The Village

I was recently surprised to learn that I had lost my desire to move back to New York. As recently as a few months ago, when people would ask me whether I envisioned myself staying in California forever, I used to respond with “Probably, because I don’t think I can convince my husband to live anywhere else.” Now I pause, because the answer is that I can’t quite imagine living anywhere else.

When and how did this drastic shift occur? I left New York when I was 18 years old. To be honest, I was thrilled to do so. I lived in the suburbs outside of NYC, had moved during my freshman year of high school (NOT a good situation), and was excited to “discover the world”. I floated around New England for college and medical school, and spent a requisite year living and working in NYC. When it was time for residency selection, my husband (also an East Coaster) and I were adamant that we needed to get out of the cold. He wanted to work in California and I was game to live in California and so I applied and was accepted.

We flew to the West Coast with one suitcase. (I can imagine myself telling this story to my children one day, at which point they’ll roll their eyes at this particular sentence.) We had less than $5,000 combined in our bank accounts. My husband was unemployed (“between jobs”) and I was days shy of starting my intern year. We rented a small unit in a house of four units total and decked it out in IKEA furniture. My husband bought a Samsung flat screen TV which we still own 8 years later. We weren’t married yet but reasoned that we needed to move in together because the rent was too expensive to swing two apartments. When he proposed to me, the engagement ring was the most expensive thing we owned. We didn’t have much but we were so happy.

In the past 8 years, we’ve spent 5 of them living together (we were apart for 3 years while I completed my residency), got jobs, got married, bought a house, tucked away money for retirement, had 3 kids, tucked away money for college education, and created the life we always wanted – one we could have never quite imagined when we landed in California in 2010.

Yet there were bumps in the road. I started my first job out of residency in 2014 and had a baby 3 months later. I’ve had 2 additional children since. I had no idea how difficult it would be to raise a family away from our families. It often felt impossible. I vividly remember those first colic-filled weeks with our oldest. We had help for a few of them but were on our own most of the time and I cried constantly. When I went back to work I was convinced there was no way I could juggle motherhood and my career without help. Most of our acquaintances at the time were my husband’s friends and, although mostly good people, they just weren’t my people. Is that a terrible thing to say? I hope not. You know that feeling when you just click with someone? When you can tell them anything – lay all your cards on the table, be completely vulnerable – and they will accept you wholeheartedly? Let’s just say I didn’t get that vibe from his people. And that’s what I struggled with the most – not having someone I could text frantically when our first was up at all hours of the night, not having someone I could ask to watch him for an hour while I took a breather, not having a tribe to commiserate with.

So I put myself out there. I met a group of women I now call “The Mommies”. My first mom friends! Now, the group has changed dramatically these past 4 years as moms move away and group dynamics shift, but we have each other’s backs, an ongoing calendar of events, never-ending birthday parties, and most importantly the knowledge that we have known each other since our little ones were just months old. I rekindled friendships with people from my intern year and became closer to co-workers with young children. I met more moms through preschool and subsequent “new mom” groups as more children joined our family. We acquired a network of people who have helped us out in some capacity around the house – gardeners, painters, nannies, cleaning crews, etc. Today, our nanny saw that I was clearing out our shed for some upcoming work and (unsolicited) called her husband to see if he would be willing to pick up all of the items we were throwing out to save us the hassle. He came by an hour later and I was so happy I could have cried. With such distance between ourselves and our families, these random acts of kindness mean everything.

I also have to admit that there are serious perks to living in California: great weather, tons of diversity, generally liberal politics. It’s also true that we both love our jobs and our house. But the game-changer for me was truly the evolution of our community and little village. We’ll see how we feel as the kids get older and schedules become more demanding but, for now, I am truly loving where we live, and this is the first time since 2014 that I’ve been truly able to say that.

Nervous Nellie

I’ve had anxiety most (if not all) of my life. Some of my earliest memories are anxiety-laden:

  • sitting in my father’s car while he was outside talking to my uncle, feeling worried about being alone in the car
  • in elementary school, feeling worried about a state project due in May…during the month of December
  • the night before I turned 10, feeling intense worry that I would never be 9 years old again

I could go on and on.

