A New Year and Returning to Blogging

“Tomorrow, is the first blank page of a 365 page book. Write a good one.”
– Brad Paisley

I’ve seen this quote many new years past, but for some reason, it’s sticking with me more so now than ever before.  I haven’t blogged for over 4 months….the longest break since I started blogging in February 2009.  If you’ve been following my blog for some time, you may have noticed it’s been quiet over here and may have wondered if I’ve decided to call it quits.   Well, I’ve previously vowed I would never completely stop.  Blogging about maternal mental health will always be a passion of mine, as my experience 14 years ago has shaped me into the person I am now.  Blogging has also been a huge outlet for my thoughts and anger when I hear about our society’s shortcomings when it comes to maternal mental health.  As I’ve mentioned before, the anger that has fueled my passion has fizzled, and my anger has been directed toward the state of our government instead.  With my district’s Democratic nominee winning on November 6th and now with the House flipping blue (wooooot!!!!) this past Thursday,  I can breathe a sigh of relief and let go of some of my anger.

I’ve also been so busy at work that each day merges into the next and into the next with 10-hour days with no stops and often no lunch breaks……to the point that I’m feeling like my life is flashing before my eyes….and my daughter’s growing up so fast, she’s heading to HIGH SCHOOL this fall!  Plus, my parents and their health and other issues have been weighing heavily on my mind.

And so it comes to my latest philosophies, which are spin-offs of my long-time philosophy of “Just do it” and “Work hard, play hard.”

“Love, laugh and live life with no regrets”

and

“Life is too short for BS”

I don’t really take crap from anyone anymore.  I speak my mind.  I try to maintain work/life balance.  I’ve been trying to achieve more down time on weekends and each evening, trying to to sleep earlier and even squeezing in before bedtime a chapter or two of the bestseller “A Discovery of Witches” by my fellow Mt. Holyoke classmate, Deborah Harkness.   What more motivation do I have than the fact that the show is premiering in two weeks on Sundance Now?!  I’ve tried to see my parents more often.  I’m trying to do more with my daughter before she goes off to college and I <gulp> become an empty-nester. I’m trying to clean out loads of stuff I’ve been holding onto and just try to keep it simpler and less cluttered.  Cuz what am I going to do with stuff I’ve been hanging onto for years and don’t really need anymore?

Finally, as the new year begins, I would like to start up my blogging once more.  After all, I’m not used to not having my blog be one of the first blog resources that comes up when you search the terms “postpartum insomnia,” “can’t sleep when the baby sleeps,” etc.  Time to get to work and get to blogging again!

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.

 

 

Postpartum Insomnia Series – Part 5: VAN

I want to thank Van for sharing her postpartum insomnia experience with us.  She reached out to me via my blog back in January and we’ve corresponded via email since then.  She is nearing the end of her postpartum depression (PPD) journey.

From the time she first reached out to me, I realized her symptoms were very similar to mine.  Every time she reached out to me, I felt like I was experiencing PPD once again. I empathized with her so much, I just wanted to give her a hug and try to do more for her.  But she was very far away.  Thankfully, we were able to exchange emails.  The primary difference between her experience and mine was that she gained weight and craved food, while I lost weight quickly and had no appetite.

Like me, she had a traumatic childbirth experience, hemorrhaging, and a 1-week stay in the hospital.
Like me, she was caught blindsided by insomnia and panic attacks within a few weeks of giving birth.
Like me, she was frightened and had no idea what was wrong with her.
Like me, she was desperate for answers and understanding.

Her frightening experience has resulted in a desire to help other mothers going through PPD.  I figured what better way to start doing so by sharing her own experience on my blog!

*  *  *  *  *  *  *  *

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

ANSWER:
Looking back in hindsight, I felt something wasn’t right shortly after I gave birth but I didn’t think much of it. I attributed it to a traumatic birth (I haemorrhaged and lost 1.5 litres of blood), no sleep, and exhaustion. I remember feeling overwhelmed and very scared. I kept on thinking “What have I done? I don’t want this baby. How am I going to look after this person?” All I wanted to do was get away from this little person, but knew I couldn’t.

