Postpartum Insomnia Series – Part 3: BRYN

This is the third of my series of blog posts about postpartum insomnia.

I met Bryn recently via the closed Facebook group for Postpartum Support International.  Thank you, Bryn, for sharing your experience on my blog.  I am very glad that the process of reflecting back to the time you suffered from postpartum depression (PPD)/postpartum anxiety (PPA) and putting your thoughts down was cathartic.  I’ve always found blogging to be a therapeutic process, and I encourage all my readers to consider writing/blogging about your experiences. It will truly make a difference and help you process/validate what you went through.

Now, without further ado, here are Bryn’s 10 Q&A…..

* * * * * * * * * * ** * * * * * *

QUESTION:
When/what was the first indication that something wasn’t right, and how long after childbirth did the first sign occur?

ANSWER:
My first sign was probably before I even left the hospital. I had a regular check-up at 38w6d and had low amniotic fluid, so I was induced that evening, Friday. Delivered Saturday morning and went home Monday late afternoon. During that whole time, I maybe slept a handful of hours total. Early Monday morning I was a wreck, sobbing about putting baby girl in the nursery so we could sleep and sobbing because I couldn’t sleep. But that just registered to me as Very Emotional First Time Mom. My first official indication that something wasn’t right was trying to sleep at home Monday night and free falling into my first-ever panic attack. I felt very, very dangerous. I remember looking at some scissors and making some very disorienting, strong connections to my panic and danger and those scissors. I actually picked them up and will never forget my husband saying, “Bryn, put down the scissors.” I made DH drive us (me and the three-day-old, poor girl) right back to the ER, where I had another panic attack. My folks had visited earlier that morning, had already driven home (80 miles away) and then drove back to be with me at the hospital. DH’s mom drove to our house to set up helping out with baby girl (So, so grateful to have one grandma who’s a Labor & Delivery Nurse and one grandma who’s a Licensed Professional Counselor Mental Health Professional). I finally got some Ativan and went home to try sleeping with Unisom. This was around 2am. DH’s mom woke me up around 6am to nurse. So, I maybe got four hours of sleep. I remember feeling so incredulous that, even after everything that had happened the previous night, she would actually wake me up. But, um, duh, I do have a baby now. Four hours was generous! I was very much in denial. So, short answer, my first sign that something wasn’t right happened 2-3 days postpartum.

QUESTION:
Did you suffer from insomnia? What other symptoms did you experience, if any?

ANSWER:
Yes. Monday night I got a few hours of sleep after Ativan and Unisom. Tuesday night, I tried melatonin and didn’t sleep. Wednesday late afternoon, I tried to go to bed early and took Unisom since that worked okay Monday night. I didn’t sleep and was also so whacked out with constant anxiety and mini-panic attacks that I pleaded to go back to the hospital. I begged and begged the ER to sedate me. I was out of my ever-loving mind, clinging to DH and just losing it. At 8pm, after a lot of doc consults and one psych consult (and the number to the local crisis stabilization unit), I finally got a cocktail of Benadryl, Ativan and Haldol. I slept for 10 hours, waking up at 6am and went right back to high-strung anxiety and all-day panic. Thursday night, I tried Ambien and woke up after an hour. Made a deal with DH that I would go to baby girl’s first doc appointment Friday morning and then we would check me in somewhere. We’d spent a week trying to figure out what the hell to do with me and how to get me better, and now it was the professionals’ turn.

QUESTION:
Now, just out of curiosity, do you have a personal history of depression and/or anxiety or other mood disorder?

ANSWER:
I had a brief period of depression in high school after moving cross country my junior year, but that experience didn’t lead to anything that truly interfered with my life the way my PPD/PPA did after I had my baby.  The sadness during my junior year definitely felt different than other times in my life. I remember functioning like a zombie, numb for a few months until I got into the swing of things. My mom says I barely ate for a few weeks, but I don’t really remember that.  I didn’t have any treatment beyond the school counselor getting me involved in the basketball team as a scorekeeper. It wasn’t until after I gave birth that I experienced a mood disorder that prevented me from sleeping, functioning and enjoying the baby that I gave birth to after a very stressful IVF cycle so much so that I truly needed medication to help with recovery.

