Friday, December 28, 2007

A Chanukah gift from my rabbi

When I met with my rabbi again a week later, he began by asking me what are the obstacles to feeling relaxed and happy in shul.

Three came immediately to mind.

The first was that I am occasionally asked to help in a variety of ways. I love this. It helps me feel connected and valued and a real part of the community. Some things, like helping out in the kitchen, are easy and require no planning on my part. Other things, like being asked to lead a children's service or women's tefillah group, are not.

It isn't that they require planning. I know these things well enough that I could probably do them cold. But I am scared to. Maybe it is the OCD or maybe it's my experience or maybe it's something entirely different, but I get extremely anxious if I haven't practiced and prepared to the point of knowing it backwards and forwards and upside down. And even then I am scared but I do it anyway. And it always works out well and no one has ever suggested I not do this anymore, but I am terrified of making a mistake.

To that, my rabbi told me what he tells his bar and bat mitzvah students. He said in school, to get an A you need to score at least 90%. So however much of whatever they are doing for their bar or bat mitzvah, if they get 90% of it right, they've earned an A. The previous Shabbos, for instance, the bar mitzvah davened about 2/3 of the service and layned all but one of the Torah readings. Figuring the bar mitzvah was leading maybe two hours of the morning, my rabbi said he could have had 12 minutes of mistakes and still earned an A, and to date, no one has ever had that many mistakes.

This helped a little. I still have to find ways to cope with the anxiety, but he said he would do his part to give me advance notice if there was something he wanted me to do.

The second thing I said was silly and I was embarrassed to even bring it up. My rabbi assured me, and in earnest, that it could not be silly. So I told him, still feeling embarrassed, that I was afraid of losing my seat. You see, I almost always sit in the same seat on Shabbos. I chose it years ago and made sure it had been unoccupied before me. It still seems silly to say, but it has great meaning and significance for me.

But one of the times I was absent with a long depression, another woman began sitting there. When I returned one Shabbos and she came in late, she was horribly upset with me that I had taken her seat. She went to other women and complained about me. One mutual friend said yes, it's been your (her) seat for a short while, but before it was your seat, it indeed was Rivka's. I felt, in a word, ashamed. This other woman decided to move and found a seat that was better for her, she said, but it took a very long time before I felt comfortable in my seat again. And to this day, I am anxious until I arrive at shul and see that my seat is available.

I did tell my rabbi that someone--like him--could use this as a reason for me to be in shul every single week, and the earlier the better. He laughed and said, I wasn't going to go there, really. The reality, we both know, is that I have young children and a brain disorder and people get sick on occasion and sometimes I can't make it on time, if at all. He said he would be willing, and saw no problem with, putting a sign on that seat that said, please do not sit here until X hour. I was afraid of that beginning a whole seat reservation system, so I declined, but he seemed seriously willing to do that and it really touched me.

The third and last thing had to do with dinners that take place a few times a year in the shul. On those occasions, I told him, when there is no pre-arranged seating, it is very common for me to wind up virtually alone with my family. Let me explain. Some tables seat 8. Others seat 10. My family is not so large that we'd occupy an entire table (b'ezrat HaShem, it will someday be larger). People tend to gravitate toward their friends and people they know well, and despite the fact that I have been at this shul actively for thirteen years, I am still a newcomer. So other tables fill quickly and I need to sit with my children, so we find a table and there are still enough seats for others to join us but no one does. It is very hard not to take this personally, even though I know it is not intended as such. My solution is that I stopped going, but this still left me feeling sad and excluded.

This Chanukah, the shul hosted a latke dinner on a Sunday evening and there was no pre-arranged seating. My children really wanted to go, so we went. After Ma'ariv, we were one of the last families to find seats, because as many parents know, people without children can move faster than those of us with, and there were few children that evening.

I was near tears, just knowing this was going to happen again, when my rabbi came up beside me and gestured to a particular table with one parent and one child sitting at it. I looked around and saw everyone else was seated. He saw that, too, and as soon as his wife emerged from the kitchen, he wordlessly asked her to sit at our table. And when he was done with the parts of the evening that required him to be standing and mobile, he came and sat with us. It was the first time in at least eight years that I have sat at a table with adults other than my husband to talk to.

I don't know if he realized just how meaningful that gesture was. In a way, I really hope he does, because it meant the world to me, not to have to be left out of the conversation, left out of the community, again. And I got to know his wife a little better, which was very nice. It was a truly wonderful gift.

Tuesday, December 25, 2007

What if you gave a party and nobody came?

Rabbi Without a Cause has a post up about birthday parties and I have not been able to stop thinking about my experiences with them.

I have already had my birthday for 2007. That narrows it down, doesn't it?

My next birthday is a big one for me. I would love to have a party. A big party. Maybe even a surprise party. But I am really, really scared about that.

Growing up, there was not a single birthday I remember--and I have a very good memory--that wasn't upstaged by a sibling. Usually a male sibling, for whatever that's worth. Extended family would come and ask me about school or whatever was new in my life, and I always had something going on that I was very excited about, and they'd be all ears until any of said siblings walked in the room. You could see all eyes turn to said sibling and I would be forgotten. Not for just a few seconds or minutes. For the whole rest of the evening. And it was my birthday party.

My sixteenth birthday I was certain everyone was planning a suprise party. None of my friends at school said anything and every previous year they had giftwrapped my locker door. This year nothing, so I was sure something was afoot. Some previous years my mom would offer to make me a special breakfast on my birthday. This year she'd stayed up late and slept in. My friends and I usually hung out for a while after school. This year they all had to go home right away.

I went home laughing with joy that I'd figured it out and when I would get home all my friends and family would be there and it would be a dream come true.

I got home and silence. My mom was at the grocery store. Siblings were at their various other commitments. I waited. And waited.

My father came home from work. My mom asked what I wanted for my birthday dinner.

There was no party. The surprise was on me; when I asked my school friends the next day, they had all forgotten it was my birthday.

As an adult I have tried a few times to host a party. Free food, free cake, no gifts expected, a fun time for all. One year I invited everyone I knew at the time, sending out a couple dozen invitations. No one called to RSVP. No one showed up.

So I am wary about having another party, or asking for one. Because with my wacky brain chemistry the way it already is, this is the sort of repeated experience that fuels the belief that no one cares.

To my husband, a birthday party is just a birthday party, no big deal. To me it is much, much more than that.

Sunday, December 23, 2007

Being truly SEEN by the rabbi

This, they would say in counseling, is progress.

It is ten minutes since I finished that last post and what I was writing sent me into a new flurry of anxiety. I managed to calm the hair-pulling by forcing both hands on the keyboard, but then those anti-anxiety cleaning instincts took over. I really should clean my keyboard. Not a wipe off the surface cleaning, but a take off all the keys and deep clean with Q-tips and rubbing alcohol. My mouse isn't looking so shiny, either. And there's dust on the monitor and the windows need cleaning and the carpet needs to be vacuumed and the children keep getting out of bed and anything--anything--but sit here and write about how I will not be needy and I'm not worth the rabbi's attention.

I will combat faulty self-talk with logic.

All in all, I met with my rabbi five times over the span of four weeks. This was not at my suggestion. I would have been happy with something more frequent than once every two years. But he saw some necessity in it, and he thought it was worth his time, and he could have had his choice of excuses why we couldn't meet and he didn't take any of them. I know that I cannot always trust my sense of self-worth, but I am certain I can trust his. He thinks I am worth it. I am overruled. Case dismissed.

I wish it were all that easy.

At my third meeting with him, I asked him if he had any idea how hard it was to come see him without an agenda. He gave me a smile that--if interpreted correctly--was somewhere between "It's good for you" and "I don't know, I've never tried it."

He wanted me to talk more about reintegration at shul. How was it going? I told him. Some people did just pick up where we left off. Some had forgotten about my late miscarriage last spring and didn't understand why I felt a pang of hurt when I saw the babies who had been born around the time of my due date. And some asked what I'd been up to, why I'd been gone so long.

How do I answer that?
  • Not much, just a little mental breakdown
  • None of your beeswax (said politely, of course)
  • Well, see it all started with a scarcity of the neurotransmitter seratonin
  • Doesn't everyone leave shul for months at a time?
  • I overslept
  • I gave it up for Lent (a good friend reminds me it's the wrong time of year for that--she finds my ignorance of Christian rituals quite amusing)

I shrugged. I smiled. And then I asked about them. It works almost every time.

One person came up to me during kiddush and said quietly in my ear, I don't mean to out you but I've heard you've been dealing with depression. I've dealt with it too. A lot. Anytime you want to talk, I'm here.

I didn't know how to take that. Did that mean this person wanted to talk? Or was just offering to be on my safe list? What if when I was feeling fragile, they were too? I'm still not sure.

But then as I was talking to my rabbi it all fell apart. I couldn't keep past hurts from intruding on the present and some of them were making me gun-shy. So he encouraged me to tell him what these hurts were. I hesitated.

I don't want to turn this into Let's Bash the Shul or Let's Bash the Rabbi Day, I said. No, no no, he said. This wasn't about him, or the shul. This was about why I felt hurt. So I told him and with it came the tears.

And then he was very quiet and I feared I'd stepped over some invisible line. It was one of those times I wish life had an Undo button. I felt horrible.