Due to my blood loss, infection and complications with the baby, we had to stay in hospital for a week. It was a day after I gave birth and during my hospital stay that the panic attacks started. I remember pacing up and down the ward, not knowing what was happening to me.  I felt an overwhelming surge of adrenalin that made my heart race and made me feel like I was going to die.  It didn’t register that something was wrong.  I just attributed it all to exhaustion, and staying in a busy ward with no sleep.  I thought things would be okay once I was home. I spoke to the midwives about it and they said that what I was going through was normal.  Since they dismissed it, I did too.  It wasn’t until after I was home and the insomnia and panic attacks continued and worsened that I finally acknowledged that something was really wrong.

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

ANSWER:
Yes, I suffered from severe post-partum insomnia. I have suffered bouts of insomnia in the past, but didn’t really have trouble falling asleep and staying asleep. My past insomnia experiences weren’t as prolonged or severe as my post-partum insomnia. I am not too sure whether it was the anxiety and panic attacks that caused the insomnia or the insomnia that resulted in the panic attacks. For the first four months, my life was pretty much a living hell. I’d have panic attacks 3 times a day, sometimes lasting 2 hours at a time. I was very hysterical and desperate.  Aside from the insomnia and panic attacks, I had a huge appetite and ate 7-8 meals a day. Every 2 hours I’d feel hungry and I didn’t know when to stop.  I would eat throughout the night too. I gained a lot of weight during the first 4 months post-birth. I later found out that sleep deprivation causes changes in the digestive hormones.

I constantly had a dry mouth. I also felt like I had a constant lump stuck in my throat and that my windpipe was closing up. I couldn’t feel my body.  It felt like my nerve endings weren’t working properly.  If you pinched my cheeks or arm I couldn’t fully feel the sensations. I couldn’t feel heat either. My heart would palpitate so much it felt like I was having a heart attack. I felt nauseous pretty much every day.  I couldn’t feel my legs, and felt this constant pins-and-needles sensation on the soles of my feet.  I didn’t know whether that had anything to do with the epidural. I later learnt that all these sensations were symptoms of anxiety. Every time I closed my eyes to try and sleep, all I could feel was the surge of adrenalin through my body.  It felt as though there was a battle between my sleep hormones and adrenalin.  It was a very horrible feeling. I could never relax and I was constantly alert. I developed a fear of sleeping because of all this.  Every night I would get scared about sleeping, wondering whether I would be able to sleep or not. I became very paranoid. I was scared to go out. I became slightly obsessed with certain things. I had certain rituals that if I didn’t/ did do them I thought I wouldn’t get better. I was very desperate to get better and I was so afraid that I wouldn’t. I feared that this would be my life forever. Every day was a battle. I felt I was dying every day. Since I wasn’t sleeping, my mind was very foggy like there was cotton wool in my head.  At the same time, I was very alert and wired. I constantly felt dizzy. Ten months after giving birth I still feel dizzy sometimes.


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:
I didn’t see my GP until 10 days after I gave birth. I didn’t sleep at all during those 10 days. I have vivid memories of the day I saw my GP.  I walked into my GP’s office and broke down.  I was hysterical. Tears streamed down my face as I begged in desperation for someone to help me.

My GP wasn’t much help, and he certainly wasn’t reassuring. He prescribed me Zoplicone to help with sleeping and Propanolol for the panic attacks. He said he has never seen anyone like me before and never heard of post-partum insomnia. I wasn’t given a formal diagnosis, but I was referred to the peri-natal team. They did some assessments and concluded that I was very depressed. But I kept saying I wasn’t depressed….. what I needed was sleep. The peri-natal team referred me to a psychiatrist who only wanted to give me anti-depressants, which I didn’t want to take. I was prescribed Paroxetine.  I had to wait 2.5 months post partum until I had my first CBT session. I had 6 sessions in total, once a week. After the 6th session they released me, as they decided I was well enough and didn’t need to continue. If I had a relapse at any point I was suppoed to contact the peri-natal team. So far, I haven’t had to.

 

QUESTION:
If you had to take meds, what was it/what were they and how long did you have to take it/them?

ANSWER:
I took Zoplicone for my sleep and took that for 2-3 month. On some nights I was able to sleep for 2.5 hours with Zoplicone.  On some nights, though, it didn’t help me sleep. I took Propranolol only for a week because I felt it was making my anxiety worse. I was also prescribed Paroxetine, but I never took it because I was so scared of the side effects it’s been known to cause.

