How to Support Someone Living with Mental Illness

When you're unfamiliar with mental illness, it can be hard to understand how to help someone going through a difficult time or their ongoing challenges. I've known Jessica since we were in high school and I can't think of anyone more suited to her career. She is one of the kindest, most compassionate people I know and I think this post is a must-read for everyone and perfectly aligned with Life is Sweet month

The statistics are glaringly clear: one in five Canadians will experience Mental Illness (MI) in their life time. Take a look around your school, or your place of work. Think about this number the next time you take public transport or have a family dinner. The impacts of Mental Illness extend to all income and education levels, all ages and cultures. Twenty percent of our population, of the people you care about, will or perhaps are currently experiencing the impact of mental health in a direct way.

In my work as a Mental Health Counsellor at a post-secondary institution students share with me the impact of their unique mental health challenges every day. I am honoured to do this work and inspired every day by the resilience, honesty and integrity I see in the clients I work with. By far the most common refrain I hear stems from the reality that a mental health diagnosis is stigmatizing. While there is a great deal of funding, attention and sensitivity being directed to this essential issue (like the work of the brave and determined Ashley Gibson) mental illness continues to be a site of embarrassment, shame, judgement and often denial. In my experience, many people simply do not know how to respond, relate to, or support someone living with mental illness. And truly, how could they? Mental illness is a subject we either sweep under the carpet or that we sensationalize, a school shooting for example. At the same time, one of the most powerful protective factors for someone living with MI is the support of family and friends. In this way, we face a double bind. MI is scary and difficult to talk about, and yet, talking about it may help alleviate stigma, encourage individuals to get the help they need and promote education. In reflecting on the incredible courage that Ashley and her guest bloggers show in sharing their experiences, I decided to focus on a few tools, strategies and insights I hope may help some readers to respond in supportive ways to the needs of a friend or family member managing the roller coaster that is mental illness. This, of course, is a large and complicated topic. I have made an effort to speak to some general strategies and perspectives. I do not position myself in this discussion, or my practice, as an expert. Instead, I view my perspective as one that is informed by the opportunities I have had to witness and share the stories of many individuals living with mental illness.

#1- Know what Mental Illness means - Information is Power

Very often I hear clients question the meaning of their diagnosis. “Does this diagnosis change who I am? How will others see me? Should I tell people?” MI is characterized by alterations in thinking, mood or behaviour or some combination thereof [Canada Public Health, 2013]. It is associated with impaired functioning and inhibits the way one lives day to day over a period of time. Symptoms range from mild to severe. Very often, an individual who lives with one MI illness may also experience a second MI. The Centre for Mental Health and Addiction notes that depending on the population being considered, the percentage of people who experience a second MI ranges from 20% to as high as 80% (CAMH, 1998).

Please understand that MI can be a reflection of environmental life circumstances, or biological in nature. It can be episodic, or a life-long reality. It is NEVER the individual’s fault. While it is important for an individual to take responsibility for living with mental illness one should never have to wear it. That is, a person is not their diagnosis. The diagnosis may be an important part of a new way of living; it does not need to define life or the individual. Learning that someone you care for is struggling with mental health is troubling. It should not become the main lens through which you understand or interact with that person. We are each made up of many identities that intersect in ways that define us: gender, religion, age, sexuality, gender, education and so on. For many people, MI is one of those identities. It does not need to be the dominant point of identity however.

#2 Listen! Listen! Listen!

In school we learn to write essays, we learn to research, think logically, share, give presentations; we do not learn to listen. Because MI is so stigmatizing, it is incredibly powerful to share, even a piece of one’s experience with someone else and to have that person listen without judgement. I try to follow the 80/20 rule. If my voice is taking up more than 20% of the discussion, I tone it down. Active listening requires the listener not only to hear the words that are being expressed, but also, the meaning behind them. Showing you are attuned to and engaged in a person’s story can be as simple as a nod of the head, leaning toward the person speaking, making eye contact and reflecting back important words or phrases. Simple questions that are phrased in a gentle way such as: “What was that like for you?” or reflections like “That must be really hard” “I’m sorry you are going through this” are effective means of communicating your understanding and your empathy. This means leaving space for the individual to share however much or little feels comfortable. To support empathetically, imagine what it would be like for you to have the story be your own; place yourself in the story teller’s shoes. This kind of active listening is incredibly powerful for the person sharing their story. You do not need to be a counsellor to support someone who is suffering or struggling. Staying with the person in their feelings and experiences, trying to understand and reflecting what you hear lead the speaker to feel valued, understood and cared for.