Then he said, you take your responsibility to the shul very seriously. I nodded. Yes, of course, the shul means a lot to me. Doesn't everyone feel this way?

He shook his head, inhaled sharply, paused, and said no. And then he said, "you have an overly heightened sense of responsibility. I suspect, from everything I know about you, that you developed it very early as a coping skill, because otherwise there would have been too much pain to endure, and without it you probably wouldn't have survived."

I didn't know what to say. I nodded silently, tears unchecked. This rabbi, this man, didn't just get it. He had Seen me.

There was pain low in my stomach, as if something shifted in the core of my being. He had managed to do what few people in this world have done. He had truly Seen me without judgment or labels or an agenda to "fix" me. We both knew it. And I was grateful.

And then, of course, we were out of time. He asked if I was free to meet again on such-and-such day. I pulled out my PDA and brought up my calendar. Yes.

Doesn't that thing make you more anxious? he asked. Always knowing everything that's coming up?

I was surprised. No, I said. It makes me less anxious because I can look at it and say here's the appointments for tomorrow, I've got notes for this meeting, nothing needed for that one, it's not my turn to bring snack, good, I'm prepared and I can relax.

That's where we differ, he said. Knowing everything that was coming up would make him very anxious. The only way he could relax was having no clue what the next day would bring. Neither one of us saw the need to go into the pros and cons of that approach.

I started to put our next meeting in my calendar, accidentally selected the wrong time, and took a moment to fix it. "Rabbi" he said helpfully.

I laughed and said, cute. Then he told me about this training seminar he'd gone to about conducting hostage negotiations. The part of my brain that censors what I say--especially to my rabbi--had apparently shorted out and I heard myself ask slowly, do you find you need to do a lot of hostage negotiations in your rabbinate? He got up and said, you never know.

We'd meet again in a week and I had no idea what we were going to talk about.

The rabbi, the gabbai, and sobbing in the bathroom

The last time I wrote about seeing my rabbi, it was October. We met again ten days later. And then again after a week, and when that meeting was unexpectedly cut short, three days after that.

So much happened in those brief 45-minute sessions that I am still not certain I can put words to it all. I think in a lot of ways we both dropped our shields. A bit.

Let me start at the beginning.

In October, I had an agenda when I met with him. I wanted him on my "team," someone to talk to about all those Jewish questions my Christian counselor is intrigued by but can't answer, someone to help me navigate the emotional land mines that come with the interaction and interdependence of community through shul. My plan was to keep to the present, set aside more than a dozen years of shul-related (though not always--or even often--rabbi-related) hurts, and try to rebuild my trust in him.

When we arranged for the second meeting, he told me to come just to "talk about this" some more. It wasn't the time or place for questions, so I began our second meeting by asking, which "this" are we supposed to be talking about?

"This" was re-entry into shul. Why, I asked. Why does there need to be re-entry? Why can't we pick up where we left off? Why can't we pretend the last few months--or in my case, maybe the last year--haven't happened?

Yet I'd answered my own question just the Shabbos before, when I went to help another woman and we got our signals crossed and I thought I'd done something horrible and as much as I tried to stop it, I wound up sobbing in the restroom again, silencing my cries every time a woman came in, so she'd never know.

I did talk to her that Shabbos and we cleared everything up and neither of us had done anything horrible. I related the story to my rabbi at that second meeting, feeling as though I was admitting to some unforgivable sin when I told him about seeking refuge--not for the first time--in the restroom.

In return, he told me that he'd had a run-in with the gabbai at about the same time that day, wanting to get across to the gabbai that those who were coming up for honors during the bar mitzvah needed better cues on what to do when. But wanting brevity over verbiage, what came out was "work with me, here." The gabbai shot something back and it was apparently rather tense for a while until they worked it out after services, and now he says they're best friends again (I don't take that literally).

But the point he said he wanted to make with this story was that we all get our signals mixed up sometimes. It was the heightened emotional state I was already in, being back in shul after being away so long, that tipped the scales toward my needing the bathroom refuge.

On top of which, he added, my self-censure about even being heard crying in the bathroom only increased the stress and made it that much harder to find relief. Instead, he wanted me to find someone. I told him about my (short) list of safe people, people who know what's going on with me, who know about the depression, the anxiety. He was glad to hear I had such a list, and then he told me to add him to it.

I wanted to cry right there. On the one hand, I was so relieved and grateful that he would say that, and on the other I didn't think I could do it, to come find him when I was moments away from completely losing it and bawling and tearing my hair out in the bathroom. Because I keep coming up against this same wall:

He. Has. More. Important. Things. To. Do.

In my more rational moments, I realize this is a self-esteem issue. I also realize this is a very deep issue because I have pulled out more than a dozen hairs as I am writing this and it started only three paragraphs ago.

My counselor has suggested that I try on a different perspective. What would I tell a friend who was about to go sob in the bathroom? Or what if I was the rabbi--would I want this person to come tell me?

I can argue against my telling faster than I can argue for it:
  1. It's not his job
  2. I already have a counselor
  3. There are at least 1-200 other people here who want his attention
  4. They might have bigger problems than I do
  5. I cannot--will not--be seen as too needy
  6. It's not something he can fix, anyway
  7. I'm not always certain I'm worth it

And with that, the bathroom refuge is inevitable.

Tuesday, December 18, 2007

My new anti-anxiety kit

It is amazing that after years of therapy, I am still learning things about myself. What I've learned recently, now that I am recognizing the signs of anxiety and the OCD features, is that I am a very tactile person. Touch is a primary way that I can ease the anxiety.

I learned that when my counselor suggested aromatherapy, to find a scent that would relax me, and all the scents I tried didn't do anything for me other than make me sneeze. But she got me thinking about what I do when I'm sitting and anxious.

I pick at things: skin, hair, scabs, cuticles, fuzz. I pull hair out, which I discovered is a diagnosis all by itself and part of the OCD spectrum called trichotillomania or TTM for short.

I'm attracted by textures. In fact sometimes I wish I could wear a tallit katan just so I could finger the knots in the tzitzit (fringes). A friend suggested worry beads but my first reaction was that it would be mistaken for a rosary!

So I went on a scavenger hunt around home and started collecting things in an old small sewing box:
  • satin binding from a childhood blanket
  • set of four 1-inch ball bearings, to manipulate in my hand
  • palm-sized smooth stone
  • pair of strong magnets to play with
  • hand-held bathing brush with bristles on one side and pumice stone on the other
  • Koosh ball
  • Rubik's Cube
  • and to top it off, hand lotion in a Eucalyptus/Spearmint scent that I can massage my hands with

Then for Chanuka my husband gave me a home manicure set from Israel, with Dead Sea minerals (or so it says). I tried it on one nail and it's smooth and shiny like I polished it and lately I've been rubbing it instead of picking at hair.

My counselor thinks it is great that my answers to anxiety are things that are self-care. I fear becoming vain or superficial, yet at the same time these things are allowing some of my hair to grow back.

While I don't usually like labels because I think they often are unhelpful, having a diagnosis to help me understand why I do what I do--when I'm not thinking about what I'm doing--has been very helpful. Finally I can stop fearing the manic episode that has never come and work on finding ways to deal with and tame my anxiety before it turns into depression.

Monday, December 3, 2007

At least life isn't boring

I don't know why I don't want to write. I am home sick today, my children taken care of, sitting in bed with my computer. For hours my mind has been going over and over the events of the past few months. I want to share but the thought of writing it all down leaves me exhausted.

I think I will have to break this down into different topics. It is overwhelming otherwise. I want to share about

For now some more tea, a nap, and I hope to be back shortly to begin.

Tuesday, October 23, 2007

Reaching out to heal

There is much to tell but today I am very tired, so I will only begin.

I saw my rabbi last week, thankfully. I wanted to be strong and in control but even on the way to meet him I was in tears. This recent downturn since the end of September has been hard though the increase in meds helps and I'm sleeping better and I've been through much, much harder. But it has kept me away from shul. Lately it has brought up too much pain, too much remembering of how it feels to be Unseen and not valued.

I know that my perspective is skewed at the moment, that the painful events feel closer and more painful than they do when I'm feeling strong and happy. I even said as much to him.

My rabbi said two things that really stuck with me. One was that he would do everything he could to prevent and help heal such painful experiences related to the shul, short of embarrassing me. I am glad and relieved that he wants to make this about the shul, not about me. I know that I am not the only one in the congregation battling depression and it would be grossly unfair for me to receive validation while others continue to remain Unseen.

The other was that he wants me to help him--and the shul by extension--learn how to help me and others like me. Already I had an idea. It is not unusual to train congregants on the mitzvah of bikkur cholim, visiting the sick. In my area it has been focused on hospital and nursing home visits. But why could we not expand it a bit to include people we see in shul, at work, friends, who are in pain?

The thing I hear most often here on the blog and in person conversations is that people don't know what to say, how to act, so they say and do nothing.

Why can we not teach people a range of things to say and do? The question or offer that helps me might not help another, but if there is a larger range to choose from, adaptable to the situation and the people involved, it would be a starting point. It would open a door that has remained closed for too long.

