Friday, April 27, 2007
Over the last three days...
...I've been experiencing an episode of breakthrough depression while using St. John's Wort. I consider it analogous to "breakthrough bleeding" which happens as a result of using birth control pills; although I've never experienced that, since I've never used The Pill for birth control. This depressive episode has, of course, been a surprise, but, as is usual with depressive states, I'm listening to it and, as I've been able, going with it.
I think the cause is partially that over the last four or so weeks I've been devoting a huge amount of time to keeping Mom engaged in life; more than usual, and specifically as a result of and in opposition to her recent determination to be less engaged, at least, less engaged in ways which would make me feel more comfortable. Expending the effort has been difficult, not as altogether rewarding as it used to be. Maybe a year or so ago, when I launched such efforts, in some way or another Mom indicated that, despite her protests, she was glad I put forth the effort and encouraged her effort. This hasn't been the case, lately, leaving me disconcerted and, well, tired: Of seducing, of cajoling, of insisting, of pushing...seems to me I remember The Wondrous FNP counseling me about this...
It's funny, too, because a few days ago, just before this depressive breakthrough occurred, as my best spirits on behalf of my mother were beginning to flag I ran across a post in a MySpace caregiver blog [10/1/08: Blog no longer available]. As I read the post, which talked about how energetic the caregiver's mother is, I thought, Wow, I remember when all it took was positive thinking and positive action on my part, and encouraging both in Mom, to turn on Mom's "can do kid" persona. Now, I haven't the faintest idea how to do this. Nothing is working. And, this woman's Mom is "almost 93". My Mom is only almost 90! What do I do now?!?
I had to quickly remind myself of something of which I am often reminding my readers: That the chronological age of one's care recipient is not a good signpost for judging what can be accomplished as a companion/caregiver. Chances are, this woman's mother doesn't have Anemia Due to Chronic Disease, the Chronic Disease being Renal Failure. Although, in one post the woman refers to her mother's brain as occasionally "confused", it doesn't sound as though her mother is as far into Dementia-Lite territory as my mother...perhaps she's not even on the fringes; perhaps she simply and occasionally experiences the normal brain confusion that periodically afflicts all of us, demented or not.
I think the breakthrough depression is primarily circumstantial. I noticed, after the above realization, that I'm at yet another point of reevaluation in my companionship and care of my mother. As well, although there are loads of baby books out there that deal with successive growth states, loads of books and blogs that address how to deal with the more severely demented and those less physically challenged by age related diseases, lots of up-'n'-at-'em talk out there to keep everyone's spirits up, lots of advice designed to strengthen the companion/caregiver's internal resolve and get-'em-up-out-'n-moving-to-keep-'em-engaged, no one I can find is addressing what to do when intractable periods of preference for what we would normally define as disengagement sneak into an Ancient One's Life. A few, like Bill Thomas, are beginning to recognize them and prescribe "acceptance", but, you know, this kind of acceptance isn't the standard...it's a lot harder, and a lot more ambiguous for the companion/caregiver.
No, I don't sense that we're somehow closer to the end of Mom's life than I previously thought we were; no closer, anyway, than each moment brings us. She certainly isn't interested in contemplating an end to her existence; I've asked her, again, recently and she remains at least as far as she was before from recognizing her own mortality. But, she's slowing down some more and, yet again, I'm surprised to find I'm unprepared.
It doesn't feel good to be here. I'm not handling it well. I've put off, until at least next week, all the plans I had for having her blood drawn this week, taking advantage of what was successfully predicted to be a spate of warmer weather late this week, which we are currently enjoying (we had snow on Monday and biting cold temperatures on Tuesday, amazingly) to force her out and about, as I've been doing, because, well, I'm confused and tired.
Mom's not. She's fine. She looks ruddy, feels good when she's up and the more sleep I allow her the better she looks and acts when she's up; except, of course, when I consider The Engagement Scale; at least, from the way I identify engagement.
That's the catch: My definition of engagement versus hers. We're at a point, now, where I think I'm find it necessary to tune my ears even more finely to her definition than I ever have and work harder to align myself with it. These periods have happened before. They'll happen again. The realization of their necessity, though, always leaves me a little shocky, a little off balance and more than a little unsure of myself and how I manage our lives on her and my behalf.
And...despite the St. John's Wort, I've withdrawn into a moderately depressive state that allows me an unflinching look at what I consider to be the good, bad and ugly, so I can evaluate what I'm dealing with, in her and in me, can get through my goose step reactions and can initiate the next phase.
I'm not disappointed by this breakthough depression. I'm, rather, encouraged that St. John's Wort isn't disallowing my usual method of dealing with befuddling change. Just to let you know, I'm very quiet, right now, turned both inward toward my resistances and outward toward my mother's changes (which divided state is, in itself, hard to negotiate), involved in close and sometimes extremely uncomfortable examination of a variety of circumstances, mostly related to my mother but not exclusively related to this current shift of hers, and a bit challenging to live with, although Mom is, as usual, taking my stony silences in stride, which isn't a surprise...after all, as I occasionally kid her when she finds my behavior surprising, "You made me, Mom. When I'm not quite what you expect, remember, I'm you're fault!"
