Well, that bandaid got ripped off (also known as trauma in the age of COVID-19)

Do you feel right now as if your heart is as vulnerable as it’s ever been?

Are you feeling unsettled? Are you experiencing intrusive thoughts, nightmares, hypervigilance, or rumination? How many of you, like me, are up at night wondering what life might look like next: physically (with regard to the virus), mentally (with regard to feeling scared, sad, anxious and isolated), or professionally (with regard to losing your job and/or financial stability)? How many of us are having fights with our loved ones and struggling on a daily basis? Achingly missing our parents or other friends and relatives on quarantine away from us? Our communities have been given information wherein the average family is sometimes treated dismissively, and the answers, if we are given any, are dim. We don’t know when this will end: the virus is terrifying, safety measures feel weak, and living with scant idea of how you’ll pay the next bill cycle is haunting. Literally nothing is predictable.

Correction: I suppose the only predictable thing is that nobody wants to get this virus, nobody wants to go bankrupt, and nobody wants to have a nervous breakdown— but the kicker is— nobody knows specifically how to go about absolutely preventing these things.

It is trauma, plain and simple, and the word we use: “trauma”, literally means to describe the things that make us feel the way we do right now: living in the shadows of our ideal selves. We find ourselves agitated, irritable. Sometimes sad, tearful, sleeping. We find ourselves checking whether we or our kids are clean enough, safe enough. We are using substances too much. We are physically isolated from the people we love. We wonder whether something or someone will hurt us. We are fearful, anxious. We find ourselves fighting with our partners, or kids.

We go into survival mode when we are experiencing trauma. We unconsciously predict what will next jump out of the woods to take us down (or read the news to find it out: murder hornets, anyone?). It is tough. It feels defeating. It feels like there’s no solution. It feels like we are bad people that attract danger. It feels like another shoe will drop at any time. It feels unsafe, it feels unresolvable. This is trauma. And these symptoms/reactions are what our brains do to survive inordinate circumstances.

I know all former NICU parents are already painfully aware of this, I also know that current NICU parents are unimaginably and enormously impacted by this (and it breaks my heart to no end and I wish I could help more). I also know that throughout this, my sister is taking her 8 year old son for chemo treatments— her family doesn’t get the gift of boredom or apathy throughout this, they don’t even get the gift to slow down and think about how shitty it is— unfortunately, too many people are in similar circumstances.

The pandemic, the political situation in the United States and elsewhere, and the interfamilial conflicts that we are all experiencing right now as a result of being locked down connect us in a certain way, even in this devastating situation wherein we feel so separated and paralyzed.

Sometimes, in times of uncertainty, the only thing we have left to hold onto is the knowledge that through our suffering we are deeply connected to others and their experience of it, too.

Remember this when you see others’ photos of seedlings or their food/dinner on social media and feel irked. Remember this when your toddler won’t go to sleep at bedtime, or starts to tantrum more and more often. Or when your tween or teen is in tears over the fact that they can’t go to a party with their friends or don’t want to finish their homework/attend a Zoom meeting. Remember this when you or your partner’s agitation gets to the point that you feel like you are OVER it and about ready to wave the white flag. Remember this when you continuously wake up feeling under the weather, and debate whether it’s COVID-19 or seasonal allergies, or when you are desperately trying to protect your high risk family members and the fear remains chillingly present throughout the day and night. Remember this when you’re trying to cope with everything simply not feeling right.

Right now, it’s ok to grasp onto whatever grounding you can and to accept others who do as well. Everyone is trying to get through this, everyone is uncomfortable, everyone is sad and everyone is scared. It’s not only ok to be gentle with our friends and family, but also towards ourselves. It is so tempting to think that someone else is doing something wrong in situations like these, but when you truly take in the nature of it all, it becomes apparent that the main thing is just to take care. Breathe in when it feels overwhelming. Imagine that we are all the same, because we are (mother earth and her methods have a way of mirroring this back to us now and again). Then breathe out, because it’s ok to express that energy and to release it (and yourself). I think the most important thing right now is to remember that we are all human, that we have no choice but to sit with each other, and hopefully, to connect.

greta and e at easter 2020

So, 2020 is happening. From what I can tell, our worlds are being ripped wide open and shaken up, and many of us NICU parents are struggling not only with the stresses and anxiety brought with the global pandemic we are facing, but also with past traumas, past quarantines, past depression, and the memories that all of those experiences reopen. It’s because those parts of our mind have been ripped back open and are back in business. The feeling is mutual for anyone who has experienced or is experiencing trauma.

