A PPD/PPA Survivor’s Experience During the Coronavirus Outbreak

A brief note from Ivy:

Ever since the whole coronavirus thing started impacting us here in the U.S., I’ve been starting my emails and calls to friends, colleagues and clients with “I hope you are doing well.”

For those who read this post, I hope you ARE doing well.  The past couple of weeks have been a period of great uncertainty and adjustment for all of us.  I’ve been trying very hard to go with the flow and not to be overly anxious about what’s going on and the fear that I and members of my family would fall ill with the coronavirus.

It is normal to be anxious.  During this period of uncertainty and anxiety, remember to use your coping skills.  Breathe, listen to music, read a book, connect with people via Facetime, Zoom, Facebook, or any of the other numerous apps out there.  Even churches have been holding online services.

If you are struggling, visit this site to learn some things you can do to take care of your mental health in the face of uncertainty.  You may also call the national Disaster Distress Helpline ( 24/7) at 800-985-5990 for emotional support and crisis counseling if you are experiencing distress or other mental health concerns.  Calls are answered by trained counselors who will listen to your concerns, explore coping and other available supports, and offer referrals to community resources for follow-up care and support.

If you are a new or expectant mom or even a mom who has had a postpartum mood disorder in the past, you know you can rely on the support of Postpartum Support International volunteers and staff to support you if you are feeling anxious. PSI provides support to mothers and their families every day via 800-944-4773 or text 503-894-9453 (Eng) or 971-420-0294 (Español). Additionally, PSI’s free online support groups meet every Tuesday (and now every Thursday as well).  Meet other moms virtually, share your story, build a community and hang out with other moms! Find info on timings and register here.  Please also like the PSI Facebook page for daily updates, including changes to frequency of online support groups.

Stay healthy and safe.

Warmly,
Ivy

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And here is my friend Stacy M’s experience during the coronavirus situation:

Tonight G said something that stopped me in my tracks. I’ve worried so much about regression with him.

At dinner, he announced:”You know I used to do this funny thing where I lined up all my animals on the steps all the time and it was so weird. I don’t know why I would do such a thing.”

I have tons of pictures on our iCloud when he would stim and line his dolls up in his own special way.  We never interfered with what he was doing and just let him run with it. We were always so careful to avoid knocking anything out of place.  We would leave his masterpieces around for days and days.

He has slowly outgrown this behavior. It’s been a while since he has lined things up. I didn’t even realize it….until now.

Now, with the whole coronavirus situation and with schools being closed, life has changed so much these past two weeks.  I have been worrying about what I would do if I had to step in for his teachers and do everything they’ve been doing that have helped him so much.

I was a broken soul his first two little years of life when I suffered terribly with severe postpartum depression (PPD) and postpartum anxiety (PPA).  I was crippled by PPD/PPA for some time.  It’s been 6 years since I felt the kind of despair that I felt when I suffered from PPD/PPA.  PPD/PPA paralyzed me so much that I was even afraid to hold my children (G has a twin sister) for the first year.

Then, when I noticed that G was showing signs of autism around 9 months old, the only way I knew I could help him was to secure as much help as I could with his autism. Even though I felt broken, as long as I had the right help for G, things would be fine.  I have always hated asking for help, but for my sake and for G’s sake, I had to let help in and let help heal us. Once I finally got my feet on the ground, I did better and so did G. We have been making progress and thriving ever since.

However, now with this new way of life of social distancing due to the coronavirus, I have been hit with a wave of feelings that brought me back to the days when I had PPD/PPA. Being a mother during these times is really tough. It’s not the kind of world I ever imagined my family and I would ever have to experience. I have done everything in my strength to be able to function well again.  But now, I’ve been experiencing waves of uncertainty from fear of the unknown, as I (along with everyone else around me) have never experienced what we are now experiencing.  The sudden turn of events requiring everyone to stop going to work, stop going to school, stop getting together with friends and relatives, and even stop going out unless we really had to caught everyone off-guard.  No one could prepare for any of this.

I’ve been having some tears build up for days now.  But I take deep breaths daily.  I’m taking one day at a time.  I have learned that I CAN teach my children from home. I have learned that I CAN manage this.  I HAVE been managing.

The fact that G could reflect on such behavior tonight made me feel so proud of myself and of him that we’ve come so far despite all the obstacles.

What I want to tell other new mothers and mothers to be is to not be afraid to ask for help and to rely on a support system.

It is important to communicate and put one foot in front of the other, one step and one day at a time.

It will all make sense again. It’s okay to be scared, it’s okay to cry right now, and it’s okay to talk about your fears and get them off your chest.

We may be quarantined but there are many online support groups that can help while we still need to maintain social distancing.

You are never alone.

– Stacy M

A Must for All New Jersey Medical/Mental Maternal Healthcare Practitioners, Doulas, Midwives, etc.

After a two-month dry spell in posting on my blog due to lots going on at home and at work, here I am briefly to help spread the word for the Postpartum Support International 2-day training on November 15-16, 2018 in Fort Lee, New Jersey:  Perinatal Mood Disorders: Components of Care. 

Led by PSI’s very own Birdie Gunyon Meyer, RN, MA (whom I’ve known since I became a member in 2006), Lisa Tremayne, RN, CPPD, CBC, and Joanna Cole, PHD, it is a critical training intended not just for mental health care practitioners but anyone and everyone who would ever need to care for an expectant or new mother.  That includes obstetricians/gynecologists, general practitioners, pediatricians, doulas, midwives, nurses, ER doctors and their staff, etc.

You can visit the site that goes over the training objectives, location, and cost via the above link, but the training will cover the basics in identifying/treating perinatal mood and anxiety disorders (PMADs)–which include antepartum depression, postpartum depression, postpartum anxiety, postpartum panic disorder, postpartum OCD, postpartum PTSD, and postpartum psychosis–as well as understanding risk factors, treatment options, breastfeeding, consequences of untreated conditions, impact on loved ones, importance of social support, cultural differences, spirituality, etc.

Please attend and/or help spread the word about this training.  It is so, so critical that we ensure as many people as possible are trained so that fewer mothers suffer unnecessarily (like I did) and even worse, fall through the cracks and become another tragic outcome of a perinatal mood disorder.

 

Recent PPD Successes and Failures in the Media

I went from blogging once in two months to 8 times so far this month!  With Maternal Mental Health Month a little less than a week away, a lot of fundraising, training and public awareness events are being prepped to happen throughout May.  Another reason to love this time of year….hello spring!

Okay, so the title of my post is “Recent PPD Successes and Failures in the Media.”  There were 2 things in the media that caught my attention on my Facebook feed today that motivated me to blog once again. One is a success and one is a failure.  If you’ve been following my blog for some time, you would know that one of my favorite things to blog about are successful and failed attempts at depicting new mothers suffering from a mood disorder in the media, like my recent post about “Black-ish.”

Let’s start with the SUCCESS……
On this morning’s Megyn Kelly TODAY a postpartum mood and anxiety disorder (PMAD) survivor, Ashley Abeles, shared her experience.  The segment also included brief appearances by Dr. Catherine Birndorf and Paige Bellembaum who are the Medical Director and Program Director, respectively, of The Motherhood Center of New York. The Motherhood Center provides support services for new/expectant moms and treatment for PMADs. I met these ladies from the Motherhood Center at previous Postpartum Support International conferences.  If you missed the show, you can watch it here.  We need more moms sharing their PMAD experiences on shows like this!  Experiences kind of like my own that, as her husband explains, isn’t “headline-grabbing” material involving the tragic death of the mother and/or baby.  Because guess what, the vast majority of PMADs experienced by new mothers are NOT headline-grabbing material.  They’re mothers suffering from anxiety, panic attacks, insomnia, weight loss and/or intrusive/obsessive thoughts who need medication and/or therapy to recover.  Yes, severe postpartum depression (PPD) can cause a mother to feel so depressed that she just wants to disappear or her baby would be better off without her since she can’t feel joyous like a new mother should, but postpartum psychosis is too-often confused with and lumped under PPD (as a catch-all term) by both the general public and doctors alike.  Yes, doctors!  Also, PPD is not the same as the baby blues and even today, doctors still mix up the two!  We’ve come a long way since I had PPD when it comes to information in the news, in publications, on the Internet and in social media.  But we still have a LONG way to go.

And here’s the FAILURE……
The movie “Tully” starring Charlize Theron.  A Motherly post by Diana Spalding titled “We’ve seen Tully– and we’ve got some real concerns” it seems yet another movie director/producer has failed to do their homework about PPD before coming up with the screenplay and releasing it.  What every movie director/producer or TV show director/producer needs to do before even contemplating a movie or TV show about PPD is consult with Postpartum Support International.  This organization is the leading authority on maternal mental health matters and should ALWAYS be consulted to ensure the right information is incorporated into the movie/show plot.  “Tully” attributes the bizarre experiences of Tully (i.e., hallucinations she has of Marlo, frantic baking and cleaning late into the night, impulsive behavior that leads to her car crash, suicidal ideation) to PPD.  However, her behavior is actually attributable to postpartum psychosis, hence this movie spreads misinformation about what PPD really is.  Her talk of suicide is brushed off by her husband, which I can see happening in the real world when loved ones fail to “get it” and ignore the mother’s serious need for help.  While this is a movie and movies don’t necessarily have to educate–after all, this is not a documentary–it should at least get terms right (postpartum psychosis, NOT PPD!)  and it should try to mention at some point that yes, the new mother who’s obviously not well and diagnosed, albeit incorrectly, with PPD needs help!  Maybe put some kind of disclaimer at the beginning or end of the movie like you sometimes see at the beginning or end of a TV show.  Something along the lines of:

“Approximately one out of seven new mothers suffers from a postpartum mood disorder.  If you are a new mother that is experiencing any of the following symptoms: insomnia, crying/sadness for more than 2 weeks, lack of appetite, sudden weight loss, rage, hopelessness, lack of interest in the baby, loss of interest in things you used to enjoy, thoughts of harming the baby or yourself, please know that you are not alone, what you are experiencing is not your fault, and you will recover if you get the right treatment.  Contact Postpartum Support International at 800-944-4773 or visit http://www.postpartum.net

Postpartum Depression Doesn’t Look the Same Across the Board

I always try to keep up with the multitude of articles that feature Karen Kleiman, MSW, LCSW, founder of The Postpartum Stress Center and author of numerous books on perinatal mood disorders.  This particular article from October 4, 2017, titled “Postpartum Depression May Look More Like Anxiety Than Sadness” that appeared on Well and Good, by Annaliese Griffin,  caught my attention.  It caught my attention because it’s because when my doctor told me 13 years ago that I had postpartum depression (PPD), I didn’t believe him.  I thought “How could I be depressed if I’m not even sad?”  He explained that depression could manifest as anxiety, but did I understand that at the time?  Nope. Little did I know that I was about to embark on a journey to discovering what PPD really was….that it’s a catch-all term that encompasses all postpartum mood disorders, which includes postpartum anxiety, postpartum OCD, and postpartum psychosis.  That my PPD caused insomnia, weight loss, loss of appetite, and being a shell of a person unable to enjoy anything, and unable to pretty much do anything.  I was so concerned about my baby’s cradle cap and eczema and her bowel movement/feeding schedules that, by the time her colic came and went at my 6th week postpartum, PPD set in and I had no idea what was happening to me.

