Thinking About the Dialectic

DBT, or dialectical behavioral therapy, has been a huge part of my therapy for the past 7 years or so. It has been the main therapeutic module that I have used and it has been the one that has shown the most success for me over the course of my lifetime.

A main idea of DBT is that of the dialectic. That idea is that universe is filled with multiple opposing sides and forces and that also leads to the fact that there’s also more than one to view a situation or solve a problem. It also has this idea that change is the only constant. Those two things, which I believe to be true, may seem a bit too philosophical; however, for me, they have been a big factor in my ability to adapt even when I am symptomatic. It’s something that my therapist and I walk through when things come up.

For example, I have two young sons, which is why this blog is called Being a Bipolar Mom, and there are times where things happen around them where we will test my perception or my problem solving abilities. For example, someone in my family will say something about my son’s speech sound disorder and tell me that he needs to have that fixed by kindergarten. I get angry because they make it sound like my son has something where it has a natural progression and we can say exactly when it will be “fixed”. I saw this as a shot at my son initially and I felt that they were placing way too much pressure on him.

Talking to my therapist, we were able to tease out details of the conversation that I may have misread because I was in mama bear mode protecting my son. I had the feeling of who the hell are they to say what my son should and shouldn’t do by such and such time and how the hell do they know if he is going to be able to do it or not?

The part that was missing was that they were trying to help. They told us they wanted us to send him for private speech therapy, which my husband and I were in the process of doing already, and that they were willing to pay for it. My mother-in-law used doctor google and informed herself of the horrible perils of a speech delay in K and how he won’t be able to learn to read, etc. Of course, she doesn’t know that my son can spell phonetically. He may not be able to say the sounds, but he sure as hell knows what they sound like. He can sound out some words too and he’s 4. Neither myself, my husband, his speech therapy team (2 SLP-Ts and a SLP-TA), nor his teacher think that he’s going to have any trouble reading as a result and think that we’re doing a great job with sound awareness.

Basically, in all of this, I learned that there was a disconnect. She was seeing his speech disorder as this horrible thing that was going to cripple him and that we should get him all the help that he needs. I heard it as you need to do more or he’s going to be illiterate. Part of that was that I let my mommy bear get out in front of me. I didn’t want him to hear any of what she said. The other part was that our communication was not clear. Instead of asking us about our son’s progress, she assumed that it was holding him back in ways it wasn’t. Instead of me asking her what she meant by paying for whatever it takes to get it fixed, I shouldn’t have bottled it all in getting more frustrated. We both wanted the same thing though.

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Child Vision Problems and Mommy Guilt

My four year old has vision problems. We learned of them a few months ago and saw an optometrist who determined that he has bilateral refractive amblyopia or, in simple terms, two lazy eyes. The optometrist and I both felt that he saw well enough to go without glasses for a year just because 4 year olds are rough on glasses and because it wasn’t having a major impact on his life. The optometrist said we really have until 7 to fix the problem as his goal is to teach his brain how to see.

Enter today’s bombshell….

His vision is impacting his fine motor skills which is being seen at school. He’s in preschool and he cannot bead a string.

So he has to get glasses.

The doctor’s office is mailing the prescription based on our visit 2 weeks ago where they determined that he has a significant astigmatism in both eyes. Unfortunately, this is genetic as I also have astigmatism and I wear glasses. My husband has astigmatism as well and he wears glasses for the computer.

The good news that hopefully he won’t need them older and that his brain will learn to see based on the messages his eyes send. I’m not quite sure how it works, but I have done some reading so I do believe the optometrist.

Now I’m laying the guilt on myself.

I’m feeling guilty about the problems my four year old has between speech and now his vision. I don’t want to get any flack for this, but my doctors kept me on medication while I was pregnant with him. I had just gone through an 8 day inpatient stay 3-4 months before I got pregnant and they all thought that it was better for the baby that I be stable versus depressed as the risk of depression in pregnancy was higher than that of the medications that I was on. I saw perinatal psychiatrists and regular psychiatrists. I was in therapy 3 times a week. I was the most stable I had been for a really long time.

Now, logically I know that my husband had a speech problem as a young child so that is likely genetic. It has nothing to do with my medication. The kid is a chatterbox, but he’s difficult to understand.

Again, my husband and I both have astigmatisms and the optometrist told me it was genetic in my kiddo’s case. That means, again, that it had nothing to do with the medication that I was on to keep myself and my baby healthy.

In case you didn’t know, there are risks associated with being depressed during pregnancy to both the mother and the baby. One of the biggest is pre-term birth and another is low birth weight.

Here’s an article on it:

Depression in Pregnancy Doubles Risk of Preterm Birth

In the end, in my heart, I know I did what was best for my sons, myself, and my entire family, but every time something comes up or is wrong, I blame the medications. I have to let that go. I have to let that go.

A word of advice for any bipolar mamas.

I do strongly recommend that any pregnant women with bipolar disorder does extensive research about medications and sees the real specialists. My medication regiment was “approved” by both my psychiatrist and a perinatal psychiatrist. The perinatal psychiatrist was up on all the studies on the medications that were taken during the gestational period. She told me the risks, explained the research to me, and even went over what to expect after the baby was born. For example, I now know topamax isn’t safe during pregnancy for sure no questions while lithium is kind of an eh… because it slightly increases the risk of a heart defect that causes a hole in the heart that can be repaired via surgery.

