Tuesday, 15 January 2013

Twenty Seven Short Thoughts About Chemistry

This is the post where I do a follow-up on what I wrote just over a year ago about being depressed,  and then a few days later about getting medicated. I'm still taking the medicine, and I'm feeling fine. Okay, that's the short version; if you want the long version, please keep reading. I want to share a bit of what I've learned, a bit of what it has been like, walking through the last year as Chemical Claudia. I'm going to do this as 'short thoughts', a bit like this post, because that seems the most straightforward.

 First thing to say: 
Depression is different for everybody. But you knew that, right?

Want to know one thing
about depression that is probably true for everybody? Depression is undoubtedly the most boring thing in the world. Really, truly, SO boring. Is there anything more stultifying than being stuck inside your own critical mind? I used to think that it would have some kind of toxic glamour, but ugh - no way. I think this is one of the reasons that depressed people often sleep so much - being awake and depressed is just so dull. . 

So Dull. 
Dull, dull, dull. Depression isn't funny at all. At least, it's not funny when other people, people who don't know what they're talking about, make jokes about Prozac, as if living under a dark cloud and struggling so much that you need to alter your own brain chemistry is something amusing. It's not amusing. It's terrifying and humiliating and it feels like the ground is dropping away. In the thick of the worst bit, I lost my sense of humour entirely. I always find myself thinking you would not be so amused if you knew what it felt like and then I get offended because I think they are laughing at me and my problems and honestly, who enjoys that? Also, as I said - no sense of humour.

Except When It's Hilarious. 
Sometimes when Jay asks me to do something I don't want to, I look at him sadly and say I can't do that, it's too hard for me. Don't you know I'm Depressed? and then we both have a good laugh. Also, when people bug us and we think they are being irrational, we hand out imaginary doses of my brain medicine as some kind of code for how messed up they were. So: He was totally flying off the handle; he needs ten milligrams of Celexa for sure. Or That woman is so dysfunctional - I'd put her straight onto forty.  We get to laugh about this because we've earned the right. We get to laugh with, not at. Big difference.

For the record, I only make jokes about depression and anxiety, and only the relatively mild kind that I had / have/ am having /will have. I am acutely aware that I have no idea what it must be like to struggle more than that, to reach a point where you can't function, to not be helped by treatment.  I hope I never earn the right to make jokes about that.

And really, even to Jay,
I don't like to talk about depression very much at all, to be honest. Day to day, it's not a big deal. Hardly anybody in my real life knows about this issue in my life. It's not that I'm ashamed (although of course, I am ashamed) but I just don't really see why they need to know. I've had enough depressed friends to know that people start looking at you, start talking to you differently if they know you are depressed. Although personally, I always hear a capital. Nobody ever tells me that so-and-so is depressed - instead, they are always Depressed. I didn't want to be that person. I don't want to be that person.

The irony is, of course:
I'm much happier now that I'm officially depressed than I was before I had a diagnosis.

It's all down to the medicine. 
I've been incredibly lucky, and I know it. The day - the very day - I started taking brain medicine, I started to feel much better. It was like turning on a light switch. It was like stepping out of December and into June. This eased some (okay, almost all) of the uncertainty I was feeling about getting medicated. If my brain responded so quickly to a physical treatment - a drug - then it was obvious (to me) that I really had some kind of chemical imbalance and that meant the whole situation wasn't my fault. It made me feel more like I was sick than I was insane. And this made me feel good because hey, I might be slightly mentally ill but I'm not crazy.

I guess this is one of the reasons why, 
if I ever do need to talk about medication,  I never talk about antidepressants; I always talk about 'brain medicine'. It makes me feel more like a rational person undergoing a necessary course of treatment, and less like a bratty spoiled housewife who just can't handle that not everything in her life is absolutely perfect, booooooo hooooooooo. Because obviously, the bratty spoiled housewife on Prozac is enough of a cultural trope that I still despise her even when I am her. Or am not her. I'd like to believe I'm not her.

you know, like the human equivalent of this. 