 

QUESTION:
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:
Fortunately, I had a very good support network of family and friends. My mum stayed with me for 5 weeks. She was brilliant and looked after me, my husband and my baby. I remember one night, in particular. I was having a panic attack, and my mum held and rocked me and sung me a lullaby. That night occurred during the lowest point of my experience with my post-partum disorder. My husband was also very supportive.  He did all the night feeds for about 3 months until I felt I was able to do them.  During that time, he still went to work every morning. He was amazing.   He supported both me and the baby. The focus was for me to sleep and get better, so I slept in a separate room from my baby and husband so I wouldn’t be disturbed. My mother-in-law also came to help with the baby while I was recovering.  My friends visited regularly.  l called my friends whenever I had a panic attack, as I found talking to others helped me through my panic attacks.  Although I had a brilliant support network, nobody really understood what I was going through. I remember one afternoon when I was having a panic attack. I was alone upstairs in my bedroom crying, and my heart was beating so much that I thought I was going to die from a heart attack. I remember feeling so alone and terrified, and crying and praying for all this to end. It wasn’t until I found Ivy’s blog about post-partum insomnia and disorders that I felt less scared.  Reading her blog and other people’s experiences helped me realize that post-partum depression really does exist and it wasn’t just me.  This realization helped with my recovery.

My peri-natal team was very good.  Someone came to visit me every week for 3 months to check up on me. My CBT therapist, Annie, explained to me that my body had gone into survival mode after a traumatic birth, which could be one of the reasons why I was having panic attacks and experiencing chronic insomnia.

I was so desperate to find answers to what was wrong with me that I was constantly on the Internet trying to find answers. I became a bit of a hypochondriac, thinking that I suffered from everything I read about. I thought I had diabetes, thyroiditis, and adrenal fatigue. I consulted a nutritionist and explained what I was going through. I did an adrenal fatigue saliva test and my cortisol level was very high, especially at night. No wonder I couldn’t sleep! He designed a food plan for me to lower my cortisol levels and told me to take certain vitamins and minerals. To my surprise, I was able to sleep better after being on his food plan. Since I was very reluctant to take medication, I sought alternative therapies. I found crystal healing helped with my recovery. Although the crystals may very well be just a placebo, I still sleep with them. On nights I feel a little anxious, I hold my crystals and I’d fall asleep.

 

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

ANSWER:
I can’t really pinpoint when I started to feel better.  It was a gradual process. I took it one day at a time. Slowly, I got out of the house more, I obsessed less over what I ate and when I ate, and I stopped obsessing about my heart rate and Googling my symptoms. The panic attacks became less frequent. I got more solid hours of sleep. I didn’t ruminate as much about how I felt and how my mind was fuzzy. But recovery was such a long process. Sometime it felt like I was taking one step forward and two steps back. I remember emailing Ivy on one of my low days asking her “Will I get better?” She reassured me and said yes. I always looked forward to Ivy’s emails as they made me feel like I wasn’t going crazy.  Slowly but surely I recovered and began to enjoy motherhood and being with my son.

 

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:
The whole experience did put me off having another baby initially, as I didn’t think I could go through the whole ordeal again. But now, 10 months after giving birth, I think I could do it again because I now know what to expect if I were to have another baby. If I were to suffer from PPD again, I wouldn’t be so afraid and I know it would only be temporary and things will get better.

 

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

ANSWER:
I would advise myself to read up on PPD. I don’t think there is enough awareness on PPD. If you are a first- time mother suffering from it, it’s a very scary situation to be in if you don’t know what is happening to your body and mind.  Throughout my pregnancy no one mentioned PPD. Healthcare providers emphasized pregnancy, labour and giving birth but never once talked about the post-partum period or possible complications during pregnancy and childbirth.  If I had known about PPD, I wouldn’t have felt so scared and isolated. I would also look into hypnobirthing and/or active birthing to have a better and more natural childbirth experience. I would hire a doula to help with childbirth and the first few weeks post-birth.

 

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

ANSWER:
My experience has had a huge impact on me. I really want to help women going through PPD. I think I’ve grown as a person. I’ve learnt to appreciate the small things. I’m more compassionate and less judgemental and generally happier than I was before my pregnancy.

 

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

ANSWER:
What you are going through is horrible, your hormones are trying to find a balance, and sleep deprivation is beyond awful.  At times you will feel like you are going crazy, but you aren’t. You have hormones that are making you depressed, angry, anxious and/or unable to sleep.

