpartum trademark: Brutal honesty.  As always, I broke down and cried. I told her I was having troubles, and was really hoping my doctor could help me.  And, as usual, my kind and caring friends tried to respond in a way that was helpful. I could hear it though - the shock.  I realize now how difficult it is to catch someone off guard with such raw emotion, but at the time, I was an exposed nerve.  Everything was wide open, and there was no way for me to find the words to cushion the blow.  So, for those who had the pleasure of taking my calls, or texts, or Facebook messages, they got the real me.  What continues to amaze me today is how responsive and understanding people were, even if they couldn’t relate.  No one respects me less, or sees me as a person unable of coping.  In my nighttime prayers of gratitude, which I instituted once I was able to get my anxiety under control a bit better, I constantly thank the powers that be for friends who didn’t run away.  

I could hear in her voice how scared I was making Megan, but I couldn’t stop talking.  Fortunately for us both, I am sure, my mom pulled into our local CVS, and it was time to pick up the prescription that would help signal a new phase for me: Healing.  It would take months still, but that day, I let all the consuming anxiety live within me.  I accepted it;  maybe this new medication would cause another panic attack, in which case I was sure I would require hospitalization.  Maybe it would do nothing, and I would continue to spend my days trembling and scared.  Or, maybe it would help me.  I knew the numbers. Up to nine weeks.  Nine weeks until the medicine works with my brain chemistry to rewire me so I can breathe again. It was torture to think about it, and I had a feeling that I would need all of that time to get back on my feet. I was right; this was just the beginning of a long road ahead.  I would eventually get back to what I considered a new normal, and after some time, feel better about myself than ever before.  For the moment, I didn’t know any of that.  I just prayed that the newest little bottle with the child-proof cap would do its job.

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The Unexpected Intrusion of Normal

6/27/2012

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One of the hardest things about my postpartum experience was the fact that in the early days, I would have moments where I felt like myself.  These glimpses into normalcy would come about unannounced, and for a brief time I would feel free of the oppressive weight and pincer grasp of anxiety that shrouded me at other times.  I could sleep for a few minutes. Or feel like eating something. When this happened, I would almost cry with relief, but then just as quickly, I could literally feel my mind closing in, and the tingling in my fingers and feet would begin, as well as the ever-present queasiness that made it so difficult to eat or just “be.”  I never self-identified as depressed, but found after a week of this that I was sinking into a depressive state.  I had no answers, and no relief.  On a day when I had to get myself back to the doctor again, I found myself laying on the couch as Chris and Bryce played on a blanket just a few feet away on the floor.
    “I just want to do that,” I sobbed, through tears of exhaustion.  “Why can’t I just do that?”
    “Do what?” Chris still wasn’t sure what to call this new me, or identify what was happening.  We hadn’t gotten an official diagnosis, so at this point, we were wading in a no-mans’ land, just making it day to day.
    “I just want to be with you and Bryce. Sit there. Lay there with you both.  I can’t even do that. I can’t do anything.”  It was true.  I was listless.  Held back from even the simplest things, I would remember these words during a sunny winter’s afternoon about 8 months later, when Bryce and I spent two hours practicing his crawling skills. Looking back,  I realized that I wouldn’t take anything for granted again.  But in that moment, I could not conceive of a time when I would ever be relaxed again, enjoying life as it comes.  It wasn’t in my grasp.
    That day, in Dr. Lloyd’s office, I took the Edinburgh Scale. It showed a moderate level of depression.  I was again shocked, as I had always held on to the idea that I wasn’t depressed, I was just anxious.  It was another moment of revelation that challenged the very core of my identity.  Almost swollen from crying, Dr. Lloyd and I devised a plan. We would try a new antidepressant, but that choice wasn’t an easy one. Because of my very unusually destructive reaction to the Zoloft, we felt all medications in the same class were off the table.  I was also still managing to breastfeed, and that took a few others away as possibilities. We settled on Wellbutrin as the new medication, and I very hesitantly agreed to begin taking it immediately.  I was so scared; what if I had another reaction like the one that had sent me into a blind panic I still hadn’t fully recovered from?  What is something else happened I couldn’t even imagine?  I had a day or two of Internet-searching “relapse” I will admit, but I felt so out of control, I had to know what could happen to me on this medication.  Fortunately, while I didn’t feel one iota better that night, at least I could tell it wouldn’t poke another hole into my damaged psyche.  I wasn’t  willing to live without, and really, what choice did I have?
    As my mother and I left Dr. Lloyd’s office, I saw several other people in her waiting room look my way. What must they think of me, I wondered? I have never judged another soul in a waiting room or hospital since those days; I understood for the first time just how hard it can be to put one foot in front of the other.  We walked across the parking lot to Harris Teeter so I could buy some Ensure, a recommendation from Dr. Lloyd since it was now over a week since I had eaten much of anything.  I wandered around the store like it was the first time I had ever been in public.  Everything was too bright and too loud.  I wasn’t ready to be there, and even though it felt like prison, home was my prison, and I couldn’t wait to be there. I had a ray of hope; maybe this medicine would be saving grace, and eventually, (and in part), it was.  

