#And the nurse replacing him is 'willing' to fill my prescriptions for the 3 months on my latest checkup

[vergess]

An adult human in my vicinity went for ADHD dx. She had a call that had a lot of standard ND screening questions and got a prescription for both Wellbutrin and Zoloft, and told that she needed acomputer test for a proper diagnosis and actual ADHD meds, plus blood work. Is that normal? Do you know anything about antidepressants and ADHD?

I mean, it's definitely normal, yes. Whether it's good is much more debateable.

But it's extremely normal, because we live in a fuckign hellscape and the government in this country likes to arbitrarily gatekeep life saving medications like pain relief and stimulants to prove they're "tough on drugs" even though it literally makes the problems of addiction, street drugs, and overdose related death much much much MUCH WORSE.

/ahem

Anyway, it's very normal for a medical practice to either say outright "we don't treat ADHD here at all sorry" or to put access to stimulants behind a bunch of weird obtrusive hoops. For example, I have to go to my doctor every three months for a physical, a mental health screening, and to sign a stupid fucking contract that says I'm Contributing To Society In The Legally Mandated Ways before I am allowed to get the medicine that literally allows me to feed myself or clean my own body.

The computer screening in particular sounds Very Legit to me, because a lot of the time they're going to end up using the same diagnostic exam you can fucking take online, but monitoring you while you do. Advise your friend to always describe their most extreme ADHD symptoms when taking the screener. If they've ever "forgotten an important work task" she needs to put that she constantly forgets them, like the maximum fucking amount. Stuff like that.

Okay the actual question now.

Wellbutrin+Zoloft is a common enough treatment for ADHD when your doctor is averse to stimulants for whatever reason. In a normal society, this would be "because you have a history of heart problems or have tried stimulants and found them unhelpful," but we don't live in that world. It's what's called a second-line treatment, which basically means it's supposed to be tried second, after first-line (stimulants) have failed.

ADHD is generally believed at this point to be a fault in the way neurotransmitters bind to neurons in the brain. They take 'too long' to bind, and end up getting cleaned up instead of transmitting their message. Since the cleanup system is being constantly triggered, you also make less of these neurotransmitters since there's an apparent oversupply. (This is a WILD oversimplification)

Stimulants cause you to make more neurotransmitters, bringing production up high enough that the transmitters have a chance to bind before the overzealous cleanup systems eat them.

Wellbutrin slows down the cleanup process of one neurotransmitter (noradrenaline, I believe). Zoloft slows down the cleanup of a different one (serotonin). So, they're often prescribed in concert.

But, they literally cannot help you produce more neurotransmitters so they fundamentally have limited overall utility in ADHD. Not no utility. Plenty of people who cannot take stimulants find this combination adequate to live with.

But in almost all cases stimulants will work fucking better.

The fact that our goddamn War On Drugs bullshit has made it this difficult to get them is disgusting and is also specifically the fault of Joseph Robinet Biden, who takes great personal PRIDE in having created this medically destructive hellscape during his pre-presidential career and now seems to take great joy in doing nothing to clean up his own goddamn mess.

Okay so!

Yes, SSRIs, NDRIs, and other reuptake inhibitors (cleanup slowdowners) are definitely An Option for ADHD, but they're SUPPOSED TO BE A SECONDARY OPTION FOR A FUCKING REASON AUGH

ETA: You can also be prescribed secondline treatments in addition to firstline ones, if you for example need stronger management of symptoms, etc etc there's a lot of nuance this is a rage fuelled over simplification.

[spiritualgravity]

A Dance with my Daughter

When I was pregnant with Isabella, I would play classical music for her through something called “Belly Buds.” My dear friend gave them to me as a gift. My husband absolutely loved the idea of having her listen to music while in the womb. If it wasn’t for him, I would have forgotten to do it most evenings. While I watched TV or read a book, I’d put the buds up against my lower belly for 30 minutes.

My pregnancy, from start to finish, was incredibly challenging — both mentally and physically. The labor was also incredibly challenging — all 36 hours — both mentally and physically. It seems that this challenging journey to parenthood was a glimpse into what was ahead.

As a first time Mom, I had absolutely no idea what to expect about caring for, and keeping a newborn baby, alive. Notice I didn’t say keeping a baby…happy. You see, I quickly learned that I had to lower my expectations. The first 3 months of a baby’s life is considered their 4th trimester, it just happens to be outside the uterus. They aren’t used to the bright lights, cold air, and freedom. The goal is to try and recreate their life inside the womb as much as humanly possible until they get adjusted.