#3 Thank the person for trusting you to share with you

I make a point of trying to thank individuals I work with for trusting me with their story. In my experience, this simple thank you does a lot to validate the importance of the individual’s story, the difficulty they may have in sharing and begins the process of creating safety in the relationship. No one is perfect, and sometimes we do not respond in ways that fit or may even offend the speaker. Saying thank you can help to alleviate any negative feelings around pieces of the conversation that did not feel so great. A simple thank you also emphasizes that the expert of the story is the storyteller and highlights the shared experience of listener and speaker in sharing that story.

#4 Focus on Needs - Avoid Problem Solving

Hearing someone you care for is hurting is painful. Like any kind human, when most of us hear this we want to fix the problem and to stop the pain. This is a natural reaction. At the same time, a person in crisis and pain is rarely in the mind set for problem solving. While listening and empathizing helps the individual to feel supported and heard, jumping into ways to manage the problem does not meet the person where he or she is at. We are all experts on our own experience. Instead of telling someone what they need, ask them! Asking the person what he or she needs in the moment, in the next few days and beyond empowers the individual. I am consistently struck by how self-aware people are even in crisis. Inquiring “What do you need for today…the weekend… the week in order to manage” is a constructive question which asserts that the individual sharing their story knows best. It also begins the process of self-reflection and self-care. People living with MI often feel they have lost control. Asking this question reminds the individual they can have some control in moving forward. Asking what you can do to help meet the needs that are identified is a constructive means to begin looking at coping and solutions without problem solving. Very often, MI brings up many questions about the future. Focusing on day to day needs can help to reduce the panic that can be brought on by mental health concerns and empower the individual that he or she has the capacity to respond to the present challenges.

#5 Understand that Recovery is a process

Recovery is both a process and a goal. Recovery is about learning to cope effectively with symptoms related to mental illness and finding quality in life. I sometimes hear clients refer to this as “the new normal”. For many people, recovery is a life-long journey. We all experience ups and downs, and challenges; mental health is no different. Very often, families and friends express hope that their loved one will “go back to normal” as the symptoms reside. The challenge is that healing from MI is not the same as healing from the flu, or even a broken limb. The pressure to be “cured” puts a great deal of pressure on the individual and promotes the perspective that living with MI is not normal. In fact, with 20% of the population experiencing the reality of MI; it is normal. The perspective that recovery is a process not an end point can help to challenge some of this stigma, set realistic expectations and allow you to better support someone you care for in managing mental health concerns. In this way, recovery should be defined by the person doing it.

#6 Get the support YOU need

When someone you care for is behaving uncharacteristically, being hurtful or suffering it is natural to have your own reaction and feelings. When a person first experiences symptoms of mental illness and seeks the support of medical health professionals, a care plan is often created. This plan outlines how the individual and their supports can respond to manage the symptoms of mental illness and what the individual needs for support. I try to encourage friends and family to connect with the supports they need as part of this plan. To think “we”, you sometimes need to think “me”. It is okay to prioritize your own needs in the healing process. Having the tools you need to process, understand and respond to mental illness as well as the new behaviours or emotions that may come with it will enable you to better meet the needs of someone you care for. For some this may mean sharing with close family or friends. For others, it could mean getting support from a professional in the field or connecting with a support group.

#7 Set Limits and Boundaries

Setting boundaries and limits is a difficult task in any relationship. I think it is one of the most common challenges that clients share with me and definitely one I struggle with myself! This is especially true if the relationship is compounded by mental illness. Boundaries and limits in relationships help each person to assert their needs, to take responsibility for their feelings and actions and to expect the same of others. Boundaries assert the difference between “my stuff” and “your stuff”. Asserting boundaries helps you to explore and determine: what is my experience? What is in my ability to control? How much am I willing/able to do for someone else in the situation? What do I expect from others and are these fair expectations. To begin the process of setting boundaries, take time to individually reflect upon concerns you have and previous challenges or conflicts you have experienced. Common points of reflection include how much (if anything) are you willing to offer your loved one in terms of: financial support, practical help, living arrangements, emotional processing, time commitments and what your expectations are around behaviour, medication and treatment.

