There’s this scene from the movie Melancholia where chronically-depressed character Justine (Kiersten Dunst) tries to sit down to a nice dinner with her sister’s family. She’s as optimistic as she can manage, given that she’s been in bed depressed, unable to bathe or function. She smilingly takes a bite and begins chewing, but her face changes almost immediately. Her brow furrows, her chewing slows, and she spits out the food. She starts to cry and blubbers, it tastes like ashes, just before bursting into sobs. Ultimately, she goes back to bed.
Anyone who has battled depression is likely to find this scene particularly resonant. As much as depression is associated with hopelessness, it is equally marked by helplessness. Nobody wants to feel that way. Sure, some people seem less willing than others to take steps to counter depression. But most people do everything in their power to not be pulled into a depressive episode, even if that means structuring their entire existence around coping mechanisms and avoidance tactics.
The past several months have overflowed with travel, socializing, gestating, and summertime. They have also been, at times, fraught with difficulty as I have kicked furiously to keep my head above depression’s black waters, struggling to balance a seemingly endless list of social and professional expectations with a need for time alone.
A few months ago, my doctor reluctantly approved my decision to stop taking the antidepressant drugs I’d been on for about a year. I was concerned that the primary drug wasn’t all that effective anyway, and I saw no reason to add to the list of ways I might be screwing up my unborn child. My doctor was worried and had even talked me out of going off this drug once before I was pregnant, as we descended into winter and he feared for my mental state and safety.
But he is my primary physician and not my OB, and the prenatal physicians are really the captains of a pregnant woman’s ship. It’s an unfortunate reality, one that I hadn’t fully understood until I was in the throes of it. As a pregnant woman, you lose a tremendous amount of agency and independence in almost every arena, and it especially pronounced in healthcare. The pregnancy and the baby’s health are primary. Your job is to survive gestation, and you can deal with all your own issues after delivery.
My doctor stared into my face and measured his words as we shook hands, knowing I wouldn’t be back to see him until well after I’d given birth several months later. Please, if you notice significant changes in your mood, step the dose back up. And call my office if you need refills. Take care of yourself.
Most everyone has heard of postpartum depression. Fewer have heard of antenatal depression, or the depression that pregnant women experience prior to giving birth. For years, people thought that being pregnant protected women against depression, that somehow the surge of hormones and the all-encompassing joy of becoming a mother should inoculate us. It doesn’t.
We are less than four weeks out from my estimated delivery date. A few weeks ago, I stopped sleeping as well as I had been, and my mood nose dived. Until then, I had successfully kept a decent, if rigid, routine throughout most of my pregnancy. I went to bed very early some nights because I was so tired, and I knew that if I wanted to get enough sleep to keep my mood stable, I needed to stretch the time allotted to being in bed. While necessary, this is a decidedly anti-social practice.
Hey, friend! Do you want to join me to eat a free delicious Japanese meal prepared by dogs wearing chef hats and then have fairies spoon feed you ice cream dessert while baby goats in pajamas perform an after-dinner show? NOPE! GOTTA GET HOME SO I CAN GO TO BED FOR FIFTEEN HOURS!
This is a funny thing about mood disorders and dysfunction, one of many funny and slightly counter-intuitive components of dealing with something like this: in order to be functional enough to live your life, often you have to engage in behaviors that are inherently isolating, which can amplify depression, thus rendering you less functional. But if I want a shot at keeping my mood even and level, I have to be hyper-aware of my sleep patterns above all else.
It also helps to be meticulous about the food I put in my body, though I fell off that wagon face first a few years ago and have not yet been able to successfully climb back on. Instead of using food intelligently as a source of nourishment and a way to balance my precarious system, I use it as a drug. I inhale four serving sizes of ice cream, buy myself two meals worth of sushi and eat it all in one sitting, tear through a whole bag of chips, eat three quarters of a jar of pickles. Then I coat myself in crumbs of self-loathing and fry myself in a vat of contempt.
Sometimes, I go for long stretches of time without eating because I get caught up working on something, or because my food tastes like ashes. There have been times during this pregnancy when gestational and depressive food aversions have culminated in me eating sleeve after sleeve of crackers just to have food in my system. Or sometimes I choke down a banana, or nibble on morsels of whatever I can manage, and force myself to gulp a lot of water and a vitamin to offset my terrible eating habits. I’m angling for Expectant Mother of the Year.
In short, my relationship with food could use some work.
Life has changed quickly and dramatically, we have been extremely busy, and I have struggled with a host of physical health problems in addition to the usual pregnancy woes. There is so strikingly little autonomy in pregnancy, it is somewhat surprising to me that more women do not suffer from antenatal depression. Maybe they do and we just don’t talk about it.
