Memoir Excerpt: My Descent Into Postpartum Depression

I recently added my memoir Adventures With Postpartum Depression to Kindle Unlimited. It is also still available as a paperback or regular Kindle e-book. Since my old PPD website decided to crash and burn, I am going to slowly add content about my experiences with maternal mental health here. To get the ball rolling, I am sharing an excerpt from my memoir.

In this excerpt, I am meeting with my obstetrician for my six-week checkup. I am fully in the darkness of postpartum depression, but I am also in complete denial that I might be suffering from a mental illness. In fact, my primary objective at this appointment was to convince my obstetrician that I felt great! marvelous! absolutely divine!

If you enjoy this excerpt, the Kindle e-book is available for FREE until May 14, 2020. Now that the memoir is part of Kindle Unlimited, I can offer the book for free for five days of every ninety day cycle. I’ll post here and on IG (I’m @Courtney.Novak) whenever the book is free.

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“How are you doing?” 

“Wonderful! I’m doing great.” I knew exactly what the obstetrician was doing. She was trying to sniff out a whiff of postpartum depression. 

As if on cue, Pippa started to scream. She sounded like a siren portending the world’s end, but the obstetrician seemed unperturbed by the noise. Instead, she looked concerned for me. I willed myself to appear calm and collected. 

“But how do you feel?” she pressed.

“I feel great.”

I was at my six-week postpartum appointment and given my history with hypochondria, did not want to say anything that would lead to a misdiagnosis of postpartum depression. Still, my doctor seemed to think I had it.

In hindsight, I realize my appearance might have tipped her off.

I usually got my long brown hair professionally cut and highlighted every two months. During pregnancy, my obstetrician had assured me that I could continue getting my hair highlighted, but I was not taking any chances. What if some chemicals seeped through my scalp, got into my bloodstream, and hurt my baby? If I was not getting my hair highlighted, I might as well skip the haircuts too. I had read about postpartum hair loss and reasoned it was better to have as much hair as possible in case half of it fell out. 

By the time my water broke, my hair was straggly and a mix of greys and faded highlights. Three hours of active labor did nothing to improve my look: the ponytail holder fell out, and my hair got tangled into a sweaty, salty mess. During my first postpartum shower, I was too tired and defeated to drag a comb through the knots. 

Six weeks later, I still felt too defeated to deal with the hair situation. Eventually, I would buy detangler and conquer the knots, but that was still several weeks away. My obstetrician must have been more than a little alarmed by my hairstyle. 

“Are you happy? Getting enough rest?”

(My hair was truly frightening.)

“I am doing wonderfully. I didn’t even have the baby blues. I haven’t cried. I’ve been so happy since Pippa arrived.” 

When I said I was happy, I was trying to convince myself as much as the doctor. The part about crying, though, was true. I had not cried since Pippa’s birth aside from the one time I started crying at one in the morning from pure exhaustion. That didn’t count. That was not the baby blues. I assumed that whether or not a new mother had the baby blues was the ultimate barometer of her mental health; that postpartum depression was an extension of the baby blues. 

In a few months, I’d know better. 

By the time of this six-week appointment, I had postpartum depression. I had not experienced any symptoms that would get me locked up in the mental ward (those would come soon enough), but looking back, I can see the red flags.

There was my new obsession with germs. Previously, my hypochondria had always been limited to symptoms I had, or thought I had, never extending into mysophobia, or fear of germs. Postpartum depression had helped me make the leap from hypochondria to mysophobia. 

The first day of Pippa’s life, while my parents and grandma were visiting us in the maternity ward, I scrolled through the online options for face masks. I needed a cache of masks for visitors who might arrive at my house with coughs and sneezes. 

“I can’t tell which one is good enough.”

“I’m sure they are all fine.” That was my mom, a woman who was always vigilant about her children’s health. When everyone, including the pediatrician, insisted my sister simply had the flu, my mom was the one who piled everyone into the car to go to the hospital. Three hours later, the nurses were prepping Katherine for an emergency appendectomy. Now that her first grandchild was here, you could be sure my mom was not going to let anything endanger Pippa’s health. 

“But even the ones that are supposed to be good enough for surgery are not 100 percent effective.”

“Courtney, if it’s good enough for surgery, it will keep Pippa safe.”

