The First Center of its Kind in New Jersey

As I mentioned a few days ago, I took the day off because  I needed to witness the grand opening of the very first center of its kind in my home state: The Perinatal Mood and Anxiety Disorder Center at Monmouth Medical Center.

 

 

 

 

 

After paying this center a visit personally and hearing about the immensely positive impact it has had the past 6 years since Lisa Tremayne first endeavored to provide a place for mothers suffering from postpartum depression (PPD) to go to for help, I am just so, so amazed and have such tremendous respect for Lisa and for the staff.

 

 

 

 

There were many mothers/babies there that were there to celebrate with Lisa and the amazing staff.

 

 

 

 

 

Robert Graebe, MD (Chairman of the OB/GYN Dept) kicked off the ceremony.

 

 

 

 

 

Followed by Mary Jo Codey who recounted her personal experience with PPD so long ago.  I’ve heard her speak what must be a dozen times by now, but hearing her wrenching experience from when she suffered from severe PPD in the 1980s and a second time in the 1990s always serves as a reminder of how far we’ve come and yet how much further we still need to go when it comes to helping new mothers realize when and how to get help, helping doctors correctly diagnose and treat PPD.  She wrapped up her speech with a statement about how grateful she is for the existence of this center and how we need to make sure more centers like this open up in New Jersey.  Click here  and here for articles posted earlier today that include pictures and video clips.

After the former First Lady’s speech came Lisa Tremayne who gave a brief history of the center and how it has been helping mothers since 2011 and then introduced PPD survivors Meg Santonacita, Luciana Mangyik, and Carolyn Stack, each of whom shared their experiences and how the center helped each of them to recover.

 

 

 

 

 

After the speeches came the ribbon cutting ceremony!

Heading into Maternal Mental Health Awareness Month with a Bang

Just like this time last year, I’ve come across so many things on my Facebook feed in the past few days that I’m just going to highlight all the exciting work, developments, other mothers’ experiences, and upcoming events all in one post.

As I stumble across more articles this month, I will add them to this blog post.

Personal Success Story: If You Only Ask – by Jordan Reid
Being your own advocate by being informed about postpartum mood disorders, knowing your risk, and being prepared for the possibility – unfortunately, you have to for self-preservation purposes because there aren’t enough resources to catch the moms who fall through the cracks of doctors failing to diagnose, treat or even refer maternal mood disorders. The post reflects the main steps I suggest in chapter 5 of my book, which delves into risk factors and coming up with a prevention plan.  I also touch on being prepared in a previous blog post by having a therapist lined up, just in case, if you think you are at high risk for postpartum depression (PPD).  I’ve also blogged about risk factors for PPD.

Postpartum Support International (PSI):
The annual PSI conference is coming up in Philadelphia!  Register by May 8th to take advantage of early bird rates for its PMD certificate course from 7/12-13, as well as for the regular 2-day conference from 7/14-15).

Additionally, PSI has just announced its partnership with the University of North Carolina-Chapel Hill (UNC-Chapel Hill) School of Medicine to expand the PPD ACT.  The PPD ACT is an iPhone app previously released in the U.S. and Australia to study PPD, which is now expanding its reach to iPhones in Canada and to Android phones in the U.S. and Australia.  The app was designed to help understand why some women suffer from PPD and others don’t, in the hope of improving the ability to minimize risk and find more effective treatments.  Women with the app can participate in surveys and DNA testing to study the genes of those suffering from PPD.  This study is the first of its kind.  Last year, approximately 14,000 women enrolled in the study.  Many women who participated were successfully treated for PPD. Ultimately, the hope is to be able to expand the study across the globe.  To download the app or learn more about the study or PPD, click here. For more information about the PPD ACT, click here to access the UNC-Chapel Hill announcement and here for a HuffPost Canada post announcement.