As if on some divine cue, I received today an invitation to join a committee at shul to study and make recommendations on inclusion. While inclusion is often used in terms of physical, developmental and learning disabilities, there is no reason it should not also include brain disorders such as depression, anxiety, bipolar, and others. Ours is often a hidden illness, but
by nature, these disorders make it hard--even impossible--for people going through an episode to reach out, get involved, or even to come to shul.

Shul should be a place that people can bring their confusion and fear and pain, a place that should be free of stigma for what we know is a biological medical brain illness, a place where those who are able can be there for those who are not, knowing that which end of the need spectrum we're on can change.

I went to another Jewish mental health conference, too. I wrote about last year's conference and I'm relieved that this year's was much, much better. I want to write more about that, too, but today I must take it slow and save my energy.

Monday, October 1, 2007

It's back

This year I had questions I've never had before. I wanted to run from Rosh Hashanah, hide from Yom Kippur. And now the old feelings have crept back into my life and as much as I try to stand strong against them, I have had to increase my meds and I still fight anxiety that several times a day is nearly debilitating.

On New Year's Day the decree is inscribed and on the Day of Atonement it is sealed; how many shall pass away and how many shall be born; who shall live and who shall die...

Is this why my baby daughter died four months ago? Did I not pray hard enough last year?

It's a question my counselor would say is ridiculous. G-d doesn't work that way. Yet here it is. In writing. We daven it. Do we say the words but not mean them? Or do we mean them and if we do, how do I take them? When does prayer move from metaphor to the literal?

I visited my baby's grave site twice during the ten days. Two friends who had wanted to be with me when she was buried, I took them each separately and we paid our respects. I could not cry.
...who shall have rest and who shall go wandering; who shall be tranquil and who shall be disturbed; who shall be at ease and who shall be afflicted...
The question comes naturally, is my depression, my panic attacks, my distorted lens through which I see the world the result of some divine decree? If I were a better Jew, would I get past this? And what would that mean? Whose definition of a better Jew?

How can I do teshuva more than I can do it? How can I give tzedaka more than I can give it? Can I possibly pray harder than I can pray?

There are some who would of course say yes. There are those who claim the Shoah happened because Jews were not religious enough. Without a doubt they would blame my illness on my failings. But theirs is not the voice I want to hear. Extremism is never the answer, no matter what the question.

Would it make any difference if I did my own Vidui?

I have raised my voice to my children; I have raised my voice to the heavens and doubted I would get an answer; I have lost faith in humanity when reading the news; I have lost faith in G-d when my depression tosses me into the depths; I have blamed others for not doing enough to help; I have blamed
G-d for giving me this challenge in the first place; I have berated myself for all the weaknesses my illness makes acute; I have berated myself for not being stronger...

It didn't even wait until October. I saw the first signs nearly a week ago. The red flags, the things that alert me to another onset of anxiety and depression, they started coming quickly and went from nonexistent to frequent in 24 hours. On the third day, I increased my meds from 30mg to 40mg. I see my counselor and the psychiatrist's assitant this week.

I gave my rabbi two weeks worth of available times when we could meet again, but I have not heard from him. I fear he is angry with me or disappointed because I could not face the crowds at shul. I could not stay. That may have been the first red flag and I missed it.

I noticed it when the first signs of hoplessness returned, the sense of being overwhelmed, of fearing attack from every side. Every e-mail, every phone call, every knock at the door I fear is someone unhappy with me. I couldn't possibly confess enough to satisfy the yetser hara's depression inside of me.

This is not how I wanted to start the year. On New Year's Day the decree is inscribed and on the Day of Atonement it is sealed. Have I already been assigned some horrible fate because of my anxiety over the Days of Awe? Has my next baby's death warrant been signed (G-d forbid) because of my depression's timing?

I don't know how to come to terms with the liturgy. I have no answers.

Wednesday, September 12, 2007

Reflections on a year

I am still just so amazed and humbled by those of you who have come to read here. I never honestly thought that a blog about coping with anxiety and depression would be all that interesting but I am grateful you all are here and I am grateful that I can be helpful in whatever way.

I wish I could thank all of you by name, to acknowledge how much I appreciate your visits. This blog has been an enormous help to me, just to say things I can't say anywhere else, to express depression in a way I've never been able to express it before, and to get reality checks from all of you. I pray that the new year will be far happier than this one has been though I realize that even in tragedy and sorrow, this year has had its gifts.

May we all find our gifts and look forward to increased happiness. Shanah tovah.

Thursday, September 6, 2007

To sleep, perchance to dream

Life is--do I dare say it?--going well.

I had my first counseling appointment without children. They were both in school. It was strange to not be interrupted every few minutes.

My sleep is continuing to be a problem, but it is improving. The psychiatrist's assistant has had me try both Ambien (worked too well) and Rozerem (didn't work at all) and each time I keep going back to Lunesta. It's taken weeks, but now at 2mg of Lunesta a night, I'm finally sleeping through the night without waking for an hour or more in the middle.

I am told this is common with many of the SSRI antidepressants, that they work well on mood but disrupt sleep, causing some people to sleep much lighter. This is exactly what I found. On the higher (for me) dose of 30mg Prozac I've been on since losing my baby in May, my sleep has gotten worse.

But now with the Lunesta, more than the number of hours a night I'm sleeping, the most wonderful, baruch HaShem, thing has happened: I am dreaming again.

Really interesting dreams, intriguing dreams, fascinating dreams. Not nightmares.

It gives me a reason, finally, to look forward to the darkness of night.

Thursday, August 16, 2007

Done and yet just beginning

I had my meeting with my rabbi. It was very good. He will help me.

He said this was the month to do this, to get my team together, to look ahead proactively. I think it is no accident that I should first talk to him about this at the beginning of Elul. Even when the world around me is ignorant of the Jewish calendar, something inside me is well aware of it and embraces it. It becomes my inner time.

My psychiatrist's assistant had said two of the things I should ask for are my rabbi's support and his understanding of what I go through. In fact, in my first post on what I'd want my rabbi to know, I said I wanted him to understand me, to understand my disorder.

I started to tell him about what depression feels like to me, the things I listed in my post about depression as adversary. I fear I was not doing a very good job at first, and then he said he throught of depression as attacking one's sense of legitimacy to simply be. It is a relief to know he understands. Only someone who understood could say that.

I told him I was not looking for therapy from him. I said only some things needed problem solving. Some of it I just felt a strong need to share and I had nowhere else to take it. Some of it involved shul and it seemed inappropriate to take it anywhere but to him.

My anxiety is a different issue and it sometimes stands in my way even when the depression does not. We talked about it a little bit. I feel I have a little clearer view of what is real and what is perceived. We will meet again just after the holidays and I feel reassured by that. I feel like I don't have to do this all alone.

My family has been invited to Shabbos dinner at a friend's house tomorrow. I feel so moved by that. It has been a year or more since we were invited anywhere for Shabbos. I have to try hard not to think of the past eight months, but to think of the promise for what the future holds, what tomorrow may bring.

The day has worn me out so please forgive me for any omissions. Adequate sleep is still a need I haven't yet met.

Wednesday, August 15, 2007

Giving until it hurts

As most of you know, my beautiful baby girl, may her memory be only for a blessing, died halfway through my pregnancy in May of this year. As many of you know, I have a small group of local women friends who are all moms of young children, though I am the only Jew.

These two facts are important to bear in mind during this post.

For lots of reasons, I am opposed to baby showers. In my case, for instance, had I had a shower just before finding out my baby had died? Or had to come home to a decorated nursery with empty arms? That pain can be avoided in most, but admittedly not all, situations. In a way I was fortunate; except for the memory book of the all too short time with our daughter and the pile of now unused maternity clothes, everything looks pretty much the same. (There are a few exceptions--a painted porch and a garden--but they are not important to this post.)

However, the mom friends I have wanted to have a party to celebrate the fact that there are so many babies being born among our friends. Five moms, me among them, were due between July and October. Now there are four.

Despite wanting to have a party--more a celebration of new life than a baby shower, I was assured--few were willing to volunteer to plan it. Isn't that the way it always is?

I didn't want to seem the resentful mom, especially because I never felt resentment toward the other pregnant moms. In fact, I struggled with my own fears for their babies' safety and safe deliveries. And I worried the moms would not want to be around me because it would remind them that pregnancy is risky and what happened to me could happen to them, too.

So I volunteered to help plan it. Now I am one of only three who are doing nearly all the work for a party early next week and I am conflicted.

I feel sad. The wounds of last May are being tugged at, scratched, irritated, and some I fear are beginning to weep. I was supposed to be pregnant at this party. I was supposed to be expecting my own baby in just over a month. G-d had other plans.

Yet it is hard for me to help plan a party celebrating new life when I so recently lost the new life I'd nurtured. We still hope, b'ezrat HaShem, to get pregnant again. But it is still too soon for that.

I sense my emotions being stuffed away, tucked into a dark corner somewhere until they eventually emerge and cry out in the light of day. My sadness is under the surface but each day I feel ambivalence growing stronger. I am distracted, distant.

I want this party to be over so I don't have to think about it anymore. I want to simply not go, but that seems so selfish. My loss shouldn't diminish the joy at those lives that have already been born or, G-d willing, will soon be within our group. My absence would be felt more palpably than my presence.

