Tag Archives: antenatal depression

Every Mother. Every Time.

14 Mar

Petition

I was in my first trimester of my first pregnancy when antenatal anxiety washed over me like the tide, insidious and unstoppable.  We were living on our own in the midwest at the time, and the loneliness was crushing.  I compensated for my irrational worries by donning a brave face and making light of my anxiety, to both friends and my doctors, and I assumed all newly pregnant women felt the same trepidation and slight panic I was suppressing.

I was 8 weeks pregnant when my OB called me into her office.  My fears and worries were suddenly compounded by a previously-undiagnosed kidney disease.  A giant mass in my abdomen.  And they had no idea what it was.  I taciturnly absorbed all the doctor said and then politely asked for a few moments alone.  When the door shut behind her, something in me broke.  I walked out of there a shadow of myself.  The next 6 months brought a multitude of diagnoses.  I was ultrasounded and MRIed (twice).  I met with several surgeons and had a cathertized void test done.  There were very few cases of pregnant women with my eventual diagnosis of severe hydronephrosis with 1% kidney function, and so few doctors could tell me exactly what to expect or how it would impact my pregnancy.  And that scared me to death.

Six months into my pregnancy, we moved to the North East.  My need for my family (who had moved up to the Boston area a few years before) outweighed my terror at the prospect of moving, but leading up to moving day, I had increased symptoms of panic attack.  I refused to drive while house hunting, irrationally fearful of the alien traffic patterns of our new-home-to-be.  I fought back waves of nausea at each apartment-hunting appointment, instead playing the part of the happy, expectant couple.  The night before our final flight out of the midwest, I became convinced I had a blood clot in my right leg – and the resulting (unnecessary) hospital trip ended in a 2am leg ultrasound for me and a busted blood vessel in my husband’s eye from the stress.  My husband tells me that when I fainted from panic on the 4 hour flight to Boston the next day, he took special notice of the halfway mark in the flight.  “At least there was no turning back,” he says, only half-jokingly.

Unfortunately, arriving in Boston alleviated the anxiety only temporarily.  As I neared the end of my pregnancy, I began having irrational, intrusive thoughts about my husband leaving me.  “He’s only staying until the baby is born,” the lies whispered, “he never wanted a baby anyway.”  I became increasingly irritable and emotional, and finally suffered enough to mention it to my OB, a high-risk, high-profile doctor at Massachusetts General Hospital.  With my mother in the room, I explained my heart palpitations and my trouble breathing.  I outlined my mood swings and my panic attacks.  It took every ounce of courage in my body to admit that I was struggling.

In return, she told me to “stop worrying.  Pregnancy is an emotional time.”

That was it.  We moved on to belly measurements and discussions of pain management during labor.

With only two sentences, she had me doubting my need for help. I suddenly “just wasn’t trying hard enough.”  And I believed her.

EMET Quote

Throughout the course of my first pregnancy, I saw 5 different OBs, 3 surgeons, 2 primary care physicians, and a myriad of nurses and techs.  None of them EVER asked about my emotional well-being, and when I did speak up for myself?  I was ignored.  Dismissed.  And the thing that angers me the most is that MGH has a world-renouned Center for Women’s Health, run in part by the incomparable Dr. Marlene Freeman, an expert in the field of pre and post-natal mood and anxiety disorders.  Sitting in my OB’s office, I was one elevator ride away from help.

Instead, it took me 5 months after my daughter was born – five months of intrusive thoughts about shaking my baby or letting her slip in the bath tub (I would like to emphasize here that intrusive thoughts are distinguished from psychosis by a mother’s ability to recognize the thoughts as scary) – five months of obsessively folding and lining up burp rags and matching bottle tops to bottle bottoms by shape and color – five months of rage and of falling apart behind the scenes before I recognized I needed help.

It’s hard for me to think back through that time because I find myself so ANGRY.  My struggle was preventable.  Avoidable.  Not once during or after my pregnancy was I asked about my emotional well-being.  A few simple questions and an honest conversation with a trusted doctor was all it would have taken.

It’s all it will take… because I am committed to getting new moms the help I didn’t receive.  We need mothers to be screened for antenatal and postpartum mood and anxiety disorders.  Every mother.  Every time.

Please.  For me.  For my daughters.  Go sign this petition.  Then share this post, share the petition and help us make this go viral.

