Story #71 - Wise Words - Christine, Psychiatric and Mental Health Nurse, Québec (CANADA) - On Mental Illness, Being there for Each Other, Raising a Strong Daughter & Stories That Last Forever
I'm a teacher in nursing school. I love it. Because of COVID, they had to shut down the program for a while. I'm trying to help however I can by monitoring COVID cases for the public health department. This virus is affecting everybody, and feeling safe shouldn't be a class thing. Individualism is rampant and dangerous.
Before I worked in psychiatry, I was a surgical nurse. I've somewhat hesitated a lot before taking the leap, but being a mental health nurse is phenomenal. The people who work there are considerate of the person as a whole and very focused on relational care. I have two degrees, one in sexology and another one in nursing. It suits my personality to work in a field that is scientific but also demands to be attentive to the mind.
We are at the core of what it means to be human.
I've learned a lot there. I had to question my prejudices and listen to life stories and the way they shape us. Mental illnesses have a genetic component, but your history and the environment you grew up in is as important, if not more, as the chemical imbalance itself. Often, people who are seriously ill had a rough start in life. They lacked resources or had highly dysfunctional families.
When you see people who come in acutely ill but leave "just like us," it's humbling.
My two kids are older now. I got a divorce two years ago, and my new partner and I recently moved in together. We're lucky because we have a house with a lot of space, which makes the confinement less stressful. Altogether, we have five children living with us at different times during the month, depending on the shared custody arrangements. Some weeks, we're all living in the same house. Others, we're alone. Shared custody is excellent for the parents' mental health! It should exist even in nuclear families!
Joking aside, as a divorced parent, it takes a lot of detachment to reinvent yourself. It can feel incredibly lonely or empty when they're gone. But I think it's our role as parents to re-individualize ourselves after they leave the nest. It's just that when you separate, you have to go through this much earlier in life.
Both my children are anxious, but my daughter even more so. She recently found out that one of the doctors I used to work with had died of COVID19 at 44. She's now incredibly scared of death: for herself and us.
We try to deal with it the best we can. She recently started having her periods, and I explained to her how it affected the body and the brain. I know the theory behind anxiety disorders, but when it's your child, it's always a little different.
We're working on it by identifying the moments during the day when she's most anxious, and then try to understand the causes. For example, is she scared of us dying in the morning or at night? Usually, it comes up at night. We know that darkness and exhaustion tend to increase anxiety. Now that we've identified that, we can talk about it rationally: is it statistically likely that I'll die? No. How about her? The risks are minimal. Now, what should we do to reduce the anxiety? Yesterday, I saw she was laying down with the dog. I asked her if it felt good, and she said yes. So she can do that when she feels anxious. She also likes to draw, do puzzles, watch a feel-good movie... Relaxation and deep breathing exercises before bed are also helping. It's great to have many.
I personally need to move. I'll clean up my countertops real' good! You must learn to know and trust yourself. If doing relaxation exercises before bed gives you more anxiety, then don't do it. Go for a run instead. Jump on the bed. Do whatever feels right.
All this is easy to say, but as a mom, even if I know a lot about mental health, I also got things to do around the house.
I might not always watch over her the way I should. It's hard. And not perfect.
Two years ago, when I separated from my husband, my daughter saw a therapist. We'll probably use her again soon because she has what it takes to develop an anxiety disorder. But it's work that only shows results in the long-term.
It takes time because anxiety starts in your head as an inner monologue. It's that little voice that sneakily brings you down. We work a lot with the inner speech in therapy, and this is why the "rational" aspect is so important. It's not to minimize the risks or the thoughts but to nuance and add "grey zones" to our reality. Anxiety is black or white. It's extreme. Sensitive people are more at risk because they take everything in and place them in these extreme categories.
For example, I can't watch horror movies! I won't be able to sleep, and I'll run the film over and over again in my head. My daughter finds true-crime series interesting, but she doesn't feel well after watching them. You just got to stand your ground... which is easier said than done.
I hope to bring up my daughter differently than I was. I was often left alone with my anguish. At the same time, you go through life yourself, hit some rough patches, and then realize that you aren't the parent that you thought you would be.
In 2014, I took a medical leave because I became depressed. I had experienced a lot of stress six months prior, and when my father-in-law died, I simply couldn't do it anymore.
I was always overwhelmed by my kids and had this fantasy to leave. I imagined myself packing a suitcase, opening the door, and never coming back. Rationally, I knew it wasn't possible, but at the time, that fantasy was essential to my survival.
My mother was an alcoholic. She went into rehab, but I have vivid memories of her not being able to care for us. I blamed her a lot for that. But when it was my turn not to be able to care for my children, something changed in me. I really, really wanted to be there for them, but I simply couldn't.