I took neither of those medications. The one thing we knew about my medication is that my medication might cause cleft lip/cleft palate, but the research leaned more toward that being a non-risk factor as only 1 study of several including a long-term registry showed that there an increased risk of cleft palate when compared to the general population.

Oh, and we were also told that there was a chance that the baby may cry a lot the first few days and that I should get help with the night feedings. For me, it meant no breastfeeding, but again, it’s what I needed to do for myself and my family. A healthy safe loving mom is far more valuable than breast milk. Those boys need their mom and I do whatever I need to in order to be for them always. That includes doing things like taking medication, therapy, and not breastfeeding for me. It may mean different things for others based on their own situations, but that’s mine.

Expressive Speech Delay Worries

My oldest son has an expressive speech delay. He goes to preschool three days a week and he has speech therapy two of those days. He also goes to a private speech therapist one day a week. At 4, my husband and I understand around 70-75% of what he says. The milestone for this year was 100% intelligibility. People who don’t know him should be able to understand him and that is not the case. It gets frustrating for him.

He has some form of a speech sound disorder. He understands what people are saying and he knows the words that he wants to say, but he can’t say the words properly.  He leaves sounds out, he makes substitutions, and he adds sounds and syllables to words. He has also begun stuttering which, at this point, is considered developmentally appropriate.

Anyway, we’re still working on the same sound as we were a year ago with some sounds added. The /f/ sound was the first sound that was tackled in speech and it’s still something that we are working on. He can now say most words slowly that begin with /f/ with a reminder. He says the /f/ first and then adds the rest of the word. He is SO proud of himself when he can do this, especially if he manages it without a reminder. We are almost to using it in conversation.

There are sounds he just cannot say because he cannot get his tongue to the right places yet. His private speech therapist gets into crazy positions with him to try to get him into a place where it will be easier to learn the physical piece. They laid down on the floor to try to get his tongue to fall back to produce the /k/ sound. They applauded when he made a gurgle sound because it means that he’s all that much closer to being able to produce the sound.

The rate of progression is frustrating and it is hard to see how frustrated he gets when people, especially family, fail to understand him. I’m concerned with his future. I know that speech delays and disorders can impact other areas of life and I don’t want that to be the case for him. He is so bright and he loves people. He loves to talk and play and creates these amazing games and stories. He is also incredibly sweet and I never want him to lose that due to frustration and feeling a little bit different.

My crazy busy mommy life

I have been very busy lately.  Tuesdays, J and I go to classes at Gymboree an hour away.  That basically eats up 3-4 hours of the day.  Wednesdays we go to therapy and that is also an hour away and eats up a lot of the day.  Fridays we go to swimming lessons and that is an hour long on Fridays, but is close to our house.  I am working on Saturdays which is also an hour away and we have been moving since the beginning of September.  We finally have all of our belongings in the new house, but we still aren’t completely unpacked.  The house is coming together nicely though.

My moods have been unpredictable lately.  I have been very sensitive to little things.  I will be totally happy and laughing one minute then so angry the next.  Then, 2 minutes later I will be very sad and break down in tears.  At first, I attributed this to PMS.  This is not a typical type of bipolar set of symptoms for me.  They aren’t long-term mood changes that appear to be chemically triggered.  They are specifically associated with different stimuli and triggers.

I had Mirena placed and I contacted my doctor to see if Mirena could contribute to such mood fluctuations.  She said it’s possible, but highly unlikely.  She had me schedule an appointment with the social worker in her office to dig into the cause of this problem.  This has me thinking.

I honestly wonder what the causes are.  Is it that I’ve got a 7 month old who is starting to teethe?  The only way we could calm him this evening was to blow bubbles.  Is it the move?  I don’t know anyone here and my husband has been obligated to go to more client events for work.  I feel lonely and sort of overwhelmed on days where I have no help with Jimmy V.  I was also physically ill a few weeks ago and I’m still tired and a bit sick.  I wonder if that’s not contributing to it as well.  I have been sleeping when Jimmy V is sleeping as often as I can to try to regain my energy.  I don’t think I should still be fatigued from a cold or from the flu a couple of weeks after being sick.

I guess long and short is I don’t know what is causing my mood issues.  I really wish I did.  My therapist and I are trying to tease it out.  I’ll track my cycle and see if the mood shifts go away.

I also need to meet some other parents of young children in my area.  I need things to do.  Being alone with a baby all day every day is so hard! I have a visiting mom who will stop seeing me November 1st because I’m out of the region.  Advice for meeting new people?  I tried finding a baby playgroup, but there were too few people for the group to start.  Hopefully, there will be a group in November.  I was going to join a gym that’s like a YMCA, but they wanted too much money for the first month. I got a free month family pass though so I am going to use it.  They also gave me information about a “matinee membership” which is good for Monday – Friday 11 AM – 3 PM which would work pretty well for me especially since they have child care.  Maybe I’ll meet some people there.

