Moving Forward After Neonatal Grief and Depression: The next step

           For those of you just joining me, this blog is specifically dedicated to helping families recover emotionally, physically and spiritually from the loss of a child during pregnancy, at birth or soon after birth, and to help mothers and fathers successfully navigate high-risk pregnancies and premature infants.

           

            On a broader scale, it can help people dealing with any kind of loss and grief, and, perhaps, burning spiritual questions about their lives.

            To new readers: Welcome!!

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            After nearly three months of depression-related posts, we now return to my story, which ended at a point when I was—in stops and starts—emerging from the throes of grief-driven depression, and had just experienced a great, “Ah ha!” God moment. And I’m finding myself asking, “Okay, God, what are You saying to me?”

           

            Then the next question uttered in my brain had to be, And what am I going to do about it?  

           

            Did I really want to know the answer to that last question? Was I willing to entertain thoughts of what “doing about it” might mean? What would it cost me?

           

            And even if I was now functioning on a whole new plane didn’t mean that everyone else had transcended to the next level and was ready, willing and able to venture forth into bold, new territory with me.

           

            Along with my “Ah ha” moment, I realized that answering that question—about where I was going from that point—was going to take time. And it wasn’t entirely, “Where am I going from here?” that had to be considered; it was also, “Where are we going from here?”

           

            Because having another child involved two people, not just one. There was only so much that I could do alone, but I knew that from that point forward, I needed to be working on myself first.

           

            And it is at that critical crossroads in my life that my story continues…

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            God’s timing is always perfect, even when we’re nervously watching our clocks. In my panicky uncertainty, it was no different for me. The next four months brought a myriad of stresses and fears, all of which had nothing to do with coming to terms with my powerful need to control the outcome of a pregnancy, yet, these issues demanded all of my physical and emotional reserves. Some of them even threatened to further drain the mostly arid well of my soul.

           

            Yet I pressed on to return to the land of the living and discovered that as much as my head wanted to move on, my heart remained resistant.

           

            I had returned to singing in our church’s choir and was scheduled to sing a solo in consecutive services, almost one year after Victoria’s death. The day’s itinerary was already packed with a scheduled afternoon birthday party for Parker at his favorite pizza place and delivering the children’s sermon. With determination, I practiced, prepared, wrote and developed. When the sun rose on that April morning, I felt fortified against the world and any challenge it might throw my way, eager to present a musical offering to God and give a brief discourse to the children, and ready to orchestrate a gift of joy, laughter and peer fellowship for my four-year-old.

           

            It had been years since I’d sung solo “in public, “ so I was apprehensive. That morning—as I stood before the microphone, first fiddling with its height and making light banter with the congregation—my heart pounded and my hands trembled. Yet as soon I started singing, a “voice” softly encouraged my heart, Give it up, Andrea! Give it all up to Me. Being newly sensitive—probably hypersensitive—to the Holy Spirit’s voice, my brain perked up, and something deep inside of me welled up to obey, to “let it go.”

           

            Within seconds, the fear dissolved, and my soul sank deeply into the lyrics and music. When I finished singing, I returned—drained and emotionally overcome—to my front row seat between two other choir members who lovingly patted my leg.

           

            Without warning, the stabbing reality of the approaching one-year anniversary of Victoria’s death unleashed smoldering grief and pain that exploded like steam erupting from a pressure cooker. It boiled to the surface with a frightening life force all its own, besieging every cell in my body, crushing the protective dam I’d erected in my heart. My hands reflexively clutched my face to control the seismic avalanche churning deep within my soul. Scorching tears threatened to trigger hysterical convulsions.

           

            Please don’t let anyone see me, I pleaded internally as the quavering spasms of panicked breathing clamped my chest. I was afraid to breathe; I knew an agonizing death wail would erupt from my cramped lungs if I so much as opened my mouth to exhale. A shear force of will allowed me to remain anchored to the seat as I choked down the swelling throat spasm. My heart and brain pounded in a chaotic rhythm.

           

            Control! I can’t let anyone see me like this. I’ve got to get control!  