When you have processed how you feel and have a sense of what you need moving forward, engage in a larger conversation that includes the person with MI as a participant. Express your perspective and hear others as well. Decide together how to respond to inappropriate behaviours or broken expectations. This creates a transparent understanding for everyone involved around what is considered to be acceptable behaviour and the outcomes for unacceptable behaviour. I am often struck at how readily people with MI are identified as “The Problem.” In fact, communication, family roles, values or behaviours inherent in the relationship may significantly contribute to “the problem”. A discussion of boundaries in which all individuals concerned are present and heard encourages a reflective process about each person’s role in creating stress or distress, establishes expectations, and allows for an opportunity to consider how all individuals participate in conflict in the family unit or relationship that may exacerbate tension or conflict. Try to be consistent in maintaining boundaries. Doing so can help to avoid burn out and feelings of resentment.

A Final Note:

Just as people do, mental illness comes in many shapes, sizes, colours and with unique personalities. Anorexia. Depression. Bi-polar. Schizophrenia. Complicated Grief. Seasonal Affective Disorder. Narcissism. Post Traumatic Stress Disorder. Borderline Personality Disorder. Anxiety Disorders. Obsessive Compulsive Disorder. And so on. For each person, relationship and family mental health is a very individual and personal process. In no way has this post intended to speak in an absolute way about the nature of these experiences we categorize as Mental Illness. Instead, the aim has been to identify particular strategies, perspectives and insights that might aid individuals in responding to their own MI or that of a loved one. Despite the commonality of these experiences, many people are more likely to cry quietly in bed than to seek support. I often express to clients that emotions and thoughts can be a bit like unruly children: the more you aim to ignore or silence them, the louder they become. My lived experience has been that people do heal, grow and change in ways that help them to manage MI and its impacts. I believe the starting point is exploring and sharing our experiences. My wish for you, reader, is to consider, if you are comfortable, how you might begin to engage in that process.

References:

1. Centre for Addiction and Mental Health, “Answers to Common Questions on Concurrent Disorders,” Journal of Addiction and Mental Health, September-October 1998, 16.
2. Public Health Agency of Canada, “The Human Face of Mental Health and Mental Illness in Canada”. Ottawa, Canada: 2006. 

Jessica Warnock works as a Mental Health Counsellor at a post secondary institution. She has her Masters in Counselling and Psychotherapy from the University of Toronto. Jessica works from a strengths-based and solution-focused perspective that draws upon a variety theoretical models and strategies in order to meet the unique needs of the client while prioritizing empathy and the counselling relationship. In her personal commitment to wellness, Jessica strives for balance and self-compassion. For comments or questions, please contact Jess via email.

When Every Day Becomes a Chore

Depression can hit us when we lease expect it and it can be incredibly difficult to accept its presence in one's life and determining a course of action. I approached Samantha about writing for Life is Sweet month after seeing some of her posts on Facebook and Twitter about how she navigated her journey with depression, and I'm glad she was willing to share her story. 

I’ve always been pretty great at keeping my own mental health in a relatively happy place before I’ve ever reached what I’ve considered to be the tipping point of needing to see a therapist. Then in December 2012 as I was hanging up Christmas decorations, surrounded by the intoxicating smell of cinnamon and cloves with Mariah Carey on the radio, I started randomly going through the logistics of my own suicide while crying into the candy cane box.

I know that they say that everybody thinks about it. However, there is a distinct difference between considering the vast landscape of what suicide means in an existential sense vs. “Wow, Santa. How quickly can I get this mess over and done with?”

Then, as quickly as it arrived, the thought disappeared. I went back to my new life, having recently quit my jobs to take on the seemingly impossible task of finally publishing my guidebook on open relationships. I met a new boy who I was really into, it was the holidays and everything was sparkly and bright. Even our beautifully decorated Christmas tree, which understandably I felt a little wary of at first, made me smile.

2013 was ushered in with the promise of being a year to really carve out my own future. I held the reins of prosperity. I was in charge! That tiny split-second suicidal thought blip, was exactly that, just a blip. There was no reason to be sad.

Until there was. Until the new relationship started to sour, and suddenly I found myself working from home alone during the harsh winter months, trying to write a book about open relationships, while simultaneously watching my external relationships fall apart and my heart break. At first, I told myself that the sadness I was feeling was strictly circumstantial. It was obvious that I was experiencing the winter blues, combined with a messy breakup, the stress of finishing a massive five-year project, a cat who was dying of cancer, and a lack of daytime human contact.

The snow and ice finally melted. I self-published the book with the best community support a girl could ask for. I was invited to be a keynote speaker at a brand new poly conference in Vancouver. Minus the failed relationship and the sick kitty, everything was coming up Samantha, with the exception of one relatively massive problem. Circumstances had changed for the better and yet I still felt completely empty inside.

