Two days ago I wrote about the onset of anxiety and panic attacks during my third trimester. I ended on a trip to the maternity emergency room where an OB, a social worker and a psychiatrist helped me make a plan to tackle the problem. This post is a list of the different aspects of my recovery strategy and how each is playing out.
I will also write a “part III” post about the odd sensation of life continuing even as I feel chaotic and paralysed (think Ikea trips, theological debates and family dinners all while living with anxiety).
My strategies for living with anxiety (in no particular order)
This was a tough pill to swallow (too easy, could not resist). Even as I talked to the doctors and saw their concerned looks at the frequency of my panic attacks, I tried to minimize the severity of what I was experiencing. I tried to convince them that, overall, I was managing. To hear the psychiatrist recommend medication, I was crestfallen, I felt like a failure, weak, a bad mom. Lies.
My OB gave me a kindly but stern talking to. She said, “You are on a downward slope, the further down you go the harder it will be for us to pull you back up. You say you are coping, that you are able to take care of your son. But are you able to take care of yourself? You are about to have a baby. We want you to feel strong, happy and ready when you deliver.” It turns out that coping is not a long-term solution, and that medication is going to help me get from crisis to regular life (even if our regular life never looks the same as it did, we will find a new regular).
I now have a take-as-needed medication that is completely safe during this stage of pregnancy. I like having control over when to take it, because it means I notice when I have good days without it. The downside is that I’m still learning to be aware of the indicators that I need to take it, so I still have days that spiral into crisis.
So far, I’ve identified the following warning signs: being physically tired, getting easily frustrated by small things (and blaming Nick for everything), relentless mom-guilt about every thing I do or don’t do with Charlie, counting down the hours until Nick has to leave for work/school, fearing my friends/community don’t really like me. On their own each of these things is manageable, maybe even justifiable on certain days, but a combination or obsession with one usually means I’m headed for a panic attack.
Full-time help and company
We hired a full-time nanny for a month and a half until my mom’s previously arranged trip to stay with us from mid-March until end of April. This was only possible because of the generosity of both my and Nick’s parents. It was my mom who first suggested I hire someone part-time to help me with the heavy chores, especially since I had already slipped on the stairs twice while schlepping laundry baskets, toddler and baby belly up and down three flights of stairs.
The social worker and the psychiatrist helped me identify “being alone at home” as one of my major stresses (due to feeling unable to cope with caring for Charlie and housekeeping, which I actually like to do, because of being hugely pregnant and tired). When I shared this with them, my parents immediately encouraged me to hire someone full-time until my mom arrives. Again, I resisted because I felt like it meant I was failing at my job – being a stay-at-home mom. I love my job and I hate not being able do it on my own right now. My mom told me to get over myself. She’s the best.
God had a special plan for who would be helping me. It just so happened that a friend from church needed a short-term job while she waited for her regular job’s paperwork to be processed (she’s an awesome high school teacher in real life). She gives me margins of rest, and energy to play with my son, by taking care of the house. And it’s great to have a friend around the house all day, to chat and laugh with and feel confident leaving Charlie with when I need to go out.
She has also been a huge blessing to Nick who had fallen completely behind on coursework and class prep while trying to support me emotionally AND do all the housework. Some nights he would get home from his teaching placement and have to take over Charlie’s bed time routine and then choose between consoling a crying wife or doing the pile of dishes/laundry that were making her cry. Let alone homework.
Large margins of rest and home time
I’m an uber-extrovert so it’s a tough balance to strike. I realized that trying to get out to do things and see people in the middle of winter, while in the waddling-ly pregnant stage, with no car, was making me physically tired beyond what I could cope with. But I also need to be social or else I wilt. Then there’s the fact that I have to save my energy for the necessary excursions to the doctor and such.