“You don’t know that.” I spent another hour agonizing over the options before settling on the best bad choice. Then I fixated on my next fear: unwanted visitors.

“What if someone wants to visit and they are sick?”

My mom had Pippa stretched across her legs, facedown, and was patting her back. This seemed to help her burp. “Courtney, no one is going to visit when they are sick.”

“But what if someone wants to visit and they are already sick and contagious but they don’t have any symptoms yet? Or they think it’s allergies? A cold can kill a newborn.”

I was imagining droves of Hennings, aunts, uncles and cousins from my dad’s side of the family, descending upon our house unannounced.

“If the Hennings ask, do you want me to tell them you don’t want visitors?”

“Yes. Be nice about it. But if anyone asks, discourage visitors.” 

The message must have been effectively delivered, because almost no one visited. Just my parents, Nathan’s parents, my siblings, my grandma, and one cousin. I have a lot of aunts, uncles, and cousins in Los Angeles who would have loved to meet Pippa, but they steered clear. 

So the mysophobia created another red-flag behavior: isolation.

Episode 82: A Very Pandemic Mother’s Day

A couple of days ago, I thought, I should add my memoir to the Kindle Unlimited thingee on Amazon. So I did. Then I discovered that if an author adds her book to Kindle Unlimited, she is allowed to make her book free for Kindle download for up five days.

How could I resist?

So as my 2020 Mother’s Day gift from me to you, my memoir is available as a Kindle download on Amazon for FREE from Sunday, May 10 until Thursday, May 14, 2020. Get your copy now! If you enjoy the book, please consider leaving a review. It helps other people who might need the book find it.

Having made the book free for Mother’s Day, I initially thought I would post about it on Instagram and Facebook. But then I thought, I could make a Mother’s Day podcast episode.

And that is why I am now typing the show notes for Episode 82! (If you have never listened to the show, it’s called Adventures with Postpartum Depression and is available on iTunes and all those other fun places that play podcasts.)

We have been sheltering-at-home for eight weeks. Eight weeks! It’s crazy and surreal but a few good things have emerged from the experience. For example, blogging. My intuition has been urging me to blog for years, and for years, I have delayed, insisting that I did not have the time. Well, enter the pandemic, and I have less time than ever but here I am, blogging. It helps me process this experience and dig into my feelings and I do believe this is a practice I will continue even when the pandemic is just a memory.

Now that we have settled in for the long haul (summer camps are being cancelled, the 2020-21 school year is very Iffy), I have also been forced to reckon with some ideas I have about motherhood. I am realizing that even though I recovered from postpartum depression, I am still carrying around an idea that motherhood = martyrdom.

This is an idea that I will be exploring in my journal. As I hash out my ideas, I’ll blog about them here as well.

But Glennon Doyle really got me thinking about this in her amazing new memoir Untamed. She writes:

Mothers have martyred themselves in their children’s names since the beginning of time. We have lived as if she who disappears the most, loves the most. We have been conditioned to prove our love by slowly ceasing to exist.

Untamed pg. 128

Wow. I could just talk about that for hours and hours. And a few paragraphs later:

What if love is not the process of disappearing for the beloved but of emerging for the beloved? What if a mother’s responsibility is teaching her children that love does not lock the lover away but frees her? What if a responsible mother is not one who shows her children how to slowly die but how to stay wildly alive until the day she dies? What if the call of motherhood is not to be a martyr but to be a model?

Untamed, pg. 128

I think I had postpartum depression because my hormones went beserk and pushed my preexisting anxiety into the realm of mental illness. BUT. I am starting to see that I also had postpartum depression because I had internalized a martyrdom standard for motherhood that annihilated my sense of self when I gave birth to my first child. How could I be the person I had been for thirty-four years when I had to now sacrifice everything to prove my love for this new person?

It feels like such a relief to finally say and write the thoughts that have been rattling around my head.

I also think that for me (we are all different!), another piece of the PPD Puzzle was a sort of “crisis of intuition.” I did not trust myself. When it came to Pippa, I wanted to trust all the parenting experts. Anyone but me. But I could not follow all of the experts’ advice because there are so many conflicting opinions. So in part, PPD was my body’s protest against the denial of my motherly intuition.

I am still thinking these things through and expect I will keep writing about them, and keep recording podcast episodes, as I dive deeper into my thoughts about PPD and motherhood.