           

            I longed to bolt from the chair into the adjoining outdoor courtyard to locate a hiding place, a corner in which to curl and embrace myself, to wrench tears from my saturated body. To wring myself dry.

           

            As the service end drew near, I slumped in the chair, relieved and utterly spent.

            Why did God let this happen when He knew I wanted everything to go just right? When He knew how hard I'd worked, how special I'd wanted this day to be.

           

            I immediately knew the answer: He wanted to teach me a lesson about how dangerous self-reliance can be, and how there’s only one thing I should really invest any energy relying on. After all I'd been through, apparently I still hadn't learned the lesson.

           

            Between services I slipped outside to wander around alone, to gather strength for the second service. Give it all up to me, peddled around in my mind as I paced the short, concealed sidewalk. But the second service time arrived, and I quickly re-entered our church’s storefront meeting place with the rest of the choir. Soon after, I headed forward to present the children’s sermon and then later rose to light a candle to recognize the gift of Parker’s birthday, and to commemorate Victoria’s death.

           

            The candle-lighting portion of our service was a time for members to express a joy, sorrow or concern in front of the congregation, a cathartic ritual for some, a time of peace for others—a means to share life and bear your soul to your immediate family of believers.

           

            In the middle of explaining my reasons for lighting a candle, I succumbed to unsolicited tears and found myself standing paralyzed in front of the congregation—hand clamped over my mouth, silently holding a flickering white taper. Motioning to Chris for help, I was grateful when he joined me to continue where I’d abruptly stopped. As I slumped against Chris’s strong frame, he expressed both the day’s melancholy mix of sadness and joy.

           

            But I couldn’t remain supported by him for long. I had to let go. I regained my composure and was soon planted in front of the congregation, once again preparing the microphone and music.

           

            Tension crept through my jaw and vocal cords as I started singing, and the song was devoid of the emotion infused into it in the first service. But suddenly the firm directive entreated me again: Give it all up to me, Andrea. Give it completely up to Me!

           

            As I responded to what felt like an intensely loving command, the tension abruptly diffused. In seconds, I’d forgotten myself and allowed the song to be carried to the congregation by an otherworldly conductor. The song was no longer mine; it belonged to the Source of its theme. Suddenly, it was over, and I opened my eyes to experience loving smiles and exuberant applause.

           

            I prayed my singing would bring attention to God, not me. In that moment, I felt that it had, in some small way, done that. In my weakness, the Author of my life was made strong; and He arranged for me to receive the blessing. Euphoria suddenly replaced my grief. It continued throughout the service and carried me through the remainder of the day.

           

            We spent the rest of the day ushering boisterous four-year-olds around, watching them laugh, tear open gifts and do silly things, while concurrently enjoying adult conversation and mediocre pizza.

           

            Something unexpected happened to me that afternoon, however.    

           

            The friend who had brought her beautiful infant daughter to church two months earlier—the baby I’d been unable to hold and barely gaze upon—brought her to Parker’s birthday party. And she confronted me with the same request she’d made of me two months earlier: “Do you want to hold her?”

           

            I say “confront” because that’s the way my fragile heart reacted to it, not because of the way she delivered the question.

           

            Did I want to hold her?

           

            I breathed deeply, and then hesitantly extended my arms to receive the baby.

           

            Ever-so-slowly, the internal trembling subsided, and my body instinctively swayed in that gentle side-to-side movement mothers seem to naturally acquire for soothing a child. But repeatedly, I found it necessary to remind myself that she wasn’t mine; that I would have to give her back. Turning my head, I noticed another friend staring at me from across the noisy table; her eyebrows raised and mouth gaping, her questioning eyes searching my face like a targeted laser beam.

           

            “Well, Andrea,” she nearly shouted. “I am surprised! Are you sure you can do that; are you okay?”

           

            “I’ll let you know if you need to relieve me,” I responded with a smile. “I am doing better.”

           

            “You must be!” she countered. “Thinking of trying to have another one?”

           

            “Maybe,” I managed to relay across the giddy shouts of pre-schoolers and heads of seated parents consumed in conversation. “Chris and I have started discussing the possibility.”

