Friday, May 7, 2010

A "graduation" of sorts

So, I've been continuing to do really well and have been feeling, dare I say it, pretty 'normal.' As in happy. And relaxed. And really, genuinely enjoying my time with the baby, my work, my hobbies, my family, my husband and all the goodness that is my life.

Really, the only thing I'm actively worrying about these days is the possibility of feeling crappy again. The brain always comes up with something, doesn't it?

I met with Ron, my delightful (he really is!) therapist on Monday this week and he had me fill out a questionnaire about my current symptoms. Not only do I not meet the diagnostic criteria for depression (woot!), my OCD is now considered at "sub clinical" levels. So, we're going to go a month between sessions and see how I do on my own. I have a variety of exercises to work through and will continue to plug my way through my book on obsessive thinking. So the training wheels have come off! Wish me luck! If I end up a sobbing mess in Ron's office (um...not that that has ever happened or anything) in the next couple of weeks, I'll let you know.

On Monday I have my next appt.with my psychiatrist for a med check-in. All seems to be well with my current dose of Zoloft, so I will be interested to see what she thinks. My first visit with her was kind of sucky, so I'm hoping this meeting goes well. I'll keep you posted!

Sunday, April 25, 2010

A Good Week

So, it's been a good week! My appetite has been healthy(which I suppose means the end to the one positive side effect of anxiety: weight loss) and I've been able to really ENJOY most days. It's been nice, let me tell you. I wanted to write this down as a reminder to myself that there WILL be good times when I find myself struggling.

I have a therapy appointment tomorrow, so I look forward to receiving my "homework" for this next week. I also have to increase my Zoloft dosage again, which always means a crappy few days (usually increased anxiety for a bit and then feeling a little foggy/out of it for a couple days). It will definitely be nice to hit the dose that works for me so my body has a chance to catch up.

I also have a few work meetings this week that the baby is joining me for, so keeping my fingers crossed that the Bug is mellow!

Thursday, April 22, 2010

Practicing Patience and "Living as If"

I was reading another blog (maybe Dooce?) that described the experience of waiting for mental health treatment to really "kick in." Imagine going to the doctor for strep throat: how would you respond if told you can expect to feel some relief in 8-12 weeks? It would seem absurd and yet it's the reality for many suffering from anxiety or mood disorders.

Because anxiety disorders tend to respond to drug treatment more slowly than depression (and OCD responds slowly even for an anxiety disorder), I've been told it can be a few months before the Zoloft really takes peak effect. MONTHS, people! AND that's once I get to the "therapeutic dose" as I am still slowly tapering up the amount I'm taking. Add to that the fact that CBT is often a long-haul treatment approach taking 6+ months, this will all give me ample opportunity to exercise some serious patience (which my loved ones would probably tell you is not my strong suit).

So what do I do in the meantime? I "live as if." I live as if I don't feel anxious or sad. I go about my daily routine, I spend time with my baby and husband, I cook, I read, I work, I participate in activities that I enjoy. And you know what? It almost always makes me feel better. Sure, I have bad days. But even on those bad days, I feel better knowing that I am not letting the anxiety win. I am not going to give up on these precious moments because I'm waiting around to feel better. I know that will come, but in the meantime I'm determined to enjoy as much of this journey as I possibly can.

Want to know more about postpartum OCD? This article describes it well.

Saturday, April 17, 2010

So why am I here?

I have been contemplating blogging about my recent diagnosis with Obsessive Compulsive Disorder for a few weeks now but have held off. What if someone from work sees this? Or a casual acquaintance? What if people don't understand? Ah, the "what ifs" of OCD. I decided that if this blog could help even one person navigate this disorder (you're not alone!), this is a risk worth taking. So here we go. Welcome to my brain.

I plan on writing about how treatment is going and sharing the ups and inevitable downs. If I'm in a good space, I might even be witty.

So how did I come to this diagnosis? Here's my story thus far.

As long as I can remember, I have struggled periodically with anxiety, usually during times of stress or transition. I even saw a psychiatrist for it when I was around 12 or so. As I got older, I became more adept at navigating the episodes and hadn't experienced a major one in the several years before my pregnancy.

