How to care for myself while I wait for meds to kick in?
September 20, 2020 4:20 PM   Subscribe

Difficulty rating: pregnant and grieving mom's suicide and other mom's slow death from cancer.

I've been on SSRIs for many years. I've experienced a couple of terrible episodes of depression when I've been off my SSRI, including one scary episode where I stopped eating as a way to die slowly, about seven years ago. I have a very significant family history of depression, including my mother completing suicide in March.

I'm well looked after by a therapist and family doctor who I trust to manage my psych meds. I also go to acupuncture even though I think it's a bit wooey, and I get a massage from time to time. I hike and swim a couple times a week for exercise. I have a supportive partner who is also a mental health nurse and is well attuned to signs of decompensation.

I've been doing quite well, mental-health-wise, for some years, and have only needed minor adjustments to my self-care plan and medications when I've noticed intrusive thoughts ramp up or mood start to get low, mostly in response to normal life stuff.

Back in June, I decided to try to conceive a baby. My doctor said I had been on SSRIs for long enough since my last episode that it would be a reasonable time to trial being off SSRIs. My aged reproductive system was mysteriously efficient at baby-having, and I was pregnant by July. I gave being unmedicated a shot between June and now, and it looks like it is a no-go. I am plagued by obsessional, intrusive thoughts, passive ideation about self-harm (no plan to act on it), fatigue, tearfulness, lability, and general misery. My doctor swiftly prescribed a new SSRI which is safer for pregnancy, and also advised that as the placenta takes over production of pregnancy hormones, I should notice decreased lability. Go-go gadget placenta!

I am taking the new med as prescribed, but my mood is the same to worse, which my doctor told me to expect for a few weeks. I am in close contact with him, seeing my therapist, acupuncturist, massage therapist, being open with my partner, trying to stay active, reducing hours at work for a few weeks so all I need to to do is focus on getting well and 3D printing a baby...

I guess my question is, besides what I'm already doing, how do I care for myself while I wait for the meds to work?

My surrogate mom, who took care of me when my mom was too ill to look after me when I was little, was given a few weeks to live a few weeks ago.

My depression often takes the form of obsessive thoughts. I am obsessed with a past relationship with someone I didn't even like being in a relationship with. They don't hate me; they sent me a nice message when my mom died. They recently unfriended me on social media and I'm obsessed with understanding why. We've both been in happy, new relationships for several years. I wouldn't want to get back together with them, but I feel so overwhelmingly rejected by them anyway and I can't let it go, no matter how much I talk about it in therapy. I think posted about it here several questions ago. I am also sad about vapid stuff like getting fat, RBG, and not being able to go on a tropical vacation this December.

I have terrible violent thoughts about harming myself and seeing my body injured or mangled in different ways, which I have no impulse to act on, but which keep me up at night because they are so grotesque.

I'm scared of alienating the people I love by being this way. I actually need them so badly right now, but I'm tearful and irritable and rigid and generally difficult. I don't recognize myself.

How can I take the edge off of this long enough to let the meds do their thing?
posted by unstrungharp to Human Relations (10 answers total) 2 users marked this as a favorite
I am so, so sorry that you are going through all of this. What a rough hand to be dealt, especially in 2020.

About 4 years ago, I also found myself waiting for a new SSRI to kick in and struggling with intrusive thoughts. This sounds silly, but the combination of listening to a podcast + doing a jigsaw puzzle was MAGIC for me. I must have done 4 or 5 thousand-piece puzzles in under a month. Maybe some kind of similar distraction would work for you?
posted by leftover_scrabble_rack at 4:34 PM on September 20, 2020 [5 favorites]

Maybe queue up an array of distractions, even? I made a kinda jokey tweet yesterday about "retreating" into video games being a form of on-demand disassociation, but sometimes my brain weasels are so bad that (as long as I put some limits on how long I do it at one time) that's preferable to just unmitigated weasels. I don't really have video game skillz, so my niche are puzzle games, Stardew Valley, Plants vs Zombies (the original, the others suck), etc. Maybe have that on deck, and both jigsaw puzzles and book/paper-type puzzles, cross stitch + podcasts/audiobooks will do it for me though some other fiber art or needlecraft might be to your preference. I always have to mix my distractions, though - there's the thing I'm doing and then I generally need audio input too, which could be DIY or cooking channels on youtube, podcasts, audiobooks, sometimes an old familiar TV show or movie in the background.