QUESTION:
Did you see a doctor right away, and was he/she able to help you?  What course of treatment did he/she prescribe? Did he/she diagnose you with a postpartum mood disorder?

ANSWER:
Tuesday, after my first panic attacks, we went back to my midwife to check in with her about all this. They prescribed Xanax, which turned out to not really agree with me. I don’t remember them diagnosing me with a mood disorder of any kind. And I don’t remember PPD/PPA being mentioned. Just that I was having difficulty getting back on track. But I did take the Edinburgh and remembering scoring off the charts, so maybe we had that discussion? I really don’t remember.

QUESTION:
If you had to take meds, what was it/what were they and how long did you have to take it/them?  Did you have enough resources to help you with your recovery?  What kind of resources did you have (e.g., support group, postpartum doula, psychiatrist, partner reduced work hours/worked from home)? Did you have enough practical help (e.g., late night feedings) with the baby?

ANSWER:
I started with Xanax (anti-anxiety) from my midwife, which just gave me jitters and put me out of sorts. I first checked in to a local, free, crisis stabilization unit Friday morning (one week postpartum) in Cookeville, TN where we were living at the time, but once I got fully checked in and started assessing the place (with my vast knowledge of psychiatric help facilities [sarcasm]), I started freaking out that they weren’t going to be able to help me because the doctor had already gone home for the day and I had zero confidence they could get me to sleep that night. I went into panic mode again. The nurse got authorization to give me some Ativan (anti-anxiety). I called my family to come get me, and we headed to Vanderbilt Psychiatric Hospital instead. The Ativan really helped keep me calm for about an hour or two. I kind of wish I had had that all that first week, but of course, that wouldn’t have addressed any underlying issues.

Vandy Psych checked me in via the ER and a Patient Transfer Unit. That place. I will always remember that place as the lowest of my low points. It was a perfectly fine unit with perfectly great, professional people. That was just where it all came to the point of no return for me. My folks were with me while DH and his mom were with baby girl. We just waited and waited, on furniture that was bolted to the ground, I might add. We had intake and consult after intake and consult. And there were a handful of other folks in the other rooms waiting, just like me, for a bed to open up. Knowing what I know now about the process, they had mercy and definitely pushed me ahead of other folks. I was pacing and freaking out and then pumping and trying to lie down and changing my diaper because I was still only a week postpartum, and pacing and freaking out on repeat. I was so beyond exhausted, my dad paced behind me so I wouldn’t fall over. I pleaded with the staff to get me in so I could just go to sleep. I remember telling anyone who would listen I was this close to just banging my head against the wall to knock myself out. I was VERY aware of feeling this “line” just right there in front of me. I very easily could go ahead and bang my head against the wall. But I knew if I crossed that line, there would be no coming back, not for a long time or without a lot of repercussions. That willpower to not beat my head against the wall or go flailing out of control, letting loose all the fucked-up crazy that was pent up inside me, that was the strongest I have ever been. Ever. I am in awe of myself for not letting go. I guess I come by my control issues and anxiety honestly.

At one point I got pretty worked up and they gave me Atarax (anti-anxiety) to calm down. Man, those -axes do not agree with me. I felt like my soul was trying to come out through my skin and my skin was trying to dissolve off me at the same time. So horrible.

When I finally got to the psych unit, I was given a brief tour and another intake and then some sleep meds. I know Zyprexa (anti-psychotic) was one of them, and I think melatonin (supplement) or Benadryl (antihistamine), or both, were in there, too. This was a bit after midnight and I slept until about 7am. The staff had been told not to wake me and seemed pretty surprised to see me lining up for breakfast.

