Adaptation

The most common, well-meaning, question I get regarding my short-term memory loss is, "Will it get better? Will you get your memory back?" I just kind of want to be like, "I was electrocuted seven times. I feel like you are asking a lot of my brain to recover memories and keep new ones stored in there," but I usually just say, "I don't know". The actual truth is that the doctor's don't know what my brain will remember and what has been permanently erased. To be honest, if everything in life is on a bell curve, my memory loss seems to be two standard deviations away from the mean on the right hand side. Meaning folks in the know seem to be a little surprised that it's so severe and continues to be a problem. Either that or it's only old people who usually comment on ECT and they don't notice a difference in the quality of their memories so they can't report either way on what effect ECT had.

I am two weeks out of treatment and I keep getting told by mental health professionals that I need to be patient. Six weeks out seems to be a more magic time when my "neurons start forming new mental pathways in the brain and the chemical reactions start normalizing". I put that in quotes because I don't really believe that science has advanced far enough to fully understand the human brain. If it did, we would have cured epilepsy, autism, and depression by now. I feel like doctors, with their medicines and their talk therapy, are still essentially stumbling around in the dark trying their best through trial and error to see if some combination of something will actually work. At least that's been my experience and I have 10 years of treatment under my belt so I feel I've earned the right to talk with authority.

Life has required some adapting. Let's start with the positive. Here are things that I remember, every time, no matter how obscure: 1) passwords, which in a computer generation where I do most of my bill pay online is somewhat amazing and definitely appreciated. 2) My kids' birthdays. I'm pretty sure this was in my long-term memory so probably doesn't count. 3) How much sleep I got the night before. Yeah, I'm looking at you Ben. Was it really necessary to be up from 3:30am - 5:30am? 4) What I wore the day before, so at least I don't have to color-code my hangars or anything or go to a standby "this is what I wear on Thursdays" system. 5) Most things regarding Zac, including what he said, how he acted, and how is day was in school yesterday.

Without fail, here is what I forget, on a day-to-day basis: 1) television series plots. Usually this occurs when I can't remember what happened at the end of last season and I'm trying to piece together what is going on this season. On really bad days, I can't remember what happened the week before. On the plus side (see all this positivity I'm putting out? It's like I'm vomiting rainbows), there are no reruns for me! Everything is a new episode. 2) Plots in the book I'm trying to read. If there are too many characters and too many locations that the plot is set in, every night it's like picking up a new novel and trying to figure out from context what the hell is going on. That's been probably the hardest to deal with in my personal life because I get so much joy from books and I read every night. It's also affected Zac the most because I can't remember the plot to the "Wrinkle in Time" books that we are reading. Let me just say, in my defense, with a fully functional brain, I'm not sure that I would ever follow the plot to "Wind in Time" and pronouncing the word "farandolae" every other sentence is hard. Those books seem to be written directly to an 8 year-old psyche and feel like the literary equivalent to "The Neverending Story". Adults aren't meant to understand. On the downside, Zac told me he didn't want to read with me if I couldn't remember what happened in the book the night before and we had to work on his empathy button for a good twenty minutes. 3) Whether or not I spoke to someone outside my family the day before. 3A) If there is a record of me speaking to them, then I can't remember what I said or what they said back to me. This is the most challenging aspect of memory loss professionally. My job is to form relationships with new people, which involves remembering small details or even big details like, "Stop calling me you crazy psycho. I hope you crawl into a dark hole and die of a respiratory disease.". Do you know what happens when someone says this to you, you forget to write it down, and then you call them back the next day? Profanity. That's what happens. A shit storm is unleashed on you making you question the worth of your very existence.

Professionally is where I've had to adapt the most. I basically talk on the phone for a living. Sometimes I make trades on a computer, but I have to be on the phone to do it. The obvious answer to my problem would be to take detailed notes on every conversation so I can pick them up the next day. The only problem is sometimes I talk to 100 or more people a day. There are only so many notes I can write. I've developed sort of a system. It's like that scene in "Memento" (a movie that I now identify with in scary and slightly heart-warming ways) where he's looking at polaroids in the back of his trunk and he says, "You learn to trust your own handwriting (because he would write on the bottom of every picture he had some important detail). You trust your instincts". It's a little like that. Sure, sometimes I get in the car at the end of the day and I forget where Ben goes to daycare, but I just start driving by instinct and eventually something will feel right and I'll remember where I'm going. Same with going to the grocery store. Sure, a list would be helpful, but if I don't have one I just walk down the aisles until it occurs to me why I came into the store. Other adults do this one.

