Depression?

Depression can be complicated, since it can be  "caused by a combination of genetic, biological, environmental, and psychological factors."   I'm thankful to God that I've only experienced mild depression.  I believe that, whatever our struggles, as parents we must do whatever we can to be our best for our children.  I also believe in talking about depression.  In certain communities, there's still a stigma attached to depression, and shame in sharing about it.  I don't know why.  I'm a traditional gal, but not always a conventional one, so... here we go!

My depression in the past has been triggered by stressful times or big changes in life.  My first encounter with it was as an adolescent, trying to navigate those crazy times of surging hormones and middle school!  I tried self-diagnosing with encyclopedias, instead of doing what I should have done: talk to my mom about it.  It didn't rear its ugly head again (in full force) until the guy I was dating and loved (now my husband!) took a job in another state.  When we got engaged, it happened again, as we tried to keep up the relationship long-distance and plan a large wedding.  The last time I had a longer episode was when we moved to yet another new city, this time with baby twins in tow.  I felt trapped in our rental with the babies, didn't have many of my own friends yet, and it was too hot to enjoy the outdoors.  (I did eventually learn some coping skills, which I outlined in this post here.)  These were the major episodes, lasting many months at a time, with smaller episodes of just a few days in between.

So cute.  Yet, multiple babies can be very draining, and leave you feeling isolated.  

For me, depression begins with the feeling that a dark cloud is moving in, getting ready to rest right above my head for permanent lodging.  Then the darkness seems to settle into my brain and my heart.  Scary ideas and thoughts that I don't even feel comfortable writing down flash through my mind.  I'm an emotional person to begin with, crying easily, but also easily excited.  The difference when I'm in a depressed episode, is that I seem to no longer take joy in...anything.  I know rationally that I have a good life, yet everything seems muted.

So, as my twins' birth approached, I read up on post-partum depression in particular, and had the number of a counselor at our church all lined up, just in case.  After all, carrying, birthing, and caring for multiple babies can be very stressful, and it was all so new.  I was ready.  I waited for it to happen.  And it didn't.  I was relieved, and pleasantly surprised.  According to this article on WebMD,  I did have some risk factors for PPD, but those factors don't necessarily mean you'll experience PPD.  But if you're expecting, it's a good idea to have it in the back of your mind, just in case.

Below is a list of things that help me.  Maybe it will be helpful for someone else, too.  However, please keep in mind my experience is only with mild depression, and I'm no doctor!  Seeking professional help is always a good thing.

• Be aware.  Be aware of your family history, of your own tendencies, and of the facts.  Sometimes just knowing what is happening to me makes me feel marginally better.
• Talk to someone.  Don't keep your feelings to yourself on this one.  Let your spouse, or family members and friends know about what your struggles.  If they don't know about it, they can't pray, listen, or support.  If they love you, there should be no shame in talking about this!  True friends will listen with love.  If someone reacts poorly to you, that reflects badly on them, not you!
• Remember, you aren't alone.  When you share with others, you may find that they have similar experiences.  You are definitely not the only person who feels this way!  In fact, mothers of multiples are at greater risk for PPD, according to this article.
• Let your doctor know.  When we moved to our current city, I let my new general practitioner know about my background at my first appointment.  She told me as a good rule of thumb, that if you cannot shake the depression through other means after two weeks, that one really should make an appointment to see their doctor and possibly obtain a prescription.  Do your research and decide who you should see: your regular doctor, a psychiatrist (sometimes you need a referral, so you may want to start with your regular doctor first, anyway), psychologist, or other trained lay counselor.  Sometimes it's good to get recommendations while you're feeling good, and then those phone numbers are right there when you need them.  
• Eat well.  Obviously.  But when I'm down, my first instinct is to eat junk food, instead of, say, a smoothie or salad.  But healthy food can do wonders for your overall mental health.  
• Exercise.  My doctor said this can be one of the best ways to keep depression at bay.  Do whatever is easy and fun for you.  For people like me, a walk around the neighborhood refreshes me.  When living in Pasadena in a good neighborhood, I could take hour long walks, pushing the double stroller ahead of me and enjoying the weather.  It's no wonder my health took a toll when we moved to Houston, in the summer, into a sketchy neighborhood:  the heat and humidity and our location kept me indoors most of the time.  If you're in this kind of situation, look for online workout videos for free, order some DVDs, or join a gym that has child care (if you can afford it).  An idea for when your children are much older: a wonderful older-than-I lady once shared that she would leave her kids in the house, and just take laps around the block.  She would close the blinds when she left, and instruct the children to only open them if there was a problem, and then she'd come back in the house.  
• Follow your routine.  Many decades ago, one family member of mine had trouble getting doctors to believe she was experiencing depression, partly because she had amazing self-discipline:  She was dressed and well-groomed; she continued to care for several children and a home almost entirely on her own while her husband worked hard outside the home.  But doing those daily tasks and having a schedule to follow can sometimes keep our bodies moving along when our mind won't cooperate, something I touched on in my post "Do The Next Thing."  
• Pray.  Lean on your faith, if you have one, for support.  (If you are a Christian, this article might be helpful.) Sometimes this is all I need.  Sometimes I need other things too.  I believe taking steps towards caring for our physical needs (and depression is a physical thing) should go hand in hand with taking steps in caring for our spiritual needs, and that these two steps together can be powerful in caring for our mental health.  

"...but those who hope in the Lord

will renew their strength.

They will soar on wings like eagles;

they will run and not grow weary,

they will walk and not be faint."

