Postpartum Insomnia Series – Part 4: AMY

I met Amy in April 2013 at an event that took place at St. Clare’s Behavioral Health of Denville, New Jersey, and co-hosted by the Partnership for Maternal and Child Health of Northern New Jersey.  I was a speaker at that event.  That night, I met a group of amazing mothers, many of whom I’ve stayed in touch with ever since.  We try to meet up as much as we can, but since we all live in different parts of Northern New Jersey, we’ve only been able to meet up once a year.  Our last get-together was just over a month ago.  With Amy’s son just turning five yesterday, writing up her responses gave her the opportunity to reflect on and appreciate the journey from the time she was was caught blindsided by insomnia and panic attacks to where she is today.

Thank you, Amy, for sharing your experience. Your story, along with the stories of the other moms who have shared their experiences, helps other moms– desperate to find information on what is happening to them–see that they are far from alone in their experiences and recovery occurs with the right treatment and support. One or more of these experiences is bound to resonate with these new mothers .

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QUESTION 1:  When/what was the first indication that something wasn’t right, and how long after childbirth did the first sign occur?
ANSWER:  After being married for 10 years, we were finally able to have a baby after trying for 3 years.  I had an emergency c-section, we all spent three happy days in the hospital with our baby, and I scored very well on the hospital’s postpartum depression (PPD) survey.  But within in a few hours of returning home, the world dropped out from under me, and I just suddenly and inexplicably wanted nothing to do with my baby.

QUESTION 2:  Did you suffer from insomnia?  What other symptoms did you experience, if any?
ANSWER:  Yes, I had insomnia. I was exhausted, but as soon as I was alone in my dark bedroom, laying on my bed, I would start having very physical panic attacks. I imagined running away, getting in the car to run an errand and just driving west and never going home. I had racing thoughts. I never wanted to hurt myself or my baby, but I fantasized about not waking up and how much I hoped that would happen.

QUESTION 3:  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: I saw my midwife within the first week or two. She gave me another PPD survey and I scored terribly. My midwife reassured me that this happens.  She gave me Rx’s for Xanax and Ambien, gave me the number of the Saint Clare’s mental health line, and encouraged me to get professional mental health care. Based on the survey and our conversation, she said it sounded like I was suffering from PPD rather than the baby blues or postpartum psychosis.

QUESTION 4:  If you had to take meds, what was it/what were they and how long did you have to take it/them?
ANSWER: I didn’t end up taking the meds my midwife prescribed because I really wanted to breastfeed, and I had this weird feeling that if I quit breastfeeding, I might actually run away. Breastfeeding was the only thing I could do that no one else could do, so I used it to convince myself that I couldn’t run away.  I truly think breastfeeding helped me stay and helped me bond with my baby even though I absolutely did not want to.

QUESTION 5:  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: The help I got from Saint Clare’s (in the form of weekly therapy with an incredible therapist AND a bi-weekly PPD support group) was priceless.  It healed my mind. My church was aware of what was going on and was fully supportive and non-judgmental, offering help constantly. My mother and mother-in-law both stayed longer than planned. My husband and I worked out a great schedule where I could get 5-6 hours of sleep each night, with him keeping the baby in the family room and taking several feedings so I could sleep alone.

QUESTION 6:  When was the first sign of light at the end of the tunnel and you were starting your recovery?
ANSWER:  After 8 months of therapy and 12 months of attending the support group, I have a vivid memory of my mom and me in her kitchen a few days before Christmas when my baby was almost 15 months old. We were listening to Christmas music and baking, and I was laughing and we started dancing to the music, and it was an authentic joy I was able to feel for the first time since I had my baby.

QUESTION 7:  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:  We tried to have another baby, but weren’t successful after a year of trying. We may try again, but for now we have finished the process of adoption, and are now waiting to be matched. I do still worry about post-adoption depression because I’m prone to depression after a big transition. I’m preparing myself and will have substantial support lined up.

QUESTION 8:  If you could go back in time what advice would you give yourself before you got pregnant?
ANSWER:  I guess I might tell myself to study a little more about emergency c-sections, worst case pregnancy scenarios, and PPD. But, at the same time, I enjoyed my pregnancy so much, so I probably would have had a hard time accepting that anything like PPD could happen to me anyway. I’m glad I had a happy, healthy pregnancy without too many fears and worries.

QUESTION 9:  Did anything positive come out of your PPD experience?
ANSWER:  Oh my goodness, through my PPD support group, I met some of the most amazing, talented, educated, professional, successful, authentic, vulnerable, and empowering women that I have ever met in my entire life. I also sorted through the depths of my heart and mind with my therapist, learned more about myself than I’d ever known, and learned how to understand and have more control of my thoughts. I have become a more compassionate person. I could go on and on.  This journey has taught me so much about myself, and about life, pain, and love.

QUESTION 10:  What would you want to say to women currently suffering with PPD?
ANSWER:  This absolutely devastating experience will not only end, but it can and will strengthen you. It seems like an oxymoron, but if you fight hard, you will be absolutely amazed at the power that is within you to love deeper than ever before. Seeking real help and being vulnerable, though so hard, is exactly what will help you heal and be everything you want to be.

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.

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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!