Every day is a battle. Take each day at a time, and do things you think will help you get by each day.  If you think having acupuncture will help, do it.  If you think going shopping will help you get through the day, do it. Do whatever it takes to get through the day.

Get help and support. Get your partner to look after the baby. At the moment, self care is important, so don’t put too much pressure on yourself. Get medical, practical and emotional support if you haven’t done so already.

I know it doesn’t seem like you will get better, but you will! Slowly but surely you will see snippets of your old self come back and you will be laughing again soon. This is only temporary.

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 .

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

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 – 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.

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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!

 

Celebrating My 6th Blogiversary

Well, ladies (and perhaps some gentlemen), I’ve managed to keep my blog going for SIX years.  If you’ve been following my blog since the beginning, you might’ve noticed the gradual transition of my blog’s focus, tone and frequency.

But through it all, my intent has remained the same….to make sure that those who need the kind of support and reassurance that I couldn’t find and didn’t have access to during my postpartum depression (PPD) experience ten years ago can find my blog and feel a little less alone in their postpartum experience.

For the moms who are going through PPD with insomnia as an initial/primary symptom and are bewildered, like I was, as to why in the world I would not be able to fall asleep when I was so exhausted and recovering from a traumatic childbirth experience, hospital stay and blood loss.

For the moms who develop panic attacks and are bewildered, not understanding what is going on with them because they have never experienced panic attacks before.

For the moms who got pregnant after many years of trying through IVF, thinking all would be blissful once the baby arrives but instead are blindsided by the sudden onset of PPD.

These are the moms who are finding my blog.  Moms who longed to hold their babies in their arms the way they had envisioned they would but could not enjoy their first weeks with the baby because of the darkness of PPD that enveloped them.

I know I am still helping some moms. I know from the comments they leave. I know from the occasions a mom reaches out and asks me to email, text and/or call her.

I want you to be well and to get the right help as quickly as possible so you can.

For those who have been following my blog these past six years, thank you.

I hope to continue to come up with blog posts that people find in searches and that help make a difference in a mother’s (or father’s) life.

I have a few author interviews and other posts coming up.  Please stay tuned.

Insomnia versus Sleep Deprivation in new moms (yes, there is a difference between the two)

Here, finally, is my post on sleep (as a follow-up to my post “Some Postpartum Advice for New Moms-Part I”) ….or actually, insomnia.  Just what is insomnia?  Equally frustrating as explaining the difference between the baby blues and postpartum depression (PPD) is explaining the difference between having insomnia and not having the ability (or lack of opportunity/time) to sleep.  Insomnia is when you can’t sleep at night and can’t nap during the day no matter now exhausted you are.  I’m not talking about sleep deprivation, which is what ALL new parents experience in the first 3 months postpartum.  I’m not talking the lack of opportunity or time, either.  To be perfectly clear, a person with insomnia has difficulty falling asleep and/or difficulty staying asleep, even when the baby sleepsInsomnia is one of the most common symptoms of PPD. In fact, it has been shown that early severe fatigue predicts depressive symptoms at 1 month postpartum.  For me, insomnia was my very first symptom of PPD and I wholeheartedly believe that the constant sleep interruptions that started during my week-long stay in the hospital charted a course that was headed for PPD.

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.  You’d think that sleep deprivation would cause exhaustion which would cause me to fall asleep readily and at first opportunity.  That couldn’t be further from the truth in my case.  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.  When I told my doctor I couldn’t sleep at night, he instructed me not to take naps, to which I said “That’s not an issue because I can’t nap either…I can’t sleep at all.”

I encourage you to try one or more of the following to try to switch gears and condition your body out of this situation.  The key is to have the patience to stick it out for at least a couple of weeks.  I know with PPD it can be really hard to do, but please try your best.  Things don’t happen overnight.

