The end of breastfeeding…

If you haven’t read the entry immediately before this one, I recommend it–it’ll give you some more insight into my fears about the meeting I had with the psychiatrist.

I have to stop breastfeeding.

This is a loss for me.

When my son was born, breastfeeding was hard. I mean hard. It took weeks of practicing with different holds and pumping to supplement to get it down, hundreds of hours before it finally got easy. I nursed him until he was over 18 months old and only stopped when I reached my second trimester with my daughter.

With my daughter, it was completely different. She latched well from the beginning and lost a little bit of weight in the hospital, but they had me pump and we immediately saw that my supply was not the problem. Once we got home, she gained over a pound in a week and I didn’t need to pump at all. It was natural. It was easy. It was beautiful… until I became too scared to hold her. Damn OCD.

I’m heartbroken. I really am.

This is just one more thing that OCD has taken from me, but it is the hardest so far.

I know this is the right decision. I trust my doctor and I’m glad that she was willing to consider changing the medication because I wanted to but was also forthcoming about the effect it could have on me.

I cried when I put my pump away last night. I’m not one who usually cries, but I cried.

As difficult as it could be at times, I’m really going to miss breastfeeding.

Damn you OCD. You’ve taken over a month of my life and now you’ve taken one of the few things in my parenting I was really secure in and proud of. Damn you. What I wouldn’t give for a NT brain.

I’m mad, I’m sad, I’m in mourning. This is a loss, and there’s not really anything more to say about it.

Medication changes…

So, I know I’ll be meeting with the psychiatrist in my program today. I know that we’ll be talking about decreasing one of my medications. I know this because we talked about talking about it last week.

The reason why we’re talking about it is that I’m currently pumping in the hopes of being able to resume breastfeeding once I am off this medication–this medication has not been tested on lactating mothers and my kids’ pediatrician thinks it’s a bit of a risk to breastfeed while taking it for an extended period of time. (He thought a month or so would be okay…)

I’m scared.

I’ve been doing really well with the current combination of medication. My intrusive thoughts are fewer, I’m able to hold and play with my kids, and I’m tackling exposures that were in the 6-7 range when I admitted. (7 is the highest ranking on the scale). I am doing well.

I’m afraid if I start weaning off this medication I’m going to backslide. I’m going to start having more of the thoughts that terrify me. I’m not going to be able to hold my kids or do all the things I need to do to take care of them.

On the other hand, I’m also afraid that if I don’t stop taking this medication it means that I don’t love my daughter enough. I breastfed my son until he was 18 months old (and only stopped because I was pregnant with my daughter and my OB/GYN recommended it). If I don’t suck it up to do the same for her, does it mean that I love her less than I love my son? Does it mean I don’t want what’s best for her?

Logically, I know that what’s best for her is a mom who can be actively engaged with her. A mom who can smile at her and hold her without fear. A mom who isn’t constantly and compulsively looking to safeguard against every perceived danger out there. A mom who can let her see the wonder in the world. I don’t want her (or my son) to pick up my neuroses.

The other thought is that maybe, just maybe, adjusting the one medication won’t send me into a tailspin.

…but can  I take that risk? Do I make the leap?

I’ll let you know after I meet with the doc.

…even my prayer life is compulsive.

So, I’m Catholic. Not just a Christmas and Easter Catholic, I’m an obsessive Catholic. Jim Gaffigan would probably call me a “Shi’ite Catholic.” I’m pretty traditional, very into the sacraments and the Saints, and I find great comfort in the Church. It is my home.

So naturally, I find it difficult when I find my OCD manifesting itself in my prayer life. I struggle with scrupulosity–a fear of sinning or disappointing God–and worry about my salvation. Which is, of course, ridiculous, because if we were perfect, then Christ died for nothing. I then find myself caught in tension between “I shouldn’t sin” and “I should have more faith in Christ’s mercy and love for me.” It’s agonizing.

My OCD further manifests in rituals I perform. Catholicism is full of many beautiful rituals, and it is very regimented. This, in and of itself is not disordered. Where it becomes a problem for me is when I cross the line from doing these things out of reverence and a desire to love God with my whole heart to doing them because not to would cause me great anxiety.

Take, for example, passing by a church. From childhood, my father taught us to cross ourselves when passing by any church where the blessed sacrament resides. (I.e., Catholic, Episcopal, Greek Orthodox churches–any of the churches that are in full communion with the RCC). I love this ritual. I find it beautiful and meaningful.

It is a problem, however, because I now have great anxiety over whether or not I remembered to cross myself upon passing a church and find myself crossing myself repeatedly and apologizing to God for being so thoughtless. This is where I’ve crossed the line into OCD.