For those of you who listened to Episode 82 and are currently suffering from a maternal mood disorder, I strongly recommend that you start with Postpartum Support International in your search for help.

I hope you have a lovely Mother’s Day, wherever and whenever you are. But if you don’t, that’s okay. Do not put too much pressure on yourself to have the perfect Mother’s Day. You have to do whatever works for you.

I Am Reclaiming My Role As A Maternal Mental Health Advocate

I used to consider myself a maternal mental health advocate. There was the memoir, the podcast, the peer support group… I even designed an awesome tote bag!

Then, as I wrote about in this recent post, my intuition told me to stop and take a big step away from my postpartum work.

It took me a few weeks to honor my intuition, and a few weeks after that to wrap up the podcast and peer support group, but I did. I am in the process of figuring out why I needed to take a break from the advocacy work. I will share more here as I figure it out! If I try to walk you through my thoughts now … well, shit, I like to ramble, but even I know when a good thing has gone too far.

During my break from being a maternal mental health advocate, my other website broke. It was a website I had created for my podcast, and so I naturally published everything I wrote about postpartum depression over there. I created this website for everything else.

I have no idea what happened to that other website. I am sure I could have paid someone to fix it, but it was a passion project and I did not want to spend more money on it. (I already pay hosting fees for the podcast and I paid someone to edit my memoir. Money well spent!) I assumed the problem would resolve itself.

It did not.

I lost all the content I wrote for the postpartum depression website.

This was more than a little annoying.

I felt defeated. I knew I could write posts about postpartum depression here. I could probably find some of the lost material on my trusty MacBook Air. But I was overwhelmed by the idea of starting over. Also, I felt like a bit of a fraud. What sort of maternal mental health advocate starts a podcast, writes a book, runs a support group and then walks away from it all? And more: what sort of advocate creates a website with all sorts of great content and then let’s the internet eat the website?

THIS ONE!

And damn it, I am proud to own my journey. I rode the narrow highway of success for years and years, getting straight As in school, going to an Ivy League college, going straight from college to law school, then taking a job at a big law firm, and then taking another lawyer gig and yet another even as my soul screamed and railed against being a lawyer. And you know what the narrow highway to success got me? An ass shit ton of misery, anxiety and depression.

I may have left the law after I had Pippa, but I still had this subconscious need to conform to someone else’s idea of success. I still felt an attachment to being “successful.” Even with my advocacy work, I felt this need to fit into someone else’s idea of what it meant to be a good advocate. I don’t know who that “someone else” is! I just got to a point where I was ticking off boxes on someone else’s checklist of what it meant to be a maternal mental health advocate instead of being the advocate I wanted to be.

Huh. Maybe that was why my intuition prompted me to take a break from my advocacy work. Or, more accurately, maybe that is one of the why’s. There are probably many.

Long story short: I am reclaiming my role as maternal mental health advocate.

I do not know exactly what that means for me.

But right now, as I write this, I feel effervescent, like there is a river of energy pouring through my heart, so I know that I am doing something that is right and true for me.

I Am Ready To Wade Deeper Into My Work With Postpartum Depression

In August 2018, on Pippa’s first day of kindergarten, I had the sudden and deep realization that I needed to take a break from my work as a maternal mental health advocate.

At the time, I was doing a lot. I had a podcast called Adventures with Postpartum Depression for which I interviewed moms who wanted to share their stories. I also ran a weekly peer-to-peer support group for moms suffering from a maternal mood disorder. I had published my memoir and was trying to spread the word about my book on social media. I had organized Team L.A.’s participation in the annual Climb Out of the Darkness event.

And then after investing so much of my time in my role of “maternal mental health advocate,” my intuition told me it was time to stop.

My mind threw a hissy fit. What? How? Seriously how? What the fuck? How can I walk away from a support group, podcast, and the promotion of my memoir?

My intuition said, You just have to do it.

I spent several weeks contemplating this decision. And by “contemplating,” I mean “trying to come up with some valid reasons to ignore my intuition and keep my life exactly as it had been for the past two years.” Many journal entries were written! But after a few weeks of resistance, I accepted that my intuition was right. I surrendered to what I already knew. It was time to enter a new phase of my life, and that meant withdrawing from the maternal mental health community.