And still it hurts.

Tuesday, August 14, 2007

Happy shul day

I had a great day at shul this past Shabbos. Davening was meaningful. I didn't feel self-conscious. I was able to contribute in a small way to the morning. A woman I admire greatly greeted me with a hug and seemed genuinely pleased to see me. My children were even fairly well behaved.

More importantly, I didn't feel like I was on the outside looking in. At kiddush, I felt confident to initiate conversations. I didn't stutter as I often do when I'm anxious.

I even joked at one point that I'd learned life was easier when I recognized that I really didn't know everything. I was a tiny bit afraid people would respond with a negative, oh she thinks she's so special, but they didn't. They laughed, and it felt like laughing with me, not at me.

My meds are working. :) And maybe all the work I'm doing, hammering away at the way I perceive the world is helping too.

My appointment with the rabbi has been rescheduled for this week and while I am still a little nervous about what I'm going to say and how it will turn out, I am also trying to see things differently. Very differently. Partly because when he rescheduled our appointment, he was funny about it, too, and that didn't seem like the part of him I know. I have to remind myself that I see what he wishes to share, and what he's willing to share may change over time or as our rabbi-congregant relationship evolves.

More soon but tonight I am tired.

126 reasons to read Jewish blogs

It is Tuesday already but it is still very worth pouring over Jack's presentation of Haveil Havalim, and I thank him very much for the link.

Thursday, August 9, 2007

Credibility, expertise, authority, esteem, respect--what am I looking for?

I decided to write about this because it's on my mind a lot and because it's been an issue for a long time, yet one I've rarely ever talked about.

I wrote just a bit ago about who is the expert on fringe Jews. I am interested in what others think about that. Do you go to the source to understand an issue, or do you trust the doctor who has studied it but never known it with the intimacy the source has? Or is it that the topic of mental illness in general automatically discredits anyone with one?

But this is part of a larger issue. RWAC wrote in a comment on one of his posts that "people with titles are taken seriously - and it makes sense that someone who has put in the time to study and work in a given field should be taken seriously, until proven unworthy. But at the same time, people who don't have the degrees should still be taken seriously, to whatever degree they have expertise and are able to communicate it."

This seems like complete, respectful, common sense to me. If everyone practiced this, there would be a lot fewer people who feel invalidated in this world.

That said, I'm still not quite sure what I'm looking for. This all came about because I felt that being female and title-less restricted me from accomplishing much of anything other than birthing and raising Jewish children.

But that's not exactly true either. I said I didn't have a title or initials after my name, but I do, technically. I just don't have the sort of initials to put after my name that wouldn't look pretentious. I have earned several degrees, though none of them in Jewish topics. I can't explain further without compromising myself, but the feeling I get in my community is that unless I hold specifically a PhD, JD, MD or semicha, none of the rest of it matters. And I don't have any of those four, for all sorts of obvious and not so obvious reasons.

At the same time, I can't help but think that the loudest most powerful force standing in my way is me, though I do not believe the entire problem resides in my head. My own lack of confidence, my hesitation in thinking I could be helpful to anyone at the very same time I want to be helpful with what I know and have learned and experienced, my fear of ever being anything close to arrogant.

My counselor thinks that I could allow myself a little arrogance, that my boundaries against that are so strong and so far out that what would seem to me to be slightly arrogant (in myself) would likely appear to everyone else as simply self-confident. That scares me a bit but I'm working on it.

Meanwhile I feel ineffective. Unheard, unseen, not taken seriously, without credibility despite initials I've earned and experiences I've lived, something.

I can't be the only one. Can I? Do others ever feel like this? What do you do? How do you deal with it?

Tuesday, August 7, 2007

And so it begins

I had an appointment with my rabbi for this week. I arranged for child care so I could meet with him uninterrupted. I was nervous, but as I wrote earlier, I am jaded when it comes to appointments with the rabbi. I usually don't expect it will actually happen until it's already underway, and even then I expect it to be interrupted by something.

And so it has happened again.

It's not anyone's fault. A funeral had to be scheduled and that takes precedence. He told me he needed to reschedule but gave no indication of when that might take place. I guess I will wait until a day or so after the funeral and contact him again. After the second rescheduling is historically when I have given up.

I understand--more than many readers may think--that this is how it is. There are life cycle events that fall under a narrow time contstraint. Babies are born and if a boy, the bris is set. Sadly, people die and the funeral cannot wait, nor should it.

At the same time, it is one more rescheduling that makes me wonder if we will get to meet at all before he is too busy with the Yamim Nora'im and before my own depression cycle starts again.

This should not further wound the trust I have that he will follow through, yet it does. If it were only the occasional disappointment, it would be easier to take, but it is not. It happens almost every single time.

I know it is not me. I have talked to others who have difficulty getting in to see him. One woman joked that he is improving and now keeps a full third of the appointments he schedules. So I don't take it personally. Yet it's still a disappointment. Each rescheduling, especially when I have to fight for it, makes it harder the next time I need to reach out.

Monday, August 6, 2007

Answer: a)Not enough sex; b)Too much sex; c)What's sex?

Yehuda has this week's Haveil Havalim on his blog and said that depression is "something that even sex can't always help you with."

I agree, from experience. Endorphins only go so far. And unfortunately for otherwise happily married couples, depression kills all desire. It can be a strain on a healthy marriage.

But Yehuda's post is very much tongue in cheek, which is probably better than tongue in other places, and I'm not feeling altogether capable of being funny right now, so I will leave it at that.

Note: I just saw how the original title of this post showed up on the links to Yehuda's post and it looked to me like I was being very judgmental or critical, neither of which I intend, so I'm changing the title and hoping it will come across better.

Friday, August 3, 2007

Who is the real expert on fringe Jews?

I have an appointment with my rabbi for next week.

I am scared.

The problem is that I can't trust what's in my head. I can't trust my emotions. My counselor has observed this, too, saying that I can't approach situations from a purely emotional stand. I have to go back to the facts, to what I know is real.

Sometimes, though, it is hard to differentiate between what is my interpretation of what I see around me and what is actually real. It is particularly hard when it concerns me.

There is a woman at my shul who has a child with a fairly severe disability. There is little hope for this child to successfully navigate any sort of shul-offered children's programming or bar mitzvah studies without individual and long-term assistance, such as a personal tutor. This woman has been an advocate for children with disabilities and their parents since her own child was diagnosed shortly after birth. Not one visible change has been made to the children's programming. No tutoring has been offered. This woman cannot enjoy Shabbos at shul because she is spending every moment assisting her child. She told me in tears that she is considering leaving the shul because it seems blind and deaf to her needs.

Not long after she told me this, another woman, a medical doctor who has children of her own but none with a diagnosed disability, spoke up at shul on behalf of children with disabilities and how to integrate them better within shul programming. Suddenly the board was interested. A committee was formed to study the issue.

When I discretely asked why no one was interested when the mother spoke but were after the doctor spoke, I was told that the disabled child's mother was seen as too close to the issue and as such, was too emotional to be trusted. Yet the doctor, being a doctor and not having any children with disabilities, was an impartial, trusted source. Now they could listen.

By this logic, I am too close to the issue of depression. I am too emotional to be trusted. Even though I know my depression inside and out and can usually find words to express what's going on. Even though I have perhaps identified some of the problems--lack of communication, insufficient community education--and proposed solutions that would accommodate a medium-sized shul with an overworked rabbi and a strapped budget.

Certainly, it would be nice to make a difference for me, to find the Jewish support I need. But that is not enough. There are far too many others, such as this woman with the child with the disability, such as Rabbi WAC's Fringe Jews, who are not finding support either. Someone needs to speak up for them. If that responsibility falls to me, I will accept it and do the best I can.

But how can I provide insight or guidance or be effective in any way if I can be written off as too close to the issue, too emotional, or worse yet, just another of the mentally ill?

It would seem to me that, having lived with this illness for most of my life, I would be something of an expert on it. Yet expertise is not something I can attribute to myself if it is not corroborated by others, is it? Can a teacher really call himself a teacher if he has no students?

And even if I could attribute expertise to myself, how does that have any impact on those many who will only listen if the speaker is objective, rational, and preferably has formal, post-graduate level training on the topic?

Or maybe my feeling ineffective and powerless is all coming from within, a product of the very illness I feel ineffective speaking about.

Too many questions for this erev Shabbos. I'm going to go braid the challah.

Thursday, August 2, 2007

Promise fulfilled but still waiting

I contacted my rabbi today and left a message. I have not yet heard back but it is early yet.

I agonized over what to say, how to say it. How much do I say? How little? I found myself using words like, if it is at all possible, and, is there any way.

My husband says I do this routinely, asking for a favor instead of asking for what I want. He says what I project is a sense that I am not worthy of asking you for this terrible imposition so I will request it as a favor and if you deny it I will completely understand since I am not worthy to be asking in the first place.

I did not know I do that, but once my husband pointed it out, I saw it very well in what I originally planned to say to my rabbi. I had built in escapes for his benefit and at my expense.

I didn't think my self esteem was quite that low. I thought I had made much more progress.

I hope that this projection of not being worthy is not the reason behind my not finding or receiving the support I need, or even why my suggestions for ways to help provide others with support are brushed aside.