So this is something we have to work on. I don’t want to stop performing the rituals for the rest of my life. I find them inspirational and I find that they help bring me closer to God, but I want to perform them because I want to perform them, not because I’m anxious at the thought of not performing them. I want to do these rituals out of a genuine love of God, not out of fear of Him. I want to pray because I want to pray, not because I’m scared. I want to come before Him from a place of confidence.

So, that’s where I’m at. I need to find a way to have a healthy spiritual life.

“Lord, teach me to be generous. Teach me to serve you as you deserve; to give and not to count the cost, to fight and not to heed the wounds, to toil and not to seek for rest, to labor and not to ask for reward, save that of knowing that I do your will.”

-St. Ignatius of Loyola

So I came out of the OCD closet….

I posted the following to Facebook. So far, the response has been entirely lovely. I am so blessed by the people in my life. Ignore the grammar gaffes, I typed it on my phone. (Names redacted, for now…)

Dear friends,
Some of you may not have noticed, others may have noticed and been too afraid of saying the wrong thing, but far too few of you know what is going on with me, so I’m just going to put it out there and say if you want to ask questions, feel free to contact me. (Be aware I’m getting well and may not respond immediately, but I’ll be grateful that you reached out and will get back to you eventually…)

After (my daughter) was born, I started struggling. I wasn’t depressed at all–seriously, not even a little bit–but I WAS terrified. All the time. By everything.

Things finally came to a head about a month ago, when I was so scared that I couldn’t even function effectively. I was terrified to hold my kids–sometimes scared to even look at my kids, and as a stay-at-home-mom of such young kids, that was a serious impairment.

I spent 10 days inpatient in a psychiatric hospital where I was diagnosed with Obsessive-Compulsive Disorder. I’ll leave the actual definitions to the DSM-V, but here’s how I explain it in my own words:

OCD is not just about being excessively neat or organized.

Imagine the thing you want to think about least in the world. (For me, this was the thought that some harm would come to my children.)

Now think about it. Think about it obsessively.

Think about it so often you experience panic and have to perform rituals (or compulsions) to try and alleviate the panic. (For me, this involved checking and re-checking our childproofing things, buying lock boxes for everything in the house I thought could be dangerous, and eventually putting anything my brain could see as a danger into (my husband)’s trunk because I ran out of room in the lock boxes.)

OCD is like a sadistic bully. It is truly a torment.

I am so blessed that my insurance covers the help I need, but programs for OCD are few, so the nearest opening was in Appleton and it required me to live away from home during the week while I worked for 5 hours in an office each day (plus homework assignments–exposures–that force me to confront my fears) to get better. This is where I’ve been. This is why you haven’t seen me around. It’s because I haven’t been around.

I’m sad that I’ve had to miss a month, but I would rather miss this month than chunks of the rest of my life, and I am happy to say the help has been helping. A lot. I write this to you after having spent my evening playing with (my son) and snuggling with (my daughter).

I’m getting better. I’ll get there.

If you’ve read this far, I’m betting you care about me and want to know how to help, so here’s how you can help:

1.) Touch base. It helps me get out of my head. Don’t worry about saying the wrong thing, I’ll know you mean well.

2.) Don’t be offended if I’m not responding immediately or canceling plans. I WANT to interact with you, but not every day is a good day, and I won’t know it’s a bad day until it’s bad.

3.) If you know (my husband) or the kids, check in on them too. OCD hasn’t just taken over my life, but theirs as well.

4.) If you are a person of faith, pray for me. If you happen to be a fan of saints and intercessory prayer, St. Dymphna and St. Julian are great patronesses for people with OCD.

Thank you all for being in my life. I love you all. ❤️

The Toll on Loved Ones

For the most part, I’m entirely grateful for the treatment I am receiving. I know that I am incredibly blessed to have insurance that not only covers everything, but that is covering it at 100%, so I don’t have to feel guilty about spending money on getting well. (Well, I am spending money on housing, but I’m not paying $800/day for the treatment, so…)

Last night, however, my husband was talking about his last couple of days. They have been rough. Our two year old is a very good boy, but he wants to be played with and he tends to get mischievous when ignored for too long… like when daddy has to work from home. Our (almost) three month old was crying. A lot. My husband said his ears physically hurt.

My treatment, while completely beneficial for me, is taking its toll on my family. My poor husband is doing the best he can, and we’re lucky that he can work from home (as childcare is egregiously expensive and we’d be hard-pressed to make that work on top of the hotel stay) but it’s hard for me to know that he has to work this hard because I’m not doing my job as his partner.

