The Troubles

This blog has been neglected. I have been sick, so very sick, that my life has been on hold, along with everything in it, including my relationship, my friendships, my household, my work. The last eight weeks I will refer to as 'The Troubles', because that's what they've been. That's how they'll be remembered.

I didn't have a trouble-free pregnancy with Max. Far from it. Unfortunately, this pregnancy has panned out in the exact same manner, marked violently by the suffering of hyperemesis gravidarum, and distressingly, the depths of a major depression.

What I should say first is that this baby appears to be healthy, despite my suffering. This is important. What I should also say is that I am still grateful for this chance, for this baby, although this gratitude has been overwhelmed so far by sickness, terror, hopelessness, and hospitalisation.

Firstly, the hyperemesis. It is so widely misunderstood. It resembles nothing like this 'morning sickness' I keep hearing pregnant women talk about. It transcends amelioration by ginger biscuits, black tea, and dry toast. It involves vomiting that goes beyond the kind that makes a funny story when you vomit one day on the train. It means you cannot eat or drink or move or speak. It requires IV re-hydration and strong medications you'd rather not take. It means you can't work, or socialise. It means you can do nothing but lie in a darkened room and count the hours, the days and the weeks away, wishing to be put out of your misery, questioning the decision you made to get pregnant again, feeling like it will all be for nothing when this baby dies too.

The nausea and vomiting has been bad. I've felt more like I've got a terminal disease than I'm pregnant. I've been taking Maxolon, Doxylamine, Vitamin B6 and Ondansetron since about 6 weeks, when it kicked in with a vengeance, ending up with me at the emergency department numerous times feeling like I would surely die. The drugs have helped, especially with the vomiting, but it's not until the last couple of days that I've felt like eating or that I haven't felt the pangs of nausea as constant background noise in my body. If I don't take the medication on time, the vomiting returns with a vengeance. With Max, the sickness didn't begin to improve until around 16 weeks, which is the usual course of the illness. That's still a lot of weeks to go. These 13 weeks have been so long.

Secondly, the depression...the depression has been something else entirely. Not that it's unfamiliar to me. I've suffered major depression most of my adult life, probably longer. But the speed with which I went down, and the depths to which I fell, shocked and scared me, and those around me. I'd been previously stable on a 20mg dose of Lexapro and weekly sessions with my psychiatrist. I hoped all of this would not come crashing down, but it did. It's been the roughest few weeks of my life.

During my pregnancy with Max I also became severely depressed, and as a result, my psychiatrist increased my medication dosage to 30mg when I was about 13 weeks pregnant with him. And then Max was born prematurely. No one can say for sure it was the antidepressant that caused this to happen. In fact, all of the experts I've consulted have assured me that it wasn't, and that what happened doesn't fit the risk profile for the drug (there are other risks associated with it, though, being a Category C drug, which my doctors and I had made informed decisions about). But it was the one definitive thing I've clung to that I did 'wrong', and so the increased Lexapro dose has rather a nasty reputation in my mind.

So, when I started going downhill this time our approach was to proceed with caution. Not to increase the drug dose until absolutely necessary. It did become necessary, about two weeks ago, after I was admitted to the Albert Road Clinic, a private psychiatric hospital, in a state of absolute despair and distress, unable to go on, unable to function in any way, shape or form. I have to say that the last two weeks have been some of the darkest days of my life, and that's even considering the time I've spent grieving for Max over the last eleven months. Depression is such a debilitating illness, and such a scary one. There have been times when I have feared I would not survive it.

I write today because I've had some small reprieve as a result of intense treatment and new medication. I could not have done this even ten days ago. I could not have done anything to help myself. I feel that I'm far from out of the woods, but the new medication has given me a glimmer of hope that things won't get any worse.

I hated being in the hospital. I felt helpless and abandoned and scared and ashamed and guilty that I was causing everyone who loves me to worry so much. But one good thing came out of it. My psychiatrist sought the advice of a specialist perinatal psychiatrist regarding my treatment. I could not have been more bloody relieved to see him. He is an expert in the field of treating pregnant women with various mood disorders and mental illnesses, including ones far more serious and debilitating than mine. He was the greatest guy. Just the greatest. He took my situation very seriously, but he was also incredibly reassuring that there was a lot we could do to make it better; that we were at the beginning of the road of possible steps, not at the end of a hopeless one that I would have to continue to endure.

There was too much information, too much discussion, to go into here. It was about causes, and treatments, and consequences, and about a giant balancing act between my health and that of the baby. We are treating my depression with a different drug, a 'safe' drug, at a higher dose. The drug has no known associations with preterm labour, but untreated depression does. The drug is working. I am at home. I am eating and drinking. I am dressed and functioning. This is what the experts say is best for my baby - a healthy, functioning mother. I have to trust them. I will not be fit to look after a baby, should this baby live, without this treatment.

There's still some way to go. I'm still so much on the edge, with so little resilience in the tank. And I'm so scared. I'm scared I will not cope with the months ahead. I'm scared I will not cope with another dead baby, and then sometimes I'm scared that I will not cope with a living one. I didn't expect to be so scared. So utterly, utterly terrified.

And where is Max in all this? I haven't been writing to him, or about him, on this blog, but he is here with me as present as he ever was. He is part of everything I experience and feel. He is part of this pregnancy. God, I wish he were here. I wish my baby were here. As the anniversary of his birth approaches this is more true than ever. November was going to be a rough month without all this other stuff. With it, it's not surprising that life has been pretty unbearable, that I've been so helpless and needy.

I want to feel better. I'm trying so hard. But this is not easy. None of this is easy.