For whatever reason, I did not have my anxiety and insomnia symptoms during my long weekend stay Inpatient. They switched me from Xanax to Zoloft (anti-depressant) because I wanted to keep trying breastfeeding/pumping. I stepped down on the Zyprexa for sleep and the last two nights switched to melatonin. After three days, I felt ready to go home, against doc’s advice. I didn’t even sign up to attend Outpatient the next day. I felt great. (My discharge papers diagnosed me with “major depression with postpartum onset.”) DH picked me up, and we drove to his mom’s where they had moved during this time to be closer to where I was. When we arrived, I immediately held my baby girl and immediately went straight back into panic and despair. My doc team and family had decided I wouldn’t sleep in the same room as the baby just yet, so I battled through panic (that I hadn’t felt in four days) in another room and somehow slept fairly well. I RAN back up to the hospital the next morning and begged them to let me in the Outpatient program. I participated in that program for the rest of that week (two weeks postpartum) and had no new meds, but did step up my Zoloft.

At the end of that week, we were going to drive back to Cookeville for baby girl’s two-week pediatric appointment and I was pretty worked up about going back to that house, that bedroom, that no-sleep zone. Doc gave me some super low dose Klonopin (anti-anxiety) and I managed to make it to Sunday without taking any. Sunday night I slept in the same room with DH and baby girl, and actually did a night feeding shift (formula) around 2am, I think. We went to her appointment, refreshed some clothing and stuff and drove back to Nashville so I could finish the Outpatient program that week.

That weekend back home in Cookeville started a set-back. I made the hard, but relieving decision to stop pumping and switch to formula. Pumping/breastfeeding sent me into panic every time and I just couldn’t take it anymore. I went back to Outpatient Tuesday (sobbing to my mom on the drive up there, sobbing so hard she made me drive to her place so she could drive me the rest of the way) and Tuesday night confessed to DH that I was having thoughts of cutting myself. Just something to distract me from this misery that I could not escape. I just wanted it all to go away and there was no magic pill for that. Mom drove me to Outpatient again Wednesday morning and I confessed the same to her. With her therapist hat on, she asked me if I had considered checking myself back in. I just sobbed more. I actually really wanted to go back Inpatient. In there, I was safe and taken care of and structured and understood. If I could just pause Life, and if they could just fix me, then I could go be a mom and a wife and Life would be doable again.

So, a week after being discharged, I checked myself back in. This time, I stayed just over a week. I had all my anxiety symptoms, but was at least sleeping fine. The doc team added Risperidone (anti-psychotic) to my meds and Pindolol (beta blocker). When I was discharged, I was scared. I didn’t feel confident this time going back to Life. I gladly went to Outpatient and continued to sleep apart from DH and baby girl. I did okay over my first weekend back (no Outpatient and no structure made weekends scary) and finished out the whole next week.

After being away for two years, we had already planned to move from Cookeville back to Nashville over this summer. So, after this second attempt at Inpatient and Outpatient, I was four weeks postpartum and we needed to be out of our apartment two weeks later.

Luckily, yes, we had resources. We had a ton of resources. Both our families lived in the area and were a HUGE help. We got moved back, DH started a new job, and I had two more months maternity leave. I no longer felt in crisis, but I also did not see the light at the end of the tunnel just yet.

QUESTION:
When was the first sign of light at the end of the tunnel and you were starting your recovery?

ANSWER:
The light at the end of the tunnel probably came around six months postpartum. I posted on Facebook that “it suddenly dawned on me that I hadn’t cried or felt miserable and had, in fact, been feeling rather “up” for almost one whole glorious week.” Going back to work was ROUGH. Finally feeling love for baby girl and then leaving her at home with Grandma was ROUGH. I weaned off Risperidone and Pindolol, but stayed on Zoloft. I continued my Psych follow-ups. I tried different counselors, but didn’t find a good fit until almost a year later. Unfortunately, what helped me most, I think, was giving myself permission to be bad at everything except surviving; I was subpar at my job, a crappy wife, I let go of chores and cleaning, and gave up and went to bed around 8pm most nights.

