My Fish Are Dead!

Or the Importance of Treating Mental Illness

When I was about 16 my OB/GYN diagnosed me with PMDD (premenstrual dysphoric disorder) and recommended that I start taking Sarafem (Prozac for women). This diagnosis and treatment plan excited me because for the first time in my life I felt like someone saw me, understood me, recognized my struggle, and was going to help me. Up until that moment I thought I was broken, too sensitive, melodramatic, should just "stop it." Now, I had a real thing. A real thing that could be treated. I could stop having all these feelings all the time. I could get better. I could be "normal."

Then, I drove home and told my mom about my appointment. She immediately discredited the doctor and forbid me to have the prescription filled because "didn't I know what happened to kids under 18 who take SSRIs? They commit suicide." End of story. No discussion. You're fine. You absolutely do not have that. Now, let's have dinner.

To say I felt deflated is an understatement, and I often wonder how the trajectory of my life would have played out had I been able to start getting treatment for my depression at such a young age.

Instead, it would take me ten years, countless poor relationships, 70 pounds, and numerous risky behaviors to seek out and get the help I needed. I was most definitely not fine and I most certainly did have that. I just couldn't always see it and neither could those who loved me.

I don't blame my mom; I know she was just scared. And I've mostly stopped blaming myself; I was scared too.

But I haven't, and I won't, stop blaming our society. Did you know that 80% of all people who had a physical illness got treated for their medical condition last year, while only 40% of those with a mental illness did? Or that one and ten adults report being depressed? Yet, nearly two out of three don't seek the treatment they need.

This is not okay. The stigma we have created around mental illness is not okay.

Mental health issues are just as real as physical ones. I'd even argue that they're more powerful, more influential, more detrimental (at times) because they come with a large dose of guilt and shame. And they permeate our whole entire lives, including our ability to genuinely connect and be in this world. To experience love, joy, and contentment which are just as much birth rights as health, or did we forget that line about the pursuit of happiness?

No one finds fault with the person who gets treated for cancer. No one whispers about them, questions their abilities, denies their symptoms, criticizes their choices, tells them to "just get over it." But those are all things I've heard, things my clients have heard. 

Things that cause millions of people to suffer in silence each year. And that is not okay.

What happens to people, to families, to towns when mental health issues go unresolved is not okay.

So, in honor of National Depression Screening Day I beg of you to begin thinking about health differently. Take your loved ones seriously when they reach out to you and even more so when they don't. Take yourself seriously. Your feelings are real and you matter.

Let's start making getting our souls "fixed" just as important as our bodies.

And because there are many people who've said it better than I ever could, here are some of my favorite depression related links:

A hilarious and accurate description of depression.

It would be like having a bunch of dead fish, but no one around you will acknowledge that the fish are dead. Instead, they offer to help you look for the fish or try to help you figure out why they disappeared. 

An incredibly moving podcast about how depression is treated in rural Africa. Transcript here.

He said, “You know, we had a lot of trouble with Western mental health workers who came here immediately after the genocide, and we had to ask some of them to leave.”
I said, “What was the problem?”
And he said, “Their practice did not involve being outside in the sun, like you’re describing, which is, after all, where you begin to feel better. There was no music or drumming to get your blood flowing again when you’re depressed, and you’re low, and you need to have your blood flowing. There was no sense that everyone had taken the day off so that the entire community could come together to try to lift you up and bring you back to joy. There was no acknowledgment that the depression is something invasive and external that could actually be cast out of you again.
“Instead, they would take people one at a time into these dingy little rooms and have them sit around for an hour or so and talk about bad things that had happened to them. We had to get them to leave the country.”

Sciencey things and resources.

Don't Think Twice, It's Alright

The advice I wish someone had given me

When I found out I was pregnant I did a lot of things, including but not limited to: freak out, cry, wallow in bed, throw up, sleep, curse, squeal with delight, deny, worry, wonder, question, and obsess. But perhaps what I did most was start Googling, and asking questions, and reading. And then I stopped for awhile. The Internet can be a scary, mean place for mamas and nothing I was reading was resonating with me. The following post is what I wish I would have found in my first burst of research.

Dear Mama-in-the-Making,

Stop reading this and go outside. Or write, or paint, or draw, or cook, or take pictures, or call your best friend. Or talk to your husband. Or better yet, have sex with him. Do anything that lights you up because what your baby needs-what the world needs-is for you to be lit up.

