Treating Postpartum Depression (and depression in general)

Hello!  Did you think I'd forgotten about this blog?  I haven't!  Now that my experience with PPD/PPA is mostly in hindsight, I've had a few more thoughts I've wanted to share, but it's been difficult to find the time because I've been extremely busy with work lately.  (I'm still a SAHM, but I work from home for my employer on an hourly basis, which means a lot of nights and weekends lately.)

In my experience, I struggled with two different types of depression.  These are not clinical categories, but just what I experienced.

1. The type of depression that hits you for no apparent cause.  You wake up, and before any thought has entered your mind, or before you are even fully conscious, you have a sinking feeling in your stomach.  You physically can't get out of bed.  You don't want to face the day, but there's no (obvious) reason behind it.
2. The type of depression or anxiety that is thought-based.  You think things like, I'm a terrible mom, or I'm a bad person, or No one likes me, or My life is pointless.

Sometimes, of course, I'd feel a mixture of the two.  I'd have panic attacks for "no reason," but I knew that my anxiety about my in-laws moving nearby was the overarching cause, even if I was not actively thinking about it at the moment.

So here's the thing, depression can have both physical (chemical or hormonal imbalance) and thought-based causes.  Medication can help with the first type, and therapy can help with the second.  A lot of times, the most effective treatment is a combination of the two because most people, like myself, don't just experience one or the other.

On medication - talk to your doctor about it.   You don't have to go to a psychiatrist; any family practice doctor can prescribe antidepressants.  However, I'm guessing a psychiatrist might be more helpful if you are struggling with something more than depression, like postpartum OCD or intrusive thoughts.  If you're hesitant to try medication, you could try St. Johns Wort or other natural remedies first.

On thoughts - One thing I've read over and over in the depression literature is that depression is not caused by emotions but by thoughts.  Eg: Sad -> Depressed doesn't tell the whole story.  It takes courage, but if you force yourself to figure out why you feel sad, you will usually find a thought lurking in there that caused the sadness.  Eg: I'm a bad mom -> Sad/frustrated -> Depressed.  Studies have shown that brain chemistry can cause depression, leading to negative thoughts, but that the opposite is also true: changing your thought patterns can actually change your brain chemistry.  (Don't ask me to cite any references...this is a personal blog, not a Wiki article!...just Google it.)  

So what to do about those thoughts?  Cognitive-behavioral therapy (CBT) is a systematic and widely accepted form of therapy to address these negative thoughts and has been proven in clinical studies to be just as effective as medication in some cases.  If you are thinking of going to a counselor, please look for one who uses a systematic approach, such as CBT, rather than just someone who uses "talk therapy."  You can also do CBT on yourself by following the exercises in the book Feeling Good by Dr. David Burns.  (Don't say it won't work until you've actually tried it.  Really - take a pen and paper and do the exercises, even if they seem too simplistic or that they won't work on you.)  It's supposed to work for not only depression and anxiety but also OCD.  You can also try a free, online program that walks you through the steps at https://moodgym.anu.edu.au.  Again, you really need to be committed to providing honest and detailed answers to some of their questions to expect it to work.  If you're too embarrassed to be completely honest with the online format, then stick with the book and pen and paper at home.

Sadly, one of the biggest barriers to treatment of depression is oftentimes the person herself.  If your trigger thought is, "I'm a bad mom," then of course you won't want to do any silly exercises to make yourself feel like a good mom because you don't think it's true.  It's a vicious cycle that the lie that makes you feel bad in the first place (eg: I'm a bad mom) is what keeps you from getting the treatment you need.  Unfortunately, you are the only one who can decide that you're ready to feel better.  But when you're ready, you'll know it!

Well, I hope this post has been helpful.  I'm not sure if I'll have time to blog in the new year, so I tried to pack as much helpful info in this post as possible.  If you're in need of other resources, please check out postpartumprogress.org.  It has a ton of resources and articles, as well as links to other personal blogs on PPD/PPA.

Read more...

Making a difference in the world as a SAHM

If you've been reading this blog for awhile, you know that the intrusive thoughts I had during postpartum depression led to a more lasting struggle with the problem of evil.  To this day, I can't read about anything (ANYTHING) sad or bad happening to anyone without putting myself in the shoes of the victim or the victim's mother.  In my younger days, I sometimes got into intellectual discussions with my friends mourning how the media had caused us to be so desensitized to the evil and suffering in this world.  Well, here I am, no longer desensitized, and it's pretty depressing (just regular-life-is-terrible-depressing, not clinically-I-need-therapy-depressing).