A day or so ago, when I repeated this to her, she said, "I know, I know, and, just for the record, I don't consider you a fault!"
Thank the gods for that. Despite this tease, I don't, either, really.
Later. Probably much.
I think the cause is partially that over the last four or so weeks I've been devoting a huge amount of time to keeping Mom engaged in life; more than usual, and specifically as a result of and in opposition to her recent determination to be less engaged, at least, less engaged in ways which would make me feel more comfortable. Expending the effort has been difficult, not as altogether rewarding as it used to be. Maybe a year or so ago, when I launched such efforts, in some way or another Mom indicated that, despite her protests, she was glad I put forth the effort and encouraged her effort. This hasn't been the case, lately, leaving me disconcerted and, well, tired: Of seducing, of cajoling, of insisting, of pushing...seems to me I remember The Wondrous FNP counseling me about this...
It's funny, too, because a few days ago, just before this depressive breakthrough occurred, as my best spirits on behalf of my mother were beginning to flag I ran across a post in a MySpace caregiver blog [10/1/08: Blog no longer available]. As I read the post, which talked about how energetic the caregiver's mother is, I thought, Wow, I remember when all it took was positive thinking and positive action on my part, and encouraging both in Mom, to turn on Mom's "can do kid" persona. Now, I haven't the faintest idea how to do this. Nothing is working. And, this woman's Mom is "almost 93". My Mom is only almost 90! What do I do now?!?
I had to quickly remind myself of something of which I am often reminding my readers: That the chronological age of one's care recipient is not a good signpost for judging what can be accomplished as a companion/caregiver. Chances are, this woman's mother doesn't have Anemia Due to Chronic Disease, the Chronic Disease being Renal Failure. Although, in one post the woman refers to her mother's brain as occasionally "confused", it doesn't sound as though her mother is as far into Dementia-Lite territory as my mother...perhaps she's not even on the fringes; perhaps she simply and occasionally experiences the normal brain confusion that periodically afflicts all of us, demented or not.
I think the breakthrough depression is primarily circumstantial. I noticed, after the above realization, that I'm at yet another point of reevaluation in my companionship and care of my mother. As well, although there are loads of baby books out there that deal with successive growth states, loads of books and blogs that address how to deal with the more severely demented and those less physically challenged by age related diseases, lots of up-'n'-at-'em talk out there to keep everyone's spirits up, lots of advice designed to strengthen the companion/caregiver's internal resolve and get-'em-up-out-'n-moving-to-keep-'em-engaged, no one I can find is addressing what to do when intractable periods of preference for what we would normally define as disengagement sneak into an Ancient One's Life. A few, like Bill Thomas, are beginning to recognize them and prescribe "acceptance", but, you know, this kind of acceptance isn't the standard...it's a lot harder, and a lot more ambiguous for the companion/caregiver.
No, I don't sense that we're somehow closer to the end of Mom's life than I previously thought we were; no closer, anyway, than each moment brings us. She certainly isn't interested in contemplating an end to her existence; I've asked her, again, recently and she remains at least as far as she was before from recognizing her own mortality. But, she's slowing down some more and, yet again, I'm surprised to find I'm unprepared.
It doesn't feel good to be here. I'm not handling it well. I've put off, until at least next week, all the plans I had for having her blood drawn this week, taking advantage of what was successfully predicted to be a spate of warmer weather late this week, which we are currently enjoying (we had snow on Monday and biting cold temperatures on Tuesday, amazingly) to force her out and about, as I've been doing, because, well, I'm confused and tired.
Mom's not. She's fine. She looks ruddy, feels good when she's up and the more sleep I allow her the better she looks and acts when she's up; except, of course, when I consider The Engagement Scale; at least, from the way I identify engagement.
That's the catch: My definition of engagement versus hers. We're at a point, now, where I think I'm find it necessary to tune my ears even more finely to her definition than I ever have and work harder to align myself with it. These periods have happened before. They'll happen again. The realization of their necessity, though, always leaves me a little shocky, a little off balance and more than a little unsure of myself and how I manage our lives on her and my behalf.
And...despite the St. John's Wort, I've withdrawn into a moderately depressive state that allows me an unflinching look at what I consider to be the good, bad and ugly, so I can evaluate what I'm dealing with, in her and in me, can get through my goose step reactions and can initiate the next phase.
I'm not disappointed by this breakthough depression. I'm, rather, encouraged that St. John's Wort isn't disallowing my usual method of dealing with befuddling change. Just to let you know, I'm very quiet, right now, turned both inward toward my resistances and outward toward my mother's changes (which divided state is, in itself, hard to negotiate), involved in close and sometimes extremely uncomfortable examination of a variety of circumstances, mostly related to my mother but not exclusively related to this current shift of hers, and a bit challenging to live with, although Mom is, as usual, taking my stony silences in stride, which isn't a surprise...after all, as I occasionally kid her when she finds my behavior surprising, "You made me, Mom. When I'm not quite what you expect, remember, I'm you're fault!"
A day or so ago, when I repeated this to her, she said, "I know, I know, and, just for the record, I don't consider you a fault!"
Thank the gods for that. Despite this tease, I don't, either, really.
Later. Probably much.
