Mental Health Blog - antidepressant treatment review

Part 3: The Turning Point
by Alicia

In my counseling sessions, my therapist was working with me to re-gain a sense of control. We learned that part of my problem was that my expectations were too high which would in turn set myself up for failure. So, I was given "homework assignments" designed to help change my expectations and recognize negative thought patterns. I told my therapist that I was having a hard time accepting that if I simply did what she asked and completed the homework, that I would feel better. She told me that it is alright to be skeptical and that this process would not be easy or quick because I basically have to re-train my brain to have a more positive outlook.

Even though my husband was coming with me to my counseling sessions, he (and the therapist) didn't know that things had been bothering me as much as they really were. This was partly because I was not being completely open during the sessions and partly because I had a hard time telling him everything that I was feeling. I couldn't tell him everything because that was so contrary to how I was taught to deal with things growing up. I do not remember having to talk about problems. Growing up, things often just got swept under the rug. Another reason that I did not tell my husband I wasn't feeling right was due to embarrassment and shame. I would tell myself that I should be able to manage the kids and the household; this life of being a "stay-at-home mom" is what I always wanted. When I did have a bad day, I often thought I could hide it from him by pulling myself together by the time he got home from work. But most of the time he could usually tell that something was wrong. It's not that I never opened up to him. Sometimes I felt obligated to share the events of a bad day with him when I knew that my "irrational" behavior didn't involve just me, but that it also involved one of the kids. Usually after talking with him on these types of days, things would go well...for a while. I would resolve to not yell when the kids did not deserve to be yelled at, but then it would happen again. I would resolve to not punish the kids when they did not deserve to be punished, but then it would happen again. I didn't want my kids to remember me as that kind of mom! I needed to change...I didn't want to get so frustrated, I wanted to have more patience.

Realizing that some of my "issues" were outside the range of normal motherhood struggles, I decided to search the internet for other people's personal stories of postpartum depression. My therapist did not "diagnose" me with or even suggest that I may have PPD, but I needed a place to start my search. In most of the stories I read, I could relate to what they were talking about. I found comfort and encouragement in the fact that others felt this way too and were able to get better. I would cry as I read these stories. I was willing to accept that my body was sick (hypothyroidism) but not that my brain could be sick (mental illness).

After 10 weekly sessions of counseling, my therapist and I thought I was showing signs of improvement. We decided that I was ready to try waiting 2 weeks until the next session. Of course that next week ended up being the week that I completely "fell apart." Although not pleasant, I know that hitting "rock bottom" was required for me. Following are a few of the events from that week.

It was Tuesday November 13, 2007 and I was driving Brooke to preschool and I could not stop crying. It was weird the types of things that would trigger crying. Irrational thoughts made me cry, things on the radio made me cry, just trying to function made me cry - I was so completely overwhelmed. Once at preschool, I wiped my face and took Brooke inside. As I was signing Brooke in, I held my head low hoping to not make eye contact with any of the other moms. Then I heard one mom say to another mom, "look, Alicia remembered that today is 'yellow day,' and she even has 3 kids." (Just so you know, "yellow day" was the day that the students were supposed to wear yellow, and some of the moms had forgotten.) I turned around and, not in the friendliest way, said, "Yes, Brooke is in yellow; however, I have not showered in 2 days, I am still in my pajamas and I do not have a bra on." They just looked at me strangely as I walked out. I e-mailed Jenna when I got home. This is part of what I wrote to her:

Here is part of the super fast and encouraging response Jenna sent back to me:

After reading this I called Russell. I told myself, "he is my husband and I shouldn't feel so ashamed and continue to worry about him possibly judging me." I called him at work, crying and barely able to get my words out. He asked what was wrong and what had happened? My answer was, "I don't know what's wrong; nothing happened." I completely opened up to him. I told him everything that I had been holding back earlier. He told me that we had to go talk to my therapist. He said that she needed to know everything that I had just told him...but I completely refused. So instead, he called her himself and told her everything.

The next day was Wednesday. On Wednesdays I take my daughters to dance class. While I sat in the waiting room outside the dance studios, I kind of felt like/wished my head would just start spinning around and my body would flop around on the floor. I know that sounds crazy...because it is. I think I felt this way because deep down inside I knew that I was mentally unhealthy, but I wasn't ready to accept it. I think I figured that such an obvious, outward symptom (i.e. my head spinning around) would make it abundantly clear to myself and everyone around me that something was definitely wrong with me. It seems as if mental illness can be such an ambiguous disorder. It's not like other ailments for which one can simply get some testing done which then yields a definite diagnosis.

Two days later, Friday, I finally mustered up the courage to call my doctor's office. Per standard protocol, I had to leave a message and wait for a call back. When the nurse called me back I broke down crying on the phone. Through the sobbing, I managed to tell her some of my "issues." She then interrupted me and asked what pharmacy I used. She said they would call in a prescription of Prozac for me. I thought to myself, "What?...Didn't the doctor want to see me first?...Do they just not want to deal with me right now because it is a Friday afternoon?...How can they prescribe this based on this one, short phone conversation?" (The total phone conversation/on hold time was only 16 minutes. Trust me...I looked up my phone records.) So I asked her on what basis she was choosing this drug? She answered, "this is what we give all our patients with PPD." Concerned about its possible affects on David, I asked her if this was alright to use while breast-feeding. She checked with one of the doctors who said it was. I called Russell and, like me, he thought it was strange that they prescribed medication over the phone. We decided that the doctor probably deals with this stuff all the time and that they knew what they were doing when they prescribed medication based on a phone conversation. He was glad that I called my doctor and was encouraged that I was willing to try an antidepressant. Being the great husband that he is, Russell said he would go to Target for me after work to pick up the prescription. I declined his offer because I wanted to personally talk to the pharmacist to further verify that Prozac was safe with my thyroid medication and compatible with nursing. Well, in spite of the ordeal at Target (this will be its own post), I went home with a bottle of generic Prozac (fluoxetine 20 MG).

You would think that I would have rushed home, grabbed a glass of water and swallowed that pill so fast, but that was not the case. I was not completely convinced that I should take this drug or that it was in fact the best one for me (and 7 1/2 month old David). Prior to my doctor prescribing this, I obviously had not done any research on this drug or any other antidepressants. So once again I consulted the internet. (How did people survive before without this wealth of information available at their fingertips?) I frantically searched for personal success stories with Prozac. Russell kept asking, "when are you going to take your pill?...Just take it and stop thinking about it so much." I told him that I have to research other drug options, figure out the best time of day to take it, see other people's side effects, and on and on and on. Finally, I gave in. With some apprehension, a little, white, oblong-shaped capsule with a black and green stripe slid down my throat that night. I decided to check the LABlog before I went to bed. I read the title of the newest post - "Pushing The Pill" - how crazy is that?

to be continued...