I think it's not actually me that's had to adapt the most, it's KGII and Zac. Being asked the same question three days in a row would get unbelievably annoying and would challenge anyone's patience. I recognize that. But I can't stop the behavior if not only I don't remember the answer to the question I've asked, but I don't even remember that I asked the question to begin with. There are a lot of sighs and, "I've told you this three times now..." around my house. Fortunately, KGII in particular, has been very kind and loving and will repeat himself. What he doesn't like is when he tells me about an event or a conversation that has happened in the past and I try to argue with him that it never happened. That's awesome. Here's a pro tip: if you are going to argue with someone with no memory, bring hard evidence to back up your claim. Once he can verifiably prove that it did in fact happen (pictures, text messages, or third party verification have all been used as evidence) I feel bad apologize. Living with me must be hard. Living with very little short-term memory is hard, but I'm adapting. It just takes time.

Irony

The irony of the concern people expressed at my last post was that I had to be healthy enough to write the post to begin with. While I was going through ECT, I was scared shitless that my brain was going to be permanently fried. When I was inpatient in the hospital, I didn't call anyone. I was too ashamed. Even if I had, who would have answered their phone? I don't blame anyone. I keep my phone on vibrate and even if I had left a message, there was no phone number to call me back. I was stuck in a place that purposefully isolates people from the stresses of the outside world. KGII tried to sneak in my check book so I could pay some bills and was stopped at the door. I can't really say how many bills didn't get paid while I was in the hospital. My Dad and KGII tried to cover most of them, but it's incredibly hard to cover the job of the primary bill payer, especially when most of the physical copies of the bills were sitting on my desk at work.


Like most depressed people, I'm in the stage where I'm isolating myself from others. I think about the reason I started this blog to begin with back in 2005. I wanted an easy way to update people on the progress and details of my pregnancy with Zac. In essence, I didn't want to have individual conversations with people where I relayed the same information. In so many ways, I'm still doing that. I'm hiding behind my writing because I want to avoid individual conversations that are too painful, too embarassing, and too uncomfortable (for both parties) to have. So I write and I publish.


There are reasons that most of my friends don't live in the same city that I do. Even the friends that live in the same place that I do, think about how long it has been since you've seen me. Even better, think how long it has been since we've talked on the phone and had an actual conversation that didn't involve text messages. I excel at isolating myself. Really, it's an art form. I realized a long time ago that if you don't reach out to people, they stop reaching out to you. Again, I don't blame people. I know that people that care about me would reach out to me if it occurred to them or if they had the time, but who has the time? Life is busy and complex. Sometimes it's just too much trouble to reach out to a friend in crisis and tell them that they matter; that you want to get together with them, even though they struggle to get out of bed.


When I don't hear from people, it's an easy mental step to say I don't matter. From there, the next step is that no one would miss me if I was gone. That's not to say that I'm actively suicidal right now. I'm not. My family, my parents, my children, and KGII keep me from harming myself. I've been in enough therapy to know how royally fucked up kids of sucidal parents are. Trust me, that's something kids never really recover from. Well there is that reason and although I'm an overachiever in many areas of my life, I'm exceptionally bad at hurting myself. Part of me wants to live. It's that part that keeps me from coming up with the right combination of drugs or physical pain to actually be successful at killing myself. Besides, do you have any idea how angry people get when you try and hurt yourself and fail? People take it as a personal afront to their friendship, to their place in your life. I know that if I were to die there would be beautiful eulogies to my life about how smart I was and how much I made people laugh. I know it would be considered a preventable tragedy and people would say that depression took another vibrant soul from this Earth. But sometimes depressed people need to hear that they would be missed. They need to hear that they matter. They need to know that their isolation won't be tolerated because their friends and family have reached out to them enough to spur them into overcoming their social anxiety or apathy. For now it's enough to know that people are reading my writing.


What I remember most from my ECT sessions was fear. Seven times I had to walk into an OR and feel the prick of an IV being started on the back of my hand. Seven times I felt the gel against my temples and the rubber band being strapped down against my head. I always struggled against the mask that would go over my mouth and nose, the one that would ultimately put me under, into sedation. I knew when I woke up I wouldn't know where I was. I could figure it out because some things are obvious. My thought pattern usually went something like: "I have an IV and I'm in a hospital bed. There is a nurse offering me apple juice. I must be in a hospital. I want my Dad. Where is my Dad? Oh, there he is. He's telling me that I'm ok and he loves me. I can move my arms and legs, I must be ok. Why can't I remember anything? Why don't I know what year it is or what hospital I'm in? They are telling me I can get dressed and go home now. I don't remember where I live. I have to be driven everywhere. Why am I doing this?"


