Lately I’ve entered into a dark place while debating my level of functioning with myself. It started when I was perusing my blog and noticed that one of my entries seemed a bit militant and didn’t fit with the tone I currently want my blog to have. However unlikely it is that I should become famous or otherwise have people pay attention to what I write, I think it’s still important to develop a responsible online presence – we live in a generation that is growing more and more visible, and we’re sort of the guinea pigs for how much about us the world really gets to know. But I digress.
The entry in question that I wanted to reform was one dealing with a bit of a hot-button topic – abortion. And I feel that I need to be really honest with the reason I decided to change the tone of the entry. In it, I talked about concern for the welfare of the mother during pregnancy – if one truly values life, then the health of the mother should be of top priority, which is why most people support abortion as being sometimes necessary to save the life of the mother. So here’s the fundamental difference between my mindset while writing the previous entry four or so years ago and my mindset now: four years ago, if I had an unplanned pregnancy, I would have kept the child or given him or her up for adoption. Now, I’m not so sure if I would.
I think it’s important to note that while writing the last entry, I was in a relationship with a man (although I wouldn’t call it a “heterosexual” relationship because my queer identity was and is a defining aspect of my relationships with people). Now, I identify as a late-in-life lesbian and I am presented with what’s known as “situational infertility”. Whether or not my reproductive organs are in working order I don’t know, and unless I am raped and become pregnant, I may never know, because my fiancée is female and cannot in any way impregnate me. In a heterosexual relationship, when a couple wants children, it is generally assumed that unless one or both partners struggles with infertility that the woman will carry the child and the couple will not adopt. With a lesbian couple, it’s not that straightforward. One or both of the partners could choose to carry a child through at-home or physician-administered sperm donorship, or the partners could elect to adopt a child. There’s an element of choice that traditional societal gender roles generally strip from a heterosexual couple. This element of choice has got me thinking: is it in my best interest to carry a child?
First, we start off with the fact that I am on medication for a mental health issue. I began therapy at the tender age of nine, began a medication regime for the first time when I was twelve, and was diagnosed with bipolar disorder, a generalized anxiety disorder, and a not-otherwise-specified eating disorder at the age of fourteen. Since I started meds when I was twelve, there has only been one five month period where I’ve been off meds and due to a variety of reasons it was not successful. Because of the long duration I’ve been taking medication, I’ve essentially tried every pill they make (one of the meds I’m currently on is actually so brand new that I needed special permission from my insurance company to take it, and most doctors don’t have it on record). Most medications for mental health issues are not safe to take while pregnant or nursing, and the ones that are I’ve been on and they don’t work. Then you add the fact that I would be at a significantly higher risk for post-partum depression, and due to the hormonal changes that occur during pregnancy, there’s no guarantee the current cocktail of meds I’m on would work after the fact. It could mean something I’ve tried in the past does work, however, but you have to take any med cocktail for two months, at least, in order to gauge if it’s working properly or not. So in my estimate, we’re talking a roughly two-year period that combines being med free and taking meds that don’t work.
Now, I’d like to detail the kinds of crises that could be of concern while med free and pregnant: there is a chance I would become suicidal, and there is a chance my NOS eating disorder would kick in. Historically, my suicidal ideology was less severe while I was off meds, and it was just that – ideology. Only once, while I was experiencing severe withdrawal symptoms from going off meds, did I ever come close to acting on my suicidal thoughts. My eating disorder is complicated and has changed over the years – it’s not simply anorexia or bulimia. I didn’t eat much during my period of being off meds; I would sometimes go two days without eating and the generalized anxiety disorder exacerbated my GURD which meant that if I did have the energy to eat I would throw it up due to stress. I struggled with equating my body to food, and if I ate food that didn’t taste good, my response was to cry, blame myself and otherwise feel terribly, and I would frequently become nauseous. The best way to get me to eat something was to try to take it from me, because I hated people touching my food. It felt like the most massive violation imaginable, and once again, would often make me cry. So, when you combine two self harming behaviors that threaten both the life of the mother and the child, you get what I refer to as “psychological infertility”. As far as I know, I am physically capable of carrying a child (although reproductive disorders do run on my mother’s side of the family, so something could develop), but whether or not I am psychologically capable of childbearing is something that deeply worries me and weighs heavily on me.