I wonder if I can fix this before I meet with my rabbi, if I really do get to meet with him. Would that really make a difference?

Wednesday, August 1, 2007

Gathering strength and information: why is contacting the rabbi so scary?

I saw my regular counselor today and I told her of my dream and what my PA said yesterday. I also told her what I posted yesterday and what readers had commented and specifically Rabbi WAC's suggestions. She really liked the team approach.

The team approach is basically this. The biggest responsibility is mine. I have to speak up about what is going on in my head, my heart, my soul. I have to tell appropriate people about when things are good, when I'm concerned, side effects, thought patterns that don't seem right. I have to ask for reality checks and be as accurate as possible in my descriptions of how I'm doing. To not downplay what's going on. I have to be diligent about taking my meds, exercising daily, getting enough sleep, pursuing stress reduction as needed.

The next one in line is my husband. He sees me every day and might notice something I'm missing. He might catch inconsistencies between my words and behavior, or sense that something is just off. He will ask me about it, and using his discretion, may or may not make sure someone else on the team knows about it, too.

My psychiatrist's assistant (PA)/counselor will handle the medication aspect. Do we need to adjust meds, add something, scale it back, try something different, all this is her area of expertise.

My regular counselor will handle most of my other issues: ongoing relationship with my mom, parenting my children, anxieties, negative self-talk, coping with depression, social anxiety, high self-expectations, and so on.

The last ring is the one I'm uncertain of. That's my rabbi. I would like very much for him to be part of the team. I want very much not to be afraid of that, too. I want him to be available to handle my religious and spiritual concerns, issues around and in shul. He sees me most every Shabbat. We have a history together, for over a dozen years. He has played a very important role in my life. I'd like that to continue. I'd like to have someone to take my religious and spiritual concerns to, because right now no one is there to offer Jewish answers.

Many years ago, a psychiatrist told me I needed to focus on both aspects of my life in order to get better: physical and emotional.

Not two, I told him. Not both aspects. There are five: physical, emotional, intellectual, social, spiritual. All five need attention. I was under his care when I began my formal conversion studies. Shortly after my conversion and just before he left the clinic, he began researching and then publishing articles in psychiatric journals on the importance of spirituality to psychiatric healing. It would be nice to think maybe I helped a bit with that, though I'm not sure.

At any rate, only four of the five are getting attention now. I need to follow my own advice and see to that fifth.

One concern my counselor raised was that my rabbi might not be the right person for this. She suggested that I ask him outright, after explaining what I need from him, is this something you can provide? If not, that's okay, just please refer me to someone--perhaps another rabbi--who can.

She is concerned that he might be stretched too thin, too distracted, focused on too many other areas. She was certain that my falling through the cracks is not intentional on his part (I am certain of this, too), but that there is the possibility I am looking for support in the wrong place.

I'm not ready to say that, yet. I haven't ever before asked him for regular, ongoing support. I want to give him that chance.

She said I should have a full year of regular support from him before I bring up past issues. My relationship with my rabbi is not broken but it is wounded. It needs time to heal, she said. I can do that.

She also said that she is concerned that the sometimes lack of follow-through issue is sort of like intermittent positive reinforcement. That is, sometimes I get the reward of a meeting with him. It is the type of reinforcement of slot machines and it is dangerous for me because it keeps me hanging onto a relationship that may or may not be healthy for me.

But she is optimistic that it might work. I did, at any rate, promise her I would contact my rabbi and ask to schedule a meeting with him. I would do my part to see this happen. Then it is up to him.

Tuesday, July 31, 2007

The power of prayer: is it time to come clean with the rabbi?

I wrote recently,
I had a dream the other night about having a meeting with my counselor and my rabbi and my husband and me. Sort of like a team approach to helping me cope when things are bad, and even when things are okay, or dare I say, good. But then I am back to what is appropriate to ask for.
I cannot stop thinking about this idea of a team approach. At the same time I know it cannot be done as I dreamt it, for logistical reasons. I began thinking about how I could achieve the same effect without us all in the same room.

Today I saw the psychiatrist's assistant for my monthly check-in. My meds continue to work at 30 mg/day. My anxiety is minimal and related to actual stressors. There is still no hint of mania, reinforcing their decision to scrap the bipolar diagnosis. My only problem is sleep disturbance. I continue to wake for 1-2 hours in the middle of the night. Lunesta is not working to keep me asleep and I risk morning panic attacks. She prescribed Ambien for me to see if it will help. I have been managing on about 5 hours of sleep a night for the past month.

I decided to ask her what she thought would be appropriate to ask the rabbi for. When he asks, what can we do, how should I answer? Especially knowing that October and the next major depression cycle is looming.

Ah, she said, pastoral care can be very important. She approved that I was asking now, before things got bad. She did say that the worse October/January depressions were almost certainly Seasonal Affective Disorder. She said exercise and being outside, getting even a little sunlight, would be extremely important for me. We might need to increase my meds during the winter, she said. I might have to wait until spring to try and get pregnant again, since she believes the increase in meds carries an increased risk of miscarriage.

She said what I should tell the rabbi is that I need his support. That I need him to understand what I'm going through, that the depression and anxiety may be lessened by medication but would likely never go away completely. That I may have to deal with this for the rest of my life. She said I should ask him for healing prayers, that I should not underestimate the power of prayer. I had to smile at that. She does not know about this blog.

I asked her if there were tangible, specific things I should ask him for and she said yes. Because shul is so important to me, because my depression and anxiety attack my Jewish identity, I should ask to meet with him regularly a few times a year, preferably before the anticipated depressive cycles. Just to check in. Just to see how things are going, how I am coping in shul, if there are things I feel I need while I am there.

Her answer helped but it scared me too. It scared me because it means I would have to be more honest with him. I'd have to be more open with him.

I might have to tell him about this blog.

I'd have to tell him that explaining my depression by using a 2000-year-old Talmudic theological world view makes more sense to me than any modern medical or psychiatric description.

I'd have to tell him that I have difficulty trusting him.

I'd have to tell him about the hurt that continues to accumulate.

I'd have to tell him about periodically feeling Unseen.

I'd have to tell him about how my illness affects my perceptions and social interactions with others at shul.

I'd have to tell him that I see quite plainly others' demands on his time, his energy, his attention. I'd have to tell him how my problems seem insignificant in comparison to others who need him, and how that leads me to not even ask in the first place. How I don't want to add to the demand.

I'd have to tell him that even telling him all this is risky because there is a precedent for lack of support within our shul, that even he does not always follow through.

I'd have to tell him that when we do meet and talk, it means the world to me, but it also raises my hopes and I can't always afford to do that.

I don't know if I can do it, tell him all that.

I'm afraid of hurting him. I'm afraid of criticizing him. I'm afraid of destroying whatever relationship we currently have.

I'm afraid of his reaction, that he'd be angry with me, whether it was for keeping all this from him all this time or for feeling it in the first place.

I'm afraid of being so vulnerable when I'm half-expecting that any meeting with him will result in my getting hurt, if the meeting even happens in the first place.

I don't know if I would be opening the door to more pain or opening the door to a more complete healing.

...for the sin which we have committed before Thee in speech; ...and for the sin which we have committed before Thee in presumption or in error...

Sunday, July 29, 2007

Good news better news best news

I am so tired tonight but I wanted to write about the good things that have happened or are happening here. It is a wonderful feeling to know that good things are going on, even as there are pockets of sadness and grief around me.

My neighbor's 16-year-old Akita, one of the gentlest dogs I've ever met, died today. We are sad for their family and ours--we'll miss him too--yet for the first time, I don't feel my own happiness over recent good tidings diminished.

The first bit of very good news is that we did receive the financial aid we asked for. This is an incredible relief. We try to make ends meet on one salary and my husband is certainly not a highly paid doctor or lawyer or similar professional. But I am so pleased that we can still provide a Jewish education for our children. It is so important to me that they have this strong start, this confident identity as they begin their school careers.

The second bit of good news is that I am gaining some perspective on the rabbi issue. I have not seen him in weeks and this is okay with me. I think that perhaps I need to be very, very, very direct with him. I think perhaps I was expecting him to have a greater sensitivity or a more perceptive sense of people than perhaps he really has.

I think I need to decide if I'm going to continue to fall through the cracks or not, and if not, then I have to make myself visible and heard. If he offers to give me a referral list of Jewish counselors, then I need to ask him exactly when he might have that for me. I think I need to pin him down, metaphorically speaking. I think I need to think in terms of tasks and deadlines with him.

I also think I need to figure out exactly what I need from him, from shul, from my shul community. October is coming fast and I need to prepare for the inevitable downturn that will accompany it. There is the possibility that it won't be so bad this year, but in 22 years it has been hard, so I expect the worst and hope for the best.

Meanwhile my painting art therapy is going well and almost complete. I will have a whole new room within a week or two. I love to go out there now and just enjoy the colors and looking out the windows. I think when it is finished, it would be a nice place to daven.

So this is maybe my homework. My rabbi often invites people to come see him before he is too overwhelmed preparing for the High Holy Days, to talk about the past year or what they envision for the coming one. If I can figure out exactly what I need from him and from the shul, what do I need when I walk into the building on Shabbat or a holiday or whenever, then I can meet with him and tell him. I might even take relevant parts of What would I want my rabbi to know Part I and bring them with me.

