ARE YOU DEPRESSED OR MERELY MALNOURISHED?
Dr. Miriam Adahan
It is an almost daily occurrence. A young woman calls me to say that her doctor has put her on psychiatric medication and she is hesitant to take it. Typically, she is a working mother with three or four children under the age of five. The first thing I ask is, "How much sleep are you getting?" The usual answer is, "Three to four hours a night," broken up by a new baby or his sick sibling. The next thing I ask is, "What are you eating?" And she says, "I don't have time for proper meals. I drink coffee and nosh to get through the day." Third, I ask, "Is your husband supportive?" In most situations, the answer is, "Who has time for a relationship?"
Obviously, I cannot diagnose over the phone. But it stands to reason that any person who is sleep-deprived, love-deprived and malnourished is likely to be depressed and anxiety ridden. If this same young woman was raised in a loving family, had friends in school and was a relatively happy person until the third or fourth child appeared, then the chances are that she is not suffering from true depression, but desperately in need of sleep, love and nutritious food!
In fact, according to Israeli doctors, approximately 90% of working mothers in the frum world are suffering from Chronic Fatigue Syndrome (CFS), also known as "mono." As the name implies, the main symptom of this auto-immune illnesses is chronic exhaustion, often accompanied by aching muscles, anxiety, thyroid disorders and digestive problems. Unfortunately, many doctors view these symptoms as indicating depression and blithely prescribe anti-depressants.
Working women are more at risk, as they actually work two full time jobs, often with little appreciation from family members and the constant life-and-death stress involved in caring for young children. If they complain to family members, they are often told, "It's all in your head. Stop pampering yourself. Ignore it and it won't bother you." Thus, in addition to a very real physical illness, these women feel isolated and misunderstood.
Husbands are likely to become quite exasperated. When she asks for help, he feels exploited and trapped. He may tell her, "I'm tired of hearing how tired you are." One mother of five small children under the age of six, was told by her husband, "You are not allowed to be tired!"
I don't blame the husbands. They usually had a lovely shana rishona (first year) during which they came home to a neat and organized home, meals on the table and a calm and happy wife. They were able to learn peacefully while the wife worked and they laughed often and enjoyed each other's company. But as the children came, the pressures built. Suddenly, the laundry piled up on the bed or the floor. Meals were haphazard and thrown together hastily. She was too exhausted to even look at him by nightfall. Having lost the sweet-natured girl he married, he may lash out angrily about her lack of libido, the mess, the same old noodles served night after night and her appearance.
His wife also feels that she has lost herself – the energetic, happy girl she used to be in high school is now a listless and frazzled homemaker with more demands than she can possibly handle: children, job, shopping, car pools, cooking, cleaning and endless social obligations. When she looks at other women who seem to managing with even greater burdens, she feels ashamed that she cannot be a sparkly, happy working mom like the rest of her peers. She may even feel truly crazy when, by evening, she has turned into a screaming witch filled with resentment and despair. She does not realize that she is suffering from burn-out.
WHAT CAN YOU DO?
My own experience with chronic fatigue has taught me that illness is never totally cured. It indicates that the liver has suffered damage and must be patiently repaired with by doing the following:
1. AVOID JUNK FOOD: A craving for sugar is the first sign of low vitamin B. When you eat sugar, your vitamin B and iron levels drop. Many young women are anemic due to over-consumption of sweets. Yet they feel they need the sweets to ward off the gloomy feelings and just get through the day.
2. BE PROUD OF YOUR EFFORTST TO RESIST SUGAR: It takes energy to fight a sugar addiction, especially with the women's magazines showing all those luscious-looking and complex desserts – as if this is the measure of a good balabosta. You will build your sense of self-worth by becoming self-disciplined and will strengthen your nervous system and immune system by refusing the junk. Eat healthy foods – the simpler the better.
3. THINK GREEN: Take supplements, especially spirulina, wheat grass and green algae.
4. EXPERIMENT WITH NATURAL SUPPLEMENTS: If you are depressed, try L-Tyrosine, DPLA, SAM-e, St. John's Wort or 5-HTP. To get better quality sleep, take L-Treonine before bed-time.
5. GET SLEEP. The body needs at least 7 hours sleep in order for the liver to rid your body of poisons and regenerate your energy. Few women get adequate sleep, especially teachers and new mothers. Lack of sleep leads to depression, diabetes, heart disease and strokes. Yes, you want to attend all the simchas or stay up late to have quiet time for yourself, but you must put your health first. With less than 7 hours sleep, your body produces cortisol, a stress hormone, and ghrelin, the hormone which makes you feel hungry!
6. DON'T COMPARE YOURSELF TO THE SUPERSTARS. Yes, there are superwomen who manage a child every year, a full time job and also entertain numerous guests on shabbos. But your nervous system may be more fragile - especially if you were raised on junk foods or by critical parents.
7. SPEAK TO A RAV: It takes two full years after each pregnancy for the body to regain it's pre-pregnancy levels of Vitamin B and calcium (which is one reason a woman is considered "weak" for halachic purposes for two years following birth).
8. GET HELP: Women suffer far less stress if their husbands are truly loving partners who participate in childrearing and housework. If your husband is not a giver - either physically helping with the chores or emotionally, by giving love and empathy - or if he is critical and demanding, your health is at risk. It is well documented that criticism takes a terrible toll on a person's health. You cannot force him to do what he hates, but perhaps you can get cleaning help or have a teenager help during the difficult evening hours.
May Hashem give us all the wisdom to know how much to take on our shoulders and when to give ourselves a rest! Even Yitro needed to tell Moshe Rabenu, "Ity is not good that you do so much; you will surely wear away…for the thing is too heavy for you" (Shmos 18:18).