Thursday, December 30, 2010

Parenting with SAD, Part 2: Treatment

Last week, I was late to the holiday party at my son’s daycare because I had to sit in front of a special therapy light before heading to the party. I debated skipping the afternoon session of light therapy so I could make it to the beginning of the party, but I had missed my afternoon session the day before and barely made it through the evening, falling asleep while putting my daughter to bed at 8:00. It’s better for my kids (as well as myself and my husband) if I am late to the party instead of missing a session of light.

Treatment for my Seasonal Affective Disorder (SAD) that will truly work for me within the constraints of my life is critical to my health, my children’s well-being and Londo’s sanity. It has taken me years to figure out what the right treatment is for me, and unfortunately the constraints of my life seem to change every year since having kids. At least every year I learn something from the year prior, and each year I’m getting better and better at staying on top of my treatments.

Before I had children, I started doing light therapy sessions once I realized I had SAD. I bought a couple of special therapy lights, which are bright lights that mimic the sunlight minus the harmful (and tanning) UV rays. Light therapy sessions involve sitting in front of the light at a certain distance with eyes open so as to “receive” the light through the eyes, the only truly proven way that the light therapy works. So I don’t get a nice tan, I can’t just sleep through the light therapy session, and I can’t move around because I have to stay that certain distance. It’s bright, which makes it hard for me to do certain thing like watch TV and makes it very obvious to anyone nearby that it’s not a normal light. The amount of light therapy I need increases the later into the winter it gets. Also, since the light helps reset the body’s circadian rhythm/internal wake-sleep clock, people with SAD are supposed to do the light first thing in the morning, and certain people (me included) also need a shorter session in the afternoon for a late-day boost.

When it’s late winter, I need the most light therapy, which would end up being almost 2 hours in the morning and another hour in the afternoon. That is 3 hours a day sitting in front of this bright light. That was manageable before kids and when I had an office with a door I could shut at work.

But now? I don’t have 3 hours to spend sitting around, except when I’m at work—but I sit in a cubicle now and am not going to have a light bright enough to land airplanes shining in my eyes while people are walking around me. I am not going to wake up at 4:00 in the morning to make sure I get 2 hours of light therapy in before my toddler wakes up—I don’t get enough sleep as it is!

And even with 3 hours of light therapy a day, I would just barely get by. I was still exhausted all the time, and only slightly depressed, which at least was an improvement to being so depressed that I couldn’t get off the couch to take basic care of myself. The 3 hours of light therapy and a dawn simulator (my alarm clock that starts to light up gradually 30 minutes prior to the alarm going off) was just enough to get me out of bed, to work, and back home. Once home, maybe I’d eat a dinner and watch TV with Londo, or maybe I’d curl up on the couch and stare off into space until Londo made me eat something and go to bed. (I could go on about how bad it would get, but I don’t think I need to. If you’ve ever been depressed or if you remember the exhaustion you felt in the first trimester of pregnancy, you’ve got an idea of what I would go through.) Though the light therapy kept me from being unable to function, it just hasn’t been enough for me to truly feel like myself all year round.

Thank goodness for medication!

Going on Zoloft in the winters, combined with (shorter amounts of) light therapy, has made such a huge difference in my life. It was a hard decision for me to make, but once I did I wondered why I ever hesitated! What made me decide to try the medication was knowing I was going to be pregnant during the winter, and time for and effect from the light therapy was just not going to cut it.

This winter is my third on medication, and I can’t tell you what a difference it has made! I am able to care for myself, my children, my house, my husband, my pets without feeling overwhelmed or exhausted. I have good days and bad, good weeks and bad--but who doesn’t? Granted my bad weeks really suck, but that usually means that I’ve not kept on top of the medication or my light or or my vitamins (multivitamin, vitamin D supplements and fish oil) or getting enough sleep, all of which I have to be very cognizant of upping dose or time as needed.

I’ll be honest, I wish I didn’t have to spend any time in front of the therapy light. But I tried going with just medication as treatment this fall, and that did not work out so well. At least with the medication, I don’t have to spend as much time in front of my light.

And that’s the toughest part about treating SAD as a parent. The time it takes. My kids are still to young to be right in front of the light (this is my opinion, as I’ve not found any age-specific recommendations for safety), and if they are in the same room as me, they often want to see what I’m doing or I need to get up to figure out what they are into. It’s not the relaxing time I need to settle down in front of my light. And the time I spend in front of my light takes away from my time with the kids, either playing with them or getting them ready for pre-school/daycare, or it takes time away from sleep, of which I need more in the winter than in the summer with a minimum average of 8 hours a night. Making sure I get that sleep and the time for my light therapy in the morning takes away spending time with Londo in the evenings or having time to myself or watching TV shows or reading or blogging. Or it means that Londo has to take more night-shift duty with the kids, which gets hard on him.

