Wednesday, December 2, 2009

mania - a play in three acts

There are a lot of things wrong with me. And, while I can understand the confusion, I am not talking about my uterus or ovaries, or even, except in a general way, my hormones.

I have been thinking about this off and on, but with focus, in the past few weeks. I have had a few smaller "ah-ha" moments, maybe even some medium-sized ones.

Revelation 1: Depression and Anxiety

It all started when I decided that, my TSH levels having normalized or whatever (see here and here), but me still being fatigued, unable to get up in the morning no matter how much sleep I get, and faintly depressed most of the time, it might be time to admit that I actually am depressed. I didn't have a specially good reason - I swear I'm dealing better lately with the challenges that life throws at me - but I suppose I may have been depressed for a year or more and just ready to admit it now.

So, as part of my big concession, I figured I would start with looking up the symptoms of depression and confirming my self-diagnosis, and then starting in on whatever things I can do to improve the problem (supplements? changes in diet? particular exercise program? little self-imposed life assignments?), since I am still holding down a job and a marriage and don't quite feel ready for therapy, around all the other things I have to schedule medically. (No, I have not called Fr. P back about the spiritual director thing, yet. I will. Tomorrow.) The symptoms I found:

-difficulty concentrating, remembering details, and making decisions
-fatigue and decreased energy
-feelings of guilt, worthlessness, and/or helplessness
-feelings of hopelessness and/or pessimism
-insomnia, early-morning wakefulness, or excessive sleeping
-irritability, restlessness
-loss of interest in activities or hobbies once pleasurable, including sex
-overeating or appetite loss
-persistent aches or pains,
headaches, cramps, or digestive problems that do not ease even with treatment
-persistent sad, anxious, or "empty" feelings
-thoughts of suicide, suicide attempts

But I don't have those symptoms. Some of them, of course; but no sleep trouble, suicidal ideation, or loss of interest in favorite hobbies. (I probably would pursue a larger number of hobbies if I had more energy, though.) No difficulty making decisions, and while I forget things occasionally, I think that's normal, right? I don't know that I feel specially guilty, worthless, hopeless, helpless, or pessimistic. (I'm pretty negative about the IF, but seriously.) No aches or pains that can't be explained medically (they're all digestive, they're all endo-related, and they all vary depending on what I eat). I was temporarily stymied, but, while I wasn't looking, my brain worked out the flaw in my conclusion: I diagnosed depression when I should have diagnosed anxiety. (My brain is clever, no?) So I looked up the symptoms of anxiety, of course, and here is what I found:

  • Are you constantly tense, worried, or on edge?
  • Does your anxiety interfere with your work, school, or family responsibilities?
  • Are you plagued by fears that you know are irrational, but can’t shake?
  • Do you believe that something bad will happen if certain things aren’t done a certain way?
  • Do you avoid everyday situations or activities because they make you anxious?
  • Do you experience sudden, unexpected attacks of heart-pounding panic?
  • Do you feel like danger and catastrophe are around every corner?

  • Answers: not constantly; not really; no; no; no; I don't think so; and no. I may be anxious by temperament, perhaps, but that doesn't sound like an anxiety disorder.