This article is very important because the number of women suffering from postpartum mood and anxiety disorders (PMADs) is pretty common.  And I should know because of the number of hits I get on my blog for the symptoms that I experienced.  So, if it’s been over 3-4 weeks since you had your baby and if you are feeling anxious, unable to sleep even when the baby sleeps and unable to function and enjoy things you’re normally able to enjoy (like listening to music), having moments of rage, having panic attacks, and/or having obsessive and even scary thoughts, please go the Postpartum Support International (PSI) website to seek help near you.  You are not alone, there is nothing to feel ashamed of, and you will get better with the right help.  Do not be afraid to ask for and accept help.

Jessica Porten’s story went viral a week ago because she admitted to the nurse at her OB/GYN office that she was experiencing feelings of anger, and that admission was unfortunately not handled correctly.  This, my friends, is why I have been blogging for the past nearly 9 years.  My mission is to help spread awareness and in so doing dissipate the stubborn stigma that refuses to go away because there is still so much ignorance about PPD.  My mission is to also help mothers as much as I can to get the help they need.  Anger/rage is another way that PPD can manifest for some mothers.  Everyone’s PPD experience is unique to that person because we are all complex people that– when emotions, temperaments, hormones, heredity, childbirth experience, and history come together–symptoms manifest differently from one person to the next.  Symptoms can range from feelings of sadness to anxiety, anger and even rage to insomnia, sleeping too much, lack of appetite, eating too much, obsessive/intrusive thoughts, etc.  As such, treatment of these moms will vary from one mother to the next.  Some moms need medication. Some moms need therapy.  Some moms need a combination of medication and therapy.  The duration of treatment will vary as well.  But there is one thing in common among all mothers suffering from PPD:  they need help.  They don’t need to be treated the way Jessica Porten was treated.  They don’t need to be treated like I was treated 13 years ago.

Erica Chidi Cohen, a doula and co-founder and CEO of  Loom in Los Angeles attributes postpartum anxiety to first-time mothers feeling uncertain and anxious about going through childbirth and taking care of a baby for the first time. It is more common than you think for first-time mother to feel anxious but when the anxiety morphs beyond worry to insomnia, lack of appetite, etc. is when medical attention is needed.  A traumatic childbirth experience increases the chances for a new mother to experience PPD.

Click here to visit Kleiman’s The Postpartum Pact. It is an important postpartum toolkit for expectant mothers and their partners and loved ones to review before baby’s arrival.  It truly pays to be prepared, regardless of whether you think you may be at risk for PPD or not.  One never knows, as I have said in prior blog posts and in my book, whether something may happen during pregnancy/childbirth that could lead to PPD.  It can’t hurt to review the pact and prepare to have folks lined up to help once baby arrives to ensure the new mother has adequate practical support, especially if this is her first baby or if she has another little one(s) to take care of already.

Speaking of adequate support, it’s organizations like Loom in Los Angeles and Whole Mother Village  in W. Orange, NJ — two examples of many childbirth, pregnancy, and reproductive wellness communities that have sprouted around the country to provide support, information, referrals and services from preconception to parenthood– that are critical because it takes a village when it comes to a family’s well-being.  Going it alone is not a viable option nowadays, especially when the significant other needs to work to support the family and the new mother is not well and family members are not close by and/or are too busy to provide emotional and practical support.  It really is no wonder there are so many cases of PPD.  Please see my past posts about the importance of mothering the mother and how it takes a village to minimize the occurrence of PPD here and here.

 

 

ONE MOM’S REFLECTION FOR MOTHER’S DAY

This is a post a mom wanted to share on my blog anonymously.  Thank you, mama, for sharing your experience!  ❤ ❤ ❤

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To think of moments like this that I would have missed had I just given up. If I had let the mental illness win.

After my twins my postpartum depression/postpartum anxiety (PPD/PPA) was severe.

Paralyzed by a sudden sense of worthlessness, hopelessness and fear of everything, I panicked.

Intrusive thoughts told me I was not good enough and that my kids were better off without me. I told my husband to leave me. I was scared to touch the twins for fear I would somehow hurt them or that I was ruining them.

This was at the time I felt it in my heart and soul something was majorly wrong with G and I blamed it on myself.

I was overwhelmed with two colicky twins. They cried all the time and I felt like a failure that I couldn’t soothe them. Fast forward they have sensory issues G with autism and S with ADHD. they have had a very hard time regulating themselves and have come a long, long way.

If I could wish one thing for all mothers is that please don’t blame yourselves.

Be mindful. Baby yourself just like how you baby your children. Be kind to yourself.

I was beyond hard on myself and it took its toll. It left me fragile and fearful and broken.

But I’ve always been a fighter and I’ve done everything I could to power through that time and learn how to live all over again.

It began with loving myself.

In June 2013 I was so traumatized by the panic attacks that the panic made me want to end it all. I called an ambulance to come save me from myself. That day on I’ve only marched forward. I’m mindful to my surroundings. I don’t blame myself for the struggle that my babies have faced with their development.

I am an excellent mom. I am worth it. They are worth it. So much that I gave it all another chance when I had R knowing that I faced a chance of a relapse with PPD. But with incredible support I did it and I’m still doing it.

I love my sweet family, my friends, my life.

I believe in second, third, fourth chances.

There is always room for improvement and to make things better and life is very much worth living.

Everything that happens to us makes us stronger.

I will never hide what happened to me from my children, especially my daughters.

It’s okay to fall down.

What matters is we keep going and with a good heart.

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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.

 

Postpartum Insomnia Series – Story 2: KIM

This is the second of the series of posts about postpartum insomnia.  I met Kim recently via the closed Facebook group for Postpartum Support International.  Insomnia was one of the symptoms that she suffered as a consequence of postpartum anxiety and postpartum obsessive compulsive disorder (OCD).

Thank you, Kim, for sharing your story on my blog!

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I’ve always been anxious.  It’s been my temperament since day one; just ask my parents.  I wouldn’t know that I’ve also had OCD must of my life until after I had my first child.  Looking back, all I can say is – DUH! – but in the 90s and even beyond, there just wasn’t a lot of information available about these mental “disorders.” My parents even took me to a child psychiatrist, but to no avail.  Admittedly, it’s hard to diagnose someone at such a young age (I was 10), but the more we talk about it the easier it might become, right?

Anyway, before I became pregnant with my first child, I had a miscarriage, specifically a “missed” miscarriage, during the 12-week check, after which the recovery went on far longer than I expected.  It was painful, emotionally and physically speaking, but we got through it and got pregnant again.

Surprisingly, I wasn’t as anxious as I thought I would be this time around.  Despite moving 2.5 hours away from my family while 6 months pregnant, I was confident everything would be fine.  My sister had had 2 kids prior and, to all outward appearances, she had made it look so easy!

Fast forward 3ish months and this baby wasn’t budging.  10 days past my due date, they decided to induce.  Again, little to no progress.  After 16 hours of contractions, they finally made the decision to do a C-section and, low and behold, there was my baby!  Yikes!

From night one, he cried.  And cried.  And cried.  I attempted nursing with very little success, but kept trying.  (Eventually, I’d move to only formula, but not before going through several different types before settling on one that didn’t cause the babe major discomfort that led to hours upon hours of late night screaming).

All of this took a huge toll on me physically, emotionally, mentally.  I felt like, because my husband was working, I needed to be the one to take care of my child during the night time hours.  Sleep was not something that came easily…initially, because of the stress of middle of the night feedings/endless screaming, later because of extreme anxiety/OCD and the consequent insomnia.

If there is one thing I’ve learned from this harrowing postpartum experience is that sleep is ESSENTIAL.  We need that time to reflect, to recharge, to RELAX.

Ultimately, the lack of sleep (I was averaging 2 hours a night on the couch with my son so that my husband could sleep) sent me on a terrifying downward spiral.  I began experiencing awful intrusive thoughts that, even thought I didn’t understand it at the time, are directly associated with high anxiety and OCD.  After some research, I discovered Postpartum Progress, an amazingly informative website that helped me to understand what was happening to me.

Even though I was hesitant to start medication, my OB prescribed me Lexapro.  I began taking it and, the first night, woke up experiencing severe anxiety bordering on a panic attack.  Now, please understand that this is a side effect listed in the pamphlet accompanying the medication.  In a twist of utter injustice, these SSRI (selective serotonin re-update inhibitor) medications can sometimes increase anxiety before decreasing it.  It doesn’t happen to everyone, but it did happen to me.

After 3 days of heightened anxiety and very little sleep, I couldn’t take it anymore.  I was a stranger to myself, completely lost in the sleeplessness, anxiety, and panic.  I could hardly take care of myself, let alone my one month old baby.  After a visit to the ER, I made the decision to voluntarily admit myself to a local inpatient mental hospital.  During my 3-day stay, I was able to see different counselors (some more helpful than others), let the Lexapro get into my system, as well as start taking trazodone to help with the insomnia.

It’s not a choice everyone would make.  And, in hindsight, I’m not even sure I would make the same decision again.  However, upon my return home, I was adamant that facing my fears (being alone with my child, especially during the lonely night-time hours) and getting better were my top priorities.  My mother-in-law came to stay for a week as added support and my family was extra attentive to my overall well-being.  I realize that I’m so very fortunate to have this support system and I fervently pray that all of you are similarly blessed.

***If you aren’t, please, PLEASE reach out to someone, anyone.  Join a mom’s group, a Bible study (if that’s your thing), even a Facebook group.  There are SO many people out there who have gone through this.  We just need to start the conversation and keep it rolling.***

I’m not going to lie.  It was a challenging couple of weeks while the medicine took time to really start working. The trazodone helped immensely with my insomnia and the Lexapro helped slow down my mind so I could separate myself from the deceptive thoughts that anxiety allows to creep in. But it got easier every day and, eventually, I began to recognize myself again.  It’s not an easy role shift, I’ll tell you that.  And it really shouldn’t be, regardless of what’s depicted in movies, television, magazines, etc.  There’s a huge learning curve associated with new parenthood.  Some take to it right away; others need a little/lot more time to adjust and that’s OKAY.

But please trust that it WILL come.  You will learn.  You will adjust. And it will be so, so worth it.

Postpartum Insomnia Series – Story 1: MRS. J

I want to thank Mrs. J for sharing her postpartum insomnia story with us.  She reached out to me via my blog a little over 2 months ago and we’ve corresponded via email since then.  Her twins are now just over 3 months old, and she is relieved and happy to report that she is well on her road to recovery and able to appreciate motherhood.  Mrs. J has had 4 other babies before and did not previously experience prenatal depression, postpartum depression (PPD) or postpartum anxiety (PPA).  Though, looking back, she thinks she might have had mild PPD before, now that she knows what having PPD is really like.  Like me, she was caught blindsided by insomnia, though hers really started before childbirth but was nevertheless what started her on her journey of perinatal illness.