I know, I know, everyone is going to tell me that my only job right now is to get well. And I know that. I do.

This is why when some others in my program are willing to daydream a little during exposure times, I’m kicking my own ass. I can’t justify slacking off because I know that my family needs me and if I can’t be there for them, the least I can do is work my ass off to make sure I’m getting better as quickly as possible. I’m going to do the work. I have to do the work. It’s the only way I’m going to get back to them.

I need to get back to them soon. They need me.

and if I’m entirely honest, I need them too…

Steering into the skid…

That’s really the only way I can begin to describe what Cognitive-Behavioral Therapy (CBT)/Exposure and Response Prevention (ERP) is like.

Example: one of my obsessive thoughts was “what if I go crazy and drown my kids in the bathtub?”

CBT/ERP says: “Okay, Moira, you’re terrified of your children drowning? How about you watch this video of a mother who drowned not one but all FIVE of her children in a bathtub, and then take this doll and drown it? Good luck!”

Sounds absolutely insane, right? I’m battling my crazy by doing something crazy, but it seems to be working.

The idea behind it is that I do or think of something that causes me anxiety… you see, with OCD thoughts, it’s not the content of the thought that is concerning, but the reaction I have to them. Most people have a thought pop into their brain (I’ve read that as many as 90% of moms have had similar thoughts) and can say “oh, that’s weird, but I would never do that” and move on. I, on the other hand, obsess about the thought…

oh my gosh, I thought about my kids drowning, what does this mean? does this mean I’m homicidal? does this mean I’m going through postpartum psychosis? am I about to snap and kill them? do these thoughts mean that I resent my children and want them to die?

[cue massive anxiety and an absolute refusal to bathe my children. Husband out of town? Too bad. We’ll just have to be stinky this week.]

So steering into the skid requires me to expose myself to anxiety and then wait while my anxiety reduces by half. I’ve got a lovely scale (0 to 7) I use to describe my anxiety, so if I start at a 4, I time how long it takes me to habituate down to a 2.

Here’s a lovely article that explains more.

I will say, so far, this therapy seems to be working. After drowning this poor doll in the bathtub for a few days, I was able to successfully bathe my son by myself  when I went home over the weekend. (I’m living almost two hours away from home during the week while I’m undergoing treatment). I mean, my husband was home and aware that I was doing it, I’m not doing anything REALLY scary like bathing my son while I’m alone in the house, but still, this was progress.

And progress is really all I can ask for.

I’m feeling hopeful today.

Comorbid ADHD

I promise I’ve started the continuation of my introductory post, but I just can’t focus on it. Today, my ADHD is the challenge, not the OCD.

I’ve been unable to focus well today. This is nothing new, I’ve had ADHD my whole life and dealt with it… The problem here is that I really need to focus on my therapy. See, I’m currently enrolled in an intensive Cognitive-Behavioral Therapy (CBT) program, and this program requires me to face anxiety-causing situations and then sit there while the anxiety subsides. So far, CBT is working…when I can put in the work.

So why does the ADHD matter? Well, for starters, I have to sit with my anxiety and not engage in any coping mechanisms.

Here’s an example:

One of my assignments today was to write the sentence “I’m going to kill myself” over and over. (Yes, I know, that sounds insane, but really, it was helpful because I had been terrified that I might be suicidal and not realize it…and yes, I do know how insane that fear sounds too.)

So here’s how that went:

Start stopwatch. Write the sentence.

[anxiety is a 3 on a scale from 0 to 7. I feel it but I’m not to full-on panic.]

Continue writing sentence over and over again while waiting for anxiety to reduce by half.

oh wow, my handwriting looks really pretty like that. Huh. I could open an etsy shop with calligraphed items. I should talk to this mom from church who has her own etsy shop…. fuck. I’m supposed to concentrate.

Stop stopwatch. This is a mistrial and does not count. Get mad for 30 seconds because mistrials do not bring us any closer to kicking OCD’s ass.

On the one hand, the fact that I’m not able to focus on (read: obsess over) this negative thought is awesome! If I had been unable to concentrate on any of my negative thoughts before, I wouldn’t have ended up here in the first place. On the other hand, I am here and I need to put in the work.

So I’m frustrated.

The other reason why my ADHD is such a hindrance is that my obsessions and compulsions are mostly thought-based. They are a bunch of sick, unrelenting, rhetorical exercises that drive me absolutely mad. I’m not someone who needs to deal with their OCD by sitting with their hands on a trash can. I have to deal with my OCD by forcing myself to think terrible, terrible, terrible things. That’s hard to do when your mind wanders as often as my ADHD brain does.