The good news is that I finally got to the point where I wasn't just mad at God (although I still have a lot of questions for Him), but I wanted to do something about it.  However, I didn't want to compromise my primary role as a SAHM, and as any SAHM can tell you, there is a lot of free time during the day, but it's difficult to use that time productively because it's fragmented.  The minute you think you might have enough time to, say, use the restroom, your older child will decide she MUST have that one toy that is buried in the back of the closet NOW, or your older child will kick the younger child, or the younger child will fall over and bang her head on the floor, and it's all over...window of opportunity is GONE.

So anyway, I have a good friend who spent some time as a medical missionary in a developing country, and I sent her this silly question:

"What can I do to help besides giving money (already do), or adoption (would like to, but don't have the immediate money for it), or going out somewhere to volunteer (because my priority is still to be at home)?"

I was pretty sure she was going to write back and say, "ummm...with all your limitations, I'm pretty sure there is NOTHING you can do to help.  Get back to me in five years when your kids are in school."  But my friend, she surprised me with her answer.  "You can PRAY," she said.  Money and other physical resources always help, but a lot of kids are suffering in ways in which physical provision can only do so much.  These children need God's love and protection, and our prayers!

Well, duh, why didn't I think of that myself?  I think it's because I didn't think praying was really doing something, and I didn't think it would make a REAL difference.  During one phase of my depression, I went on a prayer strike because I was mad at God and was questioning the purpose of prayer.  Well, I still have a lot of questions, but in the meantime, I've been praying for the beautiful, beautiful children at the Butterfly Children's Hospice.  If you are a SAHM looking for a way to make a difference in the world with the limitations of being a SAHM, would you please pray with me for these children, or for whatever hurting people God puts on your heart?  Just take one Facebook break out of your day and replace it with a prayer!

Read more...

Not being a "baby person"

I'm not a "baby person."  I think other people's babies are cute, but I'm not dying to hold them or play with them.  Sometimes I forget to offer to let other people hold my babies because I forget that most people, unlike me, actually like to hold other people's babies.  Sometimes I'm taken off guard when people offer to let me hold their babies because it's not something I was wanting to do, although I don't mind.

Not being a baby person hasn't kept me from being madly in love with my own kids.  I love cuddling, hugging, and kissing my babies.  I love the smell of my babies when they're not perfectly clean - there's no sweeter smell to me than that mixture of baby sweat, baby saliva, and milk.  (Only on my own babies, though - I prefer clean, Johnson & Johnson soap smell on other babies not my own.)

Anyway, I wonder how being a baby person affects one's parenting and parenting skills.  Do baby people have better maternal instincts?  Does it even matter?  I'm crazy about my kids, so I don't think I would love them any more if I were a baby person, but maybe I would interact with them differently.

Read more...

Searching for Theodicy

When I was in college, I took a brief interest in Christian apologetics - defending the faith through objective and rational arguments.  I thought at the time that it was important for winning people over to Christ.  I then realized that no one (no one!) is ever converted through rational debate.  You could debate an atheist until you are blue in the face, and s/he wouldn't budge an inch.  Faith is not something that can be won through an argument but is the work of God.

Image: Stuart Miles

So for awhile, I thought apologetics was just for people who wanted to argue and that it really wasn't worth my time.  I'm now realizing that apologetics is not just for defending the faith but also for encouraging believers.  Apologetics is, in essence, theology in different clothing, and good theology is vital to our faith.

I don't label myself as having postpartum depression/anxiety/intrusive thoughts anymore, but I still bear the scars.  I recently became lax about staying away from the news, and I read some news articles that shook me to the core.  I was awake almost the rest of the night doubting God's goodness, wrestling with my faith, wondering if I could even call myself a Christian anymore.

That night, I came across the term "theodicy" for the first time, which is basically an attempt to answer the problem of evil.  I think I know deep down that a true theodicy doesn't exist -- as in, there may be logical arguments for the existence of evil, but those arguments will never resolve the pain caused by evil or make it obvious that God had no choice but to allow this world to become as broken as it is.  I'm okay with that - I don't presume to think that I as a human being could ever have the same perspective as God does.  But I also think it's important to strengthen my faith with good theology.  My friend recommended Ravi Zacharias, so I'm looking to get one of his books soon.