People would tell me how amazing it was that I had written a book, and I would smile and say “Thank you”, but inside I felt like a failure who made all of the wrong choices. The romantic in me assumed that it was because of my recently collapsed relationship, but the realist in me knew it was more than that. This was more than a broken heart. I was depressed. I felt defeated. I was developing agoraphobia. I was just so damn sad.

Every.
Single.
Day.
Became.
A.
Chore.

I hated myself. I hated my overweight body and found my self-worth once again wrapped up in my appearance, after years of working to create separation. I hated my relationship with food (and still do). I hated dating. I hated my work life being in limbo. I hated the fact that I would have days of feeling “normal and social” and then another day where I couldn’t bare to get off the couch. I hated not knowing what mood the morning would bring, and I hated that I couldn’t just articulate what was wrong and suddenly feel better, all on my own.

It took months before I would finally accept the fact that I had real-life, full on depression. Maybe it was circumstantial, maybe it was seasonal, maybe it was from a broken heart, the cause didn’t actually matter. The point was that it was real to me, and suddenly I found myself unequipped to deal with it on my own. Being unemployed, I still wasn’t able to afford therapy, so I forced myself to embrace the loving, thankfully non-judgmental, arms of my friends, and my husband – who I finally confessed the depths of my depression to.

Then I embraced one very important detail: I personally accepted the very real fact that I was depressed. I accepted the fact that there were things going on within my mind and my heart that I needed help with that were beyond my capabilities.

I accepted the fact that sometimes I was just going to have a bad day, and that I didn’t need to punish myself for it, or fix it, or have a tangible reason to offer somebody when they asked what was wrong. I accepted the fact that I felt like I wanted everything to suck sometimes and that if I felt angry, that it wasn’t required of me to know why. I was allowed to simply feel it.

I stopped forcing myself to cheer up, to make things better, or to be “on” all the time. I started to embrace the sadness in a way that wasn’t encouraging it to take over constantly, but allowed it to breathe, and to do what it needed to do. I allowed myself to just be.

When I finally accepted that I wasn’t going to be able to fix everything at once, that it wasn’t possible to deal with my emotions all on my lonesome, and that I did in fact need outside help, I started to smile more. I still had a weight to carry, but suddenly I realized that the load could be shared, and that it was alright if I simply didn’t have the strength on my own sometimes. By allowing myself to feel the bottom, I found it within myself to slowly start pushing myself back up.

I don’t know how intense my depression is and whether or not it’s a thing that I always have to watch out for, or if 2013 was a lone black mark on my historical calendar. I can’t say with any certainty how much of it is based on a chemical unbalance in my brain vs. my tolerance for bad luck and sad situations finally reaching its boiling point. Nor would I ever think to suggest that what worked for me would also work for someone who requires medication to help regulate their brain’s chemicals. Everyone is different and the solutions that work for our mental health are as unique as we are.

It’s possible that I will never break as hard as I did in 2013. It’s also entirely possible that I will. But I’m not scared of it anymore. I refuse to be afraid of the dark moving forward because it’s only in the dark that we can really see what’s in the light.

Samantha Fraser is a poly advocate, speaker, nerd whisperer, and author of the book: Not Your Mother’sPlayground: A Realistic Guide to Honest, Happy, and Healthy Open Relationships. She live in the west end with her husband, and her (now) two cats. You can find her online at @nympsam or www.notyourmothersplayground.com.

Getting Back to Me

Since my mom's death, there have only been a few people who I have met who have dealt with the suicide of an immediate family member. Adrianna and I connected through the theatre / Twitter scene in Toronto a few years ago and though we've only spent a bit of time together, I've always felt greatly connected due to her experience and the path she has taken as a result. She has been a great supporter of  Life is Sweet month and I'm grateful to have her as a guest blogger.

Loss is sometimes greater than leaving your umbrella on the subway. Sometimes you lose someone you love. Forever. That’s what happened in the year 2010. It was a foggy November night when a knock at the door changed everything. My brother Andrew had killed himself. My father wanted to tell me in person so he came to my doorstep at midnight on November 12th 2010. Ever since then, things haven’t been the same. I lost more than my brother that night: I lost my home, because my boyfriend left so I had to move. I had to give my cat away. My workplace was forcing me to take minimal hours. I felt like I had lost my life. I felt like I had lost my self.