Is she one of the reasons why some people find it so hard to ask for treatment?
And by some people, of course, I mean me. Which is worse? Being Depression Girl, who can barely lift up her head to say hello and cries alone in the bathroom? Or being Antidepressant Girl, who can't handle reality and has failed so badly at  managing her life that she has to take drugs to feel happy? I didn't want to be either of those people. It's like when I offer my children a choice between two options, hoping that will trick them into thinking they have some agency in their lives, and they give me the angry face that means I don't want to use the red toothbrush OR the green toothbrush! I don't want to brush my teeth at all, idiot! That's how I was feeling. I don't want to be Depressed Person, or Antidepressant Person. I don't want to be here at all, idiot.

Yet I have eventually come to realise
that I really shouldn't be ashamed of depression. Depression is not a character flaw. It's just a thing that happens.

However, I have also had to face the fact
that depression revealed a whole lot of very real character flaws that I already had. Depression made me sad, and that's okay, but sadness made me selfish and worse and that's not okay. This is where things get extremely messy for Christians, I think. I don't know very many Christians who are able to talk sensibly and sympathetically about how to deal with depression - how to manage the tricky relationship between what's going on in your head and what's going on in your heart. I know that Pre-Chemcial Claudia was becoming extremely, unsustainably self-centred. I was not able to do anything for anybody else, ever - I was so trapped inside my own head, it was all I could do to make it through the day. I could never help anyone, I could never be there for anyone, I could never encourage anyone. I was not growing any spiritual fruit. That wasn't helping anybody. Feeling bad about going to the doctor made it harder for me to live as a Christian, not easier, and I don't think that did anybody any favours.  But I can't really untangle the head issues, the heart issues and the chemistry issues in myself, so why should I expect other people to know what to say? Like I've already said, usually I just don't tell people. I think that makes things easier for everyone.

I did feel bad about going to the doctor.
Fortunately, on the Myers-Briggs personality typing, I'm a Thinker, not a Feeler. That doesn't mean I have no feelings (would that it were so!) but that when I make decisions, I value logic more than the other, squishier stuff. This can be a blessing or a curse but I this situation I think it was a blessing. I had always thought depression was feeling sad about nothing, but I was able to recognise a pattern  in myself, and realise: Claudia, you are reacting to genuine stressors but you are reacting to them too much. I drew a little mental graph with stress on the bottom and reaction on the top and realised that y= at least 2x, maybe 3x, and then after a certain point, where a normal person would still be fine, just zoomed straight off to infinity. This is not a graph belonging to a brain that is working properly, thought I. I needed that sort of empirical push to realise that something was properly wrong, that all these sad, hard days weren't just a string of coincidences.

That maybe makes it sound easy 
to decide to ask for help once I got all empirical about it, but it wasn't easy. I didn't know if I needed to. After all, it's not like there's an on/off switch for being depressed. It's a spectrum - of course it's a spectrum. We all have good days and bad days. I think it's genuinely difficult to know when you are struggling with something real and when you are just being a princess. Who knows where feeling down becomes a proper mood disorder? Who knows when to pull out the diagnostic criteria and start making notes?

No, it wasn't easy at all.
Maybe it depends on what kind of person; who you are. For me, I don't feel like my arms and my legs are really me. If they stopped working, it would be annoying, but it wouldn't make me question who I am. It didn't feel like that when I realised that I couldn't really trust my brain any more. The thought that I might need some kind of medical intervention to fix my brain was flat-out terrifying. If I can't trust my brain - what does that mean? Who is this 'me' that can't trust my brain? Aren't I my brain?

Was the depression me?
Or was the part of me that was fighting back the real me? I wish it was just the second, but really, I know it's both. We are both me -  the irrational sadness, and the struggle against the irrational sadness. Depression was an unwelcome guest in my head but its become something that I have to fold into how I view myself, and ultimately this makes me much more able to separate how I'm feeling (because I know that might not be reliable) from what I know to be true. While I was pretending it wasn't there - while I was pretending I was fine - the world looked like a pretty gloomy place. It seemed to me that I was the only one who had this terrible clarity, who knew how bad things really were, and that everyone else (everyone who wasn't miserable) was either lying or blind.