Now, without further ado, here’s Mrs. J’s story.

*  *  *  *  *  *  *  *

When Ivy asked me to share my story on her blog, I jumped at the opportunity. Had I found her blog before things escalated with me, I believe I would not have gotten as bad as I did.  Because of my experience, I want to offer hope to other moms who are suffering with PPD, PPA, and dreaded INSOMNIA that is one of the worst things anyone can ever go through, especially after just having had a baby….or in my case babies. That’s why I am sharing my story.

I gave birth to four healthy children before I found out I was pregnant a fifth time. At my 8-week ultrasound, the ultrasound tech looked at me and announced I was expecting twins. TWINS! Wow, that threw me for a really huge loop. After my initial shock wore off, I started to feel rather excited to take on this new experience.

My pregnancy was long but pretty uneventful up until my 7th month. I was diagnosed with gestational diabetes, which in itself is not too big of a deal.  You can control it with diet, which I was able to do. But I had been diagnosed with cholestasis during my last pregnancy, and it started rearing its ugly head again in this pregnancy. Cholestasis manifests itself with severe itching, usually on the palms of your hands and the bottoms of your feet. I started to have trouble sleeping when they tested me for cholestasis and during the 10-day wait for the test results. I couldn’t shut off my mind to the worry of having a vaginal twin birth (which was my hope!) and worry that I would have to be induced early for the cholestasis diagnosis and the negative impact it could have on the health of my babies.

I started to really have problems falling asleep. My doctor recommended I take Benadryl to help me sleep, and I was able to fall asleep and stay asleep for at least 6 hours the first two nights.  But on the 3rd night, I couldn’t fall asleep. I tried everything from warm baths with Epsom salt to drinking warm milk and avoiding television.  I wouldn’t touch caffeine with a ten foot pole. Everything you could read about “sleep hygiene” I tried. Nothing worked. I would pace the floors and move from my bed to the couch and back to my bed, all while my kids and husband were sleeping restfully. I called my OB office countless times and they wanted me to try Ambien. I was terrified to try Ambien, as I had never had to take a sleep aid before and I’d read horror stories of people doing things that they couldn’t remember doing while on Ambien. On the first night, I made my husband stay awake to make sure I didn’t start sleep walking and drive off into the night. I can now look back and laugh at this. I took the Ambien at 9:30 that night and was up by 4:00 in the morning. The second night I took it, I slept for maybe 4 hours. The third night I only got an hour of sleep. I was exhausted. I couldn’t nap during the day. I couldn’t sleep during the night besides a few hours here and there. I was calling and calling my OB office for help, but they couldn’t understand my desperation. My friends and relatives couldn’t understand either, but then again, how can you really understand such desperation until you’ve actually been there.  None of them have been through this before.

My OB suggested I go on Zoloft but I was having anxiety about taking an antidepressant while pregnant and I told her I wanted to try Prozac as I was on that before and it had helped with my General Anxiety Disorder. You see, I’m no stranger to anxiety and panic attacks but this was a whole different ball game. I never had trouble falling asleep like this in the past. It’s ironic that I am someone who’s always preached about how important sleep is to mental health….and yet I can’t sleep!  I have always needed a full night’s rest to feel good.  Why was this happening to me?!

Somehow, I managed to muddle through the last 3 weeks of pregnancy.  I was supposed to be induced at 36 weeks because my liver test results for cholestasis showed elevated levels. But 2 nights before I was to be induced, my water broke. Since I wasn’t 36 weeks yet, the hospital policy required me to be transferred to a bigger hospital.  The doctor on call there told my OB that he was going to perform a C-section. I was pretty devastated, as I wanted a vaginal birth and both my babies were head down on the ultrasound. Turns out, I progressed way too quickly and couldn’t be transferred.  Three hours after my water broke, I delivered two healthy little preemie boys. They didn’t need NICU time, thankfully.  But once I got back to my room, I started to hemorrhage.  I was terrified. My husband was in the nursery with my twins and not by my side when I started gushing blood. My OB was called in and was able to scrape all the clots out (ouch!).  To say I was exhausted at this point is an understatement. I probably looked like death. I certainly felt like I was on the brink of death.

Even after weeks of not sleeping, being up for 30 something hours straight, giving birth and then hemorrhaging, I only managed to sleep 4 hours the first night after giving birth.  I thought my body would shut down for hours from sheer exhaustion, but it didn’t. On the second night in the hospital, I asked for Ambien and I was able to sleep for about 6 hours.

After two nights in the hospital everyone was healthy, so they sent us home. The first night home, I didn’t sleep at all. Not ONE minute. I was delirious. I was still taking Prozac at that point.  I called the OB and asked if I could be prescribed something besides Prozac and Ambien. She told me I needed to call my family doctor because she can’t prescribe anything other than the general sleep aid and antidepressant. I called my family doctor and got in the next day. He prescribed Xanax to take at night. So, here I thought this would solve my problems. It worked the first and second night, but by the third night (again!) I woke up after an hour of sleep and couldn’t fall back asleep. I didn’t understand how this medication would only help for a couple days but then it wouldn’t work anymore.  I’ve never experienced anything like this before.  Not knowing why I wasn’t sleeping even though I was exhausted added to my anxiety.

I thank God every day for giving me such a patient husband. He took care of the twins, and we sent our 4 other kids to stay with family. I started feeling desperate again, so I called my family doctor to see what he could do for me. His only suggestion was to double my Prozac dose.  The increased dosage didn’t help.  Now that I look back, I realize I wasn’t being as honest as I should have been. I should have told him that I didn’t think I could make it through another day.  On the ride home from that appointment, at every intersection I wanted a car to plow into us and just end it all. My husband and twins were in the vehicle and that didn’t matter to me. I had lost all will to live. I tried thinking of my kids and how much they needed a mother, but I still did not want to live anymore. I felt so hopeless and desperate.  It was on that ride home that I texted a friend to tell her that I think I needed to check myself into a psych ward. She texted back saying that if that’s what I felt I needed, it was the right thing to do. It was what I needed to hear, but it was the hardest decision I’d ever had to make in my life.

At that point, I didn’t know what I needed, I didn’t know who could help me, and I thought no one in the world has been where I was.  I just knew that I felt scared, alone and hopeless.

Once in the hospital, the first night was hell.  I was still on Xanax. I didn’t sleep at all. I wanted to die that night. And then to be in this strange place, with people yelling out all night long…..I’d never imagined I would ever need to be in a psych ward before. I wanted to disappear.  I didn’t want to exist anymore. I feared I would soon be hallucinating and hearing things. I reminded myself I was in a safe place. It was where I needed to be.

In the hospital you are exposed to all different kinds of mental health suffering. It was really frightening, eye opening and even fascinating. I had so much ignorance regarding mental health before that. In that psych ward I saw people with depression and anxiety like me, people having psychotic episodes, people addicted to drugs, old people with dementia, and war veterans with PTSD. It was so interesting to learn from the nurses, doctors, and other patients and see how much help people needed and can get for their mental health problems.

After 6 nights of trial and error I went home.  I was on the antidepressant Zoloft, the antipsychotic drug Seroquel as a sleep aid, and Vistaril on an as-needed basis for anxiety. I was terrified to go home and be in the same place where I had such horrible memories the month before. We sent the twins to stay with family. The only ones home with us were our two oldest children, as they had to go to school. I wore ear plugs, turned on the fans for white noise, and slept alone. I managed to sleep 5 hours….still not a full 6 or 7 hours like I would normally sleep, but it was so much better than before. I still felt like my life was never going to be “normal” again.

I remember hearing the train go by not far from our house.  I recalled the story of a mom suffering from PPD who threw herself in front of a train and killed herself. I felt I was going to do that.  My mind and body were so tired and I was in such a bad place that I could understand why she would carry out such an act of desperation.

After visits with a therapist, a new family doctor, and supportive friends and family, I slowly but surely started feeling better.  I started to have good minutes that would turn to good hours and finally turn to good days. Slowly but surely, I was able to sleep longer and longer stretches without waking.  If I did wake, I could fall back asleep.

I truly, truly, truly did NOT have any hope at all until I found Ivy’s blog and began reading her experience and the experiences of other moms in the same situation in the comment threads. It was such a blessing to read all of that and realize that there IS hope. THERE IS HOPE. I read about people who said that they felt hopeless and thought they would never return to their old selves again.  I FELT THE SAME WAY!  When you are in the midst of fighting dark hellish days, it is so hard to believe that life will ever return to a state of normalcy. But IT WILL. If you’re reading this and are experiencing dark days, please know that IT WILL GET BETTER. DO NOT LOSE HOPE and don’t be afraid to reach out for help.

My husband stayed home for 6 weeks to help me with the twins (once they came home) and the other two kids.  He also helped with the twins’ night feedings. But after he went back to work, I experienced a major setback. My comfort, my support, my rock was leaving and it felt terrifying. After he went back to work, my doctor upped my Zoloft dose and thankfully my mom stayed over the first week and helped with the twins at night.  A few family members helped with nights after my mom went home. It wasn’t until my twins were 13 weeks old that I felt confident enough to not only try taking on the night feedings with the twins but to also starting weaning off my sleep medication. Thankfully, as I write this, I am no longer dependent on my sleep medication! I am only on the Zoloft and I plan to stay on it for as long as necessary to make sure my brain chemical levels stabilize.

Just as Ivy’s husband feared at one point that she would never get better, my husband feared I would never recover. It was very tough for our husbands to watch us suffer and not be able to fix any of it. It was hard for our family members to watch us suffer and not know how to help us feel better.  If you are like me and have loved ones who do not understand the extent of our suffering, do not get frustrated with them. They can’t understand because they haven’t been through this kind of hell before.  They don’t understand that you are not being dramatic, and that you can’t just calm down, close your eyes and fall asleep.

I know you can’t help how you are feeling and you can’t control your anxiety levels or will yourself to sleep. In fact, the more you try to control it, the worse you feel. Just know that it will get better and you need to give your body time to adjust to your medication.  You WILL get better.  It just takes time, and I know that when you’re suffering, it feels like time is deliberately tormenting you by crawling so slowly.  Hang in there and try to avoid looking too far ahead.  Take one day at a time.  Once you get the right help, the days will go by quicker and easier.

I look back at these last few months and can now say I am thankful in many ways for going through what I went through. I have gained so much insight and have a whole new outlook on life and on mental health. I’ve learned that PPD and PPA are not due to some character flaw.  It’s not my fault I went through it.  I’m a survivor and you will be one too!

I am now enjoying motherhood and feeling so incredibly thankful for my two little twin boys.  They are such a joy and blessing!  I can now relax with my few cups of coffee during the day and not fear that darn caffeine will keep me up at night.

Hallelujah!

