Let's dive in at the beginning of the chapter.
In one of Steve's monthly home school in articles for dads ( www.titus 2.com; July 2000), he mentioned that my bouts of depression were part of the reason we decided, at one point, to limit our family size. We were amazed at how many people emailed us, after that one sentence in his article, to ask how we dealt with the problem of depression. (pg. 95)
Wow. I've discussed tangentially my concerns about mental health issues in CP/QF families before - but the fact that the Maxwells' had a wave of emails in response to a single sentence mention of Teri's struggle with depression is sobering. In the wider US society, there is still lingering stigma about mental health issues - although lessened for the "acceptable" illnesses of depression and anxiety. By comparison to CP/QF society, the rest of the US lives in a wonderland - a land where medical and psychological remedies exist to lessen the burden of mental illness. In CP/QF land, all of the asinine assumptions about mental illness exist along with a heap of guilt because if a person REALLY loved God, they wouldn't have mental illness. (If my options for reasons I have a mental illness is a) not enough faith or b) demonic possession, I think I'd pick the demonic possession. The fact I'm not entirely to blame for the demon picking on me could be comforting.)
It is only been this 8 years since the Lord has given me freedom from the at times devastating depression from which I had struggled. It was usually worse during the year I nursed a baby. My pain through those difficult years was very real and is not that distant. I can fully understand the concerned feelings of a mom who is struggling with times of depression and the worry of her husband, because that was my experience too. (pg 95-96)
That's a classic description of postpartum depression; it begins within the year after a child is born and can be worsened by the hormonal changes that accompany lactation. During the years (late 1970's through the late 1990's) that Teri Maxwell was having children, doctors tended to take an overly hard line against the use of anti-depressants during pregnancy and lactation. Now, doctors have realized that use of most SSRIs during pregnancy has no increased risk of birth defects in the infants while decreased depression symptoms lead to better pregnancy outcomes since the mother is more likely to seek prenatal care and take better care of herself during pregnancy. In a similar vein, doctors have found that the amount of most SSRIs found in breast milk is nearly none.
Personally, I remained on an SSRI during my pregnancy with my son and increased the dose slightly after he was born prematurely. I checked with the neonatal staff and they said that there are very few drugs that are incompatible with breastfeeding - and most of those are contraindicated during pregnancy so I had no reason to worry.
Postpartum depression has been shown to be very treatable through psychological therapy methods as well. I see a therapist and was extremely grateful for her support during my son's early days.
We discovered that there were very real hormonal imbalances that affected my emotions. I would do everything I could to deny this, but it was obvious to everyone except me. What I could normally handle one day would send me to tears another day. To combat this physical imbalance, I used a natural progesterone cream for a time. In addition, I followed a vitamin regimen suggested by our naturopathic doctor friend. I eliminated caffeine as well. (pg. 97)
Here's my PSA for the week: do NOT use cosmetic creams that contain progesterone - EVER.
There is a terrifying loophole I learned about while doing background research for this post: as long as a skin preparation is for "cosmetic" purposes, the FDA cannot screen it as it would a skin preparation for "medical purposes". This means that a cream may contain less progesterone than is advertised - or more.
Progesterone passes through the skin with relative ease; it has a non-polar structure that is soluble in the lipids that make up the skin. CP/QF folk already argue that hormonal birth control is evil - and horrible for women's health. Well, while I was pumping for my son I was on Nora-Be as a birth control method. It contains a daily oral dose of 0.35 mg of progestin. For the life of me, I can't remember if Nora-Be was a 21 active day or 28 active day pill - but I received either 7.35 mg or 9.8 mg of progestin per cycle. Many of the skin creams advertise that they contain 445 mg of progesterone in 2 oz. Assuming 25% of the progesterone in the cream makes it into the blood stream (which is very conservative), a woman would need to make that 2 oz of cream last for 12 months to keep her hormonal exposure under the amount in a mini-pill like Nora-Be.
If you think you have a hormonal imbalance that needs to be treated, you need to be seeing an MD, DO, PA, or FNP on a regular basis.