How could I describe that to people? Is it any wonder that I hid, that I continue to hide? I'm only talking about it now because the memories of being in the OR come to me when I'm not expecting them. I'm talking about it because it's hard to be in a constant state of 20 questions in my head. Like, "I know I've talked to this person before, but I can't remember what they said or what I said. Maybe if I ask enough general questions I'll remember something. I know their name is familiar to me. Did I take notes of our last conversation? Please tell me I took some notes. No, fuck it, I'll tell them I have problems with my short term memory and maybe they will repeat themselves. Oh, I've already told them that the last time I couldn't remember what we talked about and now they are looking at me like I'm crazy. Awesome. Guess I should take notes this time."

PPD

I didn't write a whole lot about my post partum depression with Zac because my family was so worried about his family, or more specifically, Zac's FOB finding out about it and using it against me. I was largely undiagnosed with Zac and my post partum depression (PPD) took the shape of destroying my sense of self. I was convinced that Zac was better off without me and did everything in my power to destroy myself physically so he could be raised by someone else. The crime of this is that it lasted for years. Literally, I think my last episode of self-harm was when Zac was four years-old. Between his birth and then, I was in and out of hospitals, in patient, partial patient, and out patient. What finally broke the cycle for me was dialectical behavioral therapy (DBT) going once a week for group therapy and once a week for individual therapy. I was lucky because my therapist's office was close to where I worked so I could go at lunch (although my co-workers, who didn't know where I was going, were more than happy to mention to my boss when I took longer than a 60 minute lunch break).

Everything was hidden and shameful. I once wrote a post about the amount of medication I was on in terms of sheer pill bottles and my Dad asked me to take it down. I embarrassed them. They loved, and continue to love, their grandson fiercely, and were completely at a loss at how to deal with their daughter who was entrusted to care for him, yet hell bent on hurting herself at every juncture. They were never fully confident that I could be left alone with him and for two years I lived with them off-and-on, when living with myself with a newborn/toddler was too much for me to handle.

Then things started to settle down. I got my current job which eliminated my hour commute each way, Zac and I lived in a two bedroom apartment, he enrolled in Kindergarten, and eventually I got the house I'm living in now. KGII was in and out of the picture as we dated and remained friends, then more than friends, then friends again. I got pregnant and convinced myself it was the second baby I had always wanted. Sure, the pregnancy caught me completely off-guard. I wasn't using birth control, but who ovulates a week late? It was such a rhythm method fail as to be laughable. Even though KGII might have made a different decision, I wanted to raise the baby and grow him in my body. What a decision that was. At every turn, growing Ben inside me took a toll on my body and my mind. I had to leave work at almost 5 months pregnant and spent seven months out of work. I threw up almost every day and dealt with borderline gestational diabetes, high blood pressure, depression, and countless trips to the hospital. The only bright spot of my pregnancy was that I was able to complete almost seven weeks of IOP at my therapist's office, where I went to group therapy from 9am - 2pm every day and got to be reminded of the principles of DBT and my self worth.

Then Ben came in a rush of blood and terror. He spent 20 days in the NICU and I kept waiting for the PPD to hit me. Three months turned into six months and I kept waiting for the post partum freight train to run me over. Finally, even though I had been seeing it in the distance for almost nine months, I was powerless to stop it, or even slow down it's momentum. I want to write about my PPD because I don't think I'm alone. This time KGII has been right by my side and even my clients (which I've always been worried about finding this blog and who I refuse to friend on Facebook) know that I've being dealing with post partum depression. I'm owning it in a way that I never did with Zac.

The tipping point was KGII applying for a job with my company. There was a referral bonus of $1000, so I referred him and the recruiter called in a matter of hours to set up an appointment for him to interview for the position. The job would have literally doubled our household salary. He says the interview didn't go well and the next day I was in patient in the hospital. The pressure of financially maintaining a family of four came crashing down on me. I push myself incredibly hard at work and felt like (although KGII would disagree) that I was doing a disproportionate amount of household chores and it all felt like much too much.

