Monday, December 16, 2013
A Post about Postpartum Depression
Last week a friend asked me how I'm feeling about the impending arrival of our little baby girl. I found myself stumbling over my words as I talked about feeling excited, but also about feeling nervous. With both of my kids I've had a healthy dose of postpartum depression and while that doesn't necessarily mean I will this 3rd time around, I also know the chances are good that I will. And while I've tried not to let those fears dominate my thoughts, it's hard not to worry about it to some extent. As I was talking to my friend I realize that often I feel shame for feeling this trepidation at a time when it seems I should only feel excitement, thus the stumbling over my words. Intellectually I know PPD is not something I should feel guilty about, but sometimes I do. So while I've talked about this in the past, I don't think I've ever put it out there in it's entirety and I'd like to do that today. One, to help ease my own shame and fears surrounding PPD and two for anyone else who is currently going through something similar or who has in the past. If nothing else, I hope by sharing my experience you'll simply know that you're not alone.
Let me start by explaining that as a first time mom I didn't even really understand what postpartum depression was about. For some reason (you'll probably find this laughable... I do now) I thought the depression a woman felt after giving birth had to do with the 'parting' of the baby and her body--thus 'postpartum'--and that it was directed to this loss of closeness, of actually having the baby in your body or something. Seriously! I really didn't know or understand why someone would feel sad after having a baby, so I thought that might be why. And in a way, it is about that separation... about the sudden and daunting responsibility and all the overwhelming things that come with caring for a tiny, helpless human who was somehow so self-sustaining in that cozy little womb. I mean, babies just put themselves to sleep in the womb, why can it be SO hard getting a baby to sleep once they're out? Not to mention the eating, burping, and changing of diapers.
With my firstborn I decided I wanted to try for a natural birth in a hospital based birthing center. And that is what happened. I delivered my daughter on a cold, February Sunday morning in a mid-town Manhattan birthing center. Upon talking to other moms and hearing other birth stories, I had heard about that moment. You know that moment when they place the baby on your chest and that overwhelming feeling of love and joy that just envelopes you immediately as you meet your new baby for the first time. I was really looking forward to having just such an experience. After about 36 hours of labor and an hour of pushing my daughter popped like a cork and as they placed her on my chest my first thought was, "It's over, it's over...thank goodness it's over. Why would I EVER do that to myself again," referring to labor. My first thoughts were of relief because really I think my body was in shock. (Although for the record I'm glad I had a natural birth--another discussion for another time.) As for my precious baby girl laying naked and squawking on my bare chest I felt...well not much. I didn't know what to feel, but I know I didn't feel that overwhelming sense of love and joy so many other first-times moms seemed to feel. Instead I just felt overwhelmed. I was weak from 2 days of sleeplessness and hours of hard labor, and overwhelmed at the sudden responsibility this tiny, red-faced human now brought into my life. She was here, and I didn't know what to think. Having a rather complicated relationship with my own family certainly played into my psyche, as I did not have confidence in myself as a mother. I just sort of hoped I would feel this natural mothering instinct kick in. But it didn't.
The first few days were OK... she slept a lot and I was fine. Nothing too crazy. By day 5 I was a mess. Crying off and on the whole day and not really knowing why, only knowing that I felt sad. Why was I feeling sad? Nothing bad had happened, rather something good had happened. In fact, one of the best things in the world had happened, but all I could feel was sad.
That word, overwhelmed, would define the next few weeks and months. My life now revolved around a fussy little baby who was not only unpredictable, but didn't actually seem to like me very much. She was hard to get to sleep and to stay asleep, and she was hard to feed and in-between those two things there was little time left for anything else. By this point I understood why women felt so sad after having a baby. I was prepared for hard and I knew babies were work, but I didn't know it was THIS hard and I didn't know that they were THIS much work. Yes she was cute and I loved her in a very dutiful sense, but I wasn't an over-the-moon-obsessed-with-my-baby new mom type of love that seemed to emanate from so many other mothers around me. Clearly, I thought, something was wrong with me.
A lot of people told me to give a couple months and it would get easier. I would say it didn't get 'easier' for about 5 months and it would still be until she was 8 months old before I had that totally-in-love, obsessed-with-my-baby, I-love-being-a-mom feeling. 8 months.