           

            It felt so comfortable, yet so strangely elusive to hold such a small infant in my arms again. Did I really want to have another baby and go through the sleepless nights, diapers, and complete dependence so familiar in the first three to fours years of a child’s life? We had worked so hard to bring Parker to the age of four.

           

            Or did I just want to prove that I could be victorious again. To show the world that I wasn’t a loser?

           

            More time, I thought, as I gently returned the baby to her mother.

           

            I still need more time…

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NEXT WEEK: The painful anniversary day…

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Until next week,

Thanks for joining me!

Blessings,

Andrea

12 Steps to Defeat Depression: Cognitive Behavior Therapy, and Laughter

            Cognitive behavior therapy, also known as CBT, is what is referred to as a type of psychotherapeutic treatment aimed at helping patients first recognize the thoughts and feelings they have in response to any given situation, and then helping them understand those thoughts and feelings, and answer why they might be experiencing them. It’s commonly used to treat a range of disorders, including depression and anxiety.

           

            CBT is usually a short-term therapy focused on helping people focus on and correct a specific problem. You’re taught how to identify your destructive behavior or thought patterns and then learn alternative behaviors or responses.

            The idea behind CBT, which is supported by brain research, is that our feelings play an influential role in how we behave. As I covered in earlier blogs, feelings trigger neurochemical responses, which then trigger behavior. As this behavior becomes a “learned response,” the area in the brain responsible for remembering the response dumps chemicals into the system that once again causes a triggering of the response. It becomes a vicious cycle that’s difficult to break.

           

            Notice I said difficult, not impossible. *

           

           

            A CBT patient discovers that while they will never be able to completely control their environment, it is possible for them to control how they interpret those surroundings and respond to them. Like my elevator story I relayed several blogs ago, just thinking about getting in an elevator caused my fear level to rise, which caused the fight or flight chemicals to dump into my system, which, in turn, caused my heart rate and breathing to escalate to panic level. I fed this panic by mentally entertaining all of the awful things that could happen to me if I got stuck in an elevator. It was like a rolling snowball, gathering more and more snow until it became a behemoth I couldn’t control or stop.

           

            The CBT treatment process usually begins with the functional analysis stage, when the therapist helps the patient identify their problematic beliefs. The patient learns how their thoughts, feelings, and situations can contribute to destructive behaviors. This first process can be difficult, especially for those patients uncomfortable with contemplating their personal thoughts, feelings and physical sensations. In other words: the people who don’t like self-examination.

           

            But the self-discovery it can lead to can open up insights critical to the healing process.

           

            The second part of CBT concentrates on the behaviors that correspond to the perceptions, feelings or sensations. It is the behaviors that are the major culprits: you feel depressed, so you eat. You feel inadequate, so you don’t attempt activities in which you feel you’d fail, or you avoid social situations and opportunities that might provide advancement or personal enjoyment.

            Once you’ve identified the negative behaviors, the therapist teaches you new behaviors that you practice. And the more you practice, the more likely you are to be able to change your brain’s learned response to the original trigger! You take baby steps toward a larger goal, and your brain follows suit.

           

            CBT is focused on highly specific goals and has been used to successfully treat a variety of disorders, including depression, anxiety, phobias and addiction. In my most recent neuroscience course, our instructor said that a person suffering from depression should not be taking anti-depressant medication without also undergoing cognitive behavior therapy. He indicated that while the medications could take the edge off, it was the therapy that provided the real healing. He gave me the impression that he thought CBT alone could do the job, and should be the first line of treatment, especially when the negative side effects of anti-depressant medications are considered.

           

            If you want to give CBT a try, you must be ready and willing to spend time analyzing your thoughts and feelings. You must be open to better understanding yourself, which may initially cause you some hurt and disillusionment. Later, it will bring you a sense of relief and empowerment.

            

            However, you must understand that undergoing this therapy and becoming more aware of your feelings will not necessarily stop you from having them. It is your response to them—the behavior—you need to change.

            

            There are, however, techniques employed to help you overcome or subdue these feelings and thoughts. We’ve covered many of them in this blog. They include relaxation techniques, meditation, mindfulness, guided imagery and biofeedback. To those you can add journaling, role-playing and mental distractions.