 

PPD in the Media this Week: A Postpartum Anxiety Survivor Story in the NY Times; JLo Rumors

Twitter helps make staying current on specific topics of interest a much easier thing to do.  Only problem is, there is SO much information to get through on a daily basis, and not enough time (and energy) for me to do it.  Tweets about postpartum depression (PPD) can tell you a lot in terms of people’s attitudes, swayed by knowledge or ignorance.

There are the tweets that tell you the latest in research findings.

There are the tweets that tell you when a major news outlet like the NY Times publishes an article written about a PPD survivor. An example would be the wonderfully honest piece titled “Meltdown in Motherland” in the Opinion section of the NY Times on May 14th, in which the author Elizabeth Isadora Gold shares her experience with postpartum anxiety.  The couple hundred comments (and you bet I scanned through all of them) that appeared over the course of the next 2 days were actually relatively reasonable and showed more knowledge, compassion, and appreciation for an author’s experience with a maternal mental health issue than some of the comments I’ve had the displeasure of seeing in the past.   Some commenters said they were upset by the harsh comments, but truthfully, I didn’t see any that angered me to the point that I’ve been angered in the past (thankfully).  Not sure if it has anything to do with the comment flagging mechanism or not (i.e., too many flags will cause a comment to get pulled).  But anyway, there was an individual who commented that he and his wife had suffered through a stillbirth and survived the grief  after nearly a year, without the use of any antidepressants…and how he is absolutely certain he (no mention of his wife, though) would not have needed to take any medications.  I replied to that comment as follows:

I wouldn’t be so quick to judge other people’s situations when you don’t even know what they are. There is no one-size-fits-all treatment for PPD. What works for one person may not work for the next person. Every individual is different, and every individual’s situation is different. Some women with PPD may only need medication, some may only need psychotherapy, while others may need a combination of both. The objective is to do whatever it takes in order to feel yourself again using whichever approach you feel most comfortable using. My insomnia, panic attacks and weight loss were so debilitating–and I couldn’t take care of myself or my baby–that I had to take medications to return my brain chemistry back to its normal levels.

And then there are the tweets that tell you how far from educated the public is with respect to postpartum mood disorders, or even just the difference between the postpartum blues and PPD.  An example would be recent rumors that Jennifer Lopez suffered from PPD after she had her twin boys simply because the public caught her being emotional and crying a few days after childbirth.  In her recent interview with E! Online, she quashed those rumors by explaining that her being very emotional 7-10 days after childbirth is the expected behavior of new moms due to hormones crashing after childbirth.  She said she learned that from reading the book “What to Expect When You’re Expecting,” which has now been turned into a big screen flick soon to be released…and one in which she is co-starring.

Don’t mean to digress, but that is not a movie I’ll be rushing to pay $12 to see in the theaters.  Why?  Well, for one, the trailer looked too silly and sloppily produced for my taste.  Also, if you visit Lisa Belkins’ article from May 16th on the Huffington Post titled “The Pregnancy Book That Made Me a Nervous Wreck is Now a Movie,” you’ll see my sentiments exactly…no actually, Ms. Belkin verbalizes it a whole lot better than I could ever do.  Do I hear any others out there who agree that the book only increased anxiety levels with the information overload to the point that you stopped reading it, thinking (like I did), “Oh what the heck, I’ll just go with the flow…whatever happens, I’ll just deal with it then.”

I actually would’ve appreciated reading a book like mine during my pregnancy.  Ha, sorry, couldn’t miss the opportunity to mention my book “One Mom’s Journey to Motherhood,” which incidentally is not just a memoir, it’s a self help guide as well.  The health of the family unit is dependent on the health of the mother, so it is SO important that she goes into motherhood knowing what to expect in terms of pregnancy, childbirth, and the postpartum period. This includes how to deal with certain challenges in infant care, keeping stressors to a minimum, and getting plenty of support.  My book contains advice in the form of Do’s and Don’ts for the new mother, the new father, family members and friends. I even share my experience with child-care complications like colic, eczema, and cradle cap—things that can only add to the anxiety levels of the first-time parent, yet pregnancy books and magazines don’t talk enough about.

Well, running across the two tweets that told me about the false JLo PPD rumor and the wonderful story in the NY Times are but random examples of the many, many other tweets that are tweeted on a daily basis.  Those 2 tweets gave me enough to get the juices flowing in my mind of what I wanted to blog about next.  I would love to be able to stay on top of all the tweets that come up in my feed each day, but with all that’s going on in my life right now, it’s just not possible.

Happiest Baby Tips That Can Help Curb Anxiety Levels in Parents

Wow, has it been nearly 20 days since my last post?!  Eeks.  Time is going by way TOO fast!   A belated Happy Summer greeting to you!  And boy, am I thrilled it’s summer! 

Well, here I am with a topic I’ve been wanting to post for the past couple of months.  What ultimately reminded me that I haven’t yet posted it was when I went to register for the Postpartum Support International conference today and saw that Dr. Harvey Karp, yes, THE Dr. Harvey Karp of “The Happiest Baby on the Block,” is going to speak at the conference on September 15th!   If you’re in the area then, be sure to sign up soon!
 
Two months ago today, I was contacted by Emily Weece of The Happiest Baby, Inc.  to share this information on my blog.  It’s important to remember that knowing how to cope with the curve balls nature throws our way– like colic and struggling with having to calm fussy babies– is key in lowering the risk of postpartum depression (PPD) in the new mom that is at risk for it.  See my past post for more on colic.

Hudson Perinatal Consortium Program on Perinatal Anxiety Disorders – May 3, 2011

May 3, 2011 – It was a lovely Tuesday evening at the Chart House Restaurant at Lincoln Harbor, Weehawken, NJ, and I had the pleasure of a delicious dinner with the backdrop of the gorgeous Manhattan skyline, followed by a lecture given by Laura J. Miller, MD, Vice Chair for Academic Clinical Services Director, Women’s Mental Health Division, Brigham and Women’s Hospital, Harvard Medical School.  

Dr. Laura Miller, Mariann Moore, me

I had many reasons to look forward to this event.  First, I was going to see the lovely Mariann Moore, Executive Director of the Hudson Perinatal Consortium, whom I befriended at the Postpartum Support International conference in Pittsburgh last October.  Second, the topic of Dr. Miller’s lecture on perinatal anxiety disorders was close to my heart, since I had suffered and survived from frightening panic attacks  before my medication kicked in.    Third, I’ve always wanted to eat at the Chart House.   🙂

Lincoln Harbor with the Manhattan skyline as backdrop

Dr. Miller covered over the course of her 2-hour lecture pretty much the ABCs of perinatal anxiety disorders.  She started off with an excerpt of Katherine Stone’s experience with postpartum OCD, which Katherine had (coincidentally) posted on her blog right around Mother’s Day five years ago.  The paragraph that goes into the excessive concern that her baby meets his milestones on time and tracking down what time and how much he ate and what time and how long he napped….this all sounds like what I went through too (in addition to tracking what time and the type of bowel movements my baby had), though I did not suffer from postpartum OCD.   I needed these lists in order for me to get through each day.   Just like Katherine, I felt that “If I didn’t write it down, I felt like I wouldn’t be able to remember and wouldn’t know when to do what.  Maybe it gave me some false sense of control.”  Since all newborns do are sleep, eat and poop, those were the basics of what made up each and everyday for the first weeks postpartum……and creating lists for these baby basics was one of the ways that helped to assure me that all was going okay.

Dr. Miller talked about what made some women more vulnerable to perinatal anxiety disorders than others, effects of anxiety on the fetus and future cognitive and behavioral development of the baby, the gamut of anxiety disorders (i.e., panic disorder, OCD, PTSD), and treatment (non-medication and medication options) during pregnancy and postpartum.  All the stuff that I happened to also include in my soon-to-be published book–in addition to estrogen, neurotransmitters, serotonin, risk factors (biological, psychosocial), cortisol, agoraphobia, etc.   My book also goes into stigma, social support, myths of motherhood, my experiences, my PPD triggers (all of which were anxiety inducing), and passing on my lessons learned in practical tips.

Oh, and speaking of my book, it will hopefully be published by the end of the summer.  It has been 6 long years of reading and journaling my thoughts, experiences, and what I have learned from the time PPD reared its ugly head until I finally stopped writing a year ago to start editing the mammoth manuscript down to something people might, just might, be interested in picking up to read.    A main difference in the way in which Dr. Miller presented her lecture, which is how most of the medical professionals that wrote most of the books I’ve read, and the way my book will go into these topics is that I am writing it from the perspective of a mother that has a degree in biology but not a career in a healthcare profession (who usually use scientific jargon that I sometimes even have trouble understanding).  I write it in the perspective of a mother who survived her frightening experience and wants to join the other voices out there to help raise awareness and end the stigma associated with perinatal mood disorders and the myths surrounding motherhood that only serve to make matters worse.

Seeking Childcare While Suffering from PPD – My Story

Six weeks of continuous physical exhaustion, anxiety, and brain chemical depletion led to a vicious cycle of exaggerated emotions that became progressively worse with each turn – where normal concerns turned into exaggerated anxiety that led to panic attacks and insomnia.  And it certainly didn’t help when the time came to search for a daycare provider.  It was unimaginable to me that someone I didn’t know would ultimately spend more time with my baby than me.  After all, I didn’t try so hard to have a baby for so long only to have someone else take care of her.  The guilt ate away at me.  But at the same time, a part of me felt relief that I would no longer have to spend most of my days alone with the baby, cooped up in my house (it was 3-1/2 months at that point).  Nevertheless, the remaining 75% of me felt guilty for feeling that way.  The guilt of having to return to work, prospect at having to leave my infant with a stranger, and fear of the unknown from being a first-time mother who never had much exposure to children all contributed to triggering my PPD. 

At the 6-week point, I was exactly halfway through my maternity leave and my return to work was still distant enough not to seem real….or so I thought.  Well, as the traditional thinkers wonder, why don’t you just work it out like the rest of us and stay home and tend to your child if you’re that bent out of shape about going back to work and finding adequate childcare?  Well, first of all, not everyone can afford to live on one salary.  Second, not every woman is happy as a full-time mother.  What the government and companies should do is work together to extend the maternity leave of absence to 6 months, which would catch us up with a number of countries out there. 

I thought I had done a lot of research on daycare providers in the area, but it turns out I hadn’t done ENOUGH research prior to that point.  So in a frenzy, I started calling other daycare providers.  The closest place right in town provided Internet service to enable parents to see their children during the day.  My husband and I hadn’t considered this place before due to some negative things we had heard from multiple parties.  But when we called them to see if they had any openings, they said they were completely booked until September. 