SAD seems like it’s easy to treat: medication, light therapy, dawn simulator alarm, vitamins and supplements, getting enough sleep or whichever combination of these that works for a person. And exercising and eating right would totally help! But it really is a struggle and a trade-off for each treatment, especially with young kids in the house. There are side effects of medication. The light therapy takes time away from other things. The dawn simulator might wake my daughter who comes into bed with us every night, so I haven’t been using it. Missing dosages of vitamins or supplements causes immediate reactions. Getting enough good-quality sleep is something I dream of when I’m trying to sleep (see previous sentence about daughter in bed, plus night-wakings with toddler during teething episodes like last night).

Fortunately, I know that the trade-offs are worth it considering what going without treatment does to me. And as I said earlier, each year I’m able to learn more about how to stay on top of my treatments and how to better incorporate what I need to get through the winter within the constraints of my life with young children. I have high hopes that each year will continue to get better.

Wednesday, December 29, 2010

Question of the Week - Do You Believe in Magic

This is the first year that the Pumpkin really has any idea who Santa is. I wasn't sure I would play along with the whole Santa thing, but it just kind of happened.

The first year we had the Pumpkin, I had this big conversation with Londo about how I didn't think I'd want to do the "Santa thing." I felt like it was actively lying to our children to pretend that Santa really came to our house, left presents and ate cookies. Londo pointed out that it was a tradition in both our families and that he wanted to have presents from Santa for our kids.

At the time, the Pumpkin was still little, and I figured she'd never know. So I let it go, and we had presents from Santa. I justified it and the books about Santa in my mind as just stories, the way Frosty the Snowman is a story. It was just a passive omission that those characters weren't real.

But this year... Well, this year she knew who Santa was. This year was the deciding year for whether or not we played along with what I've decided to call "The Santa Game." And this year, as happens with many things in our lives, Londo and I flipped positions. Maybe we didn't change positions--it could be that I didn't fully understand his position, but I definitely flipped mine.

I knew that the bike she was getting and the ride-on excavator that the Pookie was getting were the Santa gifts--the big presents of the year that we write from Santa, as my parents did for me and my siblings into our adulthood. And I don't know, I just decided to go for it. Not realizing fully where Londo stood on the issue, I started talking to the Pumpkin about Santa and asking what she wanted him to bring her. We saw lots of Santa stories on her shows (she especially loved the Dora Christmas special, of course). I also started saying that we'd set out stocking and such for Santa.

In talking with the almost 4 year old, I made that step from passive omission to active deception. Apparently Londo was of the mindset this year that he didn't mind giving presents from Santa, but he didn't feel right about actively lying to the kids.


(The bigger issue that Londo has with the whole being good for Santa is the same one I do, which is we don't want to use Santa as a bribe/threat to get the kids to be good or they don't get their presents. First of all, it'd be an empty threat from us, because we are going to give them the gifts. Second, that's not the way we discipline, so it wouldn't be comfortable for us. Even before he said that to me, I'd already been careful about not making The Santa Game about bribes or threats. Instead, we've been talking about the importance of being nice and good to each other, especially around the holidays when people are doing nice things for us like getting us presents, baking with us and spending time with us.)

But the damage was done. I had started the ball rolling, and it wasn't going to stop. So Christmas Eve, the Pumpkin and I set out cookies and apple juice (cause he gets milk everywhere else) for Santa and an apple and bowl of water (her idea!) for the reindeer. We set out stockings and we talked about Santa coming that night. She was excited, and I have to admit how much joy I got out of doing those things. Those are the games of childhood, putting out treats for pretend people and animals, thinking about Santa coming with a big bag of gifts for all the kids, getting excited about stocking stuffers and big presents. And being the one to eat the cookies and set out a bike with a bow on it "from Santa"? It was neat to be the adult on that side of the ritual as well.

And so, here we are. We are doing The Santa Game at least on some level. We won't be super careful about hiding it from her, because Londo wants her to be able to figure it out and not feel like we tricked her. And her face and the Pookie's face when they saw the big presents from Santa and got to open their stockings and when she saw the cookies were gone and the apple had bites out of it? It was awesome!

So this week's Question of the Week is:

In what ways have you incorporated magic into your kids' lives?

Londo and I have yet to talk about The Tooth Fairy. Right now, she's just starting to understand pretend versus real, and I did agree with her when she said that Tinkerbell and fairies are pretend and I did tell her that ghosts aren't real. But I didn't enlighten her to the reality about mermaids, though, even when there was an opportunity. If she asks, I don't think I'll lie. But she didn't ask.

What about you? Do you have a Binky Fairy (I know @Cloud does!)? Do you do Santa? Any ghosts or goblins around for Halloween? Will there be leprechauns for St. Patrick's Day? Unicorns or wizards? What kind of magic exists in your house?