Luckily, it doesn't have to last forever. Maybe that's what it takes to be a parent: 10% of mess and 90% of goodness. Hopefully, that experience allowed them to grow, and one day, they'll maybe understand I couldn't do it any other way.
I began taking antidepressants around that time. It was a deliverance when they started working. Because although I knew they had helped a lot of my patients, I had to work through my own prejudices about mental illness. I didn't become "somebody else," as I'd feared. I became myself again, and that's a relief.
Maybe one day I'll stop, but as a psychiatrist friend of mine once said, "Why stop? Brains love serotonin!"
It's a constant work in progress to untie the preconceptions we have against medication for mental-health-related issues.
I think this experience helped shape me as a better nurse. I understand the process and the grieving. For a lot of patients, going through the process means to stop medications, then to start again, many, many times. You have to put a lot of trust in people. Psychiatrists are genuinely amazing beings for that. They show a lot of understanding and faith in the process and their patients. Behavioral changes are not simple. You have to be there and ready to stick around for the ride.
In a way, it's just like with our children. You plant seeds that may be harvested someday. It's not always as grand as we'd like or had hoped for. It's also part of life.
I do think we remain postpartum for the rest of our lives after we had children: the gap between what's coming when you're pregnant, the expectations, the dreams, all the love... and a reality that is often so harsh.
That drop is ruthless.
To go through a crisis like that, you usually have to ask yourself two things: what is your perception of the event and the resources you can (or cannot) get.
My son, for example, was the first-born of the family. My mom was eagerly waiting for him. It was like carrying a treasure. I was very interested in having a midwife (it was 16 years ago) and have a natural birth. In my family, women used to give birth without any trouble, so I thought I'd be fine.
At the time, I was in love with my boyfriend, but we had some issues. Without telling me, he was struggling with me being pregnant and had alcohol problems. A couple of weeks before my due date, he was arrested for drinking and driving and lost his license. It was a huge stressor. I felt stuck with him. At the same time, I didn't want to be alone to give birth, and when you have a baby with someone, you usually think you'll be with that person for a while. But I felt betrayed, insecure, like if he wasn't considerate to the baby and me. It fragilized me.
My baby was breech, so I ended up having a c-section.
It was a complete letdown, and I couldn't get over it.
It took a nurse friend of mine, who worked in the NICU, that said, "It's not important, Christine. Your baby is alive and well," to make me snap out of it. I trusted her, and she was right.
After that, the problems with my partner kept getting worse. My mom acted like a buoy, and I used to go to her house often. She would care for my son at night while I tried to sleep. I was so exhausted, overwhelmed, and I questioned myself a lot. I'd always wanted kids, but now that I had one, there was no joy in being a mom. My whole identity collapsed. For six months, I had the worse fatigue ever. In retrospect, I probably went through postpartum depression.
Even as a nurse, even if I knew things, I was blindsided. Now I have a master's in public health, and I know the statistics are vital: the reason why so many mothers go through this without proper care is because we don't ask enough questions enough times.
Nurses at the CLSH [Local Community Services Centres in Québec] are overwhelmed when they do in-home care after you give birth. They ask, "Are you tired?" and you're like, "Of course I am! I have a newborn!" You're not necessarily sure of what's going on when it's been only a couple of days or weeks. OBs sometimes will ask, but it's also very medical and quick.
I asked myself recently if I could have talked about my anger and disarray to my OB for my six-weeks postpartum checkup back in the days, and the answer was no. Unless you have a strong trust relationship with your provider or if you go in crying and at the end of your rope, you won't talk to them.
You don't want to look weak as a new mom, especially if you're not sure what's going on with you.
Great care starts with proper screening. Ideally, all the providers would ask the same questions several times after you have a new baby: OBs, nurses, pediatricians, and family doctors.
In a way, midwifery is much better at it than hospital care. They spend more time and can identify and anticipate risk factors. Some family doctors are also awesome.
For a lot of pregnant people, this is the first event in their lives that will shake them to their core. Everything is new; it disrupts your routine, your identity, and requires significant changes. It's vital to have support.
My son was a difficult baby. He objected and fought me about everything—still does. To be honest, what healed me as a mom was the arrival of my daughter. I was ready for the struggle, but she didn't fight me. She was easy and responded positively to what I was doing. It was gratifying to say, "Oh, you're crying because you're tired!" and she would indeed fall asleep. It sent me the message that I was a good mother. With my son, I always felt like I was failing. But he was my first, so I didn't know that it wasn't about my skills as a mom: he was just a challenging baby.
In the end, I understood why the first time around had been so hard. I could still be a "good mom" like I'd imagined.
Kids are a great source of love, but also frustrations.
Our job as parents is to repeat ourselves endlessly. And then somehow, at some point, it shows results.
And you're incredibly proud of that.