I got more panicked.  I could not bear the thought of leaving my daughter with anyone, not even a live-in nanny working out of our own home.  My husband and I didn’t feel comfortable having a stranger in the house alone with our daughter, and we didn’t trust them with our belongings.  So nannies – both live-in and live-out ones – were not an option.  So that left daycare providers who worked out of their home.  I had obtained a list from my company for in-home daycare providers, and I ended up focusing on two.  One was only a few blocks from our house and the other was on the other side of town.  We made an appointment with the one near our house.  She was gracious enough to meet us on a Sunday morning, at short notice.  A few things she said sent my alarm bells ringing.  She gave us a tour of the house and it seemed drafty to me.  Again, I was fearful that my daughter would catch a cold from being in a drafty home.  I wanted to keep my options open, so I called the other woman.  A few things she said in the course of a few conversations made me think twice about even meeting her.  The fact that she seemed to be having a host of medical problems and was always making doctor appointments made me doubt her ability to take care of my daughter full-time.  Other people on the list either never picked up the phone or never returned my calls. 

As days went by, I felt more and more panicked.  My husband and I had agreed to start my daughter at daycare on February 22nd, just so we could get used to the routine and idea of leaving her with someone.  I was thinking I’d never be able to find anyone good enough to take care of my daughter.  I started calling my neighbors and others in town.  Someone recommended a woman close by who only takes in one or two children at a time.  When I talked to her, she sounded like the perfect person…..very warm and trustworthy.  However, she regretted not being able to help out, even though I practically begged her to take my daughter in. 

After I exhausted all options I was aware of at the time, it seemed to me that this one daycare center we were considering (that has a national presence and locations throughout the country) was the best place for my daughter.  I ended up calling them with questions everyday of every possible circumstance I could think of.  This was from never having gone through any of this before and I wanted to be sure I knew fully what to expect.  I was totally convinced they thought I was nuts.  I even asked the administrator whether other mothers typically ask a lot of questions and feel nervous about sending their first child to daycare.  She indicated that it was normal for first-time mothers to feel a certain amount of anxiety, but “they aren’t as anxious as you are.”  I dreaded having to call them but felt compelled to ask my questions to feel absolutely 100% comfortable that this was the right thing for me to do.  No matter how many questions I asked and got satisfactory answers for, I was absolutely dreading the idea of having someone else look after my baby. 

The week of February 22nd came and went.  The last day of February came and went.  Finally, I gave in.  I decided I had to let go…we had no other feasible options.  We went to the facility on March 1st.  My husband had to leave by 7:30 and the plan was for me to stay for approximately 1-1/2 hrs or however long it took for me to feel comfortable enough to leave. 

I will never ever forget this day…….

There was a rocking chair in the room.  I sat down in it, holding onto my daughter.  There was already a little girl playing in an Exersaucer.  A man came next to drop off his daughter who wasn’t feeling well.  Evidently, she was sick.  She had a cough and temperature associated with teething, so she was crying pretty much the whole time after her dad left.  Immediately, dread was starting to slowly but surely creep all over my body.  Then two more boys were dropped off, one of whom was new and suffered from separation anxiety and had a pacifier that kept falling onto the floor.  The daycare provider kept picking it up off the floor and sticking it back into the boy’s mouth.  My eyes grew bigger out of concern that they were not being as sanitary as they should.  At that point, there were 5 kids in the room including my daughter.  I was counting my daughter but evidently, the daycare center didn’t count her because they told me that I was there holding her so it didn’t count as of yet.  I told them that I had wanted to see them interact with my daughter while I was there.  They told me it didn’t look like I wanted to let my daughter go.  I thought to myself…..”How convenient that they would want to put it that way and put words in my mouth to suit their needs.”  That’s when they asked a new woman at the front desk to come in and be the 2nd adult supervising the 5 kids.  A 6th child was brought in….a little girl who had a fever and looked absolutely miserable and was crying non-stop.  I felt like I was going to pass out.  They told me whenever I was ready to leave, to leave my daughter in her crib, which was one of about 12 cribs in a large rectangle formation at the far end of the room (this was a long, large room).  Her crib was in the left corner farthest away from everyone and only one crib away from the back door, which had a cold draft coming through it, which really disturbed me.  The fact that I was supposed to abandon my baby in some corner crib in an institutionalized rectangle of baby cribs where she would probably lie crying for some time before anyone realized she was even there and needed attention made me want to fall to pieces.  But I had to maintain my composure.  I walked out of the room and as soon as I walked through the door, I burst into tears.  They reassured me that my daughter will be OK.  I ended up picking her up at 1:30 and telling them I had decided this place was not for us.  I couldn’t go through with it.  It just didn’t feel right to me.  I’ll never forget what the administrator of the daycare center told me as I was leaving, indicating they’ve had their doubts that I would go through with it, given the number of questions I had asked and my overall anxiety about daycare in general.  She said, while shaking her head:  “You’ll never be able to let someone else take care of your daughter.”   Never backing down from any challenges I come across, I immediately decided I was going to prove her wrong.

I was desperate.  There were only 2 weeks left before I had to go back to work, and we still didn’t have daycare lined up.  What were we going to do?  With my PPD not improving, I was contemplating staying home longer either via long-term disability or unpaid leave of absence.  However, I feared losing my job if I requested additional time away from work to recover from my PPD.  My husband, my doctor and my gut were all telling me that, even though it may feel impossible, going back to work may help me.  My old routine and mental stimulation, both of which I had been without for 3-1/2 months, would do me some good.  I couldn’t see how it would work.  I just couldn’t see a light at the end of this totally dark and scary tunnel I found myself stuck in.  So, my husband and I decided to enroll our daughter with the in-home provider we’d looked at earlier, the one that lived very close to us.  We felt that an in-home setting would work out better than a daycare center with an “institutional” look and feel.  It was working out well for 16 months and would’ve kept our daughter there until Kindergarten if it weren’t for the biting that somehow started to occur (and which we are convinced our daughter picked up from the other kid that was biting). 

In terms of the biting, this is something we had personally NEVER witnessed ourselves and determined was occurring because our daughter figured it was a way to get attention, which she probably didn’t get enough of because of the provider-to-child ratio.  She probably noticed that, whenever she bit another child, she would get picked up and spoken to (and even read to, since there were No Biting books).  She was, after all, only about 18 months old at this point.  Her biting is the reason from our going from the in-home provider to a daycare center (which let us stay there for all of 3 weeks before they kicked us out on our daughter’s 3rd biting episode without even any attempt to discuss with us…this would be the topic of one of my future blog posts because the experience has angered me to no end, and I’m still angry about it, but it is not really relevant to PPD at this point) to another in-home provider (which worked out well for about 6 mos until the woman’s family had to relocate to Texas) to another daycare center (which worked out well until our current daycare center had a spot open up in Sept 2007). 

So, in total, my daughter had 5 childcare providers between March 2005 to September 2007 (Note: My PPD was over by March 2006).  Being that my own family relocated constantly (8 times until my freshman year in high school), I’m determined to live in my current location until our daughter is in college.  The fact that we had to switch from one childcare provider to another made me feel very guilty and helpless because this is the opposite of what I had intended.  I didn’t want my daughter to experience the constant change of environment like I did when I was growing up.    In terms of the daycare center that had kicked us out, I did eventually report them to the governing authority in New Jersey for not following their published policies on biting (they are supposed to meet parents in person to discuss) and for the administrator’s lack of professionalism.

I’m grateful to this day that I was able to gather up the strength and courage to drag myself to work on March 16th, just as I had originally planned way before I went on my maternity leave.  It was tough, but thank God, I made it through that first day.  After that, it got easier and easier each day.  In the beginning, it was difficult just getting used to taking public transportation again and talking to/seeing people I know.

I went back to work only to find out that people had been taking bets as to whether I would come back to work or not.  That didn’t surprise me.  Nevertheless, it still smarted to know that people would stoop to doing something like that.  You would think that, being that we are now in the 21st century, there would no longer be this automatic assumption that a woman who just had a baby would not be returning to work.  And people wondered why I wanted to keep my pregnancy quiet until I could no longer conceal it (at 6-7 months, believe it or not).  I suppose the feeling that I was in a “boys’ club” environment, being only one of two women directly reporting to the senior manager in our department, didn’t help matters. 

After I returned to work, days sped up significantly – they were going by too fast, actually, as we were finding that the baby was growing up way too quickly, confirming the truth behind yet another warning given by everyone we knew that had kids.  Slowly, I began to recover my pleasure in everyday life.  People ask me how it was to return to work, commenting how tough it was to leave my baby with someone else and not spend all day with her like I’m “supposed to.”  I tell them that, in actuality, it was the best thing I could’ve done to regain my sanity.  Little did they realize how literal I was being.  They’d naturally respond with an “Oh, yeah?” with eyebrows arched, probably because I am the only mother who has ever dared to admit feeling this way.  So I’d have to go and explain myself as follows:  “Of course, I feel bad about leaving my baby with someone else.  But am I relieved to go back to the life that I had before my daughter arrived?  I’d by lying if I said ‘No.’  I long for the mental stimulation I get from my job.”

When are people going to stop being so judgmental about other people’s decisions/business?

FOR MORE ON THE CHILDCARE TOPIC, PLEASE SEE LAST WEEK’S POST.

Deciding Whether to Return to Work or Not to Return to Work…and Type of Childcare…Added Stressors for the New Mom

The transition to first-time motherhood involves a load of decisions to be made—including whether to go back to work or not, and what kind of childcare arrangements to make if you do decide to go back to work.  This is, of course, on top of the uncertainty and anxiety from not having had prior experience with taking care of a newborn.  All these decisions and changes can be so overwhelming for the new mother who is already so emotionally and physically vulnerable after childbirth. 

For some women with PPD, returning to work aggravates their PPD due to the added stress of trying to achieve work/life balance with an infant to take care of after a day at work.  For many mothers, returning to work can be a cause for added anxiety, guilt and sadness. 

For some women with PPD, returning to work promotes recovery, finding it a welcome relief to be able to return to the structured, stimulating environment of adult interaction and intellectual challenges to which they are accustomed. 

With or without PPD and regardless of financial situation, many new mothers will struggle with deciding whether or not to go back to work.  Though we are in the 21st century, let’s face it, many people still observe such traditional values as believing that mothers should stay home and raise their children themselves.  The decision is easier to make for some mothers than for others.  Despite what most people will say, which is that the mother belongs at home, you must do what’s right for you.   Only you and your husband know what’s best for your family.  If you feel you should stay home (and can), then stay home.  If you feel you have to go back to work, go back to work.  Don’t succumb to societal or “peer” pressure.  Don’t let other people’s opinions push you in one direction or another.  What is right for someone else is not necessarily right for you and your family.  This is a highly personal decision that requires careful consideration and weighing of options relative to you and your husband’s financial situation and personal preferences.

Different people have different personalities, preferences/beliefs as to what is best for their babies, financial situations, family arrangements, etc. It’s these factors that influence a mother’s decision whether to stay home or return to work.  It’s because these factors are based on individual preferences/beliefs that they should never be compared with that of someone else.  Each person’s preferences/beliefs have to be respected as unique to that person. What’s right for one family may not be right for another family. 