I’m frustrated. I’m frakking frustrated. That’s all I got.

By way of introduction

Hi, I’m too afraid to actually use my name on here, so I’ll be writing with a pseudonym. You can call me Moira. Perhaps one day I’ll be brave enough to share my real name, but I want to be incredibly honest on this blog and I think anonymity is the only thing that will give me the courage to do so.

What am I so afraid of? 

Well, I have OCD. (Literally. I’m not using the term lightly because I get irritated when something is out of place, I have been diagnosed with OCD.)

Why is that scary? Well, OCD is categorized by obsessive (read: unwanted, intrusive, and persistent) thoughts and ritualized behaviors or compulsions performed to try and eliminate the thought. Some compulsions are obvious to the world, but other others are invisible or seem so innocuous that you wouldn’t realize that’s what they are. Mine are more invisible, and so if you weren’t familiar with the different ways OCD manifests, you wouldn’t think that’s what I had.

Thankfully, some very smart mental health professionals have figured it out for me. 

Again you may ask, why is this scary? 

My biggest fear is that my thoughts mean I am a bad, unfit, or even dangerous mother. I’m terrified my children are better off without me.

I guess I should go back before going forward, so I’ll explain. Just over two months ago, I gave birth to my second child. A gorgeous little girl who I’ll call Nora. She really is a good baby. I mean, really. She is about as low-maintenance as  babies come, but still I started having scary, intrusive thoughts about her safety on the second day in the hospital. You see, my husband was staying home with our little boy (I’ll call him Ben, all names changed to protect them) and I was alone with her when a nurse came in to do a heel stick for some of those mandatory newborn screens.

…and Nora didn’t cry. She didn’t even fuss. The nurse said she was such a good baby.

And here’s the thought train that emerged from that:

She’s a good baby. Oh no. One of the warning signs for autism is a baby who doesn’t cry. What if she has autism? Why am I thinking about this? Why am I worrying? So what if she has autism? Does it mean I don’t love her enough if I’m worried about autism? No, no, no, I’ve got to love her no matter what. Oh no, what if I don’t love her the way I love Ben? 

…and from there I just obsessed for an hour worrying. 

The next night, Nora wasn’t ready to be discharged yet. You see, she was losing weight (despite my pumping more than enough each feeding and her uncanny ability to latch from the beginning) and they wanted her to gain some back before they discharged her. So they were ready to discharge me but not her. Obviously, they couldn’t let me keep the room if another mom needed it, so they mentioned that they do have a guest room on the floor for moms whose babies are still in the nursery. The nurse, looking out for me, said she was going to reserve it for me because it has a bathroom and other rooms did not.

A bathroom? Oh no! What if there is a bathtub? What if I drown her? i’ll be alone with her. Oh no, oh no, oh no.

CUE PANIC ATTACK, COMPLETE WITH VOMITING.

At that point, I immediately asked to talk to a social worker and a chaplain. I wanted mandated reporters to hear every detail of every negative thought I had because I was convinced these thoughts meant I posed a risk to my beautiful little girl. I was terrified it meant I was going to hurt her, and that is a thought I just could not bear. 

Every person I’ve talked to and thing I have read told me that my reaction was the important thing, and not the thoughts themselves. The thoughts were just thoughts, and the anxiety associated with them meant the thoughts were ego-dystonic or thoughts that were in conflict with the person I really am. I’m told as many as 90% of mothers have the exact same thoughts, but that was no comfort to me.

No one believed I could actually follow through with any of my scary thoughts, except me. I knew I didn’t want to do anything, but stories I had read and seen on the news of women who killed their babies in the throes of postpartum psychosis plagued me. No one thought those women would do anything either.

I kept asking my husband for reassurance. I kept looking for evidence that I loved and was worried about my children. Why would I bother changing this diaper if I intended to hurt her?

For awhile, this kind of talk worked. I was still seeing a therapist weekly (I started going within a week of discharge) and I was confessing every dark thought I had ever had to her, begging her to call the police if she thought I was a danger, threatening that my husband would surely sue her pants off if she let me go home when I posed a risk. Of course, she was as sure as she could possibly be that I wasn’t a danger. 

I wanted so badly to believe her. To have faith in myself. To trust that I was a loving mother. I had all of this anecodotal evidence that told me I was. I believed that when I was in my right mind, I was, but I also knew I was not in my right mind, and one thought kept plaguing me:

You don’t think you’re dangerous, but what if you’re wrong? What if you’re wrong? What if you’re about to snap and do something you can’t take back?

more to come later.