More on meds and breastfeeding

Well, I've been e-mailing with a woman who wasn't at all happy with me after reading my previous blog on anti-depressants and breastfeeding. (She gave me permission to write about our communication on this blog.) She shared with me her experience of suffering from bipolar disorder and being on medication for it since she was a teen. When she and her husband were trying to get pregnant, she went off her meds. But by the end of her first trimester, she was having an absolutely horrible time so her doctor advised her to go back on her medication. She did so and went on to have a symptom-free, wonderful full-term pregnancy. Her baby is now nearly six months old and she's breastfeeding her baby and doing just fine. She feels very good about her decision to remain on medication and knows that she needed to do this in order to function and to be able to take care of her baby. She said she felt like she needed to defend her decision after reading my last post and make it clear that other moms shouldn't feel guilty about the decisions they make.

I absolutely agree with her. I applaud her for handling her illness so incredibly well and being so strong to know her options and then to choose the best one for her and her baby. Taking charge of our own health care is what each of us needs to do. The big stumbling block here, that I was trying to express in my previous post, is knowing our options. Often we're given information by the medical community (via pharmaceutical companies), without realizing we have other options. Or we're given just part of the information, or worse, complete misinformation.

I do feel fortunate that I didn't need to take an anti-depressant while I was pregnant, so I never faced that excruciating choice. I do know plenty of other moms who have and who felt like they wouldn't have made it through their pregnancies without medication. I totally respect and support their decision. I remain skeptical, however, about the safety of taking anti-depressants while pregnant or breastfeeding and think we need to demand more and better testing on these drugs. We shouldn't have to settle for an anti-depressant that is shown to cause birth defects, even if it is only a small percentage. We shouldn't have to settle period, but as women, that's historically what we've had to do when it comes to our health care.

I'm starting to ramble, but I guess what I really want to express here is that I think it's always good to discuss how we all need to respect each other's differences in opinion and different choices. Motherhood is tough enough as it is, but it's certainly way tougher if we don't pull together and support each other.

Just like the mom I've been e-mailing with felt attacked by my statement in my previous post that it's common sense to avoid anti-depressants during pregnancy and breastfeeding, I went through a similar experience when I made my decision not to breastfeed my fourth baby. I had really thought it out and made this decision because I knew it would be in my and my baby's (and my other children's) best interest for me to avoid postpartum depression so that I could be a functioning mother. For me, that meant not breastfeeding so that my hormones would become normalized faster and so that I could immediately go on an anti-depressant and not worry about it being in my breastmilk. It was a good decision for me, but I had a heck of a time expressing that to the nurses on the maternity wing of the hospital where I delivered. Although they didn't come right out and say it, they practically accused me of being a bad mom.

Twice a lactation consultant was sent to my hospital room to try to encourage me to breastfeed. I was given all kinds of "breast is best" cues and whenever I asked for formula for my hungry baby, it took forever for it to be delivered to my room. It was all I could do not to feel guilty for my decision, when I knew deep down, below the crashing hormones, exhaustion and pain from the C-section, that I had made the best decision for me.

These decisions are never easy, are they??

What happens when you don't get help

For the last week my mom has been in a locked-down psychiatric ward located in a major hospital. I was stunned when I got the news because long ago I completely gave up on the possibility that she would seek or receive help. At 66, my mom has lived with bipolar disorder, perhaps OCD and other mental issues for her entire life. However, she has never been diagnosed. Somehow, by some miracle, she has managed to compensate, traveling through life while sliding up and down her manic roller coaster.

Now, she is emaciated, down in the darkest depths of a crash, and unable to function. She must weigh about 90 pounds. Tears stream down her face and neck. Her sentences are loose, jagged. She says she's confused. She has officially been diagnosed with bipolar disorder (at last!), paranoia and a "shade" of schizophrenia. She is on 5 different medications.

When I spoke to her psychiatrist for the first time this week, I found my voice. It rumbled up from a terrified little girl who walked on egg shells and hid in her bedroom. Give me the podium please. Finally, I am heard! The psychiatrist very patiently listened as I recounted bits and pieces of my life as my mom's daughter. My stories confirmed her diagnosis.

On the one hand, I'm so relieved that my mom is getting help. On the other, I'm beyond frustrated that it took till she was 66 years old to get there. I'm told it's never too late, but after all the sick programming that her brain has undergone, I just don't know. I guess I can only hope. All I ever wanted as a child was a healthy, stable mom.

Growing up, I thought my mom was "crazy." I couldn't understand why people didn't see the person she really was. In retrospect, I can see how well she hid her mental illness behind a wall of denial, taking great pains to reveal it only to my brother and to me. My dad would come home from work each day and suddenly Mom morphed into the perfect mother and wife. When my brother was killed in a car accident at the age of 15, a part of me was actually envious of him -- he got out. I wanted so badly to follow him. Instead, just months after his death, I went away to the college on my acceptance list that was geographically the farthest away from home. I still have a hard time going back to my home town, even at the age of 41, because images of the abuse from my childhood come rushing back.

My mom may have had PPD as well, although I really don't know. What I do know is that she was a mom with a severe mental illness who never got help. I'm sure there are women who suffer from PPD and other mental disorders who never recover for whatever reason. It's their kids who end up suffering -- they're the ones left to pick up the pieces.