National Coalition of Maternal Mental Health (NCMMH):
And last and most definitely not least, please have a look at how you can participate in Maternal Mental Health Awareness Week (May 1-7) led by the National Coalition of Maternal Mental Health (NCMMH).  Click here to see how you can partner along with other organizations, blogs, authors, mental healthcare providers, etc. in the awareness initiative by becoming a social media partner (like me) to NCMMH.  Help spread the word about the #1 complication of childbirth on Facebook and Twitter by changing your profile pictures and cover pictures, as well as re-tweeeting/re-posting digital messages from the NCMMH’s Twitter and Facebook accounts from May 1-7.

The Perinatal Mood and Anxiety Disorder Center at Monmouth Medical Center – Grand Opening on May 4, 2017

Announcing the Grand Opening of The Perinatal Mood and Anxiety Disorder Center at Monmouth Medical Center (MMC)!  This is such an exciting development for New Jersey that I’m taking the day off from work to attend this grand opening to meet the program’s multi-disciplinary team of experts and clinicians certified by Postpartum Support International.

When:  Thursday, May 4 at 1:00 p.m. (ribbon cutting starts then)
Where:  Maysie Stroock Pavilion (Pavilion & Second Avenue, Long Branch)
RSVP:  Email teamlink@rwjbh.org or call 888.724.7123
Agenda:  Speakers will include Mary Jo Codey (former NJ First Lady who will share her personal experience with postpartum depression (PPD), Lisa Tremayne, Robert Graebe, MD (Chairman of the OB/GYN Dept), and several PPD survivors who are former patients of the center.

Thank you to Lisa Tremayne, RN, CPPD, CBC, CCE — maternal child health nurse at MMC — for graciously providing the details of how New Jersey’s VERY FIRST perinatal mood and anxiety center of its kind has evolved under her persistent efforts.

After the birth of her triplets (after 6 years of not being able to conceive naturally and one round of IVF) in 1998, Lisa suffered from what she later learned was postpartum anxiety/postpartum OCD, which greatly affected her life as a new mom.  She experienced racing thoughts and living in a constant state of anxiety.  She never received help, no one ever questioned if she was okay, and it took years for her to fully recover.

It wasn’t until 2007 when she was at a mandated lunch and learn with the Central Jersey Family Health Consortium that she learned she had what they referred to as postpartum depression (PPD).  Not telling anyone about her experience, she started volunteering for the consortium, and helped patients find resources and help. In 2011 she became the MMC Childbirth Education Manager. As facilitator for a new moms support group she quickly realized many mothers were suffering from PPD.  She then received permission to start a PPD support group, which was instantly well received and attended by large numbers of mothers.  It was at that point she broke her silence and shared her experience with others. She presented her plan to start a PPD program to new business development, but it wasn’t until April 2015 that the plan was accepted and the program was started with the support of the chairperson of OB.  The program consisted of Lisa, a therapist and a psychiatric nurse practitioner on a part-time basis. Since then, the program has grown.  It is now a mother/baby program in which babies are not only allowed but encouraged to attend with their mothers so the staff can assess mother/baby attachment at all times.  Many classes/workshops are designed specifically for the mother/baby.

Lisa and the other dedicated members of the program are excited about the grand opening that is finally going to take place on May 4th!  To date there have been intakes of over 800 women, and 500 women have received medical evaluation, treatment and referrals to appropriate services through the program.  On average, there are 30 new patients a month.  Lisa hopes the program will evolve into a partial day stay program by 2018.  The program is interdisciplinary and every member is completely passionate about helping moms/babies, normalizing this temporary and treatable illness and educating the public that this is the #1 complication of childbirth.

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.

Help Her Get the Help She Needs

My first almost wordless blog post, ever. The words in this image say it all. It is an important message that we, as family members, friends, neighbors or even colleagues of new mothers, should take very seriously.  Permission to use this image granted by Karen Kleiman, MSW, LCSW, founder of The Postpartum Stress Center and author of numerous books on perinatal mood disorders.

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…..

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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.