Isaiah 40:31

Top 5 Tips: Twin Pregnancy

1.  Eat!

In the early stages of my pregnancy, I was ravenous.  Then came some morning sickness/nausea, which put a slight damper on eating.  But with twins, you'll get bigger faster, and your stomach will be pushed higher and higher, possibly causing more heartburn. It was so bad at the end, for me, that I didn't enjoy eating as much, because I knew I would pay for it later, and it would even keep me from sleeping.  I was also diagnosed with gestational diabetes towards the end, and it literally took the joy out of eating.  I had to avoid certain things (pretty much everything I liked) and test my blood every few hours.  SO, my advice is to get in those calories as soon as you can, in a healthful way, of course.  In their book "When You're Expecting Twins, Triplets, or Quads: Proven Guidelines for a Healthy Multiple Pregnancy," Barbara Luke and Tamara Eberlein state that a mother expecting twins should gain around 40-56 pounds.  For triplets, 58 to 75, and for quads 70-80.  I did not gain that much, and I think it was partly due to my frame and my inability to eat much at the end.  According to these authors, an ideal diet for a multiple pregnancy is actually related to a diabetic diet, and suggests 3,500 calories a day for a mother expecting twins.  Wow!  I'm not a medical professional, so of course, you should get recommendations from your own doctor; but I did find this particular book very helpful.

When you don't feel like eating, think of your first ultrasound for motivation!  They need nutrients!

2.  Take it easy.

I heard a lot of people talk about how pregnant women could be just as active as anyone else, and I even personally knew women who continued to train for marathons up to 7 months gestation.  Also, lots of people told me that when the second trimester hit, it would be the Golden Age of pregnancy, I'd have more energy and feel better.  Some mothers of multiples may experience it this way, but not me!  I was exhausted at the beginning, and when the second trimester hit, I felt REALLY BAD.  I was tired and literally in pain.  I should have listened to my body's signals, and rested more.  I felt blessed that I finished my school year teaching kindergarten at around 3 or 4 months, after which I resigned.  But I was still trying to take a long walk for exercise every day (and feeling exhausted after a block), and doing errands, and took a few trips.  I understand that we should be healthy (and have a life), and there's also the nesting drive, pushing us to want to have everything ready for the babies!  And many of us are working and have other little ones already.  But, if and when possible, take it easy!

I'd like to stress something here:  Multiple pregnancies are on the rise, but this doesn't make them less risky.  Multiple pregnancies are still, technically, high-risk pregnancies compared to single pregnancies.  They are different and should be treated differently!  Listen to your body, listen to your doctor.  There is no shame in taking a nap or putting your feet up when you can!

3.5 Months along and not very big yet, but already needing more rest than usual!

3.  Be prepared.

Many women expecting twins and other higher order multiples end up needing to go on bed rest.  I was on bed rest for my last 2 months.  This will limit many things you may have planned to do.  So, it's not crazy to set up the nursery, or assemble the crib in your room, or whatever you're going to do, as soon as possible.  Try to do errands and any physical tasks early on.  Then, if you do end up on bed rest, you can do all the sitting-down activities: setting up online registries, making and printing baby logs, preparing baby announcements (if you want to) in which you just have to add a photo, make and print address labels for announcements, write thank you notes for things you may have already received, find a pediatrician, etc. Also, we had some insurance nightmares.  Try and do whatever you can before the babies arrive!  Long phone calls and dealing with bureaucracy is only harder with multiple crying infants.  Some of it can't be avoided, of course.  I also cooked a few meals and froze them for later.


4.  Line up help.

We were incredibly blessed to have my parents live with us for the first two months after the babies were born!  My mother had recently retired, and my dad's job could be done online.  But before they even arrived, I was on bed rest and my husband really had to step it up and do everything: work full time, do everything around the house, grocery shop, and drive me to my numerous appointments.  My family was eager and willing to help; if yours is not, do your best to convey the medical necessity of you taking it easy!  If no family is around, or you are single, there is no shame in letting housework slide and cutting out any other unnecessary activities.  Try to draw upon your pre-pregnancy network of friends and acquaintances to help you: maybe someone can do laundry one day a week, another friend might be able to pick something up at the store for you.

Because everything just gets harder at this point: almost 8 months along!

Also look into lining up help for AFTER the babies' arrival.  Can any family members come stay with you for a bit?  Can you afford a night nanny? (We couldn't quite justify that cost, and weren't even very aware of the concept at the time.)  Do you need to start arranging childcare for when you return to work?  And FOOD.  If no one offers, ask your best friend or ANYBODY to set up a meal registry for you.  People love to help, they just need to be organized.  Here are some great sites for that:

MealBaby

SignUp Genius

Take Them A Meal


5.  Do your research...but not too much.

As mentioned above, carrying twins brings risk.  Some doctors are well versed in multiple pregnancies, but you'd be surprised.  In most cases you'll be referred to a specialist to see regularly on top of your usual OB/GYN.  If you're not, maybe you should request that this happens.  So read up on your particular type of pregnancy to gain a working knowledge of the facts.  It's okay if you can't remember every tiny detail.  But if a complication arises, at least you won't be surprised, and you won't feel blindsided by medical terms being thrown around at the doctor's office.  At 26 weeks I was admitted to the hospital for pre-term labor, which they managed to stop, and was diagnosed with TTTS (twin-to-twin transfusion syndrome).  At one point my husband told me to stop reading about the condition so that I wouldn't worry so much!  So, he did all the reading and worrying from then on.  Be educated, but stop random Internet searching at 1 a.m. while biting your nails and raising your heart rate!  Your babies need you to be as calm as possible for them :)

So, those are my top 5 tips for a twin pregnancy!  Eat, rest, prepare, get help, and read!  What are yours?