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October 13, 2007

Or, You Could Just Shoot Me Now

Today was my long-awaited annual visit with my OB/GYN for All Things Female. I like her, she's smart, she's accessible, and she's generally very non-judgmental. But today, we started off with the routine questions... how is your mood? Very good, for the most part. Are you exercising? Yes. Have you cut out the alcohol? My brain comes to a screeching halt. "I still have a couple of drinks per week." Disapproving frown, but she moves on.

Next, we discuss the fact that prior to my last period (which, as it happens, was my very first post-weaning period), I spent two days in tears. I figure it's just my estrogen and progesterone levels re-adjusting, and that it will straighten out in a couple of months. "Oh, that's PMS. We usually treat it with mood elevators, Prozac, Zoloft, two weeks on, two weeks off." woah. "Well, I'd like to give it a few months and see if things straighten out before I try that." "OK, then you should watch your diet. Load up on protein..." check. "Cut out the carbs..." now I'm getting worried. "NO caffeine or sugar." That bullet goes straight to my heart. Sigh. But it's better than Prozac.

We went on to talk about off-label uses of contraceptives for treating severe premenstrual symptoms, which apparently only works about half the time, and to discuss pro-active treatment of Postpartum Depression should I choose to get pregnant again (not likely, but I just wanted to discuss all possibilities). Disappointingly, the clinical model for that particular eventuality is just to start meds at 36 weeks. This is part of what I struggled with during my bout of PPD; I understand that meds have an important place in treatment of depression and other psychological disorders, and there's no doubt in my mind that it was the right thing for me at the time, but I still have to question the medical model of just throwing these drugs at everything. Is spending two days in tears before every menstrual period (not that I'm there yet) a little drastic? Yes. Is it something I can live with and maybe modify on my own through prevention, diet, exercise, whatever? Quite likely. So why is a doctor who hardly knows me so eager to just write a prescription? I really don't understand it. It's so tempting to just take it; feel like there's a quick fix for everything.

I don't know if I can cut out caffeine and alcohol. Actually, yes, I do. I know that I can't. The terrible sort of wish-thinking that afflicts the Alcoholic side of my family affects me too. I insist to myself that I have a very healthy diet, no matter how many cookies I shove in my face on the sly (they're High Fructose Corn Syrup FREE cookies!) so it's not hard to make that particular delusional leap to "I don't drink that much" and so on. I see quite clearly how it happens. So what do I do about it? Well, I think I actually DO lead a very healthy lifestyle. The "bad" things I consume, I consume in moderation. I'm not really willing to risk the sort of binge-and-purge response to forced deprivation that I've had in the past. It's less sticking my head in the sand and more If it Aint [REALLY] Broke, Don't Fix It.

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