It was the right decision. My advocacy activities had been done as a peer, but as far as postpartum depression was concerned, I was not a peer anymore. I was struggling to connect with the moms who attended the weekly support group. I was also struggling to create new content for my podcast. I wanted to tell people about the new things I was doing for my personal growth, but a podcast for postpartum depression did not feel like the right forum. I was like a snake ready to shed a skin that had grown too snug.

Walking away from all my work as a maternal mental advocate was scary. It was like losing an identity. And now, I am being beckoned back into the fold, and that is scary.

I recently read Tosha Silver’s book Change Me Prayers: The Hidden Power of Spiritual Surrender. Silver writes a lot about receiving sings from her higher power. Occasionally in the past, I felt like the Universe was sending me a sign, and as I read Change Me Prayers, I started hoping to receive more signs. So I prayed in my journal, Please, Divine Beloved, show me the next step I should take. That was about two months ago.

Over the next two months, this is what happened:

  • A mom friend asked me to speak to her book club about my memoir.
  • I felt inspired to create a new podcast episode for all the moms suffering from postpartum depression during the pandemic.
  • Last week, another mom friend texted me, asking for any advice I had about postpartum depression.
  • A few days ago, yet another friend tagged me on Instagram to take part in The Blue Dot Project’s 2020 Maternal Mental Health Week campaign.
  • And then yesterday, while sitting down to write a blog post about mom guilt, I ended up writing a very raw post instead about the lingering shame I still feel over the intrusive thoughts I had about throwing Pippa.

Well shit. I asked for a sign. The Universe sent five.

So what do these signs mean? I am not entirely certain. Except as I finished writing that last sentence, my intuition said very clearly: Wade deeper.

Okay then.

I am not meant to restart the postpartum support group. I am no longer a peer and I do not feel called to be a therapist, so that is no longer my work. I believe the same hold trues for my podcast.

What I need to do is THIS. I need to explore my lingering tender spots from my adventures with postpartum depression. As I hash things out in my journal, I can write about it here. Just because I published a memoir does not mean my work is done.

It just might be time to look at things from a different angle and see what bubbles up from my intuition.

I Still Feel Shame Connected With My Adventures With Postpartum Depression

Seven years ago today, Pippa was six weeks old. She could smile and squawked in mighty protest whenever we subjected her to the indignity of tummy time. I loved to snuggle her and talk to her during her many, many diaper changes. I was utterly enchanted with my sweet baby girl.

And I was also suffering from horrible postpartum depression.

I can write that so easily now. I do not feel even a flicker of discomfort when I say or write the words “I had postpartum depression.” But damn, it took me a lot of work to get to that point.

I suffered for months before I felt ready to ask for help, and I only asked for help because I had intrusive thoughts of hurting Pippa that scared the crap out of me. I did not want to hurt Pippa, but I had insomnia, and I was terrified that one day she would be crying, and I’d have a thought of throwing her to stop the crying, and I would not have time to push away the thought before my body responded.

Okay, wow! I can write the words “I had postpartum depression” easily but writing about those old intrusive thoughts just activated my body. As I write this, my chest, arms and head are tingling unpleasantly, as if old trapped feelings are demanding to be felt and released.

I am taking a moment to sit with these feelings and memories…

It’s not easy. Damn, I just want to keep writing and push past the discomfort.

But there it is: shame.

In Untamed, Glennon Doyle writes:

Shamelessness is my spiritual practice.

Untamed, pg. 19.

Can I do that? Can I get past the lingering feelings of shame that I still have because, almost seven years ago, I thought about hurting my baby?

I just looked up the definition of the word “shame“and the first entry is:

The painful feeling arising from the consciousness of something dishonorable, improper, ridiculous, etc., done by oneself or another.

Dictionary.com

Okay, if that is the meaning of shame, then yes, I do want to transcend my feelings of shame, because holy shit, I did not do anything dishonorable, improper, or ridiculous.

I had a mental illness.

I had insomnia.

I had hormones that went bat shit crazy.

The bat shit crazy hormones exacerbated some toxic ideas about motherhood that I had absorbed from various sources including society, books, blogs, social media, strangers on the street, and so many other places.

And then those toxic ideas about motherhood got mixed up with my preexisting anxiety.