In addition to all this, discussing this issue brings up a lot of uncomfortable topics and responses. I don’t want to suggest that a woman with bipolar disorder or who has a history of eating disorders shouldn’t have children. I’ve had people (granted, by “people” I mean trolls on an anonymous message board, but still) flat out tell me that I shouldn’t have children and that they’d feel bad for any children I may have. These people also stated that I’d be a great candidate for Dr. Kevorkian simply because I have a mood disorder, so take from that what you will. Certainly there have been plenty of women with bipolar disorder who’ve gone through this process successfully, and there have been plenty of women who’ve done this before there were psychiatric medications and counseling, and before there was even a diagnosis of “bipolar disorder.” So when I have this discussion with people and mention that my fiancée would be the preferable partner to carry children, even though she’ll be the one with a demanding career and I’ll be the housewife, it bothers me to no end that some people will respond with “oh, that makes sense.” I have no idea what response I expect them to give, especially given the information I just stated to them. I guess I’m looking for a, “It makes sense that you wouldn’t want to give birth, but I still think you could do it if you wanted to” kind of statement? Which, of course, in most cases would come off as incredibly rude. Something I had to learn the hard way when having conversations with people who choose to be child free is that questioning a person’s decision to not have children (or in my case, have children but not give birth to them, something I haven’t encountered outside of gay couplings) is incredibly offensive because it’s such a personal decision, and not one to be taken lightly. I have so much respect for people who choose to be child free because there are so many people who come into parenting incredibly unprepared and not having given much forethought to it. But going back to the original thought, I think the reason why an “oh, that makes sense” response is so painful for me is because of the way I process it. I automatically see it as an attack on my psyche because I constantly question my ability to function and do things that a person without a mental health issue wouldn’t think twice about. Of course someone else thinks I would break down and be incapable of functioning if I gave birth, I reason, because I don’t think I can do it. If I don’t think I can do it, why should they?
Mental health is a fragile state. Despite having two hospitalizations in middle school and briefly considering a gap year between high school and college to address my mental health concerns, applying for and receiving disability was never really part of the plan. I had always been labeled as high functioning and intelligent, and while I struggled with attendance in school due to my frequent taking of “mental health days”, I never anticipated needing to take off multiple years from working, school, and other stressful activities that neurotypical people handle with poise. I wasn’t supposed to get this depressed. I wasn’t supposed to need to sheepishly explain to people that I’m on disability for my bipolar disorder and wait for them to awkwardly respond. I wasn’t supposed to have crushing anxiety that made going to work pretty much impossible for me. I wasn’t supposed to be so low functioning that instead of getting a check from my job, I get one from the government. When I was fifteen and started fantasizing about having children and growing my family as an adult, my mental health getting in the way was something I never stopped and bothered to think about. I recall being in high school and making a pact with myself to stop cutting, because I reasoned that I couldn’t continue to cut myself into adulthood and then explain to my children that cutting was an inappropriate coping skill. But aside from that, I never questioned my “psychological fertility”. I relished the thought of being a mother and was confident in my ability to bear and care for children.
I share all this with you in the hopes that, if any of you have ever felt the same way, maybe you won’t feel so alone. I know I’m not the only woman with bipolar disorder, so maybe someone will read this and feel a “click” and it will help their fears subside. Initially, writing this blog/essay was painful. It triggered feelings of being overwhelmed and depressed and I sank into a state of tears. Now, as I finish this essay, I feel hopeful. A very dear friend of mine gave me a copy of “Oh, The Places You’ll Go!” by Dr. Seuss for my birthday and it arrived in the mail today. I like to think of it as a marker for change. The great think about sinking low is that you’ve no place to go but up, and I look forward to the progress I’ll make in the future, both while receiving disability and transitioning off of it. But the thing that truly makes me hopeful was something I overheard from an episode of “The Rachel Maddow Show” that I was watching while working on decorating my bedroom:
“It’s a testament to what we heard a lot in the study phase, which is that predictions of change, predictions of what human behavior will be like if you bring about change, are always better than what people think. In other words, there… people predict these negative, horrible things and then when it actually happens, it goes way better – ”
“They out perform the expectations.”
“They out-perform the expectations.”
If I choose not to give birth to children and adopt so that I don’t have to cope with being off meds and dealing with postpartum depression, that is my right and it does not make me weak or bad. And maybe these fears I have about bearing children are just that – fears. My therapist said that the fact that I have given the situation this much thought bears testament to my responsibility as a parent. Just because being off meds didn’t work out once for me, doesn’t mean I’ll have the exact same reaction again. Maybe I’ll get to a place where I have the coping skills necessary to make the transition to living off meds a successful one, and maybe I’ll out-perform my expectations. If I’ve lived through the amount of pain and torment my own mind has put me through at the age of twenty four, then I’m capable of pushing through and accomplishing things that any neurotypical person can, and perhaps even more.
“But what I’m getting at is that you’re a survivor, just from all the shit your own head has put you through, but it just means that when the zombies arrive (and they are coming) and everyone is panicking because they’ve never had to survive any damn thing, you’ll say “meh” and shoot their dead faces.”
If I can handle shooting a zombie in the face, then having a kid should be within my grasp.