Since a lot of these are typically sitting things, you might set up a standing area for one or more of your distraction hobbies, just so you can break up the sitting time with standing time, which is a little bit more healthy than hunching all day.

I can't promise any of these will truly take the edge off, but I do find the intrusive thoughts sometimes but not always can't fight with multiple distractions.
posted by Lyn Never at 5:10 PM on September 20, 2020 [8 favorites]

I was you about 2 months ago (except for the pregnant part). Back in January, I finished a very slow and careful weaning off an SSNRI I had used successfully for 10 years. I was very emotional in January, rocketing between moods and feeling fragile. By February, I was better, more stable and centered and generally seeing an upward progression. Cue pandemic and being isolated from most social contacts and family. Oh, and I started a new job and was trying to acclimate while fully remote.

By July, I had fallen into a deep pit, barely eating, sleeping poorly, and battling a UTI that would not go away. I called my psychiatrist and requested an antidepressant, although not the one I had been taking. I am not going to withdrawal from Cymbalta again. That was one shitty experience. Started Prozac at a very low dose with increasing dosages over the next 2 months.

The first 3 weeks while I waited for some little teeny bit of Prozac-inspired hope to take hold, I continued to flail emotionally. I have OCD so the intrusive thoughts, especially thoughts about something terrible happening to someone I love, were intense. I knew what it was and I knew it would go away but it was still terrible while I was in it.

My daughter and I started streaming comedies for several hours a night. She knew I was feeling just awful so she teed up some great comedies and we laid in her bed, eating M&M's and laughing. It was exactly what I needed. Some nights, she'd spend time showing me funny Tik Toks. We even made one with her stuffed animals dancing. Distraction is your friend. Whether it's reading, t.v. or puzzles. Try a bunch of different distractions. Just be careful not to stream anything that's emotionally triggering.

Your meds will kick in. It sounds like you know that. That thought was comforting to me, even when I was feeling awful. I repeated it to myself often like a mantra.

Congratulations on the baby! The first trimester can be an emotional roller coaster without depression, anxiety and family sorrows. I'm so sorry about your moms. The dumpster fire that is 2020 gave you even more to carry. I found that with both my pregnancies the second trimester was much easier as my emotions evened out. You'll likely be getting relief from your meds as you leave behind the emotional roller coaster of the first trimester. While you're waiting to feel better, distract yourself with silly stuff, eat anything that comforts you, and know that you are doing the very best you can.
posted by MissPitts at 5:41 PM on September 20, 2020 [8 favorites]

Two things that are helpful to me are reminding myself about appropriate responses to life, and also that the chemicals in my mind are making me feel a certain way. I think sometimes when one has issues with depression, it is sometimes hard to know what is appropriate. So,in your case- feeling sad, and upset about your mom's suicide, and your other mom's illness is appropriate. And feelings do feel bigger when you are pregnant- especially when you think about you becoming a mom, at the same time as losing your own mothers. Try and sit with those feelings of mourning, and acknowledge them. The responses that aren't appropriate- that are from the chemicals doing weird things- you can try and have something self soothing to say when you find yourself spiraling- like- these feelings will pass, and I am doing ok right now.

I started taking Methylfolate supplements- mainly because of research that shows that it helps the effectiveness of antidepressants, especially in obese people (which I am.) The do seem to work for me, and you might give them a try with approval from your doctor.
posted by momochan at 9:22 PM on September 20, 2020 [1 favorite]

Best answer: You’ve got a lot going on, and I wish you the best. In case this is at all helpful: I recently learned why an ex unfriended me on social media, which had been bothering me for years. He and I dated in high school and early college and had stayed in touch lightly, eventually through social media. We met up several years ago for lunch when I was in his town for work. There was nothing flirtatious about this connection at all, but I valued him as an old friend. I was deeply hurt a handful of years ago when I realized he had unfriended me. I attempted to reach out to apologize for anything I had done but don’t know if he got message. I didn’t hear back. This stayed with me for years. It was like a low key hurt whenever I thought of it. It felt very rejecting.