Really, I think it was a ton of fun to be married to me during that period.
Jay is a lucky, lucky guy.It was probably also a whole lot of fun being my kid. Although, to be honest, I think Jay got much more of a raw deal than they did, and that's why he gets to make the depression jokes now. I would use myself up on them all day and then cry on the sofa in the evenings and demand that he bring me wine.

Of course, speaking of my kids,
One of the things I worried about when asking for help was that it would destroy any chances we had of adopting in the future. It went like this: Oh, I feel so sad   -----> being this sad makes me such a terrible mother -----> nobody normal could be this bad of a mother ----->I think I must be depressed ----> if I admit to being depressed, they'll never let me adopt another child -----> no more children! That makes me feel sad! ---->oh, I feel so sad ----> being this sad makes me a terrible mother and so on ad nauseam; ad infinitum. I really worried that going to the doctor about my mood would mean that I was burning all my adoption bridges forever.

I'm someone who always lives with one eye on regret management:
I never want to do anything now that I might hate myself for later. (When I was a teenager, I never even got an interesting haircut because I didn't want to look silly in photos in decades to come. True story). So the thought of cutting out our chances for another child in the future because I was struggling in the present was almost unbearable. (In the UK, this is definitely a real concern).But in the end, I realised that it was more important to prioritise what I needed now above some vague possible future risk. (I'm sure this was always obvious to everybody but me, but it wasn't obvious to me at all).

I mentioned this concern - cutting ourself out of future adoptions -to one of the doctors who gives me my repeat prescriptions every month or so.  I got halfway through the sentence about this and she cut me off - not rudely, just emphatically - and said if that happens, you send your social worker STRAIGHT to see me. And I haven't really worried about it since. Incidentally, I usually dress up to go to the doctor for my prescriptions. I feel like it's important to look smokin' hot and in control. I want to make it clear that they might be writing me a prescription for this stuff but I am a fabulous person, an in-control person, to whom this strange thing, this depression, has happened -  not the other sort of depressed person -  you know, someone who is really that way, fundamentally that way. (See? Stigma. Even from me).

I do understand, by the way,
why social services wouldn't choose to to place a vulnerable child with someone who was actively depressed. I'm going to stretch an already overused image here and say that emotional and mental health is like oxygen. You know how in plane crashes, you need to put on your own oxygen mask before you help a child to put on theirs? If a parent is having significant struggles with their own mood, they are not in a good position to do good parenting, especially if they are trying to parent a new child with attachment challenges. I understand that. But for me, being on the medication I'm on is like wearing my oxygen mask. It means I'm okay - really - and as capable as ever at helping my children to grow and develop. I need to remember to take some medicine in the morning, but apart from that, my life looks pretty much like anybody else's.

Of course, I guess that having been in this situation once
means that I am greater risk of depression again. Statistically, this is true, and who knows - it might be worse next time, which would stink all around. I get that some social workers would think this makes our family a bad bet for another child.  They need to deal in risks and probablies because nobody ever really knows what will happen in the future, and I understand that.

Maybe they are right, I don't know.
But what I certainly know, after this last year or so, is that this stuff can happen to anybody at any time. Nobody is at zero risk of finding themselves down the bottom of the mental illness pit, clawing frantically at the sides and thinking how did this happen to ME? And in that situation, I had the choice of admitting something was wrong and asking for help or toughing it out. On paper, the version of me that toughed it out and never got medicated looks like a better potential adoptive parent because I would have no history of depression. But personally, I think that walking in to the doctor's surgery and asking for brain medicine is the bravest and smartest thing I've ever done (and that's saying something, because I have done a LOT of brave and smart things in my life. Joking, people, joking. See, depression is hilarious). Anyway, I would rather place a child with the version of me who asked for help - and is now coping pretty much fine - than the version of me that needed the same help but never got over herself enough to actually ask for it.

But of course, I may be biased.