When I would talk to my business leadership coach that my company generously pays for me to have a one-hour talk with every month, I would explain that I simply could not plan running and maintaining my at-home, entrepreneur-style business because I did not know what the first few months would be like. How could I know if I would be able to attend a video conference call if the baby was breastfeeding? How could I know if I would be able to attend a 4-hour training event if the baby wasn’t able to nap? So I decided to grant myself a self-proclaimed 12-week maternity leave.

My gut instinct was correct. I truly had no clue on the deepest level what this experience would be like. When an innocent bystander, family member or friend would ask as early as week three, “So, are you on a schedule now?” I felt an ulcer develop in my soul. Or my favorite suggestion, “Sleep when the baby sleeps.” I happen to have a baby that, coincidently, doesn’t fancy sleeping. 

Very early on, around 2 weeks in, we realized we had a special needs baby on our hands. To name just a few superlatives, Bella has reflux (this means she’d scream in pain when acid would come flying up her esophagus / throat, was very uncomfortable, and spitting up was quite common). The pediatrician prescribed a medication that seemingly did not work. We were told that there was essentially no reason to keep playing with other medications because if the first one did not work, then none of them would and she’d have to outgrow this condition hopefully between month three and month six. The doctor also explained that recent studies have shown the risk of keeping her on reflux medication long-term outweighed the immediate result, which wasn’t much. Bella is also considered colicky. The definition means the baby is younger than 5 months old, cries for more than 3 hours, 3 days a week, for 3 weeks straight. There is no cure or treatment for this, either. Sure there are dozens and dozens of gadgets and gizmos, but none of them really made a big difference. Bella is a very poor sleeper, both day and night. In addition, Bella has an intolerance for dairy, eggs, and soy. I could write a dissertation about what this experience has been like for me, eliminating lots of foods (which as it turns out, everything processed has soy in it), but I’ll save you the pity party and raise you a piece of mozarella cheese instead.

Our baby would not sit or lay in any kind of contraption that lines our house from wall to wall. A Boppy Lounge pillow, a swing, a bouncer, a bassinet — nada. So, for the first 4 weeks of her life, she slept on top of me. Which means, I did not sleep for 4 straight weeks. I also held her during daylight hours.

We finally got her to sleep in a Rock ’n Play, which after consuming an embarrassing amount of product research, I swore I wouldn’t let it be her main sleep device. It’s only meant to be a napping tool. That went out the window once our sanity was on the chopping block.

Speaking of naps, I just put baby down 12 minutes ago for a nap, and she is waking up now. This has been our reality. Essentially, every text book baby manual has been the complete opposite in our storybook. Newborn babies “should” sleep for approximately 17-18 collective hours. Ours would sleep for about 10 hours. That’s 14 hours of keeping a baby alive — not happy — who did not want to be put down in anything.

It turns out I am now ambidextrous; I learned how to use my left hand to eat, text, and type. Miss Bella was attached to me around the clock, and still very much is today.

By weeks 5-6, I was acutely aware of why sleep deprivation is used as a torture tool. I would cry, a lot, out of frustration. And complete and total exhaustion.

At this time, I randomly developed a horrible eye infection. I went to a primary care physician’s office, which happened to be the day before my 6-week OB/GYN postpartum appointment. The PCP was a new office closer to home, and so I had to complete lots of new patient paperwork. When the nurse was going through the paperwork and asked me a series of questions, it turns out she inadvertently diagnosed me with postpartum depression. When the doctor walked in, before even addressing my one-eyed-monster face, she immediately informed me that I was flagged for “moderate to severe PPD” and nearly threatened me, in the kindest way possible, to make sure I talk to my OB/GYN about it the next day. Lovely.

The one time I could have used support, the critical people in our lives — our two mothers — were both unavailable due to extreme circumstances. My mother had 2 major back-to-back surgeries and was bed ridden at home while she recovered. My mother-in-law lost a family member who lived overseas and she left for nearly 2 months immediately following Bella’s birth to spend time in her home country and mourn the loss. I have never felt more alone in my entire 38 years on earth. My husband and I were on a deserted island, together, and  stranded without any relief in sight. Friends would stop by here and there to meet the baby and drop off a dish of food, and it filled my heart with happiness to know that people were thinking of us. But, there is nothing that replaces a mother’s hug or hand of support. Nothing.