One or more of the following factor into the decision on whether the new mother returns to work or stays at home after her maternity leave is up:

  • Some women decide to stay home because their income relative to childcare costs doesn’t justify returning to work.
  • Some women firmly believe no one else is capable of taking good enough care of their babies. 
  • Some women don’t have to return to work for several years until their children are in elementary school or even older.
  • Some women may not need to return to work but do anyway because their career has been so much a part of their lives for so long they can’t imagine not going back to work.  Their careers are too important and too much a part of who they are to leave them for so long, as entry back into the job market after several years can be difficult.  These women are fearful of losing their drive and focus, not to mention all they’ve done to get where they are today.  They’ve worked too hard up until now to just put their careers on hold. 
  • Some women don’t have a choice and must return to work in order to help the husband support the family. 
  • Some women have a choice and opt to stay home not only because it is economically more feasible than to pay for childcare costs but also because they prefer to take care of their babies themselves. 
  • Some women have a choice and opt to return to work not only because their careers are important to them but also to maintain a certain lifestyle which would not be possible on just the husband’s income. 
  • Some women return to work, while their husbands stay at home with the baby. 

From the end of November til mid March, I was stuck inside the house with no routine, no face-to-face adult interaction, and no structure to my days stuck inside the house.  Going back to work proved to be my lifesaver.  But I will tell you this….it was a lifesaver not because I could get away from my baby for pretty much the whole day, 5 days a week.  It was because it got me back into a routine, which is what my mind and body were very accustomed to, since that defined my life for the past 16 years.  I had a set schedule, a routine I followed every day.  Going to work enabled me to exercise my mind and mingle with people, both of which have benefits to the average person. 

You may have every intention to return to work—with no intention or desire to stay at home—but I have to warn you that there is no real way of knowing how you would feel about going back to work until after your baby’s arrival and you’ve had a chance to do some bonding.  There is no way to really predict how you’d feel until the time comes.  True, you need to plan ahead, but don’t assume it’s no big deal to transition from taking care of the baby 24/7 to going back to work and having to leave your baby in someone else’s care. 

For some mothers, leaving their babies in someone else’s care is too much to bear.  It is not uncommon for a woman to plan to go back to work but when it came time to do so, changed her mind, giving up her job to stay home with the baby.  Of course, this can only happen if one salary is enough to support the family and/or there was more benefit in the mother’s staying home and saving on childcare costs versus the woman earning her income, having to find acceptable childcare arrangements, having to cover the cost of childcare, and working out a drop-off and pick-up schedule amenable to both her and her husband. 

Returning to work after maternity leave can prove to be one of the most difficult decisions a woman has to make in her lifetime.  My gut was telling me that I should go back to work because that is something I was meant to do until I retire.  I couldn’t imagine myself staying at home 7 days a week for 5-6 years.  I needed to be mentally stimulated and multi-tasking, as I did all through high school, college and the past 20 years at my company.  If there are other new moms in the workforce, managing to balance family life and their careers, I could do it too.  I’d invested so much hard work in college—not to mention my parents’ hard-earned money paying my way through those 4 expensive years—and the last 20 years of my career to just throw in the towel now.  Realizing this made me feel so guilty, like I wasn’t being a good mother by wanting to go back to work.  This guilt and anxiety of leaving my baby in someone else’s care—particularly if that someone else is not a relative and I wasn’t certain about the quality of care that they would be providing—was very difficult to come to terms with, especially while I was in the deepest days of my PPD.  Then, once I returned to work, I experienced a continuous internal battle over trying not to be worried about the baby all day long, which would prevent me from getting any work done, versus “letting go” and focusing on my work, which would make me feel guilty that I wasn’t thinking about my little one as a mother should.  There was this constant internal battle going on inside me.  That’s why I think it is great that my company allows flextime for employees with particular circumstances like mine.  That way, I can spend more time with the baby after work and before she goes to sleep. 

Having to find childcare arrangements with which you are satisfied adds yet another element of stress to the mother who is dreading the day she will need to leave the care of her baby in someone else’s hands.  I will have to say that quality childcare is tough to find.  My daughter has been with childcare providers since she was 3 months old, when my maternity leave ended and I had to return to work.  From March 2005 to September 2007, we had 5 childcare providers.  Two were private and operated out of their own homes, and three were daycare centers.  One of those daycare centers, which I’ve been dying to blog about since 2006, was an AWFUL experience that I will never forget.  I’m not going to really do that on this blog because it’s not really relevant to my PPD.  Perhaps one day….

It was tough going in the beginning, but once we found the one great daycare center (which we are still using today), it’s been GREAT.  I can’t tell you how stressful finding a great childcare provider was for us.  It was after we found someone we felt confident would take good care of my daughter, I was able to relax somewhat, grow accustomed to the new routine, and feel more comfortable and happy about my decision to return to work.  Before I knew it, I was in my element once more and I felt a tremendous relief.  Returning to work increased my self-esteem, which in turn, boosted my confidence in taking care of my daughter. 

Different childcare arrangements work for different people.  Some prefer the childcare provider who works out of her own home.  Others prefer a daycare center.  Both childcare options provide such benefits as development of socialization skills through earlier, daily exposure to other children, learning to adjust to a school environment, and being apart from parents at an earlier age.   

I wholeheartedly believe we made the right decision to put my daughter in daycare at an early age.  Socialization skills are very important, and it occurs more easily the younger the child is put in an environment where they can adapt and learn from, as well as interact with, peers their own age.  For me, having evenings and weekends with my daughter and working during the day is an achievement of work/life balance with which I am satisfied and over which I have no regrets whatsoever.  I didn’t want my daughter to be shy like I was.  And I’m not saying all this to justify my decision to go back to work and entrust my daughter in the care of others.  It’s the truth.

My next post will be on my experience searching for the right childcare arrangement in the midst of my struggle with PPD.

Baby PREP – Parent Readiness Enhancement Program, a prevention program for expectant moms at-risk for postpartum anxiety

Are you pregnant, live not too far from Tallahassee, Florida or Chapel Hill, North Carolina, and a first-time mom interested in prenatal education and tools for dealing with postpartum anxiety and related distress–which along with postpartum depression–are increasingly being recognized as a serious problem with negative consequences for both mom and baby?

Hope your answer is a resounding Yes!  Why?  Prenatal education is something this country, in general, is lacking.  Actually, let me clarify.  Sure, you have magazines and books catering to the expectant moms.  But what I’ve said in several posts, actual hands-on training is sadly lacking.  You may ask “But what about classes hospitals offer?”  They are usually 1- or 2-hour classes with specific topics, like breastfeeding, childbirth and infant care.  Well intended, but hardly adequate.   Better than nothing, but still inadequate when you compare the childbirth preparation and assistance with the transition to motherhood that doulas (and communities in other cultures) provide the expectant mom. 

So, going back to the question of whether you are pregnant and interested in prenatal training, then here’s a wonderful opportunity you shouldn’t pass up!   The Florida State University and University of North Carolina at Chapel Hill are conducting an exciting research study, which investigates a prevention program for postpartum anxiety and related distress.  My hope is that these studies will spur on more of the like throughout the country!

According to the Baby PREP site, which you should visit for more details, this program consists of one initial screening session, 6 FREE prenatal classes, and two follow-up appointments, for which you will be compensated $40.  Participating in this program can help you feel more prepared for the adjustments and care of an infant for the first time.   By feeling more prepared for this major transition, the first-time mother will be less likely to develop postpartum anxiety symptoms or distress.  Not only can your participation help you, it will help researchers better understand how to more effectively prevent anxiety symptoms from developing in the postpartum period for others.

PLEASE CALL 850 / 645-1766 FOR MORE INFORMATION.

Next Came the Panic Attacks….

Let me start off this post with a little primer on just what panic attacks are and why many women with postpartum depression (PPD) may experience these frightening and debilitating episodes.   You will hear me say this over and over again:  Knowledge about PPD before having the baby is so important and parents-to-be should never think they will be immune from it and avoid reading about it.   Had I known that I was experiencing PPD, which was temporary,  I could’ve avoided the panic attacks from happening.

PPD usually occurs by itself, though it may also be accompanied by postpartum anxiety (with or without panic attacks). Women with a personal and/or family history of anxiety and/or panic disorders are at risk for developing postpartum anxiety.    Some anxiety/concern about your baby is normal, especially if this is your first and/or only child, and your fear has to do with visitors picking up the baby and either not holding her right or passing on their germs.   But some women are, like me, prone to anxiety and worrying.  These women who, as first-time mothers, may have anxieties about their mothering capabilities and worry constantly about whether the baby is taking in enough milk or formula, something’s wrong with the baby if there is no bowel movement for 1-2 days, the baby fails to reach certain developmental milestones in the usual timeframes (e.g., smile, laugh, react to your voice), the baby cries too little or too much, etc.  Many of these anxieties stem from the fact that this is your first, and perhaps only, shot at parenthood and you have no previous experience to compare this to.  I will go into more detail in my next post on IVF as a contributing factor to anxiety levels and PPD.

Strangely enough, before my insomnia started, I didn’t feel particularly anxious and I thought I was handling everything pretty well. It was after my insomnia kicked in that my panic attacks began. I thought I had a handle on the mothering thing, even my nightmarish first few postpartum days. Sure, I periodically checked on her at night to make sure she was breathing, and I was concerned I wasn’t feeding the baby enough, her poops were normal, she was going to get sick for the very first time with a cold, and I would not be able to find the right care provider to enable me to go back to work.  But there’s only so much anxiety my body was willing to take, especially since my body was already physically weak to begin with.  The following chain of events contributed toward my growing anxiety until my body gave way to panic attacks:

  • traumatic delivery experience that resulted in a partial hysterectomy resulting in loss of ability to have any more children
  • negative experience in the hospital–e.g., constant sleep interruptions in the hospital, constant moving from one room to another and changes in hospital staff, multiple attempts to replace IVs in my arms/hands, food deprivation (I only had about 2 meals the whole week I was there….otherwise what I had were ice cubes for the most part, plus an occasional broth or jello), below-par treatment of certain hospital staff, searing pain (felt like someone was burning me) in my abdomen that came & went for 2 days after the surgery
  • constant sleep interruptions from the noises the baby made throughout the night, plus night feedings
  • baby’s bad case of eczema and cradle cap
  • baby’s one week colic
  • anxiety from not being able to fall asleep when my insomnia kicked in

What are panic attacks?  Panic attacks are intense and debilitating episodes of anxiety accompanied by physical symptoms often occurring out of the blue, seemingly with no reason at all.  Frequency and duration of attacks will vary. They may occur as often as several times a day and last a few minutes. I experienced panic attacks at least 3 times daily for several weeks (Feb 13 to Mar 19) – at sunset, at bedtime and upon awakening. It scares me to think that this would’ve gone on for many more weeks or even months, had I not sought treatment when I did.