From the petition website:

Suicide is a leading cause of death for women during the first year after childbirth. 1 in 7 women will experience a mood or anxiety disorder during pregnancy or postpartum, yet nearly 50% remain untreated. In pregnancy, maternal mental illness negatively effects fetal development, and leads to adverse birth outcomes such as low birth weight and premature delivery. Perinatal mood and anxiety disorders (PMADs) can impair infant and early childhood cognitive and emotional development. Despite overwhelming empirical evidence, there is no universal mandate for care providers to screen pregnant and postpartum women for depression, anxiety, or family history of mental illness–a well established risk factor. Screen every mother, every time to prevent and treat perinatal mental illness.

If you can’t sign the petition, you can still help!  Spread the word!  Donate to Postpartum Progress!  Ask a new mom how she is REALLY doing.  We can each do something.

Click to Donate to Postpartum Progress

Click to Donate to Postpartum Progress

I Need Your Help

5 Oct

I was seven weeks pregnant when my brain was taken hostage by intrusive thoughts.

“You can’t do this.”

“You’re not strong enough.”

“Just make it go away.”

“What if you just fell down the stairs?”

And then my world came to a screeching halt.  I made doctor appointments.  I reached out to friends and family.  I consulted experts and took two different psychiatric medications.  I made therapy appointments.  AND I GOT BETTER.

I tell you all of this because I want you to know that without Postpartum Progress, I don’t know what would have happened.  I waited over six months to get help after No1 was born.  I was in denial about my postpartum depression, but mostly I didn’t know enough about it, its prevalence, or where to turn for help.  With No2, I ran for help at the first symptom. And because of my vigilance and planning, my pregnancy and birth experiences were healing.  I bonded with this baby in a way I never got the chance to with No1.  Though stressed, I am fortunate to feel like myself these days.

Postpartum Progress gave me the resources, the community, and the knowledge to seek treatment this time.  Through Katherine’s blog, I found a perinatal psychiatrist to walk me though my treatment options.  I found other moms who had struggled with antenatal depression and gave birth to babies that they loved.  Most importantly, I found hope. . . and a sliver of hope is all it takes to break the cycle of shame and fear.

I’ve been lucky enough to meet Katherine in person twice.  How do you say thank you to someone for giving you back your life?  For teaching you that you are not a bad mother, merely a sick one?  There are not enough words to explain that each moment you get to love your children was made possible by the tireless work they do.

So today, I’m asking you to help me thank her.  I’m asking you to help her help moms just like me.  Today is Start Strong Day over at Postpartum Progress.  Please click over, read about the important work she is doing with her nonprofit organization, Postpartum Progress Inc., and considering donating.  There are mothers and families out there who need our help.

Mother’s Day

8 May

My first Mother’s Day was one of desperation.  I was desperate to appear and feel normal.  To want to soak in the whole day bathed in the glow of motherhood.  The pictures I have from that day are bittersweet – I can see the depression and anxiety in my eyes.

Last year, I was honored to write for the Postpartum Progress Mother’s Day Rally for Mental Health.  I wrote my post while not yet knowing I was 4 weeks pregnant.  By the time Mother’s Day arrived and the post was published, my antenatal depression was in full swing and everything I had written – all that truth – vanished behind depression’s ugly curtain.

This year, I am now a mother to two girls.  Two amazing, breathtaking girls.

I have had rough patches since No2’s birth.  She’s suffered from a milk protein intolerance for four months, making even survival a lofty goal at times.  I’ve battled anxiety’s ugly demons often.  But all along I have adored her.  If you’ve never suffered from a postpartum mood disorder, that may sound strange.  But it’s all I ever wanted with No1 – to love her more than I feared her.  

And this Mother’s Day, I have it.

Time Capsule

1 Apr

Prompt: Pretend you’re making a time capsule of you & your health focus that won’t be opened until 2112. What’s in it? What would people think of it when they found it?

The first thing my husband said when I told him I was participating in the WEGO Health HAWMC again this year was, “which health issue are your going to write about?”  We both laughed.  Because you see, I’m a mess.  This year in addition to the anxiety, I’ve battled antenatal depression, have a newborn and thus am guarding against a PPD relapse, have struggled with breastfeeding due to baby’s reflux and my OLS (overactive letdown syndrome), and have injured my back…again.  But the one that still impacts me the most is my anxiety.  Any of my other conditions have the added risk of triggering the anxiety, and possibly becoming worse because of it.