The reasons I had intrusive thoughts about hurting my baby are complicated and messy, but I know this much: I did nothing wrong. My shame is coming from some old belief that I need to find and fix.

Though I have come to terms with the “nicer” parts of my adventures with postpartum depression, I still have some unfinished business to tackle.

Full disclosure: When I sat down to write this post, I was planning to quote some amazing things that Glennon Doyle wrote about motherhood in Untamed and then reflect on how I am applying those ideas to my own life. I did not think I was going to be here, feeling all this shame, and realizing that the shame is an indication of some deep soul work that I need to do.

But here I am.

My body is practically on fire with shame.

I have published a memoir. I have created a podcast about postpartum depression with eighty episodes. I have shared my experiences countless times on social media. I even led a hike to raise awareness about maternal mental health. I thought I was done.

But I still have some work to do, because if this shame was happening to anyone else — future Pippa, my sister, one of my cousins, a friend, a stranger on the street — I would tell them that they did nothing wrong. That they should not feel shame over intrusive thoughts because they did not do anything “dishonorable, improper or ridiculous.”

Excuse me while I take a moment to roll up my metaphorical sleeves.

I want to clarify something. I am not trying to extinguish my feelings about shame because they are uncomfortable, end of discussion. I want to get at the root of whatever is causing my shame. I do not believe I have any reason to feel shame about thoughts I had during my mental illness, but I still feel the shame. So I want to dig into this feeling so that I can make whatever internal changes I need to make in order to get to a place where I am at peace with the old intrusive thoughts.

I don’t know how this is going to work. I have no idea how I will heal the lingering shame over my intrusive thoughts. How long will this take? Will I talk about it on my sort-of-retired podcast? Will my memoir’s epilogue need an epilogue of its own?

All I know is that my body is telling me that I still feel shame connected with parts of my postpartum depression adventures, and that means I still have work to do. So here I go. I am going to follow Glennon Doyle’s lead and make shamelessness my spiritual practice.

Mirtazipane Weaning: The Pandemic Edition

I have been taking an antidepressant called Mirtazipane since July 2013 when I was diagnosed with postpartum depression. My doctor yanked me off Mirtazipane when I got pregnant with Julian, but for the most part, I have been taking some Mirtazipane at bedtime since 2013.

I have tried to wean myself off Mirtazipane so many times, I have lost track. I have to check this blog to remind myself! I have also lost track of the number of times I have blogged about Mirtazipane weaning, but the most recent post is here. I wrote that post on November 3, 2019, when I was starting to wean off Mirtazipane, aka Remeron (that’s the generic, and that’s what I actually take) for the fourth time.

So here’s the update: Mirtazipane Weaing, Take 4, didn’t work.

I kept whittling my dose down to smaller and smaller amounts and then in mid-January, I had several nights of insomnia. (Confession: I cannot remember if I was every fully off Mirtazipane this go around or if I was just taking a very tiny dose. #MamaBrain.) When the insomnia hit in January, I called my psychiatrist and got my ass back on 7.5. mg of Mirtazipane at bedtime.

During this latest insomnia bout, my psychiatrist gently reminded me about the MTHFR gene mutation. My psychiatrist first suggested I be tested for the mutation, oh, a year ago. She explained that the MTHFR gene mutation makes it difficult for the brain to process Vitamin B, and for some people, this causes mood disorders like depression and anxiety (hello!), insomnia (hi again!) and weight gain (it’s like my psychiatrist was reading my diary!) My psychiatrist explained that given my mental health history, and all the work I have done in therapy, and my struggles to get off Mirtazipane, I might just have the mutation. She urged me to talk about it with my general practitioner and get a blood test to find out. This seemed like an excellent idea.

But I procrastinated.

When I was first hospitalized for postpartum depression, my psychiatrist tested my thyroid. Sometimes thyroid issues mimic postpartum depression. Oh, that sent my hopes skyrocketing! I didn’t want to have PPD. I wanted to have a thyroid issue, because back in 2013, I was still very sensitive to the stigma surrounding mental health. (And now? I give zero fucks. I know I’m a good person, end of discussion. But 2013 was a completely different time.) I was so disappointed when my thyroid results came back as normal. Damnit. I had a mental illness.