           

            But, truly, the only thing that will help you change your feelings will be drawing closer to Jesus. The closer you get to Him, the better able you are to see things clearly—as they truly are—and the more likely you will be to respond to your situations with positive, life-affirming feelings and a sense of control and peace.

           

           

            The final advice I can give you is to fill your life with laughter. Hardly anything else does so much good for the body and spirit as a good laugh, a smile, a chuckle. As the Bible says, a merry heart is good medicine! And 21^st Century medical research verifies that centuries-old wisdom. It strengthens your immunity, provides a physical and emotional release when you are stressed, and provides you with improved happiness.

            It lightens whatever load you’re carrying and causes your face—and heart—to smile. And medical research shows that just the act of moving your facial muscles into the motion of laughter, causes endorphins to be released into the system. Yes, those feel-good brain chemicals start running around the body, acting like a morphine drug! Laughter, even just the facial muscle movement mimicking it, really is good medicine!

            

            God’s marvelous word is relevant for our lives today. Science is just now validating its age-old truths!

           

            Well, this brings us to the end of our journey through defeating depression. I hope you’ve learned some effective coping skills and lifestyle changes that have encouraged and helped you. It has been an honor to go on this journey with you. My prayer is that all of you recover and stay healthy, happy and well and can face each new day with more joy and peace than you did the last!

            

             I pray that you find hope in your future, regardless of where pain and grief have led you.

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NEXT WEEK: I begin to fully recover from depression and return to life, and then face the haunting questions: Where do we go from here; and, Do we try again and take a calculated risk in pregnancy—my life and the life of my unborn child…

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Until next week,

Thanks for joining me!

Blessings,

Andrea

* PTSD is one condition that does not seem to respond well to cognitive behavior therapy.

12 Steps to Defeat Depression: Manual Therapy

            And behold, a leper came and worshipped [Jesus], saying, “Lord, if You are willing, You can make me clean.”

         Then Jesus put out His hand and touched him, saying, “I am wiling; be cleansed.” Immediately his leprosy was cleansed.

                                                                         ~ Matthew 8:2-3

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            Reread the above verses. Can you imagine it? Having leprosy? Being grossly disfigured and outcast from your friends, your family, from all of society?  

           

            Can you imagine not being touched for years, because it wasn’t allowed; and because—being afraid they’d contract the disease from you—no one wanted to touch you? To tenderly pat your back, lovingly stroke your arm. Wrap their arms around you in a hug?

           

            Since touch is one of my primary love languages of communication, I can’t imagine not being touched by my husband, my children, my family, my friends. I honestly think I’d shrivel up and die if I couldn’t experience the touch of another person.

           

            Reread the passage again, and notice what Jesus does. In other leper healings recounted in Scripture, He simply speaks and the lepers are healed. But in this situation, Jesus touches. He violates the rules and lays His hand upon this desperate, dying person.

           

            Can you imagine what being touched felt like to this man who probably hadn’t felt another human being's warm gentle hand in weeks, months, possibly years?

           

            Jesus always meets us where we are, providing our greatest needs. And in this situation, Jesus knows that this emotionally and physically starved man needed to be touched.

           

            Maybe that’s exactly what you need today: a loving touch, a hands-on therapy.

             

           

            Manual therapies, like massage and muscle manipulation, have been around for thousands of years, and they are some of the most commonly used group of treatments in the world today. There’s just nothing quite like what we always referred to as “the laying on of hands.”

           

            Whether it’s the sensation one feels when touched, the warmth of the touch, the tenderness of it, or the actual detoxification and healing one receives after a good massage, I believe manual therapy is one of the best ways to increase blood flow to the tissues, lift one’s spirit, and produce healing in the body and mind.

            

             People often asked me if manual therapy or massage works. My response was always, “Well, I think it does, but even if we can’t actually get solid data proving that it does, as long as it doesn’t cause the patient harm, and they think it’s beneficial, then I’m all for it!” There’s just something beneficial to the brain when you believe the treatment you’re receiving is working.

What is Manual Therapy?