    OK. So here are the symptoms for which I need a diagnosis:
    • Constant mild fatigue (irrespective of the amount of sleep I get). But no trouble falling asleep or staying asleep, and I don't sleep fifteen hours unless I am already sleep-deprived.
    • Some trouble concentrating, but nothing I can't manage - I think that's just laziness. But I feel as though I have no initiative, and I am used to having some, and often a lot.
    • Still have that physical fatigue with exercise. Not like it's hurting my body, but like I just desperately want a nap, while jogging.
    • Semi-compulsive (i.e., I don't stop though I know I should; but I could stop if I had to) self-destructive behavior. (This is actually the one that made me ready to admit I'm not OK.) If my husband is not around to watch me, I will keep myself awake until 2, 3, 4AM when I know I need to be up by 7:30 for work the next day - just reading garbage on the internet. I'll know I'm tired, know I'm going to be exhausted, and actually look for other nonsense to read because I don't want to go to bed. And even when I know that some food or other will make me sick, I eat it. In fact, I keep eating even when I'm not hungry, even after I'm uncomfortably full. I feel like the long-ago anorexic demons have returned in mutant form: I overeat because I feel as though someone, somewhere, is depriving me of food, when I have thoughts like "I'm full now. I can have more later," and I have to fight back by eating myself sick. (Nevertheless, there are things I can easily eat in moderation. The bag of Lindt dark chocolate truffles lasted about two weeks, and that didn't even take effort, although I love them. Oh, and I shared them.)
    • General mild depression. I can be quite upbeat when I'm distracted by something and even exuberant (with fun people or enough caffeine), but take away the stimulus, and I'm down. However, I don't have trouble getting myself motivated to attend social activities. I'm happy to go.
    • Irritable (but that could be anything, so I'm not sure it counts).
    • Also, I swear I am still steadily gaining weight and not in rational response to the amount I am eating, but I haven't actually counted all my calories, so I could be wrong here.
    That's pretty weak, huh? I mean, if I had this for a week, I would think "PMS!" or "Hormones!" or "Lousy week." Except maybe for the weird compulsive behavior. But I feel like this all the time. And I could just be sort of a weirdo/downer as a person; I mean, I would expect some 70yos to feel like this. But this isn't me. I'm not usually like this. But I'm not sure...there's really anything wrong with me? Maybe I'm just crazy. Who knows.

    Also, though I am very excited about the impending arrival of my new thyroid meds (erfa. Heck, I've never even researched what this stuff is, or does. But I'm going to take it anyway!), using that as an excuse is sort of thin too. My sister just told me yesterday that her TSH just came back high. 8.3. Mine was 7.04. Different titration methods, perhaps, but got to be at least comparable, if not worse - and this girl runs marathons. (As she noted, though, "I do sleep an awful lot." She really does. I miss being a student.) So I imagine I could be doing something different and exercising and losing weight, rather than turning into a mindless, motivation-less blob with no muscle tone.

    Revelation 2: Mothering

    Then last night, several things I've sort of been thinking idly (that don't answer the above questions) sort of fell into place together. I've complained about not belonging to a parish - that nobody seems to need me to do anything, and I'm accustomed to interacting with a parish in that way. And nobody really seems to need me in the community either. (At Mass a few weeks ago, they even had a volunteering fair, and I was good - I signed up to make food at the homeless shelter or halfway house or whatever. Have they called me? NO.)

    Last night it occurred to me that part of the reason I feel so untethered from daily Mass is because I don't feel like I belong there either. While having to deal with the readings and homily in a very foreign language that I seem unable to absorb is alienating and annoying, I realized that being the only white person in a church where everyone else looks like they're related to each other (well, I'm sure they don't see it that way) makes me a permanent outsider. They don't need me to be there. I will always be a guest. At other parishes where I've attended daily Mass, I've rapidly become a regular (even, in some cases, in city parishes). It makes me feel as though I'm part of something, and it's valuable to the community that I continue to attend. I'm not attending so that people will think I'm pious (I hope), but (in part) because it will make them happier if I am there.

    Actually, in my iconic Catholicism-practicing experience, I was sort of a mom figure for a bunch of other Catholic college students. They really needed me to be places (if anyone ever did) because I was the old reliable, and I was often the person who had invited them to come the very first time. People needed the regulars to be there.

    And that's when I realized, as I was falling asleep last night, that what I really need is to mother somebody or something, and I have been doing that at least since I was 17 (arguably with my siblings since I was maybe 6), and that ironically, now that I'm of childbearing age, at least, it's the first time in my life I haven't had someone to mother. The only people in my life who need to be fed and mothered just a wee tiny bit are the people I invite to parties, and, indeed, my husband I throw pretty good (relatively low-key) parties, and we throw more of them than any of our other friends, I think. So I've turned from attending daily Mass to partying not because I love drinking and fooling around (I do neither) - but because I am lonely and want to fill my desire to be a mother. Absolutely freaking ridiculous. But like all accurate personal revelations (in my experience), it has the feeling of truth. I think it is true. I think it's what I did. It's why I'm nuts over the matchmaking. I want people to help and take care of. That means I need help, I guess.