And how did I end up getting to sleep that night?  I prayed.  Even when I doubt Him, God is my comforter.

Read more...

Fear and Theology

Although I no longer suffer from intrusive thoughts, I still suffer from one of the after-effects...fear.  The intrusive thoughts awakened in me a fear of the pain and evils in this world that I didn't know before.  I continue to struggle with trusting God with my family and having peace.  This has been a time in my life where I've learned the importance of clinging to what I know to be true, rather than what I feel.  I choose to believe that God is good, even though I still feel fear in my heart, and sometimes that is the best I can do.

Image: Louisa Stokes

 I recently came across a blog where a man powerfully describes his choice to believe in God's goodness in the midst of a terrible circumstance.  He talks about the importance of good theology when dealing with difficult circumstances ("Theology is not for the intellectuals, those in the ministry, and those with too much time on their hands. Theology is for those with guns to their heads.")  He talks about the heartbreaking decision to "disown his children" during this trial (they are God's, not his) and that in disowning his children and all he held dear, he was able to be "invincible."

If I were ever in a situation where I had to make the same decision, I'm afraid my heart would break open and never be fixed.  Actually, I'm sure I don't have the courage to make such a decision now, but I believe God will give me the courage if and when the time comes.  If you are in the same situation where you are confronting fear in your life, I hope this man's courage will also give you courage to keep trusting God.

Read about what happened here (don't worry, no one was physically harmed).
Read about his powerful response here.

And please pray for the Sturms!

Read more...

True Love

This is what love looks like on Facebook:

My husband made chocolate-covered strawberries!  Thanks, sweetie!  I love you!

Image: thanunkorn

 This is what love looks like in real life:

On Friday, I buy strawberries at the store and tell my husband what they're for.

Saturday morning, our alarm clock (the baby) wakes us up at 6:40am.  After my husband gets the baby, I ask him about something he was going to do a few weeks ago.  My asking turns to nagging.  My nagging turns to criticism.  My husband leaves the room, taking the baby with him.  (Always take the baby with you if you're trying to make a point.)

As I wrap up the kids' breakfast (two hours after I started), I remind my husband that I'm having lunch with a friend but that I will be back before the baby's naptime to nurse her.  When I get back from lunch 15 minutes before the baby's normal naptime, I find out that my husband already put her down because he didn't know when I would be getting home.

I get upset that I rushed home and skipped several errands to make it for the baby's nap.  We fold laundry together in silence.  I'm still mad, so I go check the tire pressure on my car and fill one of the tires with our manual pump.  I'm still mad, so I go outside to do yardwork.  As I'm angrily hacking away at the hedges, my husband makes chocolate-covered strawberries.

He burns the first batch of chocolate and leaves the pot in the sink for me to wash because he's not sure how to wash it out.  The second batch turns out beautifully.

Yardwork successfully burns away most of my anger.  After showering, I shove several chocolate-covered strawberries into my mouth while standing in front of the fridge so that my toddler won't see me.  I wash out the burnt-chocolate pot.

That evening, after we've put the kids down, we look at each other with weary eyes.  "Life is really tiring," my husband says, "but I'm glad I have you to spend it with."  He smiles at me.

"Thanks, sweetie.  I'm glad I have you, too."

We go to bed exhausted, knowing that we will be woken again at the crack of dawn the next day - to another day of coaxing a picky eater, taming temper tantrums, wrestling with a baby on the changing table, wiping snot from dripping noses.  I might get impatient.  We might argue.  But I never have to wonder if this is the last straw.  Because I know he meant it when he said he would stay with me for better or for worse.  And that?  That's true love.

"Good night, I love you," he says.

"Good night, I love you, too."

Read more...

Guest post at Postpartum Progress

I don't usually blog twice in one week, but I'm incredibly privileged to share my story on Postpartum Progress today.  Postpartum Progress is an incredibly informational PPD website and blog that provides tons of educational material as well as support for postpartum mood disorders.  The website is where I first learned about intrusive thoughts.  I'm not usually a huge advocate for Asian-American issues, but my personal experience with PPD/PPA made me realize how little awareness and acceptance there is among Asians.  Please check out my story:  A Culture of Emotional Restraint: Asian-American Mom Shares Her Perspective on PPD.

