Pregnancy is an emotional rollercoaster. With the surge of hormones, the stress of what is to come, and excitement for the biggest blessing ever, it is expected that women will go through ups and downs leading to baby’s big arrival. So often we hear about the “Baby Blues” where it is expected that you may cry a little more or be a little overly emotional for a short period of time, but it is only until recent years that we even hear the truth about what happens when the “baby blues” last for weeks, months, or more. According to Postpartum Progress, approximately 600,000 women get Postpartum Depression (PPD) each year. The saddest part about it is, we still have so much stigma attached to something that isn’t even talked about as much as is should be.
While my son was in the NICU, I failed every postpartum assessment I was given. At the time, I kept telling the nurses that I had just seen my baby turn blue and we’re sitting in a NICU, of course it is going to seem like I am depressed! I began to get a lot of anxiety during our stay. It was very intense having nurses in and out constantly, dealing with wires and weighing diapers, and many of our lactation nurses unfortunately made my nursing experience more stressful than it should have been. I became obsessive about keeping track of how many wet diapers he had, how long I had nursed, how much time elapsed between feedings, how long he was sleeping. I kept an incredibly detailed log of his every movement because in my mind, that was the only way I could make sure I was meeting his needs. I attributed all of this to simply being in the NICU and the emotional toll it was taking on me.
You always hear moms talk about bringing home a new baby…sleep deprivation, stress, worry, and emotions. I had convinced myself that what I was experiencing those first few weeks home was normal. At every single appointment, I failed the postpartum depression screener, just as I had in the hospital. Even after someone close to me suggested I “just put the answers you think they want to hear”, I continued to fail. I don’t think I was willing to admit to myself that I had postpartum depression. I had battled with depression and anxiety since I was a kid, but it was very well managed before I got pregnant. Every week, my OB office would call and check in because of those surveys. At the time, I would get frustrated and annoyed, still thinking I just had the baby blues and they were overreacting.
It wasn’t until our pediatrician, who was with us through our NICU experience, said to me, “I know you love your son, and he is happy and healthy. He deserves a mom who is happy and healthy too” that I knew I had to do something.
As embarrassed and confused as I was when she said this to me, looking back at it now, I am so very grateful that she did. I finally called my OB and said, “I think I am failing the surveys because I might have postpartum depression”. It physically hurt to say those words, but I knew I had to do it. I went in and was prescribed Zoloft, since it was considered relatively safe to take while nursing. I also reached out to the nurse in the mother baby unit who was there when our son went through his episodes because she ran the postpartum depression support group at our hospital.
After about 2 weeks on medication, I was ready to go to my first meeting. I was proud of myself for even getting to the meeting that night, but it was not what I had expected. There were only three people there, in addition to the nurse running the group, a mom and a father-in-law to a woman who was currently hospitalized for postpartum psychosis. I remember introducing myself, explaining that I had just admitted to myself that I was suffering from postpartum depression even though I’ve had a history of depression and anxiety before. I explained that I decided to start taking medication and come to these meetings to help get myself out of it. When the other mom began to speak, I slowly got the creeping feeling that I needed to leave. She went on and on about how horrible it is to take medication, especially when nursing, and how she started doing crossfit and that just cured everything for her, that every mom who doesn’t become a gym rat is doing a disservice to themselves and their child because it will make your postpartum depression disappear. I wanted to leave, I wanted to run as far away from this situation as possible, but I convinced myself to stay and just chalk it up to her being ignorant. The father-in-law of another woman began to speak about his experience. It scared me. He talked about her having a history of mental health issues and how that caused her to slip into psychosis and eventually be hospitalized because she was a threat to herself and her children. He explained what a burden it was on the family, and how it was more difficult for her husband to deal with than her. I started to panic as he probed me for answers about my mental health history, as if that would somehow affect his daughter-in-law’s situation. I remember fighting back tears and counting the minutes until the meeting was over. I never went back.