There were times in my life when my worry worsened. A few weeks to months each year during my childhood when I would be exponentially worried – we began to call these episodes “La Etapa” (a stage of my life). I remember the worry intensifying in high school. I moved to a new school district during my freshman year and I would feel intense dread in the morning when people loitered by their lockers since I didn’t (really) know anyone. I remember hiding in the bathroom during this time, as this was preferable to socializing. I experienced intense anxiety during freshman year of college- fear of meeting new people/would I fit in/etc. I drank too much and gained a ton of weight which only made things worse. My anxiety worsened in medical school, especially on rotations where I had less control over my schedule/time. One way of dealing with my anxiety was through food restriction and overexercising – I could have control over one area of my life, even when everything else was in disarray. I started dieting in high school, so that need has been there for a long time.

I did speak to a few people during these years. In college, someone tipped off a counselor that I may have an eating disorder, and so I started seeing her. She would weigh me facing backyards so that I couldn’t see how much I weighed. I lost more weight when I stopped weighing myself because I was afraid of gaining weight, so clearly the anxiety was still there. I then met with a psychiatrist in medical school, during my surgical rotation, because I was incredibly moody and would break down over the smallest things. I remember running to the first appointment so that I wouldn’t miss my workout that day. He started me on Celexa. I took this for a few weeks, maybe 1-3 months max? My husband (boyfriend at the time) thought it helped, but I wasn’t so sure and stopped shortly after starting. The third time I reached out to get help was when I was struggling with infertility due to hypothalamic amenorrhea. I met with a therapist a few times near my residency program, pretty much crying the entire time through those sessions. That also did not last long.

Why did I “quit” so many times? Probably because I have pretty high-functioning anxiety. It never stopped me from accomplishing my goals or having (mostly) healthy relationships. It’s an ever present background hum, but in many ways it has driven me to succeed. I excelled in school, attended an Ivy League college, graduated medical school and matched into a competitive residency. In other words, even though I personally suffered, my goals did not. I was still able to interact normally with others, connect with/take great care of my patients, and perform daily activities with little interference. However, I have recently started wondering whether things could actually be better. For years, I thought being thin had led me to succeed. Part of the fear of gaining weight was that I would lose everything I had worked for. This was obviously a lie I had been telling myself and the world did not end when I gained weight. And so I started thinking: what if life could actually be better with my anxiety under better control? What would it be like to live in the moment, to not have the ever present buzz of worry, to not feel imminent doom over every little thing?

The other tipping point was this: my 4 year old has started to show signs of anxiety and it is heart-breaking. Yes, it could be hereditary. My whole family deals with anxiety, so maybe it would have been passed on anyway. But I also wonder whether an anxious milieu of the womb or anxious parenting (my husband, too, would factor in here; although normally a very calm person, he is quite an anxious parent) had any effect. I feel intense guilt over this. Although I can’t change anything I’ve done, at the very least I can do my very best to control my anxiety as my kids begin to grow and understand more.

Finally, I think it will be good for my marriage. My husband and I love each other dearly, but our differing personalities (mine characterized by anxiety) have definitely led to some repetitive arguments.

And so I scheduled an appointment with a psychiatrist specializing in women’s health, particularly around birth and motherhood. I met with her last week and she agreed I had generalized anxiety disorder and recommended three pillars of treatment:

  1. Medication
  2. Psychotherapy
  3. Self care

She said we could do any combination, so I am started with medication and trying to incorporate self care into my life. I opted for medication because, if I am truly honest with myself, I am dog-tired. I’m tired of always worrying about everything, of making to-do list after to-do list, of constantly playing out scenarios in my head. It is absolutely exhausting. And I want to get better as fast as possible. My father, a psychiatrist, always said that medication could be incredibly helpful to patients, to normalize their brain chemistry while they utilized psychotherapy to change their thought patterns. I picked up Zoloft right after the appointment and felt a huge sense of relief as I swallowed it. Obviously all of my feelings were still there, but I was relieved to finally be doing something about it.

I am holding off on psychotherapy for now because of the time commitment, but I am trying to do some self care. My family is in town this weekend so it’s a wonderful opportunity. I am taking the time to write this, and I also scheduled a couples massage for this evening. In the past week I’ve made time for mom/baby yoga and a stroller workout class.

And so I am trying and hoping for the very best outcome here.