I see my counselor this week. Maybe this is a good thing to work on. And yes, my high expectations. Those aren't going away any time soon I don't think, so they will be there to talk about. Ayelet is right that those often come from not being or feeling good enough. I know that feeling well. I grew up with it.

B'ezrat Hashem, I will have more good news on my other anxieties soon.

Friday, July 20, 2007

Anxious

Anxiety takes a lot of energy. I should be fixing lunch for my children right now, then getting challah started so it will be ready in time for dinner tonight. Instead I am sitting here feeling exhausted and anxious and wishing only for sleep and an end to my anxiety.

This time I think my anxiety is really caused by real things happening in my life. I don't think it's all chemical but I acknowledge my brain chemistry might make it less tolerable than it would be for others.

We are awaiting a decision on financial aid for our children to attend the only Jewish day school around. If we do not get it, they will have to go to public school.

We have to refinance our house because our current mortgage is an adjustable-rate one and it adjusts big time next month.

We are facing an unlikely but still possible 10% wage cut.

So I am anxious. And Shabbat is nearly here again and the rabbi is back and I just have so many conflicting feelings about going back.

I had a dream the other night about having a meeting with my counselor and my rabbi and my husband and me. Sort of like a team approach to helping me cope when things are bad, and even when things are okay, or dare I say, good. But then I am back to what is appropriate to ask for. Maybe all I can regularly expect is for him to announce page numbers.

Just thinking about this I feel tears coming. It hurts so much and I've been so disappointed though there have been good times as well, and leaving just isn't an option. There aren't really any alternatives that are better.

I'm just so tired thinking about all of this. So I will go make my children and me some lunch and maybe that will energize me so I can make challah. (There is no place to go buy challah here today.)

I will be in shul tomorrow. Wish me strength--I may need it. Gut shabbos.

Monday, July 16, 2007

Rasslin with the rabbi issue

I went to shul last Shabbat. I was horribly anxious but I knew I needed to go for me. As it turned out, the (shul) rabbi was not there and another rabbi who is usually a fellow congregant (and whom I like very much) was leading services. This helped a lot.

While I was there, I talked with another woman who knows the rabbi better than I do. While I did not go into detail about how I felt or my recent struggles, I did ask in a very roundabout way about the prominent member's comments regarding the rabbi's commitment to the individual's Jewish life.

She rolled her eyes at that and said something unrepeatable about shul politics. But the bottom line is that I should take what that member had to say with an entire jar of kosher salt. She then said that the (shul) rabbi is very understated in how he supports people. To him, a great deal is communicated through a handshake or a hand on one's shoulder or greeting someone with a smile rather than a scowl. He is not overt in his support, but that does not mean he is not supportive.

She also said that he shows his satisfaction or delight in what someone has learned or accomplished by asking them to do more of it or to take on a responsibility that would use their new knowledge. The fact that he has, on quite a few occasions, asked me to teach a class or lead a minyan or write something for the shul to distribute should be, she said, interpreted to mean he is quite pleased.

This helped me feel a lot better.

I talked to another friend about being visibly Jewish versus not, meaning something like when I wear my Magen David necklace versus when I don't. She laughed and said that I was always visibly Jewish and that even she (a non-Jew) could recognize Jewish values and ethics and my commitment to Jewish law in the words I chose and how I dress and how I raise my children and even the friends I choose. I didn't think it was that obvious. She thinks it is glaring but in a good way. When I told her about feeling like maybe I wasn't Jewish enough yet, she said that just wasn't possible.

My friend D called me after Shabbat and we talked for a while, too. D asked me how I was doing and how the medication was helping and about my anxiety, because that always shows up before the depression does. I told D about my anxiety around shul, around the rabbi, and D asked if any of the things I was afraid of had ever happened.

Once, I said. There is this woman at shul who, years ago, angrily told me that I'd never be truly Jewish because I'd converted. I was horrified then and a friend stepped in and defended me. But I never forgot it and that woman still glares at me when she sees me.

After saying this was clearly this woman's issues and not mine, D said if anyone at shul suggested something like that again, I should simply ask if they trust the rabbi, because if they do, accusing me is tantamount to questioning his judgment, since the rabbi is the one I learned with and he brought me before the beit din for my formal conversion. I felt not quite so alone then. I liked the idea of the rabbi's status backing up my claim to Jewishness.

D also suggested gently that much of my anxiety seemed to be as if others had very high expectations of me and I wasn't measuring up. When asked, I really couldn't point to anyone who has high expectations of me. Except me.

Might I be projecting my high expectations onto others, believing that's what they expect of me? Could this be a part of my anxiety? D knows this is certainly part of my history, my childhood. It is maybe a good topic to pick apart in therapy.

And then before I went to bed Saturday night, I picked up my book of Tehillim--Psalms--again. I thumbed through, skimming, and then stopped short. The words seemed to almost leap off the page at me.

Chapter 91:

4. With His wings He will cover you, and under His wings you will take refuge; His truth is an encompassing shield.
5. You will not fear the fright of night, the arrow that flies by day;
9. For you [said], "The Lord is my refuge"; the Most High you made your dwelling.
10. No harm will befall you, nor will a plague draw near to your tent.
11. For He will command His angels on your behalf to guard you in all your ways.
12. On [their] hands they will bear you, lest your foot stumble on a stone.

I hold onto this, the words of my friends, and the support for this blog. And I hold tight to my belief and trust in G-d, because that is my center and my foundation.

Tuesday, July 10, 2007

What would I want my rabbi to know? Part II

I wrote about this first six months ago in I cried at shul and then in Shul, and of course I wrote about it in What would I want my rabbi to know? Part 1.

I'm still dealing with it. And I still have no answers.

I'm not even sure I have questions and maybe that's part of the problem. Back in Part 1, I wrote
I wish I could just schedule an appointment and tell him all this. Tell him what I need. But I don't trust that what I want, what I think I need, what I wrote at the top of this post, is appropriate.
I know that I have to ask. I know that I need to voice what I need. I know that the more specific I can be, the better. But I'm stuck on the appropriateness.

Is what I want from my rabbi something that would fall in his job description, so to speak, or am I looking for what I need in the wrong place?

I want to trust him. I want to trust that when he says he'll do something, he does. Right now that doesn't exist. Sometimes he follows through and sometimes he doesn't, and I never know which it will be. Last winter, he offered to give me some referrals to Jewish counselors for the religious piece of my depression and I said yes that would be very nice, but then nothing happened. And I got worse before I got better and it seemed pointless to ask later.

Besides, I was afraid that asking again, or bringing up that he'd offered, would be taken as a criticism of him. I can see that happening all too well. I think it's realistic. And I know for a fact that he hates criticism.

I want to understand how to reconcile being Jewish and living with depression. I talked with a friend today who remarked how the Scandinavian trait of holding one's emotions in was so foreign to Jewish culture. Yet it's not okay to be open about depression in Jewish culture either. So which is it? How open can I be? Should I be? Can I be any more honest with other Jews than I can with everyone else?

I don't know if these are questions a rabbi can help me answer. I only know that I don't have the answer and am not qualified to answer them.

I want to feel like I matter to the shul, like I help make a difference, like I contribute in some way to the congregation.

I want to feel like he'd notice if I stopped coming to shul. I want to feel like he'd care whether I disappeared off the face of the earth or not. The last time I saw him was when I said Kaddish the first Shabbat after my baby daughter's burial at the end of May. I haven't been able to get up my courage to go to shul since. I miss it horribly but it is too hard to go. It is the one place where I am forced to confront myself, my pain, my anxieties, my resentments, my hopes, my fears.

When I talked with him after shul at the end of January (in I cried at shul), I told him that having this illness somehow makes me feel less Jewish. He rolled his eyes, clearly dismissing that as an absurd idea. I've also written in that same post that my depression makes me just feel less.

I want to feel like I've learned enough about Judaism in the past twelve years of off-and-on formal learning and twenty-three-plus years of informal learning to be considered--by him--as reasonably knowledgeable for a lay person. Like I finally qualify to really be called Jewish. Like I earned the trust he placed in me when he brought me before the beit din at my conversion.

I want to feel like I really belong, that I'm not still an outsider looking in. I want to feel like I can and should stop questioning my authenticity as a Jew. I want to feel like I'm good enough.

Two years ago I came up with an interpretation of the Four Children in the Passover haggadah that really excited me. I told my rabbi about it, explaining my interpretation. He said he'd never heard anything like it before, but he liked it a lot. He asked me to write up what I'd just explained to him and the shul would include it in the Pesach handouts they make available each year. But I didn't trust it would actually happen and I didn't want to deal with the letdown of submitting it only to have it left out, so I didn't send it in.

I want to hear these things from him and yet I am not sure I can always believe him. I know he means well but the many times there has been a lack of follow-through just hurts too much.

A prominent member of our congregation recently lost his mother, aleha hashalom. He wrote an article distributed to the congregation that read in part

what I have learned is how deeply [our rabbi] is committed to our congregants, particularly to their individual Jewish lives. [His] attention and consolation and advice was precious to me and my family.
I do not feel that I received much of anything in the way of attention and consolation and advice from my rabbi--the same man praised by this other congregant--when my father, alav hashalom, died three years ago. Or when my daughter died in May. Once my conversion was over and I had no reason to meet every two weeks with my rabbi, I am not at all sure that there is much of any commitment on his part to my individual Jewish life. If there is, how do I find it? How do I see it? Feel it?