           

            Physical forces applied to the body define hands-on treatments—otherwise referred to as manual therapies. They can include massage, manipulation and mobilization. The most common side effect is local tenderness, which usually resolves itself rapidly after the treatment, unless your therapist has been especially vigorous and overdone it.

           

            Here are some of the most popular therapies available:

           

Alexander Technique:

Named for an Australian-English actor, this technique teaches you to become more aware of your posture and body movements and is used to relieve pain improve body function and prevent injury. Its effectiveness has not been well-documented, but if your depression stems from physical issues, then you might do some research on it, find a practitioner in your area, and give it try.

Feldenkrais Method:

This treatment was actually coming into vogue 24 years ago, when I was still doing clinic work. It uses gentle movements and body awareness exercises (some of which are difficult only to the extent that they’re hard to get used to and require a lot of body awareness to perform correctly) to develop increased flexibility and coordination. I’m not sure about the increased flexibility, but it does increase your coordination by increasing your body awareness and quality of movement. It does that through continual body feedback during your exercises you perform with a trained therapist. The exercises are done sitting, lying down or standing and progress in range and complexity. It has been used to treat anxiety and depression, and may be successful in these areas because of the attention it gives to body awareness and control.

Massage:

I can’t say enough good things about massage therapy, but you must have someone who is trained in it in order to reap the benefits. During massage, the therapist manipulates the body’s soft tissues—gently or vigorously—using either their fingertips, hands or fists. (Yes, fists.) They may even do some patting, pounding, pulling, or pinching, depending upon the type of massage.

A massage may make you feel relaxed, but it can also get your blood flowing vigorously and liven you up. Swimmers—who have been some of the frontrunner athletes in using massage in their training and competition—have used it for years to get them loose and charged for a race. Be careful, though. Vigorous massage can hurt you, so make sure your therapist knows exactly what your physical and mental issues are so they can massage accordingly.

A not-so-funny story about an experience I had right out of grad school in my first job highlights my caution. 

The physical therapists I worked for had just attended a conference where they learned a brand new, wonder therapy. Well, they had what we call an “in service” event, where the staff gathered to learn this new, must-know treatment. And guess who they selected as the guinea pig? You got it! Moi. Me; the newbie.

Anyway, the therapist (my boss) demonstrating got real vigorous with the myofascial release and Rolfing (deep tissue massage ) technique he’d just learned, that he was demonstrating on my sternocleidomastoid muscle (the big one that runs from your collarbone and breastbone, and then up and around your neck to the base of your skull). As he pulled, stretched and attempted to separate the muscle from the "tight" connective tissue (or loosen its connection, which, in turn was to give me, the "patient," more flexibility and range of head and neck motion), my neck started getting pretty sore. 

Unfortunately, I didn’t have enough guts to tell my boss to lighten up, but I should have. Upon awakening the following morning, my muscle was so swollen that it put pressure on my airway and caused me considerable breathing difficulty. My lymph glands were swollen to the size of grapes, and my throat was sore and nearly closed.

So, find someone who’s had experience with the different techniques, and don’t hesitate to alert your therapist if they’re causing you pain. It doesn’t always have to be painful to provide effective healing. (Although sometimes rehabilitation can and does cause a patient considerable discomfort.) Most often though, the guideline is for gentle manipulation.

Massage is highly effective for people suffering from stress, anxiety and depression, regardless of the cause. So it’s way up there on my list of favorite therapies. And it has also been shown to increase the strength of the immune system, which means your body is more likely to be able to defend itself against viral and cancer cells.

That wraps up manual therapies. You can probably think of others to add to this list, but I’ve concentrated on those treatments most likely to help you in your battle with depression, grief-driven or otherwise. You may have some you would like to share with all of the readers. Please leave a response so we can add them to the list!

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NEXT WEEK: We’ll be wrapping up this series on depression with cognitive behavioral

therapy and some additional spirit and mood-lifting activities! Then I’ll return to my story, which also covers high-risk pregnancies and premature infants. You’ll be both encouraged and amazed.

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So, until next week,

Thanks for joining me!

Blessings,

Andrea