Bereavement was harsh and looked a lot like depression. I have select memories of the first year of bereavement. They are dark, sad, and drenched in alcohol and loud music. But through it all I was writing in my diary. Despite having two therapists (one just for me and one for family and group therapy), I felt like I didn’t have anyone to talk to. I wrote and wrote and wrote to try to work stuff out. In my past life, a.k.a. pre-2010, I was a playwright of historic adaptations. So writing was a part of my old self that carried over into the new. I would write out conversations with my brother. I would write out alternative endings to our story set in other universes. I would write out the things I ate for breakfast, on the rare occasions I managed to eat breakfast. I just wrote. It was my private therapy. In the end I would use those diary entries and fake letters to deceased and living loved ones as fodder for a solo show about bereavement and suicide—“Everything but the Cat…”. Creating this not-so-one-woman show, dealing with all the above, was my attempt to come out of this with something helpful, something to contribute, something to say about the terrible truth of suicide.

I want Andrew’s story to continue. I hope to educate those around his age that they are not alone. My brother was depressed and needed to hear he wasn’t the only one experiencing the weight of transitioning into adulthood. He needed to hear that life can get pretty dark, sad, lonely and downright awful at times. But in an age where everything is photo-shopped, auto-corrected, and Instagram-filtered, it’s hard to remember that. It’s so easy to be tricked into believing that everyone else’s lives are so frickin’ perfect. So when yours is not, you question yourself. What am I doing wrong? I’m wrong? I am wrong, it’s me. And that can be a dangerous headspace to live in.

I want to tour my show to get that conversation out of the dark and into the open. I want people to know that failure in life is not optional – everyone experiences it. Really, failure is a gift; a gift that sucks. But the part that failure sucks out of you makes room for something else, something potentially better, something new! I want to help people embrace that dark feeling and understand that it is only temporary; it is only a stepping-stone towards something much better. And what if the embrace lasts too long or you don’t know how to let it go? I want people to know that it’s okay to talk to a therapist. It’s okay to see a doctor about medication. It’s okay to do what you have to do to get yourself back to you.

I lost my brother. I lost my self. I will always miss my brother, but I won’t ever miss who I was, because it helped me get here — to me.

Adrianna Prosser is a Toronto based actor and playwright. You can learn more about her project at  www.everythingbutthecat.net

Finding Forgiveness

Talking to my bloggers last year about their experience writing for the project was incredible. Many were uncertain about writing, others were unsure how their content would be received. After the month was over, many told me how therapeutic is was for them to write and be more at peace with their feelings and experience. When I heard Shannon's account of forgiveness, I thought it would be especially appropriate for her to write and share that experience for Life is Sweet month. 

“I forgive you”…three small albeit powerful words that can change you.

Last year, I had the privilege of sharing my story for the Life is Sweet project. Sharing my experience with Seasonal Affective Disorder (SAD) and depression, in I Want You to Know that Life is Sweet, was difficult and terrifying and almost did not happen. However, something from deep within urged me to break open the past and with a giant breath I shared the details of something I rarely spoke of—the time I tried to commit suicide. This part of my past was the skeleton I kept hidden in the furthest depths of my closet since I was 12 years old, in hopes it would just disappear. I hated acknowledging its presence because of the pain surrounding it and because it felt like my “dirty little secret” that would expose me for who I really was…not perfect, and simply human.

Twelve months later, I am incredibly grateful for embracing the opportunity that Ashley and the Life is Sweet project presented. I am grateful because of what I received in return, forgiveness. Forgiveness from the most important person in my life, myself.

It did not dawn on me—though it makes absolutely perfect sense—that I needed to forgive 12 year old me for a choice I made 22 years ago. That part of my journey feels like a lifetime ago and while I am not defined by my depression or my actions all those years ago, there was a small hole in my heart that ached when a glimmer of my past came to mind.

It wasn’t until recently, when reflecting on the 13 things I was grateful for in 2013, that I realized what had occurred. I did not actually have a profound moment where, looking in the mirror, I boldly declared “I forgive you.” It just happened. It happened through breaking open my past and participating in Life is Sweet. It happened as I shed the many tears while writing. It happened as I listened to and read the reactions of loved ones, friends, and even strangers and as they continued to embrace me in the same way they always had. It happened as people bravely confided in me their experiences with depression—I cannot begin to tell you how much that meant to me. It happened when I let go of the “dirty little secret” concept and the skeleton just evaporated into thin air. “I forgive you” just happened because it was time. It was time to forgive myself and love myself completely. I knew this moment of forgiveness had come when I thought back to my experience with Life is Sweet and my past, and no longer felt that tiny aching hole. It was a powerful realization.