All I can think of is, what does this prominent member have that I don't? Why does he get what I felt I needed, both when my father died and just recently when my baby died?

He is able to donate a generous amount of money to the shul.
He is born Jewish.
His brain chemistry is normal, not wacky.

I have none of these things, since the whole thing with my maternal great-grandmother still meant I needed a conversion. Is that why? Is that why I don't count as much? Does my individual Jewish life not matter as much?

I never say these things out loud, never tell anyone especially the rabbi for fear I would be labeled too needy. But these things are in my head anyway. I don't know if it's the depression talking or my history or reality.

And it's why I don't know what's appropriate for me to ask for. Or if the rabbi is even who I should be asking.

Monday, July 9, 2007

I had thought there were no words

I have not been on the blogs lately. I guess you can tell. I was inconsolable for many days after losing my baby, almost a week. I feel I did eventually make peace with it. I think maybe she left me with gifts, changes in both my attitude and my body. Changes for the better.

The universe was kind to me, overall. I had an appointment with my new psychiatrist and my counselor two days after I was discharged from the hospital. The psychiatrist immediately increased my meds. We talked longer than our alotted time and she was, I think, very supportive.

It turned out I had two side effects from the increase--a higher dose than I've ever been on, though it is considered a starting point for most people. My side effects were a loss of appetite and dry mouth. So I was eating less and drinking more water. So sad.

Seriously, if I could have picked any side effects those would be the ones I wanted.

I made a memory book of photographs we took at the delivery. I included our ultrasound photos and photos of the burial. Since her death, I am seeing (living) dragonflies everywhere. They fly to me and around my head. I wonder if they are a message from her. I picked an album with dragonflies and butterflies on the cover.

I thought I had done a quick recovery and was playing "it would have been worse if..." games with myself. it would have been worse if she'd been full term. It would have been worse if she'd been born and lived only a few days or weeks or months. It would have been worse if she'd been my first child. I'm quite good at those games, but they serve no purpose other than to keep me from feeling my grief.

So I turned to another better method. I am painting a (large) room in my house. It had been unusable before but I have fixed and repaired and sealed and am now painting. It will be a cheery yellow with white trim.

It occurred to me today after emailing a friend that painting this room is kind of like Jewish prayer. It is something for my body to do, moving and concentrating on something known and familiar. Just as reciting prayers is almost like a mantra, painting is something like a kata, repeating movements as in a martial art. Both free my creative and spiritual mind to contemplate Something Else.

I have thought of my daughter a great deal while painting. I almost feel as if this room will be one she and I will share. It is comforting.

I am still hopeful that we will have another baby. Meanwhile I work on getting healthy again.

Having mentioned healthy, I did have another depression, as my psychiatrist expected. It was much more mild and the worst lasted only one day. She increased my meds again a little bit to try and keep my depression cycles to a tolerable level. I have usually four a year: January, April, July, and October. The worst are always October and January and the psychiatrist thinks it may be related to SAD, Seasonal Affective Disorder. I am sure that the fact that there are many, many holidays in both months might play a part, too.

I am exercising, briskly walking two miles a day. My sleep is not so great. I wake at 4am and can't get back to sleep for a couple of hours. My psychiatrist prescribed Lunesta but both times when I took it I woke with panic attacks and acute anxiety that lasted for a couple of hours, so no more Lunesta for me. I have lost 18 pounds in the past five weeks, which makes me happy. My blood sugar remains normal.

I am slowly unraveling my issues with my shul. I will save it for another post because it's so involved.

It is still so hard to reach out, so hard not to isolate, so hard to feel. Thank G-d for medication. And good doctors. And good friends. And a place to share. And the words to begin to heal.

Monday, May 21, 2007

Why, G-d?

I must announce at this time the birth--and death--of our beautiful daughter at 18 1/2 weeks gestation. I am heartbroken.

There is so much to say but the words won't come. I am exhausted and sore and empty. There is little in the way of Jewish ritual to deal with this.

I miss her. I miss feeling her kick inside me. I miss dreaming and thinking about welcoming her into our family. I miss the security of knowing we would at last have our long-prayed-for third child. I am sad I will never get to know her, never learn her hopes and dreams, never watch her find her own way, never hold her little hand in mine, never kiss her sweet face.

We do not know yet what happened, other than that when I went into the doctor's because I had the stomach flu, they could not find a heartbeat. Three ultrasounds and two hours later it was confirmed. There was no heartbeat. She had died, as much as a week or two earlier.

Labor was induced the next day and I labored for 9 1/2 hours and with one push she was out. We held her tiny body and marveled at how developed she was. Her hands were the size of my little finger's nail. Her knuckles and fingernails were exquisite. She had long slender fingers.

We will have a short private funeral/burial tomorrow. I don't want to say goodbye. I want to still be pregnant.

It is not fair. This pregnancy helped me out of my depression last winter. It was a promise of hope, that life goes on, that it's worth going on. And now? Now it's taken away. It feels like a cruel joke. I worry that this will send me right back into depression.

My meds have been adjusted to deal with this and whatever postpartum depression might follow. My care team is in place. We know we will try again.

But this doesn't change the fact that my baby is dead. And I am heartbroken.

Sunday, May 13, 2007

I don't even know where to start (good post)

I would never in a million years have guessed what has happened over the past two months.

Yes, I am still pregnant, baruch Hashem! Four and a half months and counting. Baby seems to be doing well and I should start feeling movements any time now. I have developed gestational diabetes for the third time in as many pregnancies, and while I have to inject insulin twice a day so far, and test my blood sugar four times a day, I'm doing okay with that. I don't enjoy the needle pricks, but I do like knowing that I'm taking care of myself and my baby by doing so.

That isn't the zinger though. The event that blew my mind is this:

Apparently, I am not bipolar and have been living with the wrong diagnosis for 13 years.

Here is the background. Remember when I was really depressed in January? I was referred to a psychiatrist and a psychiatric physician's assistant back then, but didn't get an appointment until April. I guess a lot of people need psychiatric help. I had an in-depth intake and several long appointments. They reviewed my psychiatric history over the past 17 years and had one question: how did I get the bipolar diagnosis?

I remember that part well. It was 1994. I was hospitalized for the second time in six months and my doctors convinced me to begin medication. To determine what meds I should be on, I had to answer a ton of questions about my moods.

Did my depression last for more than two weeks? Yes.
Did it interfere with my ability to live life? Yes.
Did I ever feel like I had a lot of energy? Yes.
What did I do with that energy? Clean, organize, shop.
Did I find it hard to sleep when I had this extra energy? Yes.
Did this extra energy alternate with the depression? Sort of. I never had the extra energy during my deepest depressions.
And so on.

There was no question about episodic depression, and one doctor suspected bipolar. So I was put on an anti-psychotic, a mood stabilizer. I was told that if this stabilized my moods, I was bipolar. If I didn't react to it, then I wasn't.

It stabilized my moods. Sort of. I wasn't sad but I wasn't happy either. I was just mildly depressed all the time. I lived life like a zombie. I did this for two years and finally couldn't stand feeling like I was just taking up space. I weaned off the meds and found that exercise, avoiding sugar, and a strong spiritual/religious life kept me pretty grounded most of the time. My depressive episodes slowed to two bad times per year--October and January--and two more mild episodes in April and July. My psychiatrist at the time told me to keep doing what I was doing, and eventually ended treatment.

Fast forward to April 2007. I was asked more detailed questions about these energy surges.

Did I ever feel invincible? No.
Did I ever take risks that put me or others in harm's way? No.
Was this excess energy goal-directed or generalized to everything? It was always goal-directed. That's why I couldn't sleep. I was so excited about my grand plans for whatever I was about to do (as in finding that perfect clock radio), that I couldn't wait until morning.

Then they asked other things:

Do I ever feel anxious in social situations? Yes. Always.
Do I ever worry about something that may or may not happen in the future? Constantly.
Do I ever have physical symptoms from my worrying? Yes--lack of sleep, headaches, stomachaches, sore muscles.
What do I do when I feel anxious? Clean, organize, shop.

Aha.

There is nothing here, the psychiatrist said while patting my very fat psychiatric file, to indicate mania. Episodic depression, yes. Anxiety, yes. And a high likelihood of Seasonal Affective Disorder. Even indications of Obsessive Compulsive Disorder--a type of anxiety disorder. But not mania. Every episode I had where I had to clean my kitchen until it sparkled, or shop for the perfect clock radio, or reorganize all the bookshelves? Anxiety attacks.

After a month of appointments, they are about to toss the bipolar diagnosis. My new diagnosis is Major Depression, General Anxiety Disorder with Obsessive Compulsive Features, and Seasonal Affective Disorder. And the reason for the recurring depressive episodes--roughly every three months? Most likely a hormonal imbalance.