The next day I was given a prescription for Zoloft. The best part of this story is, Zoloft’s side effect was insomnia — the very cause of my PPD. The fluctuation in hormones I’m sure plays a part, but I’m convinced staying alive AND keeping a baby alive without much sleep is the ultimate culprit.

After giving this medication 4 weeks, I recently switched to another medication, which hopefully will allow me to get into REM sleep again when Bella gives me the limited opportunity.

I am not ashamed to share my story, feeling depressed, because it’s actually quite common. Many women in my life have admitted to me that they think they had PPD after giving birth, but never talked to anyone about it or received help. One in seven women suffers from PPD but 50% are never detected. I was prepared to have “baby blues” which happens the first two weeks after delivery, but never PPD.

We just crossed the 9-week mark with our little girl and continue to face pretty significant challenges, particularly in the sleep department. She has FOMO — Fear of Missing Out. She hates going down for naps. We have to rock her to sleep with white noise and most times, she’ll fight it with all of her might. This process has become nothing short of debilitating. My lower back is in knots, and my heart is ripped out on the regular trying to console this little one while she screams bloody murder and tries to wiggle her way out of our arms.

I have read books, downloaded baby development apps, absorbed thread after thread on Mommy message boards, been added to multiple Facebook Mother groups, and feverishly texted friends who have come before me with similar baby issues. If there is a trick, I have tried it. I have even been acutely aware of my own energy to make sure the anxiety is not rubbing off on the baby, to the best of my ability.

She is “healthy” as far as growing and her overall condition as a tiny human. For that, I am eternally grateful and know that others have it much, much worse with terminal or chronic conditions. But the struggle to survive has been real, day in and day out and has taken a massive toll on everyone living under our roof. Someone recently told me about Unicorn babies, and Dragon babies. Unicorn babies are the ones you hear about when the parent says, “Baby XYZ was SO easy. I was lucky.” Bella is a Dragon baby. She is stubborn, strong-willed, breathes fire, and is super duper needy.

Last week Bella had some kind of divine intervention because for one week she got all the way up to 6 consecutive hours of sleep in the evening, and a few days of a 90 minute nap vs. her usual 30 minute naps. But this past Monday she received her immunizations and has spiraled downhill ever since then. The last 3 nights have sucked the life out of me, and this morning at 6:45am, I sobbed. I sobbed while gasping for breath. I couldn’t stop crying for nearly 30 minutes.

I cried for all of it. For my marriage which has been put to the test due to an inordinate amount of impatience. For particular people in my life who haven’t been supportive and only caused additional stress. For being trapped in my house for 2 months {she hates, hates, hates the car seat and car rides}. For being a prisoner to feeding my daughter as an exclusive breastfeeder and suddenly decided she did not want to use a bottle which was my only source of relief from time to time. But mostly, I cried because I am so damn tired.

When it was time to “rock” Bella for her mid-morning nap today, I had just gotten off my monthly business coaching call and still had my Apple Airpods in my ears (wireless headphones). I had an idea. I would play a Pandora music station on my phone and stream it through bluetooth in my ears. Maybe, just maybe, listening to music turned up extra loud in my ears would drown out her screams and make the 15-20 minute experience of willing her to nap a little bit more tolerable. I prepared Bella by putting her in her sleep suit since she loathes being swaddled, and got the iPad white noise app ready too. I hit play on Pandora, and classical music began.

I evidently have not listened to music since I was pregnant and played it for Bella in my belly.

I put her head on my shoulders and held her across my chest, bracing myself for the inevitable. Instead, she fell asleep. Right away. She closed her eyes, and fell asleep. No crying. No tears. No kicking. She just drifted off to sleep, instantly.

But I didn’t put her down right away. 

I danced with her. I listened to the beautiful music of gentle instrumental piano sounds, and slowly waltzed in circles with my 10 pound, 11 ounce baby. And I sobbed. I sobbed because this morning during my 30 minute cry fest, I prayed. I prayed for mercy. So now I sobbed from gratitude.

I danced with my daughter and swirled around with her in my arms for several minutes while she was sound asleep. That moment with her was everything, second to her smile.