    Revelation 3: Madness

    And finally, I was reading the delightful big girl blog, and Plumcake recommended some particular model of "Ovation boots." Did you just read that as "Ovulation boots," too? I did. So clearly that even when I realized that was very odd and looked again, I still saw "Ovulation." And I thought, why would they name a boot that? Who would buy a boot with that name? I would buy that boot. Wait, what? I would buy that? Because I wanted to tell people about my ovulation obsession, or as my little secret, or would I be charmed that they had been marketed to me, but not want people to know the name? Oh, I get it. I think I'm losing my mind.

    And the big question - is this caused by the infertility?


    1. I don't have a diagnosis, but I do have some of the symptoms that you mentioned (fatigue, staying up too late, irritable, mild depression). I definitely understand needing to mother. I'm lucky that my job is basically mothering since I'm a nanny. I think that the ovulation reading was definitely IF related.

    2. Oh goodness! Was I supposed to be laughing at loud at the end of this post? Ovulation boots are just too funny an image...
      I really do think your symptoms sound like thyroid, not depression. We share quite a few of the same symptoms (like 99%), and I can tell you since I've been taking my vitamins regularly (including the thyroid supplement), my energy level and general mood and productivity levels have increased quite a bit. My thyroid level wasn't even abnormal, so I can't wait to hear if you feel any effects from your new meds :).
      And I feel you on the mothering thing. Anytime our friends are around, or my sister's college buddies, I go into mothering mode and hostess mode. I've wanted something to mother for so many years now, that I even find myself doing the same to our younger part-timers at work. Silly me.

    3. My cat gets my "mothering"....haaaa...he likes it some of the times..but when I wrap him in a blanket and rock him..he gets upset...I feel (for me) becoming a teacher is one way I'm going to nurture children...I'll be nurturing their intellectual needs and many others.

      I have some of those symptoms you mentioned at times myself however nothing I haven't been able to overcome. I do believe some of it is due to IF. It is depressing to be "left out, behind" and not having any control over it and the never knowing when it will all end is trying, to say the least. *sigh*...Blogging/journaling is very theraputic. I hope us blog "sisters" can help you through these harder times. Blessings!

    4. What about adrenal fatigue? I had a lot of your symptoms (constant fatigue, sleeping too much, mild depression) and I feel a lot better after going on hydrocortisone. That may not be your problem, but it's just a thought. You should google it (although, like with much of this stuff, mainstream doctors don't really believe in it.. although Dr. B at Tep.eyac knows a lot about it).

      Here's one site with a symptoms list: And guess what.. it says one of the contributing factors is "Staying up late even though tired"!

      And just another thought on the compulsive thing - maybe it's unrelated to the rest (or, maybe it's a contributing factor to your other problems, rather than another symptom). I, too, have compulsive behaviors. In my case, I've had OCD since childhood, but maybe it's a result of stress with you (not to go out on a limb and diagnose you as stressed, but infertility and fatigue definitely stress our bodies mentally and physically). I know it gets worse with me when I'm stressed.

      I hope you feel better soon. And yes.. call your spiritual director!

    5. YOu sound like me....Have you checked food allergies?? The place that TCIE went to called LEAP isn't too expensive. My insurance covers the testing part.

      They call it food sensitivities, but the guy was saying it was a delayed allergy response. The WBC attack the food....etc...It's really interesting!

    6. I am sorry you are feeling so badly, but recognizing what is going on is huge. Prayers for you as you work to find a diagnosis. Also, thanks for the laugh about the ovulation boots. Can I get a pair, please!?!

    7. wow. that was really interesting, esp. the part about needing to mother. I understand that.

    8. Do you have any pets? I am not sure if it si healthy or not, but a pet would give you something to mother. I think that infertility causes a lot of weird things to occur that seems unrelated to one's reproductive system, so perhaps everything you described is related to infertility.