I’ve had to let go a little bit and accept that this season of pregnancy is always a quieter, home time. I’m trying to have people come to me when possible and to jump on opportunities to be social when others can help me with a ride or make it physically easier in some way. Sometimes I still overfill my calendar and have to cancel plans last minute, when I feel the bone-tiredness and weepiness in the near future. But when I keep the margins in place, and let Charlie and I have quiet days at home, I can feel the difference.
I’m being protective of our time with Nick too. He has a super busy schedule between his placement and evening classes and homework, so instead of trying to get things done when he IS home, I try to plan nothing! Life doesn’t always permit that but it’s surprising to find what really needs to get done and what is just so much busyness.
Also – ordering groceries online! When the weather was nice, grocery shopping was just another family outing. Charlie could walk home when we loaded the stroller up with our purchases. But in this weather, it’s such a blessing to have the groceries come to me! Sometimes it’s the little things that make a huge difference.
Naming the demon in therapy
After our emergency room visit, I was fast tracked to see the hospital’s maternal mental health specialist the next week. She will be following me up to six months after delivery because with the anxiety I am at a much higher risk for post-partum depression (still hopeful that the anxiety is mostly hormonal and all be well once baby girl arrives, but I’ve also got to accept that things might not go down that way).
During our first meeting the specialist helped me to understand my diagnosis (not a panic disorder, but anxiety with panic attacks, caused by hormonal fluctuations, situation or a combination – not sure yet which one). Sensing I’m an information junkie she gave me reading material about panic attacks and anxiety, which has helped ease the guilt-tripping and fear of what is happening. I feel armed by knowledge and by being able to name what I am feeling.
She prescribed psychotherapy and said it’s possible therapy could eventually replace the medication. She also told me not to rush into finding a therapist, because I was feeling overwhelmed by the number of doctor’s appointments I already had. She gave me “permission” to implement my recovery plan piece by piece and slowly.
She also pointed out that I kept using the phrase “need permission”, and I should think about why I felt that way and how it could be contributing to my anxiety. Well that’s easy. I’m a people-pleaser with a desperate need to be liked and valued by others. If I’m going to be unwell I want my family, close friends and random acquaintances to take a vote and decide it’s ok with them for me to have anxiety and panic attacks. So messed up. I think therapy is a good idea.
Focusing on what I love
The lovely social worker at the hospital is the one who steered me towards this coping strategy. It’s so obvious but so hard sometimes! An example of what she meant is our choice to hire a nanny instead of enrolling Charlie in daycare. Although I think daycares are great and Charlie might really enjoy it, I actually love being a stay-at-home mom and getting to take care of him during these little years. Daycare had come up as one of the options for taking stress off my plate and helping me get more rest. But it actually stressed me out more to think of finding a good daycare in a rush. It may be a good choice for us in the future, but as the social worker said to me, “focus on doing what you love”.
Another thing I love to do is cook, but I had almost stopped that altogether because I could barely manage keeping a few dishes clean, let alone planning meals and dealing with the pots and pans. Having our lovely nanny to help me means I’ve had the energy to plan and cook and bake. Everyone is happier when the house smells of apple crisp! Again, the little things matter.
Finally, I am focusing on that which is most important to me: God. In my spiral downward I had started to believe that my anxiety was somehow a result of not being a good enough Christian, or that God had given up on me and left me to my own pathetic devices. Hearing that what I was feeling was a mental health issue helped me snap out of those lies. Although I am unwell I am no less loved, no less saved, and no less capable of working out my faith. After my first post I got some really encouraging emails from women I admire as “giants of the faith”, who have also experienced anxiety and panic. I’ve turned my face back to my Creator, and the anxiety has not magically evaporated. I have not left the chaotic fray, but I can be in the midst of it with my soul armoured now.
I’m on a waiting list to see an affordable therapist, and will plan to see them even after my daughter is born. I am hopeful of going off my medication in the coming months. But as all these things fall into place, I’m trying the protect the precarious balance of normalcy we’ve struck and to give myself grace when I have a bad day, or a terrible day.
More on how regular life mixes with mental illness another day!