As it turns out, the Prozac I'm on is what they'd first recommend for the depression and anxiety. And I don't have to worry about triggering a manic episode. Come September, we will develop a plan for when the baby is born, since I have a documented track record for severe postpartum depression. After that, probably after the baby weans, we'll look at other options, and both have said that I will be a full participant in deciding which option to try in what order. But medication may be some combination of an antidepressant and hormones.

This has completely changed my identity. Here I have worried, sometimes excessively, about triggering a manic episode, and the worry itself is part of what's wrong.

And yet it's a relief. It feels more right than the "atypical bipolar II" ever felt. I don't have to explain how my manic episodes aren't like everyone else's manic episodes. Now when I get the urge to clean (and it's not just prior to Pesach), I ask myself if I'm anxious about anything. So far, I always am. I try to deal with what I'm anxious about instead and that helps a lot.

The best part is, I feel like I can finally get the help I need for what's really going on with me, and that, I believe, will better my life not only for me but also my entire family.

Sunday, March 25, 2007

I do not remember it being this hard

the last time I was pregnant. I don't remember constant morning-noon-night sickness and fatigue that won't let up. I don't remember only being able to walk from the parking lot to the store entrance and then needing to sit and rest before continuing my errands. I don't remember bouncing from elation to fear about having another child.

My husband does. According to him, this is the only way women are willing to go through this all again to have more children, if we forget the day to day difficulties. I can understand that.

My depression seems to be completely gone, but the odd concurrent problem is that I'm frequently so nauseous that it's hard to take medication, including my depression meds. I am under medicated right now but trying to get back on track. Maybe if I hid the pill in a spoonful of chocolate frozen yogurt?

Pesach has me completely freaking out. I don't have the energy to clean the way I should and my husband is doing what he can, and quite willingly, but I'm afraid it's just not going to be the same this year.

One of my favorite Pesach dishes is called Turkish Pie and is a wonderful mixture of ground beef and onions, cooked for an insanely long time, like three hours, and then placed into a shell made of softened matzo so you have something like a meat/onion pie. I look forward to it every year, and it takes pretty much all day to make. This year, I can't stand to be around the smell of cooking meat or onions of any kind. I guess I will have to wait until next year.

I'm very worried about controlling my morning sickness with kosher l'Pesach products. Saltines are my best friend right now, and I just worry that matzo won't do the trick. My previous pregnancies never took place over Pesach, so this is a first.

On a much more positive note, I have had some strange cravings at various times:
  • Pineapple
  • Caesar salad
  • Poultry
  • Potato salad
  • Chocolate frozen yogurt
  • Orange juice
I guess they're not that strange. In previous pregnancies, I craved tuna noodle casserole, pickles, Greek olives, rainbow sherbet, salsa, and Coke icees. I see there's progress here: this time there's more fruit/veggies and proteins and fewer sugars and carbs. :)

Maybe I should call myself the new improved Rivka. No longer (for now) depressed. Just hormone-enhanced. ;)

Friday, March 9, 2007

G-d has a sense of humor

I know I have not posted in quite some time. The depression got a little better, then a little worse, then a little bit more better. And then it just plateaued. I wasn't exactly happy, wasn't exactly hopeless and down. Just sort of existing.

And then I got really really tired, which made sense because of the higher dose of meds. So with my doctor's consent, I adjusted my meds down a bit.

And then I got sick.

Every morning.

So I peed on a stick and it seems now is the time G-d has decided was appropriate to bless us with the likelihood (G-d willing that all goes well) of another child.

Now I don't know what is going on. My emotions are not quite back to where they were before but now I've got hormones running the show. I can't separate what is depression and what is pregnancy.

The doctors all think this is probably why the depression was so severe this time. Normal depression + pregnancy hormones = scary.

By April I will have a whole team working with me: counselor, psychiatrist, obstetrician, OB nurse, primary physician. The plan, since I have the long history of depression and a well documented history of severe postpartum depression, is to stay on the Prozac. It is well tested and the benefits, especially at this dosage, far outweigh the risks. It will be monitored closely after birth, with no hesitations to increase it in order to head off the worst of the PPD. I feel comfortable with this plan.

I have my first OB appointment next week. I am so glad that my strength is slowly returning, even though it is tempered by the pregnancy exhaustion, and I can be alert and involved. I am glad I was not hospitalized for the depression and they didn't try changing up my meds. Who knows what that could have done to a developing embryo.

This all is a big reason why I haven't been blogging much lately. I feel nauseated pretty much all day and all night. I have a package of soda crackers nearby at all times. I have no idea what I'm going to do during Pesach if I'm still having morning/noon/night sickness. I don't know if matzo will accomplish the same thing. I don't know how I'm going to get my house cleaned for Pesach. I have decided I will not be hosting a seder this year. I may be depressed and pregnant, but I'm not a masochist.

On the other hand, G-d willing all goes well, we will be welcoming another life into our family around Sukkot. Talk about welcoming strangers! What an amazing, incredible gift. I am truly blessed.

Wednesday, March 7, 2007

My life in lyrics II

It´s been a long road, getting from there to here.
It´s been a long time, but my time is finally near.
And I can feel the change in the wind right now. Nothing´s in my way.
And they´re not gonna hold me down no more, no they´re not gonna hold me down.

Cause I´ve got faith of the heart.
I´m going where my heart will take me.
I´ve got faith to believe. I can do anything.
I´ve got strength of the soul. And no one´s gonna bend or break me.
I can reach any star. I´ve got faith, I´ve got faith, faith of the heart.

It´s been a long night. Trying to find my way.
Been through the darkness. Now I finally have my day.
And I will see my dream come alive at last. I will touch the sky.
And they´re not gonna hold me down no more, no they´re not gonna change my mind.

Cause I´ve got faith of the heart.
I´m going where my heart will take me.
I´ve got faith to believe. I can do anything.
I´ve got strength of the soul. And no one´s gonna bend or break me.
I can reach any star. I´ve got faith, faith of the heart.

I´ve known the wind so cold, and seen the darkest days.
But now the winds I feel, are only winds of change.
I´ve been through the fire and I´ve been through the rain.
But I´ll be fine.

Cause I´ve got faith of the heart.
I´m going where my heart will take me.
I´ve got faith to believe. I can do anything.
I´ve got strength of the soul. And no one´s gonna bend or break me.
I can reach any star. I´ve got faith.

I´ve got faith of the heart.
I´m going where my heart will take me.
I´ve got strength of the soul. And no one´s gonna bend or break me.
I can reach any star. I´ve got faith, I´ve got faith, faith of the heart.

It´s been a long road.

***
Enterprise Main Title
Available on the Broken Bow soundtrack
Lyrics by Diane Warren
Vocal by Russell Watson
Source: http://www.startreksoundtracks.com/lyrics/sts-lyrics-wheremyheart.html

Thursday, February 22, 2007

It's Adar; reconciling happiness and depression

I never really thought about this until this year, but how do we reconcile the fun and good-natured wish of, be happy--it's Adar! with the fact that some people have really good reasons for being unable to be happy and are not necessarily in control of whether they are happy or not? When I'm in the midst of a depression, I simply cannot just be happy.

It's everywhere now, on signs and emails and web sites and mailings from the shul. I so want to be happy, whether it's Adar or not, but there's only so much I can do. And I dread walking into shul and being met with a cheery smile and a why aren't you happy? It's Adar! Be happy!

I'm not saying we shouldn't encourage the increase of happiness, or that we should ban the signs and the greetings out of some politically correct concession to those who have every reason to be unhappy. Not at all. At the same time, I'm wondering if we're asking everyone to fake it 'til you make it. Just what do we mean by, be happy--it's Adar!

I just wonder how we reconcile it. Or if we do. And if we don't, why not?

Wednesday, February 21, 2007

Taking risks

Yesterday I managed to get out of the house and together with some other moms and their children. I was able to laugh some. I was shaky and had to be driven; it wasn't safe for me to drive, but it was a nice couple of hours.

When I got home I was terribly tired and took a nap and when I woke I had several blips of hope for the future. I liked the happy hope but it also scared me. It meant getting out and being vulnerable. It meant taking risks.

Today I woke without any of the happy hopefulness. Just a heavy blanket that makes it hard to move and terrifying to leave my bedroom. I see my counselor again tomorrow. I know I am better than when I saw her last week but I am not all better yet. Meanwhile life goes on for everyone else and I have other responsibilities stacking up. It's all overwhelming and panic-inducing.

I am very touched that people I know, even some people who know of me but whom I've never met, have been providing meals this past week because of the efforts of one of my close friends who sent out email asking for volunteers. I keep reminding myself every day, every few hours if I need to, that people do care and they want me back to my normal self.

I also took the risk of telling a handful of moms yesterday about my diagnosis and my current depression. Not only were they not bothered by it, but one of them was looking for help for a friend who is bipolar (more mania than depression) and pregnant and untreated.

I talked to her about my experiences and recommended that her friend get a team together, her midwife, an OB or psychiatrist or other MD who is familiar with bipolar I, her partner, and write down a plan for what they'll do if she needs treatment before the baby is born, and also what they'll do if she needs treatment after the baby is born, and someone to check in on her periodically in case she is particularly predisposed to postpartum depression. I also gave her some other local resources for moms and for information on bipolar.

The mom who was looking for help for her friend said something about it being serendipity that I came that day. Maybe so.