I suspect most of you would agree with me, though. Logically, I think it's an impenetrable argument. But getting the stamp of a diagnosis still has a lot of stigma, and on days when I'm not feeling very robust I worry what would happen if people at work / church / the rest of my life all knew. Most of them would be fine but I know that some people's view of me would change; I know that because they've told me about other people with mental health struggles, with much clucking of tongues and shaking of heads. Of course, at that point, I know that I should say 'hey! That's me you're talking about there, too!' but mostly I'm not smart or brave enough to do that. I did it once and it did not go well; I watched my stock with that person crash to the floor before my eyes. I pretty much got whiplash as they reversed their opinion of me. I know that I shouldn't care about the opinion of a person who is that prejudiced, but I think that part of being human means I do care, even if I wish I didn't. I understand that lots of people don't understand that depression is a real and involuntary thing. I know that is true, and I'm okay with it. I mean, I'm not okay with it but I've made a strategic decision that my life is complicated enough - you know, just living it - without getting too uptight about stuff I can't change. (And if that's not a mentally healthy attitude, I don't know what is! Where's my third kid, social services???) Anyway - back to keeping my mouth shut.

Also: I feel sensitive 
about having said 'on days when I'm not feeling very robust'. It feels to me sometimes like I have two choices - give into this thing and be depressed or BEAT IT. You know, beat it with a big stick; give it no purchase in my life. I want to do that second thing but that's not how life works. It feels to me like if I'm going to be more than this I'm not allowed to have a bad day ever again, but that's stupid. We all have bad days. I still have bad days, sad days, mad days, days like we all do. In the olden days, I used to have a bad day and think 'Nuts! I'm having such a bad day! This stinks!' but it didn't bother me in any kind of existential way. Now, I find myself thinking 'I'm having such a bad day! Oh no, the depression is coming back. I need another 10 mg of brain medicine. How can I need more medicine? This is a disaster. Soon I'm going to hit the normal dosage ceiling. I'll have to get special approval to get more medicine. Then they'll say no and I won't cope and soon Jay won't be able to bear the sight of me and he'll kick me out of our house and keep the children and I'll be homeless and wandering along the highway alone, picking up trash and eating it'.  A bad day seems like a portent of disaster, like the end of the world. Which is funny because seeing it as a portent actually is a bad sign - hello, totally unamusing irony. This is the kind of situation where I'm learning to pay attention to my own stupid internal narrative and say: enough. No more catastrophising. It's really helpful, and the ability to actually do it is a huge difference between Chemical Claudia and Pre-Chemical Claudia.

We all have bad days. Honestly, I have no idea how bad your bad days are. I would hate it to seem like I somehow think that everyone who cries too much should go and get medicated, that I deserve some kind of medal. I'm not saying that. I'm really glad that I did it because I know I needed it, and all that was holding me back was stupidity. Your mileage may vary. Believe me when I say I know how lucky I was, too. Not everybody responds quickly (or at all) to medicine and I've never experienced that - it must be truly scary and I'm really sorry if anything I've written here makes anybody in that situation feel worse. I know how lucky I was and I don't take it for granted. And of course, I'm not stupid enough to recommend pumping your body full of chemicals unless you really do need it. (Unless they are cheese chemicals, of course, in which case BRING IT ON).

And now I'm at this point, a year on,
I don't think I'm ever going to be 'cured'. I don't think this is ever going to go away completely. Even when I'm fine (and honestly, I feel fine) I will probably always be looking over my shoulder a little bit, more aware of my moods, more aware of what might happen in my mind than I ever used to be.  It would be nice to be wrong, but If I'm waiting to suddenly feel cured, my question is always 'when is this going to go away?' Whereas I think a much better question is 'okay then, how can I best live with this? If it goes away while I'm busy doing other things, that's great - you know, like they always say to single girls about finding a boyfriend. It'll happen when you aren't looking for it! (Which I'm pretty sure is a lie).

So
This means learning to live with it without letting it own me. I'd be lying if I said that was always easy, but it's an awful lot easier than it was a year ago when I was trying to pretend it didn't exist.

I think that's enough about that. 
Like I said - contrary to how this may appear, I don't really like talking about this very much. And anyway - this princess has to go and polish her tiara.