  1. If you can’t fall asleep within 30 minutes, stop trying to sleep.  The more I couldn’t fall asleep, the more I was unable to fall asleep.  This effect is referred to as conditioned insomnia where your mind doesn’t expect you to fall asleep, which in turn, keeps you from falling asleep. Lying there waiting to fall asleep but not succeeding will only eat at you and make you more and more frustrated.  It will do you no good.  The harder you try to sleep, the more anxiety you will experience, and that anxiety will keep you from falling sleep—a vicious cycle.  The key in those situations, it seems, is not to expect to fall asleep.  If you fall asleep, great.  Just relax and try to blank out your mind from any thoughts.  Sounds so easy, but is so hard to do.   So many people warned me that the last thing I should do is toss and turn in bed for more than half an hour at a time.  Instead, I should get out of bed and go into another room to watch TV or listen to some quiet music before trying to fall asleep again (this is to interrupt the conditioned insomnia).  Of course I didn’t heed their advice because I was stubborn.  In my mind, sleeping was the only thing I should be doing in the middle of the night.  Plus, I should be exhausted and able to fall asleep instantly.  But after 2 hours of tossing and turning, I was in a state of anguish beyond words.  Had I known at the time that PPD was behind this all, it never would’ve gotten this bad.
  2. Avoid looking at the time.  Move your clock(s) out of the room, if necessary, as watching time go by will only serve to make you feel even more anxious about not being able to fall asleep.
  3. Get a headphone noise canceller or white noise generator to use while getting your 5 hours of uninterrupted sleep.  This is, by the way, just if you have someone like your husband or relative staying with you and helping to care for the baby at night.  My husband had suggested getting me a headphone noise canceller or white noise generator in terms of helping me not to overreact to my daughter’s noises and his snoring (which I could hear even when he was in the den or living room downstairs).  I swear back then I could hear a pin drop, I was so attentive to every little sound that was made in the house!
  4. Have your husband or whoever might be staying with you to give you a back/shoulder massage right before bed.  Ordinarily, a back/shoulder massage right before bed feels so good and is so relaxing, I would fall asleep immediately.  Needless to say, my husband’s massages when I was already sick with PPD didn’t help me one smidgeon.
  5. Establish a bedtime ritual:  Much like trying to condition your baby to associate a bath, reading a book and/or humming a lullaby with going to bed, you should try to recondition your mind to associate drinking warm milk (if you’re not lactose intolerant) and eating something high in complex carbs that can promote drowsiness like bread, taking a hot soothing bubble bath or listening to relaxation music (the kind that would be played during a massage) with going to bed.  I never realized that the reason why so many people suggest warm milk to help you sleep is because it contains tryptophan, which increases serotonin, promoting sleep.
  6. Avoid exercising within 2 hours of going to bed.  My doctor suggested exercise anytime during the day except for within 2 hours of your bedtime may burn off excess energy/reduce jitteriness and promote sleep.  I tried but couldn’t keep this up.
  7. Avoid napping during the day.  My doctor suggested that I avoid napping during the day, as it may charge me up to the point and increase the likelihood that my body will feel less tired at the end of the day.
  8. Do a wind-down routine.  My mother suggested I do a wind-down routine, similar as I would do for my daughter, every night before going to bed.  I should avoid exerting myself or watching stimulating television shows or read books that require too much thinking.  She gave me some information about Chinese relaxation techniques that have been used for centuries.  I tried that, but that night, I ended up having my first anxiety attack from failing to fall asleep after 3 hours of doing that relaxation exercise.  She also suggested I try breathing exercises and visualize positive things when I’m in bed, so as to facilitate sleep.  But try as I might, it was to no avail.  The harder I tried, the more I expected to be able to sleep, and the more agitated/panicked I felt that I would never fall asleep without medication for the rest of my life.  A friend told me that counting backwards in three’s helps her sleep.  I tried that too, but with no success.  It actually drove me crazier.
  9. Reserve your bedroom for sleeping only.  There’s a reason behind the saying “Mothers know best.”  But nearly half the time, I dismiss my mother’s advice as “old wives’ tales.”  Well, when my mother advised me to reserve the bedroom for sleeping only and not do anything like read, watch TV or write in bed, I waved off her advice saying “Uh huh whatever you say, mom.”  Then, I read in “Postpartum Depression Demystified“ by Joyce Venis, RNC and Suzanne McCloskey (pg 41) that you should “Make your room your sleep sanctuary.  In other words, don’t watch TV, read, or play with your baby there.  Your bedroom should be only for sleep.” So, mom really does know best, after all.
  10. Stay away from caffeine.  For me, caffeine wasn’t a factor, since I was totally caffeine free all of my pregnancy and continued to be caffeine free postpartum.
  11. If within a week all the above suggestions fail–provided you don’t experience tremendous anxiety from not being able to fall asleep–then it’s time to see your doctor.  Don’t wait or you could you find yourself going down the same road I traveled—in other words, experiencing high anxiety and panic attacks from not being able to fall asleep.  Don’t wait.  You could go from bad to worse very quickly, and I wouldn’t want you to experience what I experienced (or worse).  Do see a doctor for an evaluation to help determine what is causing your insomnia.  Be honest about all your symptoms when talking to your doctor.  No question is a stupid question when you are a patient.  Doctors are paid to provide medical care, which includes consultation about your diagnosis and treatment.  Leaving out key details will only impede your recovery.  Also, do not let your doctor try to convince you that this is temporary and is experienced by all new mothers.  If you find that your doctor doesn’t know the difference between the blues and PPD, it’s time to find another doctor.  If you don’t know where to find a doctor that can help, reach out to your state PSI coordinator.