Your baby does not need you to be an expert. Your baby does not need you to read books, or studies, or blogs.

Your baby needs you to be happy. Content. It needs you to take care of yourself. To experience the world. To pay attention.

It needs you to trust your intuition. And none of that will you find in a book or on the Internet.

What you'll find there is a lot of crap. A lot of people telling you what you need to do, or should do, or absolutely can't do. And for every expert opinion, you'll find ten more that are contrary.

Why do you believe they know better than you? Why do you let their voices override yours?

You are designed to do this. 

Every atom of your body knows its role. How to grow and form a life. And no matter what you do or don't do, that process will happen. Your baby will grow. It will push itself out into the world. It will thrive.

Whether because of or in spite of you, it will have its own life. It will make its way. It can't not.

And I know you want to do everything right. You want to be perfect so your little one will have the best possible chance. It's how your brain will work from now on. In worst case scenarios and late night fretting. In protection and preparing. But think back on your own life.

When have you grown? When have you learned?

Not when life is perfect. But when it's messy and hard. Don't forget to give that to your little one. To be vulnerable and imperfect. To make mistakes, and repair, and learn. To be honest. Deeply honest even about the hardest things.

The best thing you can do. The only thing really. Is to live. Really live your life. 

So, do what you've always done...

Eat what feels good, even the bad stuff sometimes. Delight in what you put in your body even when you reach for something processed, or with high fructose corn syrup, or from the forbidden list. Food is just food. Parisians eat soft cheeses, the Japanese sushi. So stop worrying and enjoy it. Praise the miraculous tingle of sugar on tongue. The texture of cheese on bread. Then, be done with it. Don't worry about not doing right or getting enough leafy greens. Stop beating yourself up. Your body knows what it needs. And sometimes it needs pleasure. It's ok. Take your prenatal and eat a salad tomorrow.

Do what you like, all of it. Even the stuff other people don't understand, or accept, or tell you not to do. Take a nap. Skip your walk. Run a marathon. Read a book. Whatever makes you feel alive. And be gentle and kind to yourself when nothing feels good. It will pass, as all things do.

Have feelings, every single one of them. Be mad. Cry. Hate that you are pregnant. Love that you are pregnant. Nothing you could think or feel will make you a bad mother, or someone who doesn't deserve a child. Even if the Internet tells you otherwise. Allowing yourself to be honest about this whole mess is an incredible gift-to you, your partner, your child, the world. Having the courage to tell the truth is more honorable than hiding behind fear and judgement, and it's something most don't do. So admit and acknowledge where you are. It's the only way to create true connection, you know that.

You also know the peril of that. Of speaking your truth. It makes other people uncomfortable sometimes. Can ignite loneliness and isolation. Embrace those moments of pulling in. Then, get out of bed, fix your hair, and get on with things. You know who your tribe is, who gets to hear your whole story. Call them. Tell them.

Worry, knowing it won't help a bit. But realizing when we try to dam up our thoughts they soon become an overwhelming torrent. So let them be. Wonder and be curious about them without indulging.

Know that when people are harsh and judgmental-when they offer their opinion as God's given word-they are probably just scared. You're scared too. Tell them that. And listen. Chew on the kernel they offer until it splits open and reveals a deeper truth, even if takes awhile. Even if you have to dig through a mountain of bullsh*t to find the pearl. Even if you end up spitting it out or throwing it away. Because everything is a opportunity to go deeper. To learn more. No matter who's mouth the words are coming from.

Be open. Let things unfold as they will. Control is just an illusion we give ourselves to sop up fear.

Pay attention. Listen. Not only to your body, your mind, your feelings, but to your baby's. And to the world around you. Life is much bigger than your tiny existence. Look up when you get too myopic. Lay down on the ground when you feel disconnected.

Say you're sorry. But only when you really are or when you've truly wronged another. It's not a filler word. Not to be uttered when you are doing what you need to do to take care of yourself.

Respect the little person you've created. See her for what she is-what we all are-beings trying our best to make our way in the world. She can be your greatest teacher if you let her.

Ask for help when you need it. Tell people no when you mean it.

And mostly importantly know that there's no one way. No best way. No perfect way. 

“You have a right to experiment with your life. You will make mistakes. And they are right, too.”
-Anais Nin
So, stop reading this and go outside. It will all be fine. Is fine.