It’s hard to describe how this realization feels, however, a quote from Gabrielle Bernstein's Facebook page articulates it perfectly. The quote appeared just as I finished writing this. Talk about timely! “When we change the way we feel about what’s happened to us in our past, our body chemistry changes in the present.” –Lori Leyden #SpiritJunkie

As I shared in I Want You to Know that Life is Sweet, the depression I live with now is very different from the depression I experienced growing up and thoughts of suicide never cross my mind. There are days though where I do struggle with SAD and depression. It seems to sneak up unexpectedly and the easiest of tasks and the things I love most feel like the biggest, most exhausting challenges—like I had climbed Mount Everest without any training. I wish this wasn’t the case, but I know that I don’t have control over that. What I do instead is embrace those moments, even when it is hard to do, urging myself to be gentle and kind to me until it passes—I take a nap or two…or three, cook a favourite meal, curl up with a cup of tea and a good book, curl up and watch a movie, practice yoga, close my eyes and calm my mind with meditation, or simply just be. Sometimes it passes quickly and sometimes it stays a little longer, but it does pass.

I also shared that I would be transitioning from medication to working with a clinical nutritionist to treat depression naturally. That has happened and I have also: returned to therapy, slowly but surely started practicing yoga and meditation on a regular basis, and have started exploring light therapy. So far these have been working for me.

For those who are struggling with depression and those who have not yet forgiven themselves for something from their past, I leave you with this:

I want you to know that life is sweet. I want you to know that so many wonderful things are in store for you that you do not yet know about. You are not alone and there is love around you, even if it may not feel like it. If you need help, please hold on to hope and reach out to someone. Your experience around depression is not a “dirty little secret”. You are human. You are amazing, and deserve to know that life is sweet. And, when you are ready, forgive yourself. You deserve that too.

By day Shannon works in the not-for-profit fundraising sector. At night she dabbles in theatre and explores her interest in health, wellness, nutrition and personal development. You’ll find her sharing her discoveries on Twitter and Instagram at @ShanDMC. 

All I Wanted Was to Be Listened To

Asking for help can be an incredibly difficult thing for anyone, especially when it's related to our own mental health and well being. When your asks are not heard or you receive misinformation, it can be extremely difficult to want to repeat the process. Today Catherine talks about her experience in seeking help after the birth of her first child. 

It was when I had my three week old daughter peacefully snuggled against my chest that I realized something was wrong with me. I couldn’t get myself to do anything. Moving was hard, eating was near impossible, but the worst was sleeping. As soon as I would close my eyes, I had a chilling sensation that I would lose everything.

No, not everything; everyone. Everyone I loved. The same way I lost my father when I was seventeen. I had fallen asleep in the car and woke up to a metal wreck on the highway. Even though I had been only a few centimeters away from him, I wasn’t given the chance to say goodbye. The same way I had been blinded into pregnancy bliss in 2010. It was the happiest I had ever been as I awaited our first child. Week after week, building hopes for our future son or daughter, only to find out that the foetus had stopped growing months ago. It was like being smashed with a rock on the head. Wanting to be dead, or, at least, in a coma, so I didn’t have to live through this. The physical and mental agony. And the blood, so much blood.

Needless to say, in February 2011 when I, again, found myself pregnant and heavily bleeding, I numbly drove myself to the ER and asked for a D and C. Again. Quickly counting, I figured I was seven weeks along. No one knew I was pregnant, so there would be no disappointing anyone this time around. No awkward, “I lost the baby” announcement to make. Somehow, I was relieved.

To my surprise, the baby was alive. At least for now. So, I went on bleeding as the baby went on growing. But there was no bonding. No hope, no bliss, no big announcement, no baby shower. It was one big secret between my husband and I, and our close friends and relatives. I just could not deal with another loss. Somehow, pretending I wasn’t pregnant was my best way to cope with it.

Every once in a while I would feel terribly guilty. Why couldn’t I be happy? Why could I not enjoy my pregnancy? Why did miscarriage haunt me every night? At 37 weeks, things went from bad to worse. At 39 weeks, she came – emergency C-section. It was nothing like the water birth I had planned. The worst feeling of all was that I had no happy memories to tell my daughter. I had hated everything about the way she came! And, I hated myself for feeling this way. Yet, I loved her. From the first moment that she was put in my arms, I loved her like I had never loved before.

Over the next few days, after we got home, the hate just grew bigger and bigger. I hated my body so much for killing our first angel baby, for not being able to care for our newly born daughter, for not being able to birth. Also, I hated myself for not being blissfully happy. At four weeks postpartum, I started to run again. It was after the C-section. No enjoyment there, but a way to punish my body seemed like a good idea at the time. Hatred and anger now filled my daily life.