Read more...

The mask I wear

It starts as soon as they begin to speak.  The first time my daughter said, "No Grandma!" I immediately shushed her.  We must be polite to others!  And she learned to be polite, but she also learned to put on her first, little mask.

Image: Adell Rucke

Later, we learn that the mask not only protects others but also protects us - from the rejection that might happen if others knew our deepest fears, our inner sufferings, our greatest dreams.  So we put the mask on a little more frequently.  And it starts to feel more comfortable, so that this mask, which was meant to hide who I really am, becomes a part of me.  I don't even have to put it on anymore because it's always there.

Sometimes when I talk to other people, I wonder, what's behind that mask?  Does she ever feel unsure of herself?  Does she wonder what the purpose of her life is?  Does she sometimes just want to run away?  Sometimes, there's a small, very small crack - just a faint look in the eye or a falter in the smile.  But most of the time, the mask is seamless, airtight.

When I started this blog, I wanted to take off my mask so that other women would have the courage to take their's off, too.  Because I have all this sadness, guilt, frustration, and anger that just wants to get out of me, but there's also love, sacrifice, joy, and beauty inside of me, too.  The mask keeps it all in and only lets out a sterile version of me.

But when I sit down to write what I really want to say, I start censoring myself immediately.  I don't want to make so-and-so feel bad.  I don't want my kids to read this someday and misinterpret what I mean.  I don't want to discourage my brothers and sisters in Christ.  I don't want to dishonor God.  Raw is good but raw can also be hurtful.  And by the time I'm done writing, I've written something with a lot of inspiration but very little of my heart left.

Don't get me wrong, I love inspiration.  But how do we also be real with each other?  How do we take our masks off without killing each other?  Maybe as long as we live in this broken world with our broken hearts, we can't.  So for now, I'll keep this mask on.  Because it holds together my brokenness.  And it keeps me from trampling on you and breaking you more than you already are.

So...all this is a very long and dramatic way of saying that I might be changing the content and format of my blog soon.  I'm just so tired of struggling.  What about you?  Are you comfortable with your mask?  Or do you wish you could take it off every once in awhile, let your heart breathe a little?

Read more...

Two under two

Some of you may wonder how I ever had a second child, considering how depressed and anxious I was with my first child.  I knew I wanted my daughter to have a sibling, so the decision to have a second child was cerebral rather than emotional.  I prepared myself for double the stress and read tips on "baby bunching" (having two children under the age of two).

Image: digitalart

Having two children is definitely harder than one on some levels.  There's more laundry to do.  There are two nap schedules to coordinate, which makes it difficult - some days impossible - to get out of the house.  I'm outnumbered when we do go out, so just getting everyone in and out of the car can be a workout.  Don't even get me started on mealtimes - I can't wait until the day all four of us can eat the same thing for dinner, unassisted.  

But ironically, there was a huge emotional burden that was lifted from me when I got outnumbered.  A lot of my depression and anxiety stemmed from my obsession with my daughter.  I wanted to "make the most" of every moment with her, so I forced myself to sing, play, and hold her during every waking moment, no matter how tired or bored I was.  There was nothing else to do but spend time with each other, so that's what we did.  I also never let her cry if I could help it

When I had my second child, I was forced to stop obsessing.  I can no longer immediately respond to every child's first cry.  Oftentimes, one of my children will just have to cry while I finish a certain task.  I've learned that that's okay.  I've noticed that when there's more people around, my kids are less likely to seek my individual attention.  Even though they aren't old enough to play together, just having another child in the room helps to keep them more occupied.  I don't quite understand the psychology behind it, but I'm grateful for it.  I've learned to tell my daughter to play by herself if I'm busy or tired and to not feel guilty about it.  It's been good for her, too, because she has learned to be more independent and creative.

So if you are a young mother with just one child, take heart that having another child may be twice the work physically and logistically but will provide a level of emotional freedom when you are no longer revolving your life around just one child.  I still obsess over certain things and feel anxious daily, but I'm somehow able to enjoy motherhood more now.