I have this friend who I’ve known since we were teenagers, and she gave birth recently. When I went to see her and meet her creation, she asked pragmatically and frankly if I had heard of So-and-So, an excellent postpartum mental health provider who specializes in helping women and families navigate welcoming a new baby. I had not heard of So-and-So. You should probably set up an appointment now, so you can see her immediately, my friend said, taking a bite of pizza while her one-month-old slept soundly strapped to her chest.
I forget how easy it can be to discuss mental health candidly, especially with people who have dealt with dysfunction. My baseline is to paint it with a thick varnish of humor and self-deprecation because it’s the only way I know to soften the blow of my sometimes heavy reality for those around me.
It is exponentially more difficult for a pregnant woman to talk about mental health, lest she be perceived as ungrateful for this incredible blessing. I know several women who are at various pregnant and postpartum stages right now, and I have spent the past several months quietly talking with them about the complexity of not really enjoying pregnancy, facing heavy antenatal feelings, and bearing a boatload of guilt because of it.
A few weeks ago, I managed to put on clothes and go to the chiropractor’s office, despite feeling like curling up in the fireplace and never leaving the house again. I wasn’t sure how many days it had been since I had washed my hair, or showered at all, because it had been a stretch of days and weeks like that: no physical or emotional energy for frivolous activities like personal hygiene. I ran into a new-ish acquaintance and we hugged and it was terrible. Sometimes when you’re depressed, physical touch is a great way to feel a bit better about life. Other times, the sensation of someone’s touch makes your skin feel like it is going to melt off your frame.*
And, sometimes, you smile and say, I’m good! How are you?! because you have to because it’s just easier than responding to, How are you? with, Pretty terrible, for no justifiable reason since my life is pretty charmed at this point, but I can’t seem to find the energy to bathe myself and I think it might’ve been a mistake going off my meds, although they really weren’t helping all that much, mostly I was just angry, and I feel really guilty for not walking the dog as often as I should, and I’m worried I’m going to be a terrible mother, plus I miss my own mom A LOT and I’m completely incapacitated with indecision about everything in my life, and I feel like I’m barely getting by professionally, and I kind of just want to crawl into my deep freeze and take a really long nap, and I can’t believe we haven’t frozen any meals yet in preparation for the baby, and we got weird news but they told us not to worry and I’m trying not to, but did you know that some people recite poems to their babies in the womb and I’m pretty sure the only thing my fetus is learning is how to cuss in context, and I can smell my own hair because seriously something about the thought of a shower feels like a thousand tiny razor blades on my skin even though it actually feels quite nice, but then I have to decide what to do about my hair because it can’t be trusted, and I wish I could cry but that seems to only be possible at inopportune moments, and I’m scared about my brain and how dysfunctional it is, and seriously I miss my mom.
Not only is it easier, but also, the emotional energy it takes to talk about all the things the drain your emotional energy? I see a therapist regularly, and there are some days when it seems like more than I can manage to open my mouth and speak words to her. It’s easier, and sometimes necessary, to just laugh and smile and let interactions be what they are.
The past couple of weeks have been slightly better as my sleep has improved, but it gives me pause about the arrival of a new baby and the inevitable sleep deprivation we are likely to experience. Then again, I have exhibited a weird, zen-like quality in the face of trauma in the past. I’m good in the storm. It’s once it’s passed that I fall apart.
Some of the best advice I have gotten this pregnancy came from a friend who never intends to procreate. Her mother gave her some glorious German input about new babies, and she passed it on to me. You may not fall in love with your offspring right away. They tell you that the moment they put the baby on your chest, you fill up and explode with love and the heavens open and Mother Mary’s maternal magnificence rains down from the sky and bathes you and your new bundle in light and goodness and everything is right with the world. Except… maybe not. My friend’s mother told her (about her, which makes the message extra meaningful) that it took a solid two weeks to fall in love with her new baby. Once she did, there was no turning back, but it was not immediate and it was not otherworldly. It was practical and slow and deliberate.
It is hard to know what my process will be like. I’m already in love with this baby, but in the same way that I was in love with my pet rats and my dog and every other animal with which I’ve ever forged a relationship. He’s only real in that very surreal way… he is a creature that lives in my body whose behaviors I can observe and with whom I can interact in that way. But I don’t know him yet.
I’m hoping that when I get to know him, he’s a pretty likable little fellow, or at least cute enough to offset it if he’s not.
*For me, there are exceptions to this. But that circle is small.