Thankfully, she does have some recommendations that are sane:
Daily exercise was critical at this time. I know daily exercise sounds impossible to an already depressed, overwhelmed, terribly tired mom. My walks were about the only time I was away from home. When I began to feel myself spiraling down, getting out would be the single thing that would change the course of my emotions. Just being away from the environment I was struggling with for a short period each day, plus the effect of the exercise itself, was very helpful (pg. 97-98)
Exercise is huge for my personal sanity. When Spawn first came home from the NICU, he was a mellow baby who had complicated medical needs. Going for a walk every day kept me sane. I needed some time out of the house where I could be away from listening for alarms while scheduling appointments, doing physical therapy with him or caring for him or his equipment. That mental break boosted the stress-relieving and mood-lightening effects that exercise has for me - plus being outside is very calming for me.
What I was more struck by is how much Teri Maxwell struggled with the entire concept of a SAHM who home schooled to boot. She doesn't describe struggling with herself nearly as often as she describes struggling with the environment or feelings produced by her environment - and that's a sad commentary on what life must have been like for her.
Being tired was sure to put me off balance. I am a light sleeper, often being awakened in the night by a noise or perhaps the need to nurse a baby. After that, I wouldn't be able to go back to sleep. For 8 years now, I have worn earplugs when I sleep. They have transformed my nights! I thought not being able to sleep was just part of my physical makeup. Not so! Since I began wearing earplugs, I hardly ever have a sleepless night. Steve became the "ears" for our family. I know he will wake me up if the children need me.(Earplugs may not be an option for a mom whose husband can't do this.) (pg. 98)
I have been wearing earplugs for around 15 years now and I sleep much better with them. Some people are simply wired to respond strongly to noises in the night. Having earplugs in mutes out a lot of the repetitive noises in the night like the furnace kicking on or the random sounds of cars driving by at night while still letting high pitched noises like fire alarms and human voices make it through.
At the risk of being overly nit-picky, her youngest child was 4 or 5 when this book was written. Little Mary was more than capable of waking her mom up by shaking her shoulder if she needed her to wake up. Likewise, if my son is really upset at night - like starts to cry loudly instead of sleep whimpers - I can hear him through my earplugs.
I have another revolutionary idea as well: Steve can deal with most -if not all - of the family's needs at night if he wakes up! Crazy!
I think if depression-prone moms could figure out a way to work on even a skeleton of a schedule, it would help. I have had moms write to me that when they are depressed, brain-dead, or just overwhelmed, their schedule directed them through the day. This was especially helpful because they couldn't make decisions themselves. If you have somewhat of a schedule in place, despite tiredness or feelings, many things would be accomplished because that is the easiest path to take - just do what the schedule says! Without my schedule on those bad days, I would have simply sat and cried. That would have made everything even worse because then I would have been a day behind! In addition, you can let your schedule direct your children when you don't have the energy to keep up with what you wish you would like to be doing. At least they are accomplishing things rather than just undoing everything. (pgs. 102-103)
Schedules have helped me when I was depressed - but I tend to have an internal schedule naturally when I am not depressed. Trying to institute a schedule while depressed or overwhelmed by external events may work - but it should be undertaken slowly and gently. Add one item a day like "Eat breakfast" or "Go for a walk". This is NOT a good time to purchase the Maxwell's "Managers of Their Home" system and try it for the first time.
I feel bad that Teri Maxwell cannot articulate how angry she felt being at home with her kids. Oh, she has a chapter devoted to anger - but she never fully owns that being a homeschooling SAHM drove her batty. Instead, it slips out in bits and smidgens like when she describes how her kids just destroy everything when left unscheduled.....
The last post in this series will be about some spiritual methods of combating depression that sound completely worthless to me. The next book to be reviewed will be her husband's book "Preparing Sons to Be Single-Income Earners" - in which you can help me try to figure out what kind of career path Steve Maxwell has had.....
And I would not use any creams which had reproductive-type hormones in them or that provoke them. Thank you Nature Lover Mel.
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