Ambivalence

In order to be admitted to a hospital as a formal patient, two physicians need to fill out and sign an Admission Certificate (Form 1). Typically the first is the emergency room physician and the second is a psychiatrist (that isn't always the case, but is how it worked for me). The ER physician's certificate was quick and not overly specific. The psychiatrist's certificate, on the other hand, read like this:

On the following facts observed by me: Postpartum depression for several months, no apparent trigger but has been feeling like harming herself and her child. Some ambivalence about hospitalization with risk of harm on discharge.

 On the following facts communicated to me by others: History of depression, becoming worse, now with thoughts of killing herself and harming her 8/12 baby. Describes dissociative episodes. Does not feel safe leaving the hospital.

Two words stuck out to me as I read this Certificate in the days that followed: Ambivalence and dissociative. I'll talk about the idea of dissociative episodes at another time, but for this blog post I want to focus on the word "Ambivalence."

I would like you to understand that the word ambivalence epitomizes my struggle with PPD. It is my ambivalence towards every part of my life that makes this depression so incredibly hard, confusing, and frightening.

Let me give you some examples:

- Life: This is what came crashing down on me that Friday night. I don't want to die. I didn't want to die. Believe it or not, I would much rather live. But that night, and many others before it, I also did not want to keep living. Living was too hard. Living requires motivation, concentration, energy, will. I just didn't have any of those things in that moment. Death seemed like the only answer to a series of questions about the point of fighting to stay alive. I do want to live. I want to see my daughter grown. I want to have many more "I love you" moments with all of those people most important to me. It's just that all of that fades so far away when depression pulls so deep.

-Being a mother to my baby: I love my daughter. Please, please understand that. I want what is best for her. I beg God for protection over her every night. And every night I sneak into her room to watch her sleep. So often, though, I have wished I didn't have to be her mother. Sometimes I wish she didn't exist. Not that she would die, not that I would go back in time, knowing what I know now and choose not to have her. No, simply that she would never have been. I am certain I am a terrible mother. I am certain I am making terrible mistakes. And she exhausts me. I barely make it through some days holding on to her bed-time like a beacon to the time I will have to myself, only to have her stay awake far beyond her usual routine. And I crumble. I don't want to do this. I just want to disappear. I don't want to be a mom. But please believe me when I say I love her with my whole broken heart.

- The way to heal: It's possible those observant readers have already picked up on this one. In this post I mentioned my psychologist encouraged me by giving me specific things I could do to help speed up my recovery, but in this post I wrote about how comforting it is to know that the depression isn't my fault, that there isn't anything I could have done to prevent it and that I will eventually heal. I've found this example of ambivalence in my life as a new mother time and time again. Someone will offer some (not-so-helpful-and-not-so-asked-for) advice and I get so frustrated because don't they know this isn't my fault? And in the next moment I'm trying to find one strategy or another to fix my depression. I think that I do need both: There are things that I can do, but I also need to be patient as I heal.

- Hospital vs. Home: This is the ambivalence the psychiatrist was talking about. I mentioned in my last post that I did not want to go to the hospital. I begged and pleaded and stalled and stalled before finally letting my husband take me. By the time morning came nothing had changed. I still wanted to go home. But I remember as nurses, social workers and doctors did their rounds that morning, they all talked about discharge... and I cringed. I didn't want to stay, but I couldn't imagine going home and I felt like they weren't listening to me. My husband came to the hospital to let N. nurse and I remember crying because nobody was taking me seriously. Then the psychiatrist came in and decided to hospitalize me. He told me he was going to admit me as a formal patient and I cried again. I didn't want to be there but I still didn't want to go home, either.

There are other examples, but I think that this gives a pretty good picture of what I mean by living ambivalently. Honestly, I don't really understand how I can feel so strongly in opposite ways. It really is confusing to want two things that cannot possibly exist together. It is frightening to want something that flies in the face of everything I have ever valued and everything I truly care about. And it is hard to go through such conflicting emotions, trying to sort them out in a mind that can barely comprehend those things known to be true. It's getting easier, though. I'm enjoying being at home (most of the time), I'm beginning to find the balance between patience and action, and I rarely think about death, or about blotting out my daughter from my life.