I had gone back to work after 11 weeks of maternity leave, stayed on my medication, was nursing and pumping pretty well, and was lucky to have my son be in the daycare I used to work in, with a dear friend that I trusted completely. I still had a hard time with worrying about my son, but it helped to receive picture updates throughout the day. I felt so guilty that I was going to work every day. I had decided that because I needed to work, that made me less of a mother than those who had the ability to stay home. I still wasn’t sleeping, sometimes for several days at a time, which did not make things easier emotionally. I was still crying in the shower, not inviting anyone over, and struggling to truly feel happy. We were getting ready to move across the country due to my husband’s military orders, and the guilt of taking my son away from his family was eating at me every single day. I continued to convince myself that this was normal, and that I just had to keep taking the medication so that I could eventually feel better.
We drove across the country and I ended up needing an emergency gall bladder removal immediately upon our arrival. As a result, my supply dropped drastically, and I ended up giving up nursing. I was disappointed in myself because my goal was to make it to at least 6 months, and I fell one month short of that goal. With the hospitalization and pain medication, I just couldn’t keep up with the pump and dump and the inability to eat normally didn’t help either. I hated myself for not being able to do what was “best” for my son, because giving my son formula was somehow feeding him my failure in a bottle.
I wish someone would have told me about the changes your body endures after you give birth and then again after you stop nursing. I didn’t know that my hormones would change and things would go from bad to much, much worse.
Moving so far from home, to a small island community, was culture shock for me, but I convinced myself that if I just focused on my son and work, that everything would eventually go back to “normal”. I wasn’t interested in going anywhere, let alone by myself. If my husband wasn’t home, I didn’t go anywhere except work and daycare. My husband began going on detachments for a few weeks at a time and I was forced to start doing things alone. I had no interest in doing anything, but I also remember this crippling fear that kept telling me I couldn’t. I remember the feelings I would get each time I had to do anything…my heart would race, I would get cold sweats, I would be constantly looking over my shoulder, I tried to get in and out as quickly as possible. Somehow, I was convinced that everyone, anyone, was going to take my child. My mind began to go in directions like “What if someone crashes into my car and kills my baby?” “What if I’m strapping him into his car seat and someone comes up and steals my car with my son inside?” I had lived in some not-so-safe areas in my life, and never ever felt this way. I chalked it up to being a new mom and the normal fears you have when you are now responsible for another life.
I had been struggling with being away from our family and friends, that they wouldn’t get to watch him grow, and how that was all my fault. I couldn’t find happiness other than when I was holding that sweet boy in my hands, but even then I felt selfish for being happy because I felt that he was given a horrible person for a mother. Nothing else interested me or mattered. I struggled with feeling inadequate as I saw my friends happily having babies, makeup and hair done a few hours after labor and delivery, jogging with their strollers, and having friends and family visit. I started to convince myself that my lifelong dream of becoming a mom was maybe not something that was right for me. I loved my son so much, but I felt I was failing him and everyone around me.
About the same time that the anxiety and fear started, my mind would wander a lot. I started to have these thoughts that were unsettling and, honestly, terrifying. I didn’t want to call them hallucinations, because, at first, I knew they weren’t real, but I couldn’t get them to stop. It would happen right before I walked over to him in his bouncy seat, while I was in the middle of teaching math, as I was feeding him, every time I gave my son a bath…it started with once or twice a day but quickly grew to countless times. I would see my son, laying there, blue, and dead. No matter how hard I tried to avoid it, there the image was. And as time went on and they became more frequent, they became more real, they became harder to differentiate from reality.
I would open the door to his room, completely convinced that I would walk in and see my son dead in his crib.