I went and saw my prenatal psychiatrist and she recommended electro-convulsive therapy (ECT), which was done in-patient at a world-renowned hospital a block away from her office. She said, "At least this way you won't have to fake every second of every day". So I went and admitted myself. I had forgotten how horrible in patient is. How they take all of your belongings and catalogue them, deciding what it is "safe" for you to keep and what isn't. I had forgotten how literally crazy your roommate could be and how she could wake up screaming every two hours. I had forgotten what it's like when bipolar folks go maniac and fly into a rage. What I was most struck by in the few group therapy sessions that I went to (they made me too anxious) was how all of the people seemed to be in the beginning of their therapy/recovery journey. I'm practically a guru of psychological teaching, even though I struggle to implement it in my life.

The hospital made me watch a video on ECT and my first clue that something was amiss should have been that everyone in the video was over the age of 75. They were happy and clueless. Just some very happy old people. ECT is done when medication is either ineffective or when a person's body can't tolerate the side effects of medication. In my case, ECT was considered viable to get me off of the large doses of psychiatric medication that I was on which was causing secondary side effects and, actually, PPD is the number one indicator of ECT in women my age. It is most common with the elderly and with women who need to return to their responsibilities quickly.

Sylvia Plath documented her experience with ECT in "The Bell Jar". Ms. Plath is one of my alma mater's more notable alumna and her book is one of the definitive works on depression in the 1950s. When she did ECT, she was awake, biting down on rubber to not swallow her tongue, and she tasted copper. Now, it's considered more humane to put someone under sedation to administer ECT, although not much beyond that has changed. Memory loss was listed as a possible side effect and I was taken off almost all of my medication (early psychiatric medication was actually early anti-seizure medication and to perform ECT, you need to be off all anti-seizure medication). I had four sessions of ECT in-patient and then I was discharged from the hospital and had three more sessions. The first four sessions were done bilaterally, which means I had electrodes on both sides of my brain. My memory loss was so severe and my confusion was so profound when I woke up that they downgraded me to right unilateral treatment, which at least allowed me to know that I was in a hospital when I woke up.

It was traumatic and I still find myself thinking about it. I have the memories of going into a OR, getting an IV started, feeling electrodes strapped to my head with a rubber band, going under sedation, and waking up and not knowing where I was seven times. Think about how many times that is. Seven. I remember almost nothing for the little over two weeks when I was having the procedure done. I'm on the more extreme scale of memory loss. I might have partially contributed to it because I was on very small doses of anti-anxiety medication (because having your memories erased and living in a state of confusion causes a lot of fucking anxiety) and that might have contributed to the memory loss, although that was never explained to me. I basically can't remember from August - early November. If you tell me something happened or I said something, there is a chance I'll remember it, but it's not guaranteed. The big question people ask is will your memory come back. Basically, it's unknown right now. What I do know is that my memory is not as good as it was even before the procedures. The most embarrassing thing that happens is when I tell someone I have problems with my short term memory and then get stuck somewhere in a conversation and I'll forget that I told them about my problems, so I tell them again that I have problems with my short term memory. They look at me strangely and reply, "Yeah...I know. You told me". It's incredibly embarrassing professionally, but my friends have been more forgiving personally. My main psychiatrist said that my immediate memory problems should resolve themselves within the next six weeks, provided I stay mentally active. Whether or not I will ever recover the memories from those four months is anyone's guess.

As for Ben and I, it's a struggle. Part of what is so hard is that he's been constantly sick for the past month with double ear infections so he cries all the time. He looks at me and starts crying. He also looks at the cats and starts crying, so I try not to take it personally. He is very, very attached to KGII. He's also one of the most opinionated babies I've ever encountered. Very little happens to that baby without his complete approval or noisily voiced, rowdy disapproval. Whereas with Zac I thought he was better off without me, with Ben, I feel like I'm better off without him. Here is where the judgment comes in, hard and heavy, both from myself and from other people. I cringe when Ben pulls my hair or pulls my lips and explores my face. I want to walk out of the room when he starts crying and have to force myself to attend to his needs if KGII or my parents aren't home. He's largely indifferent to me and I'm ok with that. It's when he is on a mission to attack my Iphone or grab handfuls of pumpkin pie off my plate that I struggle most with him. I took him and me to the doctor yesterday and we are both ragingly sick. At one point, I couldn't handle him crying anymore (he screamed throughout an entire 15 minute breathing treatment) that I just started crying. KGII doesn't understand and I've been begging him to talk to his therapist about it. I know there are times I shouldn't be left alone with Ben, but I don't know how to make a partner take that seriously, other than continue to repeat it over and over. I love both of my sons, but this is very hard.