So I’m going to focus on mental health again this year, including postpartum depression, antenatal depression, and generalized anxiety disorder.

I’d like to think that on April 1st, 2112, my time capsule will be irrelevant.  That anxiety and mood disorders will be so well-treated and understood that it will be incomprehensible to anyone who opens it why I have included the items I chose.  That people will look back 100 years to a time when stigma surrounding mental illness prevented new moms from getting help and will regard it as barbaric.  And while neither of those will probably happen, a girl can dream, right?

Bottles of Medication:  If there’s one thing I have really learned during my experience with mental illness, it’s that psychotropic medications carry a heavy stigma.  I didn’t realize how many misconceptions and negative stereotypes I myself held about anti-depressants until I was faced with the decision to take them.  It took me nearly a year to make peace with my need for medication but now? I take my pills without any shame.  I did nothing to cause my condition and I can’t magically wish it away or fix it with positivity.

Now I hope that in 100 years the pills will be a mystery.  But if they aren’t, I’d like to think that they will be considered just a part of a person’s medical care, as necessary as a daily aspirin and just as banal.

Medical Journals and Research: I’d want people 1o0 years in the future to see how far the medical community has come.  You know how they say that you have to learn about history so you don’t repeat it?  I think that’s true.

Photographs: Pictures of moms and their babies – families who have overcome mental illness.  These need to be included.  They serve as a reminder that others have paved the way, proving you can survive and thrive.  I do feel like I’m paving the way for future mothers – perhaps my daughters and their daughters one day.  I want them to see that mental illness is nothing to feel shame about and can be triumphed over.

The Music of Lady Gaga: Just to mess around with the future folks.  I’m sure they’ll look back and wonder what we were all smoking.

Of course, all of these objects will be lovingly contained in a stray baby wipes container.  Cause that’s all I have lying around. ;)

Warning Signs

14 Dec

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.

What 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.

But.

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.

35 Weeks

2 Dec

Only a few more weeks to go.  I have so many blog posts rumbling around in my head…about how hard it is to accept help, about how I keep from yelling at my ever-more-frustrating threenager, and about how much I love this little girl who is about to join our family.

But alas, I’m spending my free time sleeping these days.  I forgot how hard the last few weeks of pregnancy are and my hat is off (once again) to pregnant women everywhere.

I’m done.  So very pregnant and uncomfortable.  So ready to be full-term and for a little girl who will hopefully come just a smidge before Christmas.  I’m nervous about all the big changes about to rock our family.  But I’m also really good – calm, prepared, letting go of my need to have everything perfect, and feeling *normal*.  Any mom who has suffered with PPD, antenatal depression, or anxiety will understand how valuable normal is.  It’s a beautiful thing.

So I’m trying to soak up these last few weeks – because this will be our last baby – and I will miss moments like this:

Invisible Wounds

20 Nov

I recently encountered a mom who took one look at me and assumed I had it all.  And y’all?  I can’t lie.  I have a wonderful life.  I am 34 weeks pregnant with a healthy baby girl.  I am fortunate enough to work from home and for myself, doing a job I adore.  My amazing husband is currently working on his PhD at an Ivy League school, has job security, and is home almost every night for dinner and to bathe No1.  And my first-born is a thriving, energetic, bright little girl who is mostly well-behaved.

I know it must look perfect from the outside.  But like @Hopin2bHappy said to me the other night, “Sometimes I wish I could just open my brain and show them the broken parts. “

Because sometimes?  I feel like I have no excuse to be struggling with antenatal depression and anxiety.  I think people glance at my life and see the house and the cute preggo belly and the crafts and the swept kitchen floor… and decide that I can’t possibly be struggling.  How dare I?  Look at how great my life is, how much I accomplish, how pretty I am, and how my floor and countertops are clean.  (Really, folks, I can’t tell you how often people comment that my floor is clean.  As if I’m sweeping my floor not because I have an anxiety disorder that compels me to sweep every day lest I feel out of control, but because I want to make them look bad.)  I know I shouldn’t care what they think, but it gets to me.