Ah, pregnancy. While I had a rough time with some physical issues (horrific morning sickness that lasted all day until month five and swelling that made even the nurses shocked), I felt like the Buddha. I was Zen. My mind was calm. I had never been so much at peace emotionally (certainly the absence of PMS didn't hurt!)

So, while I sometimes had a niggling "what if I end up with postpartum anxiety or depression?" concern, I didn't do anything to prepare myself for the possibility in the weeks leading up to our daughter's birth.

And then our gorgeous Lucy was born. In the first few weeks following her arrival, I remember being surprised by how well I seemed to be navigating everything. I had expected a bunch of crying fits and bouts of the "baby blues", but all in all I felt pretty good. Lucy was an easy baby, I had my husband at home for a few weeks and all was going well.

And then the scary thoughts started. I remember burping Lucy in the middle of the night and thinking "what if I accidentally hit her too hard and really hurt her?" And then more worries surfaced. Everything from bath time to carrying her over a hard surface became inspiration for the horror movies playing in my head. I started obsessing over why I was having these thoughts. Did I want them to come true? Was something really wrong with me? What kind of mother thinks these things?

My wonderful husband, who's also a counselor, tried to reassure me. He promised that everyone has thoughts like these and that I'm a good mom. I wasn't satisfied. I decided to talk to my OB at my six week follow-up appointment.

When I finally screwed up the courage to tell her I had been feeling anxious, she acted surprised and even a little disappointed. She didn't ask about my particular symptoms and I was too afraid to tell her about my thoughts given her reaction. She just asked if I was able to take care of myself and the baby (check) and if I had episodes of uncontrollable crying (not at this point). She prescribed 50 mg of Zoloft and sent me on my way.

I decided against taking it and tried to put the thoughts out of my mind for the next few weeks. My husband and I went out to dinner when Lucy was around 2 months old and I was completely distracted the entire time. As much as I tried to focus on our conversation, my mind kept drifting back to the scary thoughts. We got home from dinner, put the baby to bed and my mind kept racing. I literally did not sleep that night.

The next day I decided to start my Zoloft prescription, but my doctor hadn't told me to start on a lower dose or that initially Zoloft can make anxiety worse. I had a full-out panic attack lasting most of the afternoon and the following night. I insisted my husband stay at home from work with me. I couldn't imagine being alone with the baby.

At this point, I knew I needed help and needed it now. I had all kinds of fears: I would be determined to be crazy. The doctor would find me an unfit mother. My baby would be taken away. But the fact that I saw myself spiraling quickly downward gave me the courage to reach out.

I was seen by a psychiatrist who honed in on my issue within the first few minutes of me explaining my symptoms. He assured me I wasn't crazy (phew!) but told me I was suffering from Obsessive Compulsive Disorder. Huh? I didn't have any of the hand washing or other ritualizing behaviors of someone with OCD, so how could this be my diagnosis? He explained that many people with OCD have obsessional thoughts and internal compulsions (seeking reassurance, rationalizing, etc.). Suddenly, all of my past anxiety episodes snapped into place. YES! I DID obsess! YES! I DID rationalize and seek reassurance to make myself feel better!

Despite the relative seriousness of being diagnosed with such a disorder, I felt tremendous relief and hope that we could work together to find a solution. That was six weeks ago. I have since had five sessions with a wonderful, wonderful psychologist and we're working on Cognitive Behavioral Therapy, which has been proven to be very effective at treating OCD. I am also gradually increasing my Zoloft dose.

So how's it going so far? While it can sometimes feel frustratingly slow, I know I am making progress. I also know my good days will increase and the bad days will seem less scary. I am having more periods of calm. More periods of being able to enjoy my new family without worry.

It will be a hard road, though. The kind of therapy I am engaging in requires the patient to face anxiety and their worst fears head on. When we get into the meat of the treatment, I know there will be some scary and difficult moments. But I'm ready for it! And I will share those moments here.

Postpartum OCD Fact of the Week: Up to 90% of new parents experience intrusive thoughts about their new baby. It's time to consider help when the thoughts cause significant anxiety and/or affect your day to day life. There's great help out there! Don't suffer needlessly.