Having said that, I can't even imagine having a third child.  If any moms with 3+ children would like to share how much more difficult or easier that is, I would love to hear from you!

Read more...

Overprotectiveness

My parents rarely let me attend school dances.  They were typical strict, overprotective parents.  Unfortunately, I was part of the leadership council of the anti-drug club that put on several dances as fundraisers.  Attendance at dances was mandatory for those on leadership.  I dreaded telling our club sponsor that I couldn't attend the dances.  She was a stern woman who rarely smiled.

I lied to her every time.  My relatives were coming to town, or I was attending a rehearsal for something.  I wondered if she would see through my lies, if she would reprimand me for not attending yet another dance.  But she always just nodded her head and let me go.

Image: Michael Elliott

Now that I am a mother, all I want to do is protect my children from the darkness of this world.  I don’t let them watch any violence or read about anything scary, even fictional monsters in children’s books (besides "friendly" monsters). I once turned on the TV and accidentally let my two-year old daughter watch part of a nature show featuring a crocodile snapping at some fish bait. When she had night wakings the following week, I just knew she was having nightmares about crocodiles.  I blamed myself.

It makes me sad that my parents' overprotectiveness drove me to lie.  I take responsibility for my lies, but I also hope that I can somehow protect my kids in a manner that doesn't put them in that type of situation.  If my parents had known I was lying, I think I would have just gotten into more trouble, and they wouldn't have understood why I felt so ashamed.  I hope that I will have the wisdom to balance my desire to protect my kids but also to be sensitive to their social needs and to trust God for their protection.

Read more...

How it all (sort of) ends

When I was in the midst of my postpartum anxiety, I feared that the daily panic attacks would affect my physical health.  The anxiety and stress were so intense and frequent that I could not imagine overcoming them.  I felt that my only hope would be a divine intervention - a miraculous healing or perhaps a certain Bible verse that would provide instant peace.

Image: Sura Nualpradid

And...nothing of the sort happened.  I got better over time, but there was no trigger or moment that I can point to as the start of the healing.  I no longer have daily panic attacks or intrusive thoughts, but I'm still susceptible to both.  Depression does not characterize my state of being, but it is still a familiar friend.

We give praise when God blesses with discrete changes in circumstance or emotional state (I was sick, and He healed me.  I was laid off, and He provided a job for me.  Bonus to anyone who gets engaged in the process.).  And rightly we should give praise to God for those blessings.  But sometimes our struggles in life do not have an identifiable turning point and resolution.

I read the poem Footprints in the Sand for the first time when I was in elementary school.  In my 8-year-old mind, it was the most inspired and beautiful piece of poetry that had ever been written.  I aspired to have a copy hanging in my house some day.  HGTV has since taught me that my house should be filled with gallery photos and pop art rather than cheesy Christian poetry, but I was reminded of the truth of that poem during my "dark night of the soul."   To be sure, in my darkest times, I felt alone, but even deeper than that feeling of aloneness was the security that no matter how much fear or anxiety filled my heart, no matter how much I doubted God's love and goodness, no matter how much I ignored Him, He would not abandon me.  Sometimes He doesn't "show up" the way we want Him to, but He's still there.

Read more...

Visions for the new year

When I was in college, I attended a talk where the speaker was casting a vision for the new year.  I don't remember the speaker or the vision, but I remember how he defined vision:

the intoxicating dream that hurls you into pursuit of that reality

I think this wins the prize for packing the most number of loaded words into one definition.  Intoxicating.  Dream.  Hurls.  Pursuit.  Reality.

Image: Salvatore Vuono

I'm extremely grateful for the ways I was challenged in college to pursue a radical lifestyle and for books like Crazy Love and Don't Waste Your Life.  However, sometimes I feel that I have only been equipped to live a life full of adventure, travel, physical hardship for the sake of God's glory, and if I am honest with myself, personal glory.  But I have been ill-equipped to live a quiet life with little to no personal glory or adventure.  Lately, I am in need of inspiration more along the lines of:

• Contentment with leading a quiet life
• Joy in the midst of boredom
• The work of Christ in domestic matters (if there is such a thing)
• Laying down your life for your husband and children
• Toddler evangelism

These are my "visions" for how I will eventually grow as a wife and mother.  More sobering than intoxicating.  And moving at a reluctant snail's pace rather than hurled into pursuit.

Read more...