I had been embracing and loving the gift of “normalcy” after my daughter was born. She’s a beast and was born 4x the size of each of her brothers (8 pounds) and has a personality that reminds you of why people that are intense are fun. She has fury and passion. She likes wearing sunnies and playing basketball and following birds and examining artworks. She likes color and she likes interest. She likes wrestling. She shrieks intermittently at the various small animals in our household, and I think she enjoys that kind of language better than words. She’s, so very thankfully, healthy (side note: she loves quarantines.) She loves people. She’s like her brother.

The world decided to dole out another reminder, though, that there are no promises: that “normalcy” is a story we construct that makes us feel better— not a reality— and we should never take our gifts for granted.

The Silent Struggle: Mental Health and the NICU

In becoming parents, we oftentimes accept the silent assumptions that are made by our culture of what that's supposed to look like. An "ideal" parent, for example, seems to live in a blissful state of sacrifice, made happy by the sheer existence of their child, doing their best to take on their responsibilities according to whatever parenting technique may be in vogue at the time (see the book "Our Babies, Ourselves: How Biology and Culture Shape the Way We Parent" for some great writing on this subject).

Cracks in our ability to do that, made visible in mixed company or in the necessary public outings we sometimes have to make, can be harshly judged by strangers and other parents alike, as if our take on parenting is expected to be at top notch regardless of our surroundings or the context. Paradoxically, depending on your audience, different values will be upheld, and surprisingly, people oftentimes feel little need to censor their comments. 

The NICU parent, by virtue of their baby's traumatic entrance to the world, has a unique set of expectations placed upon them, in addition to a unique set of stresses. I remember when my son had terrible colic symptoms after discharge, which caused him to cry for numerous hours a day every day for months, of feeling like I wasn't grateful enough to have him home, that I was taking his health for granted, that I shouldn't feel depressed or anxious because, after all, he was out of the NICU. What else could possibly be as serious as that?  The depression, the haunting memories of the NICU that often flared up over the course of his entire first year-- how could I let those things overshadow the fact that he survived, that he was with me, that at any moment I could hug him? The fact that we were on quarantine to prevent infection, keeping us away from any kind of meetup groups or any kind of regular support from other parents didn't help matters much.  The guilt and shame that had accompanied his NICU stay carried on throughout his first year, in the form of my own expectation for myself that I should be happy and grateful, that struggles with emotional challenges were selfish or pointless. 

The NICU parent has to contend with the very real effects of trauma long after the discharge paperwork for their baby is signed. It's suspected that a staggering number, between 21-23%, of NICU parents have symptoms of PTSD. It's been found that amongst NICU dads, late-onset PTSD is common, cropping up sometimes as long as 6 months after the baby is home from the hospital (as a result, PTSD amongst NICU dads is underreported and difficult to measure). For moms and dads, untreated emotional trauma can wreak havoc on their ability to connect with their child or with each other well into the first few years of their child's life, and sometimes beyond. The very harsh experience of witnessing your child fight for their life can have profound influence on one's emotional health, and too often, no space is made for parents to grieve the experience, to put a name to what they lost, and to integrate that into their lives. Compounding that experience is the fact that NICU parents also have to deal with the very real threat that their child may have disabilities or health issues related to their prematurity or the medical issues that led to their NICU stay. 

As such, the NICU parent is not only held up to the expectation to be blissfully happy with their circumstances (sometimes, as it was in my case, by themselves), but they're contending with very serious, very real issues due to the fact that they were faced with an unpredictable, challenging, and in some ways emotionally devastating circumstance. With an implicit cultural assumption that parenting should be a joyous thing, too often we are silenced, and prevented from speaking to the struggles we may be contending with privately, afraid of the dark shadow that something like "mental health" might cast over our experiences. 

In resisting this silence, it becomes evident how powerful it can be for NICU parents (and parents in general!) to speak to the struggles they've had in parenting after discharge, to give a voice for others who may be too frightened to express it. In honor of Mental Health Awareness week, I'd like to make this a safe space to share your struggles as a parent, where you've gotten to with it, and if there has been any thing that's given you reprieve. Have you connected with other parents yet? How have you healed from your NICU experience? How would you like to see things change for others struggling with the same thing?