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How Did I Get Here?

6/24/2012

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June 24, 2012 -
I couldn’t believe that I was now in this position; unable to eat, sleep, drive, or hold my own baby without a concerted effort. Getting on the floor for tummy time was impossible; I felt invisible strings tying me back to the couch, my bed, anywhere but where I wanted to be. Everything inside was squirming and if I could have shed my own skin and found a new one, I would have, gladly. I ached to return to the person I had been only a week before, when I was tired and sore, but comfortable within my own body, in control of my mind and my emotions.  
Mom came to take me to the doctor today. I sat at Starbucks with her before the appointment; sobbing, not even caring that people saw me and definitely unable to stop asking her to tell me why this was happening? What was happening to me? Between the blur of my tears through sunglasses, I could see people looking; it’s not every day a youngish woman breaks down in front of her herbal tea for all the world to see.  It didn’t even matter. In 30 minutes I’d be standing in front of Dr. Lloyd, begging her to help me, make me better.  I would do anything I said, just please fix me.  I had gone from the ultimate heights of wonder at the beauty of my childbirth experience to something so low I couldn’t describe it to anyone.  I was just...existing.

How did I get here?

    The path to all-encompassing anxiety was for me, brief and intense.  Just like a flash flood, the overwhelming sense of fear and dread that I was dealing with constantly came upon me without much warning, and without time to prepare.  I was helpless in its wake.  I couldn’t help thinking about the contrast to just a week ago, on my birthday (and Chris’s first Father’s Day), when things were still OK.  
    I was upstairs feeding Bryce.  We loved this time; it was the most amazing I had ever felt about my body and what I could do with it, and I was in heaven.  Bryce had latched in the hospital like he’d been through in-utero training on how to get it right, and we never looked back.  Even the lactation nurses at the hospital, who have a reputation as sometimes been a little dictatorial about feeding techniques, didn’t have much to say when they walked into our room and I proudly showed them my careful notes on how often Bryce was eating. I knew how hard breastfeeding could be, and was grateful every time he settled in, when I could take the time to look at this perfect, beautiful boy that I had been given, gifted.  He was a healthy, happy, chubby vision of love, and all the things that a baby should be.  
    Even my labor and delivery were, in my opinion and memory, a dream.  I couldn’t believe that I had delivered this child through my own deep breathes and pushes from a place within myself that I didn’t know existed.  Chris had told me that watching me push for those two hours, he saw a strength in me that surprised him. It was incredible to know what I was capable of, and so far, we had been doing great at home.  We had a good routine, and Chris had even gone back to school for his last week of teaching while I stayed home. I knew I probably wasn’t eating enough, but I figured that I was busy trying to manage a newborn. Didn’t everyone struggle to get all those calories in each day? And occasionally in a quiet moment I had flashes of a hot white shot of adrenaline for no particular reason.  Now I know it may have been anxiety, but I excused it and went about my business. I had so much to be thankful for; of course there would be a few things to iron out in time. All in all, life was great.
    We had a good crowd over that day, at our new house. I’m still thankful we had that one day, when I was comfortable to just be in a room with other people, holding Bryce, and laughing.  When I could go upstairs and sleep for a bit, soundly.  I held onto that 32nd birthday for months to come as proof that I could be OK. I didn’t know that only a few days later, my world would crash down around me like a burning building, and that strength would evaporate, leaving me scared and unable to do the most basic things alone.  

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    Based on experiences after her son was born in 2012, Bird in a House is Amanda Cadran’s memoir about postpartum depression and anxiety, and the many small miracles along the way that helped her survive.  

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