There are days I feel an overwhelming sense of guilt.  Guilt for having so much going right in my life and for not always being able to enjoy it.  So I remind myself of the truth.  Women struggling with PPD or PPA (or any kind of mood or anxiety disorder) are strong, successful, talented, and loving.  We have passions: we bake, we sing, we write, we craft.  We parent the best we can and reach out to help others despite our pain.  We work: for ourselves, for companies, for our families.  We are normal people dealing with an extraordinary situation.  The depression strikes despite all we have going right in our lives.  It literally prevents us from being able to enjoy our blessings and windfalls.  That’s why it’s called a mood disorder.

I realize that if you haven’t walked in my shoes, it’s impossible to truly understand where I’m coming from. I get that it’s a complicated subject, and often uncomfortable for people to discuss.  I’m managing the antenatal depression and anxiety well these days, but it is what I spend 80% of my energy doing.  They are always humming in the background, challenging my daily tasks with their lunacy.  My wounds are invisible, I know, but they are so very real and so when asked, “how are you?”  the answer is “I’m okay.  I’m in survival mode, but I’m doing okay.”  I choose authenticity, and I hope in response you choose compassion.

Rainy Day Letter

4 Sep

I adore my #ppdchat mamas.  ADORE.  I haven’t met any of them in person (yet!), but our common struggle has become our bond.  There’s a safety in the anonymity of the internet, and although I don’t post anonymously per say, these women aren’t involved in my daily life.  They don’t know my friends and family, and because of that separation, I can say things to them I might not say to anyone else.  Also?  They get it.  Really get it.  As much as my IRL support network may try to understand, unless they have lived with a postpartum mood or anxiety disorder, there will always be a part of me those folks will have to wonder about.

Not only to these mamas know just what to say, their stories resonate with me, giving me a sense of belonging and worth.  I admire them for who they are as mothers and women – their struggles do not diminish their worth in my eyes – so why should I allow myself to feel any differently about me?

Story’s Rainy Day Letter (posted on PPD to Joy) struck a chord with me.  She asks only for Peace and Purpose, giving herself permission to be who she is and to have bad days, while making a point to remember her progress.  What a beautiful idea, inspired by Yael’s post, The Opportunities in Setbacks, to write a letter to yourself to come back to when your truth is mangled by depression and anxiety rules your heart.

I hold so much hope that PPD will not take me away from myself and my family after baby girl #2 is born.  I am beginning to feel more confident that the antenatal depression is managed and that I will continue to not just survive, but thrive, as I have been.  But I don’t want to be naive.  Depression is a sneaky SOB that warps your reality, twisting the truth until you aren’t sure who you are anymore.

My defense?  Knowledge.  Preparation.  Medication.  An army of doctors.  Support of loved ones, on and off-line.  And this: my rainy day letter.  I’m honored to have Yael Saar add my letter to her collection of hope over at Postpartum Depression to Joy.  I’d be honored if you’d click over and read it.

CLICK HERE for my Rainy Day Letter

Yael Saar lost her mother to postpartum depression when she was 6.Years later, when she had kids, guess what? Yael struggled with PPD as well. She survived it and became a silly-side-up mama on a mission: to disarm postpartum depression and anxiety by removing guilt and shame from parenting. Yael shares her story (with coping skills on top) at www.ppdtojoy.com. She is @yaelsaar on twitter and www.facebook.com/ppdtojoy on facebook.
Yael hosts a monthly ppd support phone chat called the PPD SpeakEasy. It is free, confidential, and loving. This chat happens on the 2nd tuesday of each month at 8:30pm Eastern. In September, to celebrate her birthday, Yael will be holding 3 SpeakEasy chats. For more info and dates click here: http://www.ppdtojoy.com/support/speakeasy-call/

[Photo Credit: eikaiwa-blog.blogspot.com]

Why You Didn’t Know

21 Aug

After my two posts on Antenatal Depression (Part 1 Here and Part 2 Here), so much love came my way.  That’s the beauty in being vulnerable – putting your truth out there and finding out that you are not less for it, but more.  I had many friends comment online about how brave I am to share my story (there’s a whole post coming on that) and others call to just check in on me.

I also had a few folks mention casually, “You know, if you ever need anything I’m just a phone call away.”  Not during a discussion of the blog posts or even the depression or pregnancy, but just as an aside to whatever conversation we were having.  I realized that they must have been wondering.  “She sure didn’t look depressed.  Did I miss something?  Why didn’t she tell me?  Why didn’t I know?”