I need to stop having these crazy mood fluctuations.

Busy Busy Busy

I have been very busy lately which has caused me to neglect my blog.  I got a new job and we put an offer in on a house.  The offer was approved and we are due to close on August 28th.  We have so much to do before then.  We still have to find a lawyer.  We are getting home insurance quotes and the home inspection is scheduled for July 10th.  We are cutting it close with the home inspection as we have to have a list of things to negotiate on based on the home inspection by that evening.

Anxiety

I am having trouble sleeping from all of the stress which I know is a horrible thing for me.  Sleep issues can trigger an episode of depression or mania.  My husband wanted me to talk to my psychiatrist prior to the problems getting like this.  We discussed that I would do it at my next appointment.  I only have to wait it out until July 19th.  I will talk to my therapist about it as well and I meet with him today.

I have been having catastrophic thoughts lately.  My anxiety is high.  Often, the thoughts are that my son will die of SIDS.  I’ll wake up and he won’t be breathing.  It’s terrifying.  My therapist said part of it is that things are going so well I need something to worry about. We talked about the fact that I don’t know what it’s like to spend a day without worrying during our last session. We also talked about the fact that a lot of this stems from the past trauma that I experienced.

We came to the realization that I have had a lot of uncertainty and instability in my life in the past.  Often, I had legitimate worries that lead to me worrying all the time.  Now, I need to worry.  We also talked about my need to have control of things.  I have worked so hard on radical acceptance, but it still feels like things are chaotic when I don’t have control.  I feel like I’m free falling.  We talked about the fact that I don’t trust things to work out because they haven’t so often in the past.  He said I need to learn to trust things – to trust people.  It’s so hard to do.

Work

I start the new job on Saturday.  I have been taking my son to classes at the new job.  He seems to enjoy it, but he’s not getting everything I wish he was out of it.  He has been eating at the start of class which means he misses part of the class.  He is only 4 months old though so I have to pay attention to his cues.

I am looking forward to this job as I think the experience will help me with my long-term career goal of working as a preschool teacher.  I need to get back to school to get my masters degree in order to do so which we can’t afford right now.  The job will help me save for that and help me learn developmental milestones of 0-5 year old children.  I’ll get the hands-on experience of working with those age groups as well.

The weather and my mood

I have been down lately and I think the weather is to blame.  I tend to feel down on rainy cloudy days and we’ve had several in a row.  We finally have some sun this afternoon and I’m a bit more cheerful today.  We have been experiencing a great deal of cloudy rainy cool weather.  Since I’ve been down, my sleep has been thrown off.

Two nights ago, the night I started this blog, I tried mindfulness meditation to sleep.  The meditation was a body scan where you relax your body one part at a time – starting from your toes.  I couldn’t concentrate on the recording because of my mood.  I have this fear of SIDS – that one day Jimmy V will stop breathing and I won’t be able to revive him.  I don’t want to buy a house with a pool or near water for fear he’ll drown.

Last night, I couldn’t sleep.  I was up every couple of hours and it wasn’t because my son, Jimmy V, was awake.  The alarm on our baby monitor went off at 1 AM last night signaling that it couldn’t detect movement.  I felt like my worst fears were being realized.  I nearly had a heart attack and my first thought was call 911.  I ran into Jimmy V’s room where I discovered he was fine and stretching.  He moved off of the motion sensor in his sleep.  I had already been having trouble sleeping and this made matters worse.  My heart was racing.

Jimmy V woke up for the day at 3:50 AM.  Typically, Daddy gets up with him when he gets ready for work, but the baby was awake before 4 AM.  I walked into his room and he smiled at me.  I fed him and changed him and put him into his swing.  He just kept cooing and speaking baby talk.

Fortunately, I got to take a nap that lasted 30 minutes this afternoon.  Jimmy V took a short nap which gave me the opportunity to rest.  I felt a little bit recharged – especially when I saw that the sun had finally started shining.

It is supposed to be sunny here for Fathers Day weekend so hopefully my mood will pick up.  I don’t qualify for a clinical diagnosis of depression yet since it’s only been about a week downturn.  I am not due to see my psychiatrist for a while so I will keep an eye on it.  I will contact her if things do not improve with the change in the weather.  I will talk to my therapist about it tomorrow.

A Dozen Things Reference Books Won’t Teach You About Raising A Baby (Guest Post from Kristine Wise)

I thought this was interesting and I could relate.

The Science of Mom

I’m so excited to roll out ScienceofMom’s first ever guest post today! I love the idea that this blog can be a platform for the voices of other parents. In today’s sweet post, Dr. Kristine Wise touches on many of the joys and challenges of first-time parenting, and I’m sure you can relate! I met Kristine when we were both students in the doctoral program in Nutrition at UC Davis, and last year we gave birth to our first children about one month apart. She is a scientist, a teacher, a runner, an amazing cook, a steadfast friend (as in the kind who calls you up after 6 months have slipped by since you last talked and says, “ahem, we need to catch up!”), and now a fabulous mother. Her post is focused on the surprising lessons she’s learned as a stay-at-home mom. Any working moms want to weigh in…

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