36 comments:

  1. Oh dear, how is it that I'm the first commenter here? So much pressure...Well, all I can say is that you reassure me and scare me and stop me dead in my tracks all at once. I can't process this post right now because it's hitting too many buttons. But know that I thank you, for laying these feelings and experiences bare, for sharing this with such generosity and clear-sightedness, for demystifying and normalizing what remains so doggedly touchy and thorny and taboo in the public sphere. Even among friends and loved ones. I am keeping this post up for now so I can revisit it over the next few days. In the meantime, would you consider packing yourself up and popping over to NYC so we can get manicures and split a bottle of wine and trade stories about brain chemistry? My treat.

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    1. Ummmm... YES PLEASE!!! Especially if you are also paying for the plane ticket :)

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  2. As you know, I read a blog post written by an AP suffering with PAD more than two years ago and after screaming at my monitor that she must, must, must get medicated, I called my doctor because I realized she wasn't the only one. Since that time I have encouraged many others to at least consider better living through chemistry.
    I always assume they will be honest with their doctor, and their doctor will know what she/he is doing. And the two together will decide if it is the proper course. Regardless of the outcome of that particular appointment, the first step, considering having that conversation, might also be the first step to being a better parent, wife, daughter, lawyer, boss, employee, whatever...
    I am glad you wrote this post. I hope if there is someone else out there who needs to consider getting this type of help, that your post pushes them in that direction.

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    1. You know just how important you were in helping me to make that decision. Even if you come over here one day and trash my house or steal my husband, I will still always love you, because of that.

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    2. ps please don't steal my husband.

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  3. You are so brave - for drawing that graph (I love how you turn to diagrams!) and then for marching into your Dr's office to ask for a hand. So thankful for great writers who reach way in and then pour it all out. Your story will help another struggling soul, I'm sure of it.

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  4. So many times reading this I felt like saying "YES" "that's it".
    So nice to read in words so much of what I feel and live each day.

    Says me who is having a not very robust day. :)

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    1. And it's taken me so long to reply because I then had a slew of them. They really suck, don't they? I really wish we could beat this thing with a stick!

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  5. Thank you for this. One of my most panicky feelings is when my husband skips a few days of his brain medicine, and starts sitting grimly in his chair. It makes me feel so sad and hopeless to not be able to help him, because it's NOT that he's just "down" or having a bad day. Those I can help with. But depression is immune to affection, chicken soup, pep talks, and nature walks.

    After that happened a few times, we had a talk in which the phrase "Sometimes I don't feel like I deserve to take the medicine" was said. Ever since I have made it my act of love to keep the presciption filled and the pills in the 7 day container, and to monitor the damn container to be sure he doesn't succumb to that feeling. It's worked for over six months now.

    We were really nervous about his depression when adopting, as was our agency. They asked us to get our medical paperwork submitted BEFORE we did our dossier. Basically they wanted us to get pre-approved by the country of our choice rather than waste our time if they wouldn't allow us to adopt. We went to an adoption specialist for our checkups, and she found a way to be honest but vague about his prescriptions. She was completely on board with the idea that a person being TREATED for depression is way more fit to parent than a person undiagnosed and/or untreated. Very strange that people could see it differently, really.

    I have to say though, in the past 15 years it seems that a sizable percentage of friends, family, and even coworkers are openly taking brain medicine for depression and other issues. I feel like it is coming out of the closet. Maybe it's a regional thing? My husband, however, is super private about it, so please don't tell him I just told the entire internet about it.

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    1. Wendy, I can't think of a bigger act of love than that. No bigger love at all.

      I think your last para is probably right - I think the UK is a decade or so behind on this, so I'm hoping that we'll see more of those changes soon!

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  6. This was so so good. Thanks for always sharing from your heart.

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  7. Dearest Claudia
    I think that this may be my first comment on this blog. You write so beautifully. As a Depression sufferer I get it. Completely. The shame. The embarrassment. The ugliness of it all. That black hole is just something that I would NOT wish on my worst enemy. I take brain medicine, I try to exercise regularly and watch my diet and I have gone for therapy. Interestingly enough, the Christians in my life have judged me the most and supported me the least. I've learned to ignore them because really, at the end of the day many of them are just ignorant. Can't exactly blame them for that. I think it's damn hard work to be married to someone who accepts that this is who I am. Heaven knows, it has taken YEARS for me to get to a point of acceptance. I am finally OK with it. I talk to whoever wants to know about it. And I do NOT forget for one minute that I am wonderfully and fearfully made.
    Thank you for writing this.