Getting tested for the MTHFR gene mutation felt like I was back in the hospital, clinging to the hope that I had a thyroid issue. I just needed to accept the fact that I need to take a little antidepressant in order to sleep well at night and stop trying to pin the blame on some other health issue. Besides, there is no blame in this! It’s just the way my brain works.

But I finally realized I was being idiot. I am going to take an antidepressant if that’s what I need to sleep, but if there’s some other health issue, that should be addressed as well. Knowledge is power.

So I got the blood test in January.

I waited.

I had an appointment with my naturopath in early February.

She handed me the results from my blood test.

I have the MTHFR gene mutation.

I’m actually tearing up while I write this. When I gave birth to Pippa in 2013, my hormones went batshit bonkers. I had a lot of preexisting anxiety, and my hormones just pushed my anxious mindset into Mental Health Crisis Land. But my poor brain was also starved for Vitamin B. Zoloft and Mirtazipane pulled me out of my PPD crisis, but damnit, I still needed Vitamin B.

Now I am at long last getting the Vitamin B my brain needs. I take a supplement after breakfast, lunch and dinner. (Ok, always after breakfast and dinner. Lunch is 50/50 whether I’m going to remember.) The supplements gives me 125,000% of the recommended daily dose of Vitamin B. Translation: Holy shit! My brain needs a lot of Vitamin B!

For the first few days after I started my new Vitamin B supplements, I did not notice any changes. But then I slept seven hours straight one night, got up to pee at 5 a.m., and fell right back to sleep. WHAT THE HOLY FUCK? I have not done that since I was, I don’t know, eleven years old? Ten years old?

I still tend to wake up during the night to pee, but only once, and then 98% of the time, I fall right back to sleep. I feel better rested than I can ever remember feeling. I am sleeping more deeply for much longer stretches of time. I have even been sleeping beautifully during the present shit storm.

I also have more energy and zip during the day. Was I slightly depressed before I got my Vitamin B needs met? I don’t know. I have to reflect upon that idea some more. I thought I was as mentally healthy as anyone could be, but now that I am getting my Vitamin B, holy shit, maybe I have been slightly depressed for all of my adult life.

I feel like with all this fantastic Vitamin B, I might actually be ready to wean off Mirtazipane.

Except for this whole pandemic thing.

Yeah… I don’t have a lot of experience in this arena, but it seems to me that when one is sheltering at home during a pandemic, that might not be the best time to wean off an antidepressant.

So I am just going to continue taking 7.5 mg of Mirtazipane at bedtime for the foreseeable future. But damn, I love the way I feel with my mega Vitamin B supplements! I’ll just have to add Mirtazipane Weaning, Take 5 to my post-pandemic bucket list.

To The Mama Crying At The Mall

I saw you as I was buying my coffee. You: sitting, eyes brimmed red and tears flowing, while the baby kicked in her stroller. Me: Just over six years away from those tender raw postpartum depression days.

I am projecting, of course. I had postpartum depression, so when I see a miserable new mom, I assume she is struggling with the transition to motherhood just as I struggled (and thrashed and suffered and nearly drowned) when my daughter was born. Actually, I project my PPD days on all the new mamas I see, not just the ones who are crying at the mall. Even the mamas who are smiling and seem radiant: I worry about you. What worries might keep you awake at night? What OCD rituals might you be performing to calm the anxiety? What intrusive thoughts did you have yesterday when the baby would not stop crying? I know how easy it is to look like everything is okay, because that was what I did. And I’m not even that great of an actress.

I saw you, Mama Crying At The Mall, and I wanted to say hello. I wanted to stoop down and ask, “How are you doing?” I wanted to look into your tear filled eyes and say, “I worry about mamas with babies, you see, because my babies kicked my ass.”

But I didn’t, because I was worried I would say the wrong thing and make you feel worse. Also, I was waiting for my coffee. But mostly, I was just worried that I would say the wrong thing. So I said nothing and by the time I got my coffee, you had wiped away your tears and pushed the stroller away.

To the Mama Crying at the Mall: next time I will try to do better. Fuck these 21st century manners. Fuck pretending feelings do not exist at the mall. Fuck all this social and emotional isolation.

It’s been over six years since I was diagnosed with postpartum depression, and damn, those raw intense feelings keep fading and fading. But I want to remember them at least a little so I can relate. So the next time I see a mama with a baby, whether she is crying or not, I remember to ask the most important question of all:

How are you?