The first time around, nobody knew.  I even had friends say things like, “Well, at least it’s not postpartum depression.  You sound like you’re doing okay.  Everybody has rough days.”  Even my mom had no idea, and she saw more of the real me than anyone outside of my husband.  I worked ferociously hard at appearing fine.  I showered, dressed, straightened my hair, and went to playdates, the mall, and the grocery store.  From the outside, I really did seem fine.  And to a certain degree, I was.  One of the misconceptions about PPD (or depression in general) is that you have to be miserable all the time – and usually people think of crying – to be diagnosed with depression.  I logged many, many hours of tears in that year, but my PPD manifested itself as anxiety and rage more often than not.  And some days, I would feel alright, especially those days I was able to get showered, dressed, and out the door.  It is a complicated mood disorder, hard enough for medical professionals to diagnose, let alone friends and acquaintances.

This time?  As soon as I found out I was pregnant, I called one of my besties.  I shared my good news and my joy with her, and eventually my anxiety, too.  I asked her that very first day to check on me throughout the pregnancy – to be honest with me – and to help me stay myself this time.  The moment I felt numb, I took notice, told my husband, and made an appointment with my doctor.  I let my mom know I was feeling overwhelmed and anxious and explained I was going back on some medications and would need help while dealing with the side effects.  I rallied my online support army (love you, #ppdchat mamas!), called my old therapist, and started journaling.  But I also allowed myself some peace and quiet.

I tend to hibernate when I’m feeling depressed – I withdraw and need space, and I know that now.  So I didn’t broadcast my new antenatal depression diagnosis on Facebook, or start conversations about it with my casual friends or neighbors.  In the last 5 months (I’m FIVE months pregnant, people!  How did that happen?), when I’ve been asked how I’m doing by someone who really wants to know, I haven’t faked being fine.  My answer is sometimes “I’m pregnant…so um… I’m excited, the baby’s doing great, but pregnancy is hard on me and I’m doing my best.”  And yet if someone catches me at the right moment, I might honestly be able to say, “I’m doing really well and feeling pretty good.”  It’s all a matter of timing.

There is freedom and value in having some of the people in my life not know.  As much as I needed support to get through these last few months (and to where I am now), I also needed to feel normal.  I needed to work – to teach and play music.  I needed to be able to have casual conversations with my neighbors about their kids and the weather.  I needed my extended family to just be excited about the pregnancy, without worrying about any mood disorders, because their joy was contagious.  So if you didn’t know I was struggling, it’s not because I didn’t trust you, or that I felt ashamed.  Your not knowing has helped me just as much as the emotional support of the folks who did…just in a different way.

If you want to know?  Ask.  Really.  I’m over feeling ashamed about a mental disorder I did nothing to deserve and couldn’t have prevented.  I’m more than happy to explain how I’m making progress and to shed light on a topic shadowed in stigma and misunderstanding.

Thankfully, these days, if you ask how I’m feeling, chances are I’ll be able to say I’m good.  Really good.  And I’ll be able to mean it.  So thank you – thank you for being there for me, whether you knew I was hurting or thought I was fine.  Either way, it was just what I needed.

Antenatal Depression, Part 2 – Where Do I Go From Here?

7 Aug

Antenatal Depression, Part 1 – The Steep Descent can be found here, on the new WordPress site. ..  And here, on the old Tumblr site.

I thought I would have more time.

When I found out I was pregnant, I had immediately started thinking about the possibility of the PPD returning.  I spoke with my doctor, let my close friends know I might need help, and started planning to be proactive.  I thought I would have 8 months to prepare…to ready myself and my family…to batten down the hatches.  So though everything, from the symptoms to the treatment, was familiar, I felt blindsided when the depression and anxiety returned only 7 weeks into the pregnancy.  The hopelessness was crushing.

And then I remembered…hopelessness is a symptom of depression.  As tangible and debilitating as it feels, it isn’t real.  Two years of therapy trained me to separate myself from the symptoms.  And somewhere deep down I knew that if I could get just a little bit of that hope back, I might have a chance.