I still wasn’t sleeping much at the time because I was so hyper vigilant (Is he breathing? What if he chokes in the middle of the night? Is it too hot in his room? What if someone breaks in?) and I was having horrific nightmares that would wake me up in a panic. I averaged maybe two hours of sleep a night. The fear of strangers hurting us, someone stealing my kid, and my son dying became so overwhelming that it was all I could think about. I could no longer make it through a quick trip to the store without a full blown panic attack. I was constantly worried he would choke on his bottle, on the rice cereal, on anything. I became obsessed with safe sleep while being paralyzed with fear over the thought of SIDS. I baby proofed the house to the point where I only let myself and my son stay in one small area of our living room. I began to check doors and windows, sanitize bottles, wash clothes, disinfect things in a ritualistic manner. I stopped opening the blinds, afraid someone would be able to see my son inside and come in and take him. I was seeing the image of my son dead everywhere in increasingly scary ways, like me driving off a bridge, getting hit by a car in his stroller, me falling down the stairs while holding him, my son being strangled by his blanket, or him simply dying in my arms. I never EVER had the thought or image of me hurting him. I just had this overwhelming fear that he was going to die, and I knew that if that happened, I could not and would not live without him. I kept telling myself that postpartum depression was one thing, but this was just me being dumb. But no matter how much I told myself that this wasn’t real, and these things were crazy, I couldn’t get myself to stop.
It slowly started to become so real that I could no longer tell myself that I was crazy, or that these things weren’t real. I finally hit the point where I wasn’t just seeing my son die, in my mind I knew he was going to die. I couldn’t remember if things were real or a nightmare.
I hadn’t told anyone about what was happening because I was afraid they would think I was being over dramatic or looking for attention. I had considered talking to the doctor, but I was so terrified that, without my husband being home, they would call CPS and take my child away from me. That thought consumed me. I was convinced, at that point, that somehow CPS was watching me, following me, waiting for me to slip up or make a mistake, just so they could take my son away from me.
I don’t remember what caused me to do it, but one day I just unleashed it all on my husband. I told him everything. I explained the images I saw hundreds of times a day, the fears that I knew, at first, were ridiculous, but had become so bad that I could no longer talk myself out of them, the overwhelming guilt I continued to have for taking our son so far away from his grandparents, the sadness I felt that I wasn’t cut out to be a mom. The only way I could think of to describe it was like I had a giant spring inside of my body, that was twisted and suppressed so tightly that nothing in my body could work, that it could pop at any given moment, and that I was spending all day, every day just pushing that spring down to keep it from unleashing. I felt like I was no longer living in my body, that I was watching myself do all of these things and couldn’t recognize myself anymore because I had no control. I felt dead inside. Sometimes I knew it wasn’t right, but I couldn’t make it go away. My poor husband, I can’t imagine how he felt as I let this all out. He was scared, I could tell, but so was I. He reminded me that I was doing a good job, and that it was ok to be worried and scared, and that maybe I should find a doctor to talk to. I knew he was right, but it was not easy.
I’ll never forget when I finished talking to the nurse about wanting to discuss options for postpartum depression treatment, the doctor came in and said (in the worst condescending tone), “So…you’re feeling a little sad, is that right?” I lost my freaking mind. I remember fighting back the urge to scream, “This is more than being a LITTLE SAD. This is terrifying and I can’t get myself out of it!” I tried to explain a little more, saying that I was seeing scary images and that I was so anxiety ridden that I couldn’t sleep or leave the house. When I explained that the Zoloft wasn’t helping and that I maybe needed something more, he decided that “this is a bit more than I am comfortable with” and gave me a referral to a psychiatrist. Living on a small island made finding healthcare for mental illness extremely difficult, especially when working with my work schedule, but I eventually found it.
I started to see a therapist and I am lucky to have found one that was a mom and had been through a lot in life, giving her a ton of experience to draw from. When she explained that she felt I was suffering from Post Traumatic Stress Disorder (PTSD) that exacerbated my postpartum depression and anxiety, I was confused. PTSD? I thought only victims of abuse or combat veterans could have that. I had no idea that the night I woke up to my child turning blue and gasping for breath, was enough of a traumatic event to affect my brain. My therapist was a strong believer in explaining how your brain works, which helped me understand that I am not crazy, that my brain is wired a certain way and this was my brain’s reaction to trauma, that it was protecting me from future trauma. The more I learned about PTSD, the more I realized that it all made sense. My symptoms, which often overlap with PPD/PPA were also the very textbook symptoms of PTSD. Once we started to dissect this, I started to feel a little better.