According to the Diagnostic Manual of Psychiatric Disorders-IV (DSM-IV), a panic attack is a period of intense fear or discomfort, in which four or more of the following, mostly physical, symptoms develop abruptly and reach a peak within 10 minutes and may last longer:

  • Palpitations (racing/pounding heart)
  • Trembling or shaking body and/or hands
  • Numbness, tingling and/or coldness in the extremities
  • Feeling chilled, having hot flashes, sweating, waking up in a sweat, sweaty hands and/or feet
  • Nausea, stomach pain and/or diarrhea
  • Feeling dizzy, shaky, unsteady, light-headed or faint
  • Chest pain or discomfort
  • Shortness of breath or feeling as if you’re choking or about to suffocate
  • Feeling like you’re losing control and/or going crazy
  • Feeling trapped
  • Feeling agoraphobic (fear of going outside)
  • Feeling like you’re going to die

Quite paradoxically, the fear of having more panic attacks brings them on – it becomes a vicious cycle.  Panic attacks are such a frightening and debilitating experience that it is only natural that those who suffer from them will feel apprehensive and on edge about the onset of the next attack.  I was caught in a vicious cycle of fear of not being able to sleep, which drove my anxiety up to a level my body obviously couldn’t handle, which then triggered my panic attacks, which caused me to fear trying to go to sleep, and so on and so forth.  Did I mention that my panic attacks would even happen while I was sleeping?!  That’s how bad it was.

My Experience

As I mentioned in my last post, I feared I would depend on Ambien to sleep for the rest of my life.  It was that fear that dragged me into a cycle of fear and despair, which developed into full-blown panic attacks that caused me to shake, my arms to go numb and my body to go so cold that a thick blanket wrapped around me didn’t help. I would wake up in the morning with my feet and hands all in a sweat but my body freezing cold. I couldn’t bear the thought I was going to be like this for the rest of my life.  I felt so despondent that I could not see the light at the end of the tunnel. I had nowhere to turn, no one to talk to that understood. If at that point I didn’t receive the help that I ended up receiving in the form of Paxil (and Xanax), I don’t doubt that I would’ve wanted to die to escape the torture I was going through on a daily basis.

February 13, 2005:   I tried to substitute Ambien with Tylenol PM on the advice of one of the nurses at the OB/GYN office. Thinking that I was saved from dependency on Ambien, I was thrilled and relieved at having stumbled on such a simple OTC remedy. When I took the Tylenol PM and it didn’t help me sleep at all, but in fact made me feel worse…..I had trouble breathing and my head started to spin…..I had my very first panic attack. I was frantic. I didn’t know what to do. At that point, I was totally at my wits’ end. I waited as long as I could before paging my OB/GYN. I knew I should only do that for emergencies, but I didn’t know what else to do. I needed someone to talk to. He didn’t sound pleased at all when I explained what had happened. I explained that I was still experiencing insomnia and experiencing what seemed to be a panic attack because I was out of Ambien and Tylenol PM didn’t work for me. I asked if he could prescribe me some more Ambien. He said “I’m afraid not. I can no longer help you. You need to see your regular doctor.” Since I was looking for a new doctor, he referred me to his own doctor. Right at 9:00 that morning, I called to make an appointment with that doctor. He had an opening for me 2 days later. Two days is not a really long time in a normal person’s perspective, but from a panic-stricken person’s perspective, it felt like an eternity. I had to force myself to get through the next 2 days without being able to consult with anyone. It was such an awful experience….quite beyond words.

February 15, 2005:  I told this new doctor what was going on (reiterating the fact that I had had a baby on December 10th, I had my uterus removed on December 13th, and a month afterwards, I started experiencing insomnia and have been on Ambien for the past 2 weeks). He prescribed me more Ambien. I had another panic attack that night. I felt so helpless and needed to talk to someone so badly that I paged the doctor. I left a message for him, apologizing for feeling compelled to call him despite the fact that this was not a medical emergency. He did not call me back.

February 16, 2005:  The nurse called me back saying that the emergency number was for medical emergencies only. I explained what was going on and she scheduled another appointment for me that afternoon.  During that appointment, the doctor listened briefly to my symptoms and prescribed Paxil (anti-depressant) and Xanax (for the panic attacks). I told him I understood why he’d prescribe me an anti-anxiety medication like Xanax, but why Paxil? He explained that Paxil is a broad-spectrum medication that is prescribed for depression and anxiety, that there is such a fine-line separating the two and that anxiety is most oftentimes attributed to depression. He reassured me that the Paxil is not addictive but Xanax can be addictive so I had to take that only when I absolutely had to. He warned me that it would take at least 4 weeks before the Paxil would take effect. And let me tell you, the next 4 weeks felt like an eternity to me. It used to be that there weren’t enough hours in a day, with my main complaint being that time was flying by way too fast. Now each day crawled by as if there were 48 hours in a day instead of 24. It was tortuous. He had me take 12.5 mg of Paxil everyday for one week, at which point I would have to double the dosage and stay on it for several months.

Being that this is the first time in my life I was prescribed a medication to be taken for an indefinite period of time, and this meant I was on 3 medications at once, I felt more anxious than ever. It’s crazy that I’d go from never taking any drugs to taking three at once. But I was desperate to be back to my old self again.    I didn’t like the idea of being on 3 new drugs simultaneously, especially when they didn’t appear to have any immediate effects, they made me feel strange (not myself), and the doctor didn’t provide adequate explanation in terms of how he chose these and why.   It was shocking to see that I needed medication for so long.

Each day, I’d stand by a window, staring out at the snow (there was so much snow that winter!) and pleading for God to help me get through all this. I’d find myself running around just to keep busy and avoid the sensations I’d inevitably start experiencing each night, as the sun went down. I just wanted to shrivel up into a tiny ball and disappear. As night approached, in the back of my mind, there was dread that I would soon be trying to go to sleep. I’d start having a panic attack where coldness would creep down both arms, I’d have a tough time breathing, and my stomach would turn to knots. Very quickly the cold would take over my entire body and I would start shaking. I just wanted to tighten myself into a ball…anything to stay warm. We kept the house at a consistent 70 degrees all winter long to make sure the baby wasn’t ever cold. There were drafts by the couch where I’d sit to watch television, and to compensate, we kept a radiating heater there. But that didn’t help me much during my bouts of coldness. I’d be shaking with cold, even under a blanket and with my husband’s arms around my shoulders. One too many times, I gave him a miserable look and told him how scared I was that I didn’t know what was going on with me and I was afraid that I’d never get better. There would be tears in my eyes but I couldn’t cry. Most of the time, he didn’t know what to say. It was way after I had fully recovered from PPD that he finally admitted that he had feared I would never get well, never return to my old self, and never appreciate watching our daughter grow up.

March 19, 2005:  The Paxil kicked in and I was off the Ambien for good!  Hurray!

August 18th, 2005:    Initially, the doctor told me I’d be on the Paxil for 6 months. By the time August rolled around, I felt I could stop taking the medication. I asked my doctor about starting the weaning off process. He told me I should take my time. I told him I wanted to be off the medication by year end. He reduced my dosage back down to 12.5 mg.  You can imagine how happy I was!

March 18, 2006:   It ended up taking me about 7 months to get off the medication completely, after first halving the dosage and then taking the medication every other day to every 2 days and every 3 days.  During the weaning off process, I experienced what I thought had to be vertigo…the sensation of losing balance while walking and everytime I turned my head.  It was a weird feeling indeed and the main sign that I wasn’t ready to be completely off Paxil yet.  Finally, at the direction of my new doctor (I finally got up the nerve to drop my original doctor), I stopped taking it on March 18, 2006. She told me that Paxil taken at such long intervals and at such a low dosage was basically not taking any Paxil at all, and I should be able to stop taking it immediately. It is critical that you wean yourself off the medication in close consultation with your physician. Look what happened to Brooke Shields when she went off Paxil cold turkey. She suffered a major relapse.  So at a minimum, you should be taking your medication until you feel you’ve returned completely to your old self, and then taking as long as necessary to wean yourself off.

Seeking Treatment

A sign that you may need medication–but let the medical professional tell you so– is when your symptoms are so bad (e.g., inability to sleep or stay asleep for several weeks, panic attacks, loss of appetite, quick weight loss) that they get in the way of your day-to-day functioning and taking care of your baby properly.

If you’re not experiencing severe symptoms and you have adequate support, you can give a few sessions of therapy a try to see whether it alone will be sufficient. Of the many stories I read about, I was amazed at the number of women who were so ashamed at how they were coping so badly-and it didn’t help that they didn’t know they had PPD-that they endured their symptoms for many weeks, months or even over a year. Perhaps their PPD didn’t debilitate them to the point that they could no longer function. I don’t know about them, but my PPD was SO BAD, I felt my only option was to seek medical help immediately. In my situation, therapy was not a practical option. But I dreaded the thought of having to rely on any medication. In fact, just the thought of having to take 3 medications simultaneously for insomnia, depression and panic attacks-all for the first time-increased my anxiety even more. As soon as the medicine kicked in, my insomnia disappeared, I was able to return to work, smile, appreciate all that I used to enjoy before my PPD set in, able to go outside without feeling overwhelmed, and function near 100% on a day-to-day basis….all without having to see a therapist.

Since my condition required immediate intervention by way of medications (first Ambien, then Xanax and Paxil) to enable me to function day to day-otherwise, I’d be rolled up into a ball crippled both physically (panic attacks numbed my arms and legs, I couldn’t sleep at all) and mentally (my state of mind was on the verge of complete and utter collapse), I am obviously going to present the case for psychotropic medications. There will inevitably, and unfortunately, always be the naysayers and Doubting Toms of the world who are ever eager to attack a person’s position on a topic as hotly debated as meds versus no meds. Hey, all I can say to that is, more people should learn to mind their own business. It’s fine for people to think that doctors seem to automatically prescribe medication for everything. In a way, I believe that the statement is true from a general trend perspective, particularly with respect to children being treated with medication for not having enough attention span to sit still for a few minutes at a stretch. But that’s my own opinion and I keep that to myself, rather than preach it everywhere….a hum, Tom Cruise, are you listening???!!!   Without knowing another person’s situation-and only immediate family and the individual himself or herself (if they are mature adults) can really know what their personal situation is, and sometimes even parents don’t know or understand what is going on with their child-how can you claim to know what is right or wrong for someone else?

In Conclusion:

A word of advice from someone who has been through panic attacks (while suffering from PPD) to a mother who is currently suffering from them:   You WILL get through this with the right treatment.  Do not endure this on your own.  Get help now.  Do not wait.  Do not worry about what other people may think if you take medication to help you be well again.  It’s not their business.  It’s your life and you must take control of it, so you can return to your old self and enjoy your baby.