Things with my second daughter were different. Obviously we had a very crazy pregnancy finding out that she would be born with special needs (at the time we didn't know what to call those needs and we didn't know the extent of what her needs would be). However, by the time of her arrival we were excited and ready to meet this sweet little girl. She was born 3 weeks early via c-section as our Dr. was concerned about possible complications. The c-section and recovery were actually quite easy and my first few days with my baby and I in the hospital were a dream. She was a calm, quiet baby who was sweet as can be. And because I was now well acquainted with that motherly love and I felt infinitely more confident in my abilities as a mother, I wasn't paralyzed with overwhelming fear and uncertainty as I had been my first time around.
In general things were going great. The weeks rolled by as family came to help and everything was going well. Lamp was definitely an easier baby than PSP had been. She slept better, she ate better and was overall just more calm. She could be awake and not cry! This was amazing! However, she was still a baby and even 'easy' babies have their hard times. Right around 6 weeks--when the last of our family was leaving and B was returning to a longer work schedule (he had an easy rotation at the hospital during the first 5 weeks of Lamps life and was home very early every day)--I started to feel that familiar uneasiness. I was certain the postpartum fairy wasn't going to visit me this time around, but anxiety and fears started to creep back in. Finally it hit me and one Sunday morning I was laying in bed shaking, crying and pleading for my husband to help me. I wasn't feeling sad or like I just didn't want to do it, I was completely mentally paralyzed and knew I couldn't do it. My mental state was such that I could not have been more incapable of taking care of my baby had I been in a full body cast. That's the best way I can think to describe it.
Two different babies and two very different experiences. Here's how I handled them.
The first time around was less paralyzing, but longer and characterized by sadness and a constant feeling inadequacy and everything being difficult. Looking back I definitely had a lot of irrational thoughts that also seemed to characterize that period as well--thoughts like when my baby woke up from a nap I would wonder, What if she never sleeps again? And in my mind, that was a real and legitimate concern. Or rather than just recognizing that she was fussy, I actually thought she didn't like me and that I was just an annoyance to her. Irrational thoughts like those tell me my brain just wasn't right.
I came up with a game plan during this time to help me through this difficult period. Here are some of the things that helped:
1) Getting up, showered and ready every day. This included doing my hair and makeup. For some reason just looking my best, helped me feel better.
2) Getting out of the house every day. Even if just for a walk around the block. Living in NYC and being on the tail end of winter, I couldn't stay locked up in my small apartment all day or I'd go crazy.
3) Reaching out to other moms. This was big--I emailed, called, and talked to anyone who was willing to talk. It helped to know that other new moms had struggled, or were struggling. It helped to share my feelings and ask for advice and tips as well.
4) Doing what I needed to in order to survive and reduce anxiety. This may sound strange, but I think every mom has their 'things' or their trigger points for stress and for me, it helped to do certain things to counter those triggers. For example sleep is a huge trigger point for me--yes night sleep, but also naps. With both of my kids but particularly my first, I kept actual sleep logs on excel spreadsheets tracking nap/sleep times. I did this for months! Sure it's a little crazy, but it's completely harmless and it really helps me feel better. I think it gives me a certain sense of control over the uncontrollable and having a visual also helps me establish a schedule and notice patterns as the baby starts to become more predictable. As long as it's harmless I try to give myself permission to do crazy 'survival mode' tactics without worrying about what other people think or even if I myself think it's a little extreme. Additionally, I become the crazy-nap-lady when I have a baby. It's not always convenient and our schedule sort of rotates around the baby, but that is part of easing my anxiety--so I do it. For other moms this feeling of life revolving around a baby's nap might do the exact opposite as it does for me--perhaps that will throw her further into PPD! We're all different! And our babies are different! The point is, I do what I have to do to cope as best as I can and I try not to let the judgement of others get to me, and conversely I try not to judge others for doing the baby thing differently from me.
5) Finding ways to still do things I love or that bring me joy. Sometimes it's as simple as putting on head phones and listening to music I enjoy, other times it's getting out for an hour by myself. You may not get a lot of these little moments in the beginning, but trying to make room for little joys helped a lot.