So I got online.  As strange as it may sound, hope lives in this little corner of the internet created by Katherine Stone over at Postpartum Progress.  Her blog brings survivor stories, honest discussion, support, and resources to mothers suffering from postpartum mood and anxiety disorders.  And sure enough, not only was I able to read story after story from women who had fought and won their battle with antenatal depression, I was able to find the name of an area psychiatrist specializing in medication use during pregnancy.  If I had to fight this again, I was going in armed with the best damn arsenal I could find.  This was a familiar foe, one whose pattern of destruction I knew well.  The hopelessness lifted just enough to let me think I just might have an advatage in the fight this time around.

Surely this specialist would have a magic answer for me…perhaps a magic pill.  One without side effects and that provides immediate relief.  Made of unicorn horn and fairy dust.  Maybe she would tell me I could stay on my old meds.  I don’t know…I guess I was honestly hoping for a miracle.  When she told me she wanted me to do exactly as my regular psychiatrist prescribed, I was disappointed.  Certainly psychotropic medications were unsafe during pregnancy, right?  Wasn’t I going to hurt my baby by taking them?  Wouldn’t the side effects be too much to bear?  She spent an hour covering relevant studies regarding the safety of SSRI use during pregnancy, interpreting both the results and the validity of each study.  She told me of countless patients who had experienced little or no problems and had benefited greatly from treatment.  And then she won me over with two simple statements:

1. I could choose to expose my baby to medication, which carries the risk of some very rare complications.  Or, I could choose to expose my baby to the depression, which would likely lead to complications including low birth weight and premature labor, not to mention issues after the birth.  Put another way, there is no such thing as non-exposure.

2. If I worked with my doctors to find the best treatment now…if I did the work in therapy and took care of myself, she felt I had a very good chance of recovering and then having no PPD after the baby was born.

The thought of being able to enjoy the new baby, of being able to care for myself and my family, and to continue to be my husband’s partner instead of needing him to care for me – it brought me to tears.  I was ready to give it a shot.

The side effects came in like the tide: unrelenting.  And just as I had predicted, they were torturous.  On top of morning sickness and the normal lethargy pregnancy brings, the meds caused headaches, nausea, and zombie-brain.  I had trouble putting sentences together.  DoodleBug spent hours watching PBS.  I can’t even guess at how many frozen pizzas and cans of soup we ate for those three months.  I struggled with all of this while my reality was warped by depression.  So even though I started to feel like a terrible mom and I worried I would never feel better, I had to hold on with a death grip to what I knew for sure: the side effects would go away.  The medication would eventually begin helping.  Sometimes with depression, all you have left to do is wait.

It was a long three months.  But what I learned from last time was that even though I wanted to hibernate, I would need a support network.  Not only has asking for help always been a challenge for me, the shame that accompanies depression makes it hard to share with friends and family.  But this time, I did it anyway.  In fact, I showed up on my best friend’s doorstep in tears.  She answered the door in a towel and I poured my heart out to her.  I called my old therapist and made an appointment.  I reached out to my #ppdchat army (shoutout, ladies!), who understood how I was feeling and knew just what to say.  I let my family know I was having a hard time, and asked my long-distance bestie to check on me each week.

Today I am 19 weeks pregnant with a little girl.

I find myself rubbing my belly and talking to her when she kicks.  I revel in the moments when DoodleBug lays her ear on my stomach and swears she can hear the baby.  I’m finding it easier and easier to laugh.  We’re thinking of baby names.  And now instead of comparing this pregnancy to how I felt the first time and feeling guilty, I feel empowered.  And yet.  Pregnancy is still hard for me, physically and mentally.  I recently had a string of bad days that led me to talk to my doctor and increase one of my medication doses.  I will probably have more.

I do many things with ease – math, friendship, teaching – pregnancy is not one of them.  But I know now that I don’t have to do this gracefully.  This will be a long road with many difficult weeks, but at the end of the day, all I have to do is grow a human being and get it out somehow.

I’m prepared to increase medication doses as my body changes.  I’m ready to put a plan in place to ensure I have support after the baby is born.  I’ve accepted the possibility that the PPD may return after the baby is born and I may need to change medications or therapies.  But for now, my anxiety is manageable.  And although tired and sometimes moody, I am no longer hopeless.  I can separate myself from the symptoms and identify when I need to ask for help.  But most importantly, this time I know I am not alone.  Not only do I have an army of friends, family, and online mamas ready to help me fight (fist-pump time!), but through being vulnerable, I have learned that I am worth the fight.

I CAN do this.

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