Recently I learned some upsetting news about a former high school classmate. I was reluctant to reach out to my ex because of the unfriending, but I wanted to check in with him. I contacted him via LinkedIn, of all places. I was so careful in my wording, concerned I was violating some boundary.

He was warm and friendly in his response. He told me he had unfriended me because he and his wife had decided to unfriend all of their exes on social media. I did not ask for details but I presume there was some conflict in their relationship and this was the agreed upon resolution.

Here’s the important thing: it had nothing to do with me. I had been so sure it was personal. How could it not be? I must have done something terribly offensive. But that wasn’t the case at all. I was simply in a larger category of people.

It was a relief. I don’t know why your ex unfriended you, but there’s a good chance it’s for something similar, which is to say... even though it feels personal and hurtful, it might not be about you at all.
posted by bluedaisy at 11:28 PM on September 20, 2020 [6 favorites]

I'm so sorry. All I can add to the discussion is that the first trimester is also just really hard. Hopefully the second and third trimester hormones are helpful. (Also I like that suggestion above -- podcasts plus puzzles, or in my case, knitting or video games.)
posted by slidell at 2:49 AM on September 21, 2020

I've never been pregnant but have a long history with depression. I'd recommend finding things you can lose yourself in: silly lightweight fiction, a show you like, making art, knitting, a video game, podcasts. Depression is brutal, but it's a lying liar and part of what you need is a way to make time pass and to focus on something else, so my recommendation is finding things you can do that will let you place an easy focus elsewhere.

Best of luck.
posted by bile and syntax at 6:51 AM on September 21, 2020 [1 favorite]

I can't help with the depression and the incredible loss you're living with, but it may be helpful to hear that pregnancy and the newborn period was the first time I had intrusive thoughts. I would lie awake at night and they would arrive, wholly formed, like they came from outside my brain and just unfolded there. Maybe you can frame them for yourself that way? "These thoughts are part of pregnancy, they are intense, I can let them happen and let them go."

Wishing you peace and calm. You sound like you have a great team and a well thought out support plan, and I hope things get better soon. It's a terrible year for us all, and you deserve grace.
posted by Lawn Beaver at 7:37 AM on September 21, 2020 [1 favorite]

I'm so sorry you're in this hard place, in this very hard time!

Three unrelated things I'd suggest, if this were me.

One - sometimes when I'm having intrusive thought or OCD type worry, it's really helpful for me to name what specifically I'm worried about, or even write it down, so that I'm not constantly just experiencing amorphous dread. Sometimes I'm worried about big things, but sometimes I'm worried about something relatively small, but I sort of lose focus on it and just feel general worry, so naming it helps.

Two - when your mental health stuff spills over onto partners, family, or friends, name it then, too. I can be really rigid/"should" about stuff, but it feels de-escalatory to say "sorry I was short about that - I'm just feeling really anxious about XX. Thanks for sticking with me." That way, it acknowledges the moment, thanks them for being on your team, and makes it not another thing to worry about after the fact.

Three - podcasts. For me, it can be hard to fill a significant amount of around-the-house time without making space for worry, or twitter/phone games/etc. So, for me, longform, discussion/information podcasts can be a good way to fill that. The "In Our Time" BBC podcast, or other history, science, medicine, podcasts that are not current events/politics, etc work really well for me. They're distracting and interesting, but allow me to putter around the house and do light housework, dishes, laundry in a much more enjoyable mode.
posted by mercredi at 10:29 AM on September 21, 2020 [1 favorite]

Best answer: I'm scared of alienating the people I love by being this way.

If someone in my life was pregnant, had just experienced their mother's suicide, received their surrogate mother's cancer diagnosis, while all of this was happening [gestures at 2020] I would not expect anything from that person for upwards of a year, at minimum. Instead I'd be asking myself how I could make their life a little gentler, or easier.

Saying this because it's one thing if you want to feel better for yourself, but if anyone is pressuring you to be 'fine' right now they can be fired into the sun post-haste.

Wishing you strength and comfort.
posted by coffeeand at 8:51 AM on September 23, 2020 [1 favorite]

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