Love, too. Love, because I adored my daughter. Nothing was too good for her. I put all my love and strength into breastfeeding her. It was hard and painful, but that was the only thing my body seemed to be doing right. So, I devoted myself to nursing. By the time my daughter was three weeks, I knew something was wrong with me. I couldn’t be happy, I couldn’t eat and the nightmare of losing my daughter just would not go.

It was just after Christmas, and my daughter was two months old, when I walked into my doctor’s office and I begged for her help. It was on a whim and something very unlike me. I asked for help. I still don’t know why I did it, or how I even found my way there. I just did. I walked in and said, “I need help, I can’t do this anymore.” Everything moved really quickly after that. The next day I say a lovely social worker and was referred to a psychiatrist for the following week. Part of me was relieved. That week, things got a little better, there was hope in sight. I was going to be helped; I was going to be happy. I was finally going to be normal.

On a Tuesday morning, I drove myself to the psychiatrist. He was an older man. I was also introduced to residents that would be sitting in on my appointment. I was so happy to be there. I sat in the chair with no expectations and surrendered myself to their questioning. Not knowing what to expect, I was a little surprised and confused about the first few questions. They were yes or no questions; black or white. I thought to myself, were life this easy, I wouldn’t be here. I couldn’t just express my feelings or emotions on a scale of one to ten, much less a stoic yes or no. I tried to explain myself, but he wasn’t listening.

Ten minutes into the appointment, I started feeling a little frustrated. He asked me, “Do you feel like you want to hurt your daughter?”

I told him the truth, “No.”

“Of course you feel like you might!” He replied, following it by asking, “Are you paranoid when you go out in public?”

I gave him a no, and he responded with, “Really? You look to me like you might be.”

Twenty minutes into the appointment, he told me, “You have postpartum depression.” I just silently nodded. Nobody likes to hear the word “depression,” but I believed him. He was the expert. Yet, a part of me felt uneasy. In the last twenty minutes, although I had only been allowed to say yes or no, he felt compelled to reword my answer with his own thoughts. I didn’t like this. It just did not seem ethical to me, and I knew ethical. Part of my work at the university is to conduct research.

So, he prescribed some medication for me and told me I had to start them today; as soon as possible. That, without this medication, I was “bound to kill my own daughter.” Yes, those were his exact words. I took the prescription and saw the name of the medicine. I gently pointed out that this medication was not breastfeeding-friendly and that I’d rather prefer it if he were to prescribe another brand. That is when my whole world collapsed again. He looked at me straight in the eye and said “Your nine week old does not need to breastfeed anymore. Past six weeks, there are no benefits anyway.” He went on, adding, “You are a bright, educated young lady and should know better!” I was at loss. I started crying. Me! Stop breastfeeding! The only thing my body can do right! Between tears, I asked him how long I would have to take the medication and how many weeks it would take for the dosage to adjust. I will always remember his words. “You are sick!” He said, “There will be no getting off this medication. Do diabetic patients stop their insulin when they feel better? You are smart. You should know that.”

After this, the rest of the appointment remains a blur. I tried my best to hold my tears on the way out. When I sat in my car, I started hysterically crying. I had been torn into a million little pieces. I was shaking in anger and disappointment. I took my phone out and called my husband at work. I told him what the psychiatrist had said. It just didn’t make sense to me. Then, I called my cousin, a social worker. I told her about the appointment. I just couldn’t wrap my head around what had been said to me. Was I this out of the loop? Was I in denial? Was I going to kill my daughter? My body was useless and I was stupid. I was sick. I would have to stop breastfeeding. And, as I sat in the car reflecting, I believed him.

After I got home, I went straight to bed. Not for sleeping or for crying, but, for thinking. I just could not shake off the feeling that something was wrong. If psychiatrist were there to help, why was I feeling worse after seeing him? Why would he insist I stop doing the only thing bringing me joy right now? Also, since when had postpartum depression needed to be controlled with lifelong medication?

The next day, I found out that if I went against the doctor’s order, I could be held responsible for it. Since, apparently, I was in danger of “killing my daughter.”

