This pregnancy has been completely different from my first. Easier. Less stressful. More joyful. Don’t get me wrong, it’s been an uphill battle, and I’ve had some of my very lowest points during this journey, but with the right medical care, therapy, support, and medication, I feel like I’ve experienced a *mostly* normal pregnancy this time around. I am so grateful for all the help I’ve received and so proud of myself for all I’ve done to stay healthy and happy. But also? I look back at pregnancy number 1 and want to scream in frustration over all the warning signs I missed. I realize that I did my best last time, and even more so, that patients cannot expect to self-diagnose mood and anxiety disorders. But hindsight sure is 20-20, isn’t it?
Because I have seen what a contrast my two pregnancies have been, I feel hopeful that my postpartum experiences can be different, too. And like I’ve said before, this time I’m prepared. Armed. And I want the people around me to feel armed too.
I’ve spoken with my friends and family. I want them to know I’m wary of the PPD returning and that I will need their help to stay healthy, but I don’t want to feel like I’m being babied or watched over unnecessarily. Even a normal postpartum experience can include mood swings and tearfulness. When I talked with my mom (Hi, Mom!), she said she looks back now and feels like she missed signs, too, and she wanted to know what to look out for.
should we have seen before did we miss because we didn’t know? What do I want my friends and family to watch for?
- Inability to Sleep: Even when someone else was caring for No1, I couldn’t sleep. I was too anxious and my mind spun with a million thoughts. And the sleep deprivation was a huge trigger for me. This time around, I’ve asked my mom to stay some nights with us early on, and I plan on being flexible about feeding No2 in a way that lets us all get some rest.
- Control Freak: I could not let anyone else take over for me…with the baby, with household chores, Christmas shopping. I had to do it all. Part of me felt like I was supposed to be able to do it all, like I had something to prove. I remember distinctly telling my mom not to do the dishes and feeling like an enormous failure when she cleaned my bathtub. I had to pack the diaper bag because I was certain hubs could not do it well enough, and I struggled to let anyone else care for the baby. This time, my mantra is “I’m pregnant (or I just had a baby) and I shouldn’t have to <insert your least favorite chore here>.” I’ve come a long way in the last three years and feel like one of the biggest changes I’ve made is my ability to let go of perfection and to accept help.
- Rage: This was the scariest of my symptoms and one I think very few people were privy to. The littlest things would set off a chain reaction, causing me to spiral into an Incredible Hulk – worthy temper tantrum. Missed naptimes were the biggest trigger. The quality of my entire day hinged on how many naps No1 took and how long each was. The anger was directed at the baby for not sleeping, at hubs for not matching the bottle tops and bottoms by color, at drivers on the road for running red lights…at anything and anyone. And it was terrifying. I became unrecognizable. These days it takes quite a bit to trigger any kind of temper, and I truly hope it stays that way.
- Fear: This sounds ridiculous, but for a while, I actually felt afraid of my baby. Afraid that I didn’t know how to take care of her and afraid that she didn’t love me. At times I thought she was trying to make my life difficult, and I expected way more out of her than a baby can give. My confidence was nonexistent as a parent. I remember once my husband telling me “caring for a baby actually isn’t all that hard, when you take the emotion out of it.” I still think it’s a simplification, and at the time he said it, I was offended and hurt. But you know what? There’s a little truth in there. My fear was making caring for No1 so much harder than it had to be.
- Lack of Confidence: I know new moms read a lot of parenting books. In fact, I believe that there are an awful lot of people capitalizing off of the lack of confidence most new moms feel. But I did more than just read a few books. I read all of them, certain one would have “the answer”, because I certainly didn’t. I lacked confidence in how to feed my baby, how to get her to sleep, and whether or not to use a pacifier. Basically, if there was a book about it, I was sure I was doing it the wrong way. It wasn’t until the fog of PPD and PPA lifted that I started to trust my instincts and it turned out, they were pretty darn good! I’ve noticed that when I start to have an episode with anxiety or depression, my confidence is the first thing to go. I doubt every parenting decision and the worthlessness creeps in. What I know to be true fades into a complicated mess of confusion. I anticipate needing advice about having two children – and I’m sure I’ll pick up a book or two along the way – but if I start to feel like I *need* them to parent, I’ll know something is amiss.
- Inability to Deal with Noise: This is a common trigger for many of us on #ppdchat. Noone likes a screaming baby, but with PPD or PPA, the sound is torturous, quite literally. These days, I can listen to my toddler holler, yell, and scream at me and as long as I know she’s not physically injured, I can walk away, put in some earplugs, and wait out the storm. I’m sure I’ll still be triggered by the baby’s crying, but I hope this time around, it doesn’t completely shut down my brain like it did the first time around.
- Tearfulness: This one’s tricky, because I think it’s what most people expect to see when someone they love is depressed, but it wasn’t my main symptom. Yes, I would cry, but it was often mixed with the rage or came after an episode of explosive temper or anxiety. It’s still something I want my loved ones watching out for. If I’m tearful and extra-sensitive (especially to criticism) for longer than a couple of weeks after No2 is born, please check in on me.
- Shutting Down: This one’s from my husband. I asked him what the worst symptom was and he said it was that he worried that I would shut down when I needed to care for No1. For a while, I stopped being able to bathe the baby, go to doctors appointments, or run errands. A pile of unfolded laundry would sit, wrinkling, because it seemed like too big a task to undertake. The anxiety made everything seem overwhelming and my husband had to take over for me. I expect to need help, but not for irrational reasons.
Quite honestly, I’ve done a bang-up job of recognizing symptoms over the last 9 months as they appear and asking for help immediately. I’m extremely optimistic that should I take a turn for the worse after this baby is born, I will know it and continue to reach out to my support network. I’ll be under the care of both my psychiatric nurse and therapist and I have the contact information from an amazing perinatal psychiatrist at MGH who specializes in postpartum mood disorders.
I know that my brain overreacts to hormones and the postpartum period is an especially vulnerable time, specifically when you’ve suffered from PPD before. PPD is a sneaky little bastard and at its worst can make you believe things that you know to not be true. Denial is one of it’s most vicious weapons, and so I’m not going in alone.
How can you help? Please ask me how I’m doing. Check on me. Ask me how I’m sleeping and if I’m letting people help. Ask me if I feel supported by my husband and if I’m connecting with my daughters. Remind me to come here and to read the blog and to take my own advice. And if, as I hope it will be, my answer is that I’m doing well…trust me. Let me be okay.