Insomnia – My Very First PPD Symptom

The very first sign that I was about to begin my postpartum depression (PPD) journey was a sudden development of insomnia one day six weeks after I had my baby.   One day I was fine, the next I wasn’t sleeping.  It was like my mind decided to stay on, despite the fact that I was exhausted beyond words.  Especially since I never even really had a chance to “recharge my batteries”–if you will–from my 7-day stay in the hospital after suffering from complications during delivery.  Some people may think that I developed PPD as a consequence of the trauma of having a partial hysterectomy only 3 days after having my first child and realizing I would never be able to have any other children.   Well, sure, the fact that she was going to be our only child and we had gone through a difficult IVF process (more on that in a later post) certainly didn’t help matters.  It was not, however, the only factor that caused PPD to rear its ugly head.   While I was in the hospital, the hospital staff always had to come in during the middle of the night to take my temperature and sometimes blood.  I’d be sleeping and they’d come and wake me up.  Didn’t they understand how important sleep is to a new mother?  I was never able to get a block of 4-5 hours of sleep during that dreadful week in the hospital.

After the past four years of introspection and journaling my thoughts and feelings into a book, I wholeheartedly believe it was the constantly interrupted sleep and prolonged hypervigilance that kicked off my PPD journey.  The first 1-2 months postpartum is a period in which the new mother is particularly vulnerable to stressors particularly if she doesn’t get the rest she needs to recover from childbirth.  She needs at least 4-5 hours of uninterrupted sleep a day during this time to allow her body to reach the deep sleep it needs to help her body recover.  I’m not saying this to be funny, as I realize all new parents are sleep-challenged during the first 3 months.  It’s what the subject matter experts are recommending, which is why practical (and emotional) support is important for new mothers during that time (see previous post).

For the first month, my husband and I wanted the baby to sleep in our room.  She could only sleep in her car seat, which we kept in a pack n play next to our bed, which made sense because the car seat kept her in an “in-utero” like position.  She also had to be tightly– and I mean tightly– swaddled–also to simulate the in utero experience to which she was accustomed for much of her existence up to this point.   She couldn’t sleep lying flat.  Of course, we learned all this through trial and error.   She also kept making strange animal-like sounds all night long. It’s a shame we didn’t record any of those sounds, which were like little grunts and chirps and what-not.  Anyway, every little sound she made startled me awake, while my husband slept through it all out of sheer exhaustion. After all, we had gone through hell in the hospital and he was just about as sleep deprived as I was.   A natural concern for my baby’s health and fearing SIDS probably contributed to my hypervigilant state (though I understand this is a relatively common phenomenon among new mothers).  We eventually had no choice but to move her into her room so I could sleep better.

When the baby was 36 days old, she developed what seemed to be colic.  She’d cry non-stop for hours at a time, sometimes after 5:00PM, sometimes starting from 8:00PM.  One day that week she didn’t stop crying until 4:00AM.  It was the scariest experience, not knowing what was wrong with her…what was causing her to cry non-stop like that.  We wanted to comfort her, but nothing we did would stop the crying.  We had heard some horror stories of babies crying non-stop for 15 hours at a stretch for months.  We thought we were doomed to the same experience.

Exactly one week later,  just as suddenly as her colic started, it stopped.  Of course, we weren’t sure when/if the colic would return.  So I guess you could say we were both quite wary from the time the sun went down and all through the night.  Just as with everything in life, there’s always a negative where there is a positive.  The colic stopped, so we both thought things could go back to normal.  I would get up for the late night feedings so that my husband could go to work.  Turns out, things wouldn’t work out the way we planned.

Two days later–or the 45th day (or about 6-1/2 weeks) postpartum– my insomnia started from out of the blue.  I couldn’t fall asleep until after 3:00 AM.  In fact, I wasn’t sure whether I slept at all.  It certainly didn’ feel like it.   I didn’t know why this was happening.  Perhaps I was waiting for the baby to cry.  I thought it was a matter of calming down, telling myself that the baby’s colic was gone and probably would not return.  I should relax.  Other mothers were telling me that they were always in a state of shallow sleep and jump at the slightest wimper from their babies.  I was like, great…..I’ve got a lot to look forward to.

I’ve never not been able to fall asleep before.   It’s painful for me to reflect back on those days of not being able to fall asleep all night, tossing and turning, knowing that everyone else is asleep, looking at the clock as the time to get up and feed the baby approached, and seeing the sun come up–all the while knowing that this all didn’t make any sense because, after all, I was exhausted beyond words.  At one point, I got less than 9 hours of sleep over 3 days.  My fear was I’d be physically and mentally impaired from not getting any sleep for so many days in a row that I wouldn’t be able to take care of the baby.  I just wanted to tear my hair out.  I wanted to go screaming into the night, running until I reached a point of exhaustion and just pass out.  I couldn’t endure all those hours of tossing and turning any longer.  The feeling of loneliness was so overwhelming and almost too much to bear.  I was desperate for company, for someone to comfort me and help me overcome this dreadful condition.  I couldn’t expect my husband to keep me company much because he had to go to work early in the AM and had a long day of work, so he needed his sleep.  I only woke him up when I felt I was at the end of my rope.

It didn’t help that every time a friend/relative asked me how I was doing, I’d tell them exactly what was going on….with the insomnia and all.  And each time, I would get this look and a wave of the hand and the comment:  “You’re a new mother….new mothers never get any sleep.  But you should definitely sleep whenever the baby sleeps.”  And I’d say the same thing over and over again…..I wish I could sleep when the baby sleeps, but I can’t.”  Then I’d get the same response:  “Just try harder…..put your feet up, lay back and you’ll fall asleep….all you need to do is relax.”  To which I’d say:  “You just don’t understand.  The baby’s been sleeping through the night since she was 2 months old, which is great.  But I will lie there all night, tossing and turning until the sun comes up, arms numb and cold, heart beating fast/palpitating – all of which is, needless to say, disconcerting.  How can I take care of the baby when I can’t get any sleep at all?”  Then infuriatingly, they’d say:  “Just take a nap during the afternoon, when the baby sleeps.”  Then I’d end the conversation (because I would’ve had enough at that point):  “You don’t get it….I can’t nap.  I can’t sleep, even if I wanted to and even if the baby sleeps.  She sleeps fine.  I have INSOMNIA.”  Telling them that was just about as easy as telling them that I had PPD.  You could see from the look on their face that they still didn’t get it, even though they’d nod to give the the appearance of understanding.

I didn’t know anyone who’s had insomnia, so I never had the support I needed to get me through those dark days.  All I needed was some understanding and reassurance that I wasn’t losing my mind.   My doctors were no help in that respect.  NO HELP AT ALL.  My husband tried to comfort me, but of course, he had no way of knowing what it was like and how scared I was.  I think this was the only time in my life in which I felt so scared and helpless.  All other times in my life, I had some amount of control whether it was a problem at school, problem at home, problem at work, nastier-than-hell fight with a boyfriend, or illness (there was always a cure, like medicine for my recurring bouts of bronchitis and colds throughout the year, or major surgery to remove my dermoid cyst).

Had I read all the books that I’ve been reading these past 4 years BEFORE my PPD journey began, I probably could have avoided the panic attacks that developed 1-2 weeks later (more on this in a later post).  The books all say that insomnia–the inability to fall asleep and/or stay asleep EVEN IF the baby is sleeping– is one of the first symptoms of PPD, especially if it occurs beyond the 3rd week postpartum.  Had I known what I know now, instead of simply taking the Ambien that was prescribed to me by my OB/GYN, I would’ve insisted that he screen me for PPD.  Ultimately, after the insomnia spiraled into panic attacks and the Ambien started to lose its effect, I had to find a GP (this is the one I referred to in an earlier post) who prescribed Paxil and Xanax (I was still on Ambien at the same time).    Thankfully, within a month I was sleeping without the Ambien.  Such a relief that I was not dependent on Ambien as I feared I’d be for the long haul!

There is a tremendous difference between sleep deprivation–which ALL parents experience in the first 3 months–and insomnia which is not being able to fall asleep and/or not being able to stay asleep, even when the baby sleeps. Insomnia can be caused by a fear of falling asleep because something bad will happen if you do, or a constant state of anxiety with busy thoughts and worries that keep you running on high energy like the Energizer ® rabbit that keeps going and going and going. I suppose after 4 weeks of constantly interrupted sleep and such a state of extended hypervigilance–both of which my body was unaccustomed to–were enough to turn on the insomnia switch.   I read that adrenaline, which is produced by the adrenal glands during stress, can increase the body’s fight or flight response, and persistent high levels of adrenaline can cause palpitations, insomnia and anxiety or panic attacks.     I also read that an extended period of sleep deprivation and/or constantly interrupted sleep is a form of torture used on POWs to extract information from them.  Not that I’m trying to draw an analogy here to my first motherhood experience as torture.  It wasn’t.  It was just that my body was not used to enduring sleep deprivation and high levels of  anxiety over an extended period of time, without fully allowing my body to relax and recover from childbirth and all the drastic hormonal changes that went along with it.

When I was well on my road to recovery, I asked my GP and OB/GYN (and staff) why they didn’t think I had PPD even though I had some of the symptoms (e.g., insomnia and extreme anxiety), they said I didn’t exhibit the typical signs of PPD and I didn’t communicate my problems sufficiently to them.  Well, hello….but why do I, the patient, need to tell the healthcare professional that insomnia lasting beyond the 4th postpartum week should act as a telltale indication for PPD?  Symptoms persisting beyond the 3rd-4th week is no longer the baby blues.  Crying, the trademark of baby blues, is not necessarily a primary symptom for those suffering PPD.  It certainly wasn’t for me.  If they had asked me to describe my symptoms and better yet, if they knew enough about PPD to put one and two together, they would have diagnosed me then instead of starting me on a painful voyage seeking answers, compassion and treatment.

Here’s my advice to you if you are experiencing insomnia and you are beyond 3 weeks pospartum:

  • Seek medical help before it has a chance to spiral into something worse.  Don’t just take Ambien or some other sleep aid, and leave it at that.  Ask your doctor if he/she has experience treating PPD.  If he/she doesn’t but you’d prefer to stick with this doctor, tell him/her he/she needs to screen you for PPD and reach out to Postpartum Support International for information/resources.   You always have the option to find a psychiatrist who can screen you for PPD, provide you with a listening ear and advice, and prescribe any medications as necessary.  If this is your first time experiencing a mood disorder, don’t be afraid to seek therapy.  What matters is you must do what it takes to get well.  Certain PPD patients do well with a combination of medication–especially if they are very symptomatic and need treatment for their symptoms before therapy can be beneficial–and therapy.
  • Be honest about all your symptoms when talking to your doctor. Leaving out key details will only impede your recovery.
  • Ask all the questions you feel you need to ask.  No question is a stupid question when you are a patient.  If your doctor doesn’t give you the opportunity to ask questions, rushing off before you’ve had a chance to ask any, that’s a sign you need to ditch that doctor.  Doctors are paid to provide you with the care that you need and deserve, which includes consultation about your diagnosis and treatment.

Remember this:  You need sleep to stay healthy and to be able to take care of your baby day in and day out. I had it bad and I wouldn’t want you to go through what I went through.  You’d think that sleep deprivation would cause exhaustion which would cause you to fall asleep readily and at first opportunity. That couldn’t be further from the truth for me.  With insomnia, I couldn’t fall asleep even when the baby was sleeping. I couldn’t nap during the day, even with someone taking care of the baby for a few hours.