The second time around the PPD was much more short lived, but also much more severe. I now realize I was on the brink of a mental breakdown and I needed more than just lipstick and a walk around the block. Here's how I tackled that second bout of PPD.
First, around 5 weeks as I started to feel that uneasy feeling I talked to my husband and a good friend and decided to get on medication. It was difficult for me to make this decision, but I also know I was willing to do whatever it took to be mentally healthy. However, by the time I started medication I was already sinking fast. So that one Sunday morning, as I lay in bed shaking not knowing what to do, I called a friend from my church. I called this friend because I knew that somehow she would help me, I didn't know exactly how, but I knew she'd help. I told her point blank that I needed help. She listened and asked what I needed. I told her that what I really felt like I needed was someone to just be there. I wanted someone who could be with me, at my house and act as a safety net 'just in case'. We hatched a plan and immediately I felt relief--not all the way better, but I knew it was going to be OK. I guess that would be step 1--recognize that you need help and ask for it. So that first week my friend came, with her three kids, to my house at 8 in the morning and stayed until B got home around 5 or 5:30 in the evening. She stayed all day, every day for that first week. The first few days she sent me out of the house while she took care of my kids (and hers!) and let me get some space and time to myself. The next week she came every day, but didn't stay as long and the week after that she came a little less. By the end of those 3 weeks I felt ready to handle it again. Yes I was still on medication and perhaps it had kicked in by then and was really helping, but if I had to bet which was more helpful to me it was my friend who was willing to be there for me when I really needed her. I asked her what we would do if I needed more help and she said we'd figure it out--we could get other people from church to help and we'd figure it out. I can honestly say thats one of the most serviceable things someone has ever done for me. It literally felt life saving. And while it wasn't easy asking so much of someone, I'm glad I did. I really don't know what would have happened if I hadn't asked for help.
So what am I doing to prepare for another case of PPD this time around?
1. I'm praying, asking for help and insight and doing some mental preparation for when the baby comes. For example, I walk myself through past newborn baby experiences to help me mentally cope with them if/when they should come up this time around. The thing about mental health is that when you're in the moment, you can't reason your way out--things that seem like 'no big deal' to me right now become catastrophic in the moment. If you have never experienced these sort of mental chains, it's likely you don't understand how debilitating they can be. So right now, while I am feeling healthy and strong I try to talk myself through scenarios from past babies in order to help myself have some pre-PPD ways of handling the stress.
2. I'm prepared to get on medication again if needed. Like I said, I don't know how much the medication helped with baby Lamp, but I'm willing to do just about anything. This time around I may consider some alternative choices before medication--like acupuncture, for example. So we'll see.
3. Scheduling family and paternity leave around the time I think I'll need the most help. We've asked for help from my mom and from my in-laws both of whom came after the births of my other children. The difference is that this time I've asked them to come a little later in the game--we're shooting for them to be here around the 4-6 week mark instead of right away as this seems to be the period when chaos and stress really kick in for me. In the immediate aftermath my husband has a pretty generous paternity leave (generous compared to our past options at least) and he has many vacation days saved up that he can use as well if/when I feel like I need him around in between his leave and our parents coming.
4. Lastly, and probably most importantly I sent out an email to a few friends giving them the rundown of my history and asking for help if/when I should need it. Again, this is not easy! But I'm lucky to have wonderful friends who I know will be there if I need it and addressing it before it becomes a problem actually helps ease my worry now. They were all so great in letting me know that yes they would be there, here are the days/times that would work best for them and their schedules and just to let them know what I needed.
I really hope I don't have to sound the alarm too hard this time around, but just feeling prepared, having a plan and asking for help ahead of time has relieved a lot of the pre-baby stress I was feeling. That being said, it doesn't erase the anxiety completely, but that's OK. What about you? I'd LOVE to hear your thoughts on PPD--how it affected you (since I think it affects each of us in different ways), how you coped and any other methods, tricks, advice, etc. for getting though those initial crazy weeks. Also, I think the actual baby has a lot to do with PPD--how fussy/calm they are etc. Thoughts?