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nap spitting up in a way I’d never seen before. Instead of seeing this as a normal occurrence, cleaning her up, consoling her, and moving on, as I’d done so many times with Liev in his infancy, I panicked. This seemed different. I was alarmingly convinced that this could be Noa’s end—that somehow she’d throw up again and again, that her body would purge its stockpile of resources, and then poof, she’d be gone. I called the pediatrician straightaway as I watched Noa go from her usual pinkish color to opaque to a camouflage green. I explained what had happened to the nurse on the other end of the line. She instructed me to hold Noa upright and monitor her as we remained on the phone together. The nurse compassionately listened to what felt like a big ordeal to me but was a small one (if an ordeal at all) to her. Noa was perfectly fine—thankfully, she resumed normalcy within a minute or two—but this was the turning point that alerted me to the fact that maybe I was not.

A few weeks later, as I drove along Mulholland Drive’s winding curves on my way to work, I found myself keenly aware of the lack of guardrails along the road’s steeper edges. I’d been driving this road without a second thought for as long as I could remember—music blasting, dancing in my seat, enjoying the glorious view—straddling the San Fernando valley and the hills of Hollywood. But on this particular morning, amid the clear, blue skies and the all-too-familiar surroundings, my mind veered from taking in the beauty to realizing it was possible I could actually slide off the edge. With these eerie and porous feelings encasing me, I had to coolly talk myself off the proverbial ledge as I continued along my drive to the office. But this disquieting experience drove home something unfortunate: the ubiquitous aftereffects of PTSD were still clawing on, showing themselves in ways that felt unbearable. Hard to swallow was the fact that this new stage—of mothering my little rainbow baby and her older brother—was accompanied by an intermittent, pervasive ticker tape of what-ifs.

• • •

Claudia wasn’t aware of my loss history. Not to my knowledge, anyway. When she came to therapy, I was already out of the baby-making phase of my life. It’s possible she was privy to my writing on the topic of pregnancy loss, but we hadn’t discussed it face-to-face. I was struck by how different this felt, how interesting it was, to sit with Claudia (and other newer patients) as she (and they) often described feelings I knew too well in my own life, but which I had good reason to believe they had no clue I could precisely understand. I got them in a way they might not have known, or ever assumed. What a different phase of my career this turned out to be.

With my specialty area now bound to me corporeally as well as metaphorically, I was rendered uniquely able to identify with my patients in an entirely different way from before. For better and for worse. I’d pursued emotional work; I knew that from the get-go. I loved the idea of sitting with people as they bravely poured over the particulars of their lives—making meaning, solving relational riddles, exploring long-held beliefs. But what I didn’t know was that a handful of years into private practice, my work would no longer be nebulous or simply the stories of others. It would now be my story too. If patients ask about this area of my life, I tell them. But if they don’t inquire about my personal experience with loss in motherhood, I keep it to myself.

When Claudia’s daughter was just shy of four months old, Claudia made an important decision. A well-thought-out one. One she had been hesitant about since her daughter’s birth, when it weaved its way into the ruminating thoughts as yet another anxiety-producing thing to consider in this nascent transition. Her anxiety hadn’t let up. In fact, it had only worsened. Sometimes, time alone does not make a dent. And sometimes, talk therapy isn’t enough either. Sometimes, something more is necessary. In this case, it was. Claudia decided to pivot and try something new. She started medication, under the care of a perinatal psychiatrist I recommended after seeing how deeply she was struggling.

Within six weeks of taking the prescribed SSRI, Claudia described feeling like herself again. The medication sufficiently cut through the anxiety, and though the initial side effects were off-putting, the benefits were substantial. The constant loop of what-ifs faded into the background and eventually fled the scene completely, allowing her to relish more subtle and enjoyable feelings, like joy and contentment—giving her access to being more fully present. She was still human, of course, and experienced the expectable ups and downs, but since she was no longer lambasted by unruly thought patterns, things were looking up. She’d been tentative about going this route, but now that she was reaping the benefits, she was more resolute than ever that this was in fact a wise move.

The stigma associated with attending to mental health in our culture is chronic. Talk therapy is troubling to some, yes, but oftentimes, medication is even more taboo. Seen as a stealth thing, taking pills is often done in private and shared with no one, or if revealed at all, it’s done so sparingly. I could relate with Claudia in more ways than one. I’d been there too.

After my Mulholland Drive incident, I knew it was time. It was time for me to address my anxiety in more ways than one. Talk therapy was grounding and illuminating, but it wasn’t able to affect my biology the way my anxiety was unabashedly screaming to be addressed. Too many incongruous instances were now under my belt. I had mixed feelings about starting medication, though. I bargained. I kept hoping time would do the trick and I’d get to skip this step.

The biggest stumbling

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