I also saw a psychiatrist who prescribed medications that would help treat the symptoms I was experiencing. I mentioned that I didn’t want to live off pills and that I should just be able to get off the meds once I felt better. The doctor said something I think everyone should hear.
He said, “If you have a heart condition, it might not be your fault, right? So you take medication to treat the symptoms, so you can have a better quality life. If you get a bad cough, you take medicine to treat the cough, right? What is different about this? You are having symptoms of PTSD, so you take medication to treat the symptoms. Thats it.”
It made sense. There is such a stigma around taking medication for mental health, hell I experienced it when that mom shamed me for taking Zoloft. We did some trial and error and ended up with a medication to help me calmly fall asleep and prevent nightmares, an anti-depressant, and a mood medication I had been on as a teenager. These things, along with therapy, started to help. We continued to monitor and tweak my medication and eventually my doctor suggested Adderall. I remember thinking, “Umm no, I’m a teacher and I know what ADD looks like. I do not have ADD”. My doctor explained that I only see the pediatric side of it, the kind of ADD that prevents some kids from succeeding in school. He said that sometimes, the symptoms of PTSD are very similar to ADD in that you cannot focus and have a hard time shutting off my brain so I could get some sleep. In my case, my pervasive thoughts were keeping me from focusing on anything. I was a bit reluctant, again because of the stigma attached to drugs like Adderall, but I gave it a try. It was life altering. The best way I can think of to describe it is that I was finally able to slow down my brain enough where I could process the thoughts that were rushing through my mind. This, along with the coping skills I had learned in therapy, helped me confront those pervasive thoughts, those horrifying images that I would see, those panic attacks that would start, and talk myself through them. Through therapy I learned how to ground myself during times of panic or visions of my son, teaching myself to stop and evaluate instead of immediately reacting before I got a chance to think. I was challenged to “go left instead of right”, do things I might be afraid to do (like hiking or go shopping in a new mall I hadn’t been to before), and to force myself to address the trauma, reason through it, and use my arsenal of coping skills to get through tough times.
I don’t want to make it sound like this happened overnight or that I am somehow just “cured”. It took almost a year of weekly therapy, and medication, to get to the point where I am now. At this point right now, I am stable. I still struggle, I still have guilt, I still have bad days, and I still have work to do. I know that PTSD, PPD, and PPA are not things that will just go away and that this is something that will be a part of me for the rest of my life. I know that I will forever be a different version of myself because trauma changes your brain, but that it is ok. Its ok to need medication to help treat the symptoms. Its ok to talk about that night, that I can’t be afraid of what people might think. Its ok to admit that I have Post Traumatic Stress Disorder brought on by my son’s birth, that my history of mental illness and this PTSD made my Postpartum Depression and Anxiety much worse than it may have been without that trauma.
Its also ok to admit that I waited far too long to get help, and that I was walking a fine line between PPD and postpartum psychosis, and that waiting any longer could have been life threatening.
It has taken me over a year to write this down. My therapist and doctor encouraged me to talk about it and write it out as a means of facing it head on. I have tried and failed so many times, because it would bring back such horrible feelings that I couldn’t finish. Writing this today, I will admit, I have done it through tears. But now, those tears aren’t because of fear or sadness. The tears I am crying today acknowledge the pain I endured, but also applaud the strength I have gained because of it. I am proud to say that I am a survivor of PTSD, PPD, and PPA.
I am motivated now to be a mental health advocate. I want new moms (or “this is not my first rodeo” moms – because they are just as susceptible to it too) to know what the signs and symptoms are before they get too far. I want resources to be more readily available and easy to access. I want healthcare professionals to know and understand the appropriate ways to approach patients who ask for help. I want families to know what to look for and how to get a new mom help or support her through her treatment. I have owned my diagnosis and have been empowered to share my story in hopes that other moms don’t have to go down the road I did. Do not be afraid to ask for help, don’t be afraid of the stigma. The process is worth it. Your baby is worth it. You are worth it.