QUESTION:
Did you have any more children after this PPD experience, and if so, did you do anything to prepare yourself and were you able to ward off PPD the subsequent time(s)?

ANSWER:
I am 16 months postpartum and just starting to think about more kids. This time last year, even thinking about more kids was a big Hell No. But, here we are. Baby girl was such an easy baby and is seriously a delightful toddler. Surely, we’re setting ourselves up for a colicky next kid! I will say, we battled through infertility for a few years before conceiving via IVF, and if we didn’t have frozen embryos already, we’d be one and done. We just don’t have the funds or energy for a fresh cycle, and, clearly, the old-fashioned way just doesn’t work for us.

To those ends, I have been reading What Am I Thinking? by Karen Kleiman. Her book This Isn’t What I Expected was a bible for me during Inpatient and those first several weeks. DH and I want to find some counseling so that we’ve strengthened “us” the best we can before a second potential crazystorm. I will likely stay on my Zoloft, maybe step down a bit, but stay on.

QUESTION:
If you could go back in time what advice would you give yourself before you got pregnant?

ANSWER:
Advice for pre-crazy Bryn? I don’t know. Unfortunately, I tend to be a “go through the mess myself” kind of person instead of believing the person who says, “Don’t go that way, it’s a mess.” I got pregnant via a never unstressful cycle. I was commuting 80 miles one way for work a few times a week and staying with my folks (away from DH) a few nights a week (thus not having to commute every day). I had Factor V Leiden which meant I gave myself shots of Lovenox in my belly twice a day during the entire pregnancy until six weeks AFTER delivering. I had an ER scare with severe abdominal pain mid-pregnancy (inconclusive, but definitely not pre-labor/BH). And I was eventually induced a week early because of repeated low amniotic fluid. Whew. I think my advice would be Pay Attention and Take It The F Easy. It’s so easy to look back and see the massive amount of stress I was managing and living with. When the swirling hormone stew that is postpartum became a reality, the control I thought I had of everything that I had been dealing with just fell apart.

QUESTION:
Did anything positive come out of your PPD experience?

ANSWER:
I remember feeling incredibly raw and vulnerable during those first several crisis weeks. And that actually felt good. To just be so real and open and honest and bare with those around me. Everyone knew what was what and I just didn’t care what folks thought of me. I was in crisis. I was a mess. I was fighting for my life. And I REACHED OUT. I RAN to help. Maybe it’s because of growing up with a therapist for a mother, but I had zero shame in seeking help. I had shame about failing my daughter, my husband, burdening my in-laws, scaring the hell out of my parents. But I didn’t have shame about sharing the hell I was going through and hoping someone could reach down and help pull me out. I see that as a positive.

QUESTION:
What would you want to say to women currently suffering with PPD?

ANSWER:
I have no idea what to say to others going through this. I don’t know that anyone could have said anything to me. I babbled and raged and folks listened and I started meds and I kind of feel like I just waited it out. I just kept putting one foot in front of the other. I made sure I felt safe with the folks around me in case I fell, and then just gritted my teeth and kept going. It REALLY sucked. But it doesn’t now. That’s probably not very inspiring or life-affirming, but maybe that will resonate with someone.

 

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2 thoughts on “Postpartum Insomnia Series – Part 3: BRYN

  1. Bryn,

    Thank you so much for sharing your experience, as I was reading, so much of it resonated with me and brought back my own birth and post partum experience. I am so grateful for Ivy for setting up this blog, without it, it would’ve been more difficult for me to understand what was happening and to know that it wasn’t just me going through PPA/PPD and insomnia was comforting. This blog has really helped my recovery.

    I am so glad to hear that you are doing well and thinking about having another. Like you, I was exactly the same, my LO is only 9 months old, so not going to have another any time soon but I’m not completely ruling it out.

    I do wish you all the best and thank you so much for sharing your experience and I definitely think PPA/PPD needs more awareness in the UK.

    Sending you lots of positivity.

    Van x

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