Additional Suggestions

Here are some of the things we did to help my daughter sleep through the night, which may be helpful to you:

  1. If you are breastfeeding without any difficulties, you may want to consider having the baby sleep in your room in a co-sleeper so you can pull the baby into bed with you for nighttime feedings without ever having to get up.
  2. If you aren’t breastfeeding, it would help to prepare bottles of pumped milk or formula in advance and have your husband take turns with you in terms of nighttime feedings.
  3. By 3 months if you haven’t done so already, have the baby sleep in her crib in her own room so you will not constantly be disrupted, especially if the baby tends to make a lot of noise while sleeping.  My daughter started sleeping in her own room at 6 weeks because her noises kept us from sleeping during the night, which I know contributed toward my insomnia and PPD.  I had every intention of keeping her in our room through the 2nd month.  Avoid setting this expectation, as it will only let you down harder if you are unable to follow through.  The fewer expectations you have and the more open-minded/flexible you are, the better off you will be.
  4. Keep a clear distinction between night and day as bed time and awake time, respectively.  Keep the room completely dark and quiet at night and bright during the day, with constant noise and hustle and bustle of activity (even when the baby naps during the day).  Doing this consistently can contribute toward your baby’s sleeping through the night earlier.  Every baby is different, I realize.  Fortunately, our daughter was sleeping through the night within 2 months.
  5. Establish a bedtime ritual for your baby, like reading a book or humming a lullaby so she associates bedtime with them.  My daughter used to hum and then drift off to sleep.  So she clearly associated humming with sleeping.  In fact, at four years old, I can still tell when she’s tired because she would all of a sudden start humming/singing to herself.
  6. At 3 months, you may want to start trying to avoid immediately going to your baby when she cries during the night or as you put them to bed.  It’s tough to not immediately go to your baby when they cry.  A minute can feel like an eternity when you hear your baby crying.  At first, you may want to give it 5 minutes before going to her.  If you can’t last 5 minutes, try 3 minutes at first and work your way to 5 minutes.  And then over time, stretch the interval to 10-15 minutes before going into her room, calming her down and letting her cry another 10-15 minutes.  To calm her, you can try humming a lullaby or talking to her, avoiding picking her up, and then walking out of the room.  Repeat this until she falls asleep on her own.  Pick her up and comfort her (or feed her if necessary) only when all else fails.  Keep this up…it will work.

 We found that for 1-2 weeks at a time while she was teething, and even after she learned how to go back to sleep, she would wake up every night at around 2:30 AM crying.  She needed our comfort during that time to fall back asleep.  So we’d pick her up, hold her while sitting in the rocking chair, and sometimes hum her back to sleep.  After about 5-10 minutes, we’d put her back in her crib whether she was asleep or not.  At first, we feared she had regressed.  But it was only temporary.  You may find this will happen to your baby while they are sick, teething or have an ear infection.  A baby who is teething and/or has a fever and/or is not feeling well should be comforted immediately.

 By 4 months, in order to teach her to fall asleep in her crib while she is still awake, begin putting your baby to bed at night while she is still awake.  If your baby will only fall asleep if you rock, nurse and/or hum a lullaby, she will come to depend on being rocked, nursed and hummed to in order to fall asleep, so that when she wakes up in the middle of the night, she won’t know how to fall back asleep without your intervention.

Stay tuned for my next post that continues on this topic, specifically in relation to awareness of the importance of sleep and setting up a support network before you have your baby as being the key to prevention of insomnia (and PPD).

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.