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    1. Wonderfully and fearfully made - exactly. I think that one thing this has given me is a chance to really come to grips with that - what it means to be made in God's image, even as flawed as I am. So true.

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  8. Effexor saved my life. I don't care if I have to be medicated until I die. It's so much better than the alternative.

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  9. This is so awesome. I love the point you brought up about how depression can make you self-centered, and just not have much to give -- HUGE realization for me. I think that really encapsulates why I needed to start meds myself (especially being a mom now). I definitely think you going on meds was a big inspiration to me, made me a lot less freaked out to take the plunge myself.

    By the way, I currently have a prescription for liquid Zoloft -- it cracks me up. I got it because swallowing pills was making me puke due to my pregnancy. You have to mix this giant syringe-ful into a drink. I usually do juice, but I keep thinking how funny it would be to mix it with so many things... mommy's happy milkshake, etc.

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    1. Oh yeah... surely you could mix that stuff into a gin and tonic?

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    2. Uhhhh... yeah. Maybe not with the baby. Ooops.

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  10. There are so many things I could say here. I love your transparency. And I'm grateful to you. A while back I messaged you about a close relative who suffers with depression. This gave such perspective.

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  11. Thank you very much for sharing this.

    I don't suffer from depression, but for the last few years I've begun to suspect that my husband does, at least intermittently, and I've been contemplating what I can do to help him with this. (I also suspect that he will never make an appointment to see someone about possible meds, and thus this will be up to me). A lot of what you say here has helped reinforced my thoughts on this matter.

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    1. I think men often have a harder time with this than women - especially the feeling of weakness (which stinks no matter who you are, but is probably worse for men). I think that having a wife who understands and is looking out for him is a huge, huge, huge head start whatever he needs. You and Wendy could compare notes :)

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    2. Ugh, no idea why I smileyed that. Ignore!

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  12. Wow, what a brave post. Seriously. We've had moments over the past few years where I thought I should probably see the doctor, but didn't as I feared jeapordizing our adoption. Which always struck me as weird, as for years I took meds to regulate my heart rhythm and no one really cared about that. Unfair and unfortunate, and I hope that posts like this dispel some myths about those taking brain medicine.

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    1. You will come here every day? AWESOME! I am so glad you like my website. You are very welcome for my share to you.

      Also, how did you *know* I wanted sexy lingerie wholesale underwear wholesale? Have you been reading my DIARY? Get out of my HEAD!

      And costume Christmas? No way! Make it stop, it's too much awesome! I'm clicking right now!

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  14. Just wanted to say that I have all the same issues you do with being willing to support and not-judge anyone who needs meds to regulate a depression or anxiety issue, but not me! Oh no, it's OK for *others * to have this but not me. I wont' want to be the "weak" one. I have depression running rampant with the women in my family, and my husband has said he is on "depression watch" and I've always been offended by it. But I need to realize it could happen and I cannot let it tear me down to a point where I am no longer a decent mother. Right now, I feel good. I am taking steps to make sure I take care of me, and I need to let go of my issues... Good on ya girl.

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    1. Yep... that's what I mean by humiliating!

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  15. I nodded so much reading this, my neck is sore. Your blog sustained me during the dark, pointy times when every day felt like I was living in North Korea. I used to read it in the course of breaks during long solitary walks with our much longed for, much wanted boy, who is of course golden. But I still felt like I was living on another planet. Drugs got me right. For me, I have taken the approach to be upfront, to tell people. But it's had its fall out. Difficult to enumerate - but start with the loss of my best friend? Thank you for your candour. As I've said, it sustained me. Rock on darlin. Go for your third child too; you're well up for it

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    1. I don't know what to say, Elliej. Thank you.

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Over to you!