With my husband’s support, I went back to my social worker and explained to her how my appointment went. I placed a formal request for a second opinion (with a different psychiatrist), declining to start the medication until then. Two days later, I found myself in Toronto, meeting with a psychiatrist specializing in postpartum depression. I walked in holding my daughter in my arms. I stood before him and, taking all of my courage, said, “I don’t know what is wrong with me but, please, if you have to prescribe me medication, pick a breastfeeding-friendly medicine.” I will always remember his look of utter surprise. He was shocked. It took him a moment before he finally replied, saying, “Well, I don’t know you yet, but I can assure you that if indeed you need medication, there are breastfeeding friendly option, so it will not be a problem.”

Taking in his words, I sat down and prepared myself to answer with yes or no, one to ten, white or black. But, that isn’t how it went. Instead, for just over an hour, we had a two-way conversation. I was allowed to express my thoughts, my feelings and my concerns. He listened. I even breastfed my daughter in the middle of the appointment. Towards the end, he asked me “Do you believe you need medication in order to feel better?”

I replied with a maybe, “I don’t know anymore. But I know I will not feel better if breastfeeding is taken away from me.”

“I would never let anyone tell my wife to stop breastfeeding for this reason,” he said.

Our one hour talk felt so good. I told him, “If I could have more talks like this, I think I would feel better.” So, he agreed, I should remain in weekly therapy for the next few weeks and then decide for myself if I needed medication. Just as I was leaving, I said to him “Just for the record, I love my daughter and, not once, did I feel I could hurt her.”

I thanked him after he said, “I don’t doubt you.” He added, “It really does happen. It could happen to anyone. Postpartum depression is a serious matter. However, I do not believe you have postpartum depression. In my eyes, you are suffering from Post-Traumatic Stress and that is what you will be exploring in therapy. We are going to learn how to deal with the events that have shaped your life in the last two years. We are going to find ways to cope with them and move on.”

On my way out, I had no tears to fight back. I got to my car and called my husband and told him, “I think I will get better sometime in the near future.”

It was January 2013 when I found I was pregnant again. I panicked. A wave of doubt and fear came over me. I looked at the positive test and cried. I was unable to be happy. Right then and there, I had to make a decision and I had to make it quick. I had to make it for myself, by myself. I looked in the mirror. I was pale. I thought, this is it, this is your chance to make amends with yourself. I called my husband over and showed him the positive test. He was so happy. I wanted to be as happy as he was, and decided I would be. I decided I was going to enjoy being pregnant. Or at least try. I was going to bond with this baby from the start, no matter what happens. I will have a baby shower, I will make a grand announcement and I will welcome him into this world with a smile.

Well, it was hard to do, a constant fight with myself. At times, it felt so forced. After all, isn’t the mere fact that you have to try to be happy, a failure in itself? Every morning I had to remind myself, every night I tried to be thankful. As the end of the pregnancy came into view, and as the feeling of happiness became more natural, I set my sights on a VBAC (vaginal birth after cesarean) delivery. I needed that chance to test my body. I needed to know what it would be like. I needed closure.

I was 36w7d when my water broke. For the first time, in three pregnancies, I felt the excitement of a new life about to come. We made our way to the hospital. Twelve hours later, our son was born. Naturally. On the last push, I just knew I had come full circle since that dreadful morning three years before, when I had started bleeding uncontrollably. It was a very slow and very long process; a process in which I had to completely regain my self-worth. It was also a journey in which I also had to be my own advocate, mentally and physically.

Many times, I found myself wondering how many women go to seek help, only to end up more devastated because of comments the psychiatrist may or may not have made to them. How many of those women had the strength to demand a second opinion? How many women were wrongly diagnosed because of a few yes or no questions? Many times over, I have felt anger about the possibility that I, too, could have been wrongly diagnosed. I did fill in a formal complaint about the way in which I was first diagnosed. However, as far as I know, nothing came of it. I, on the other hand, thrived with therapy and was able to build a support system around me that served me well during my last pregnancy.

It is now January 2014. I have a three month old son and a two year old daughter. I love them both more than I could ever describe in words. I never ended up taking the medication, nor did I kill my children. As I type my story, I am still breastfeeding both my daughter and my son. I am also no longer haunted by nightmares of blood and miscarriage. My only regret was, and still remains, that I never accepted help during and after my miscarriage. When the rock hit me, when my whole world fell apart, I went on. I went on by myself, terrified and sad throughout a whole pregnancy. I look at my daughter and, although I have no happy memories of her birth, I cherish the pain and anxiety I felt for nine months. Looking back, I can tell, amidst all this, I never stopped loving her.

One day, I will proudly tell her that.

Catherine Cua is a PHD student and mommy of two. She enjoys writing and is the owner of the travel/craft/mom blog "the things I find on the way"