Your True Self

Just Be and Other Things I Learned While Recovering

Wild Geese
by Mary Oliver 
You do not have to be good.
You do not have to walk on your knees
for a hundred miles through the desert, repenting.
You only have to let the soft animal of your body
love what it loves.
Tell me about despair, yours, and I will tell you mine.
Meanwhile the world goes on.
Meanwhile the sun and the clear pebbles of the rain
are moving across the landscapes,
over the prairies and the deep trees,
the mountains and the rivers.
Meanwhile the wild geese, high in the clean blue air,
are heading home again.
Whoever you are, no matter how lonely,
the world offers itself to your imagination,
calls to you like the wild geese, harsh and exciting-
over and over announcing your place
in the family of things.

When I was in pre-school I informed my parents that I wanted to learn how to read. So they marched me across the field and our very patient next-door neighbor (Hi Frances!) pulled out some See Jane Run and got busy fulfilling my wish. In elementary and middle school there were special classes, and camps, and trainings. And then in high school, when I felt I had out grown my public school, I decided I was going to an elite boarding school. In college, I studied Art History in the Louvre––in. the. Louvre. After that, in grad school, I was voted "Outstanding Marriage and Family Therapist Student." Since then, I've applied to and participated in yoga trainings, counseling seminars, local boards, and extra classes.

I do not tell you this to brag or tout my accomplishments, because at the end of the day I haven't cured cancer or solved world peace, I haven't done anything all that great except have an insatiable need for knowledge, for learning, for growth. A need so painful, so intense it has driven me across continents and countries. It has made me annoying, and humble, and depressed.

Yes, depressed.

Because when you base your life solely around accomplishing things, you're bound to get let down. Not every moment is great, there's not always something to learn, and sometimes there's nothing more to do than keep your head down and slog through.

And slog through is exactly what I have been doing lately. Getting up, going to work, coming home, and watching TV like most Americans. Except, I am not most Americans. I am the Valedictorian of Everything. The Valedictorian of Everything does not just slog through.

The Valedictorian does things. Accomplishes things. Has projects. Is great.

But I've accomplished all the major things on my list. I have an advanced degree, a job in my field. A wonderful husband. Amazing friends.

I've ticked the boxes I've been told to (that I've wanted to). So, what's next?

It's a question I've had a long time to ponder as I've been laying around being the Valedictorian of Doing Nothing, of recovering from my surgery. My it's not cancer, you may have endometriosis, but you'll be fine surgery.

And all I can come up with is that my next project is realizing that the mundane, ordinary life I've created (that I've been granted since my it's not cancer, you may have endometriosis, but you'll be fine surgery) is actually quite extraordinary. That it's what I worked hard to create. That it's what I walked across that field for when I was three.

And that it's enough. I'm enough.

Which may be the hardest lesson of all. Becoming a human being instead of a human doing. Funny how we do that. How we learn that we have to do things, accomplish things, run marathons, tear down walls, cure cancer to be good enough.

When really all we have to do is let the soft animal of our body love what it loves.

And my body loves my husband, and seeing clients, and cooking food, and snuggling on the couch. And that's good enough. I'm good enough.

So are you.

New Year's Resolutions

December 31st, 2013

While most pop champagne and share ruddy cheeked kisses, I sit on the couch running my fingers along my belly. No outward sign of the abnormality I know is there. No rippled skin. No hard place. No indentation or bulge.

Nothing to announce the presence under my skin except for a phone call and a hunch, "mass, right ovary, abnormal, cyst, large, specialist." A string of words I arrange and rearrange as the clock ticks. As the new year slams into me.

And I can't help but wonder what's really there among the old spent cells, among the blood and viscera of my sex. Is it the story of my mother? The unwanted glances, missed opportunities, and regrets of my youth? Or is it newer? Maternal ambivalence, over-striving, and always measuring myself up short?

What has grown, but then been discarded?

The doctor says it's just endometrial tissue. But I know it must be something more. Why else would my body turn against me? Why else would it threaten my fertility?

January 10th, 2014

Google search:
Chocolate cyst
Treatment for endometrioma
Endometrioma and ovarian cancer
Can I have babies
Will I die

I'm tired of not talking about this. Of saying, "it's nothing," "millions of women," "no big deal."

There's a golf ball sized growth in my ovary, and the blood work doesn't come back until next week. I'm tired, and full of too many thoughts.

I need to say, "this hurts," "I'm scared," "please pray."