Monday, February 10, 2014

Postpartum Update

                                                                                                                                 Photo credit Mark Warnick



How are you doing?
So, how are you feeling?  Everything OK?
Do you need any help?


I've been getting these questions a lot, especially since my post on postpartum depression.  It's been so nice to feel loved and more importantly, to know there is help there if I need it.

As this baby girl is 7 weeks old today(!!) I thought I'd do an update about how I've been doing so far.  Hopefully this will be helpful to someone out there.  Of course I'm no doctor and I'm not trying to pass off my experience as medical fact.  This is just me sharing my experience hoping that it may be helpful to someone else out there.

To begin, I'm going to rewind a bit...

Almost immediately after I wrote my post on PPD I started to feel anxious.  I'm really glad I wrote that post, as it seemed to resonate with a lot of people, however retelling every little detail also seemed to jump start my anxiety.  While walking with a friend one night and talking about my experience with medication after the birth with Lamp she asked, Why don't you just get on medication now?  She wasn't the first to ask.  I once again recounted how really, the medication probably didn't hurt, but I think it was my friend coming to my rescue for three weeks that really made the difference.  

Then I said, It's not like I didn't have difficult things to deal with after those three weeks.  I mean Lamp went from sleeping 7-9 hours a night, to waking up every two hours... then she had surgery and was in and out of the hospital... it was all really stressful, but it didn't throw me back into a tailspin.  A lightbulb went off... I can't believe I didn't realize it before, but for the first time I thought, maybe the medication did more for me than I thought.  I had always assumed that I just had a rough patch that I just needed to clear and that I did clear that with the help of my friend.  It almost sounds ridiculous not to have seen it before, but that night I finally realized (or maybe finally accepted) that medication really had made a difference.  With that surprising conclusion and after talking to a few people, including my doctor, I decided to get on medication this time around as soon as the baby was born.

So how has it been?

Great.  This is the best me I've ever been at 7 weeks postpartum.  Just writing that out feels like a dance-by-myself-fist-pump-in-the-air-a-la-Kevin-Bacon-in-Footloose moment.  Is it all behind me, has the fat lady sung?  I don't know, but I'm going to celebrate the here and now.  As I stand right here and right now, I'm feeling great.  I'm tired but not exhausted, my plate is full but not overwhelmed.  This is no small thing my friends.  

If you or someone you know is struggling after the birth of a child and you're not sure if medication would be helpful here are some thoughts I'd like to share.  There are many things you can do to fight PPD (I mentioned quite a few things that help me in my post about PPD) that don't involved drugs but since I know I had a lot of reservations about medication (and many people do) I'd like to focus on that specifically.

First, it's all about preparation and in order to prepare you have to be honest with yourself.  Honest about your feelings, fears, stress triggers, etc.  If you've had PPD in the past, there's a good chance you'll have it again.  If you don't have it again that's great!  But if you do, you might as well be prepared.  Asking for help isn't weakness, especially after having a baby.  It's not just about you, it's also about your family.  If you have a hard time asking for yourself, ask for the benefit of your family.

However, it can be really difficult to even recognize you have PPD, especially if it's your first baby.  Which of course makes it all the more difficult to take the next step of seeking help.  In fact you may not even realize you have PPD until after the fact.  I know that's how it was for me with my first baby.  I also had a friend who recently had the same experience--she had PPD but she didn't realize it until it was over.  Another problem might be that you resent the label of 'postpartum depression.'  I know I was insistent that I did not have it the first time around and I was upset at the doctor who suggested otherwise.  Was I in denial?  Maybe a little.  But it's also hard to recognize a mental health issue when you've never dealt with it before.  My advice is to talk to a friend or family member, and then talk to your doctor or midwife.

My first measure of preparation was getting the people in my world lined up for help and support.  It's important to have the people around you who really know you aware of your concerns and past struggles because you might need help recognizing that you need help.  Also it was really great having my husband home for almost a month and then having my mom here, followed the next week by my in-laws.  I'm really glad I had our parents hang back a bit and come around 5-6 weeks as I know many babies hit their fussy period around that time.  And of course I'm glad I emailed my friends ahead of time, giving them a heads up and asking for their support as well.  It's not easy asking for help, but it's better than the alternative.    

Now about medication.  To be honest, the only reason I was so open to taking medication this time is because I took it after Lamp was born.  It was a really, really big deal for me to take medication for PPD as I've never taken medication for anything related to mental health and there were several reasons why I was hesitant.  In a way it felt like a cop-out, like Well life is always hard after you a baby, why should I take a pill to make the hard things go away?  I can't just take a pill every time life is hard.  My other hesitation was that I wasn't someone who had struggled with mental health before.  Sure I'd been depressed and had gone through hard times, but I had always managed on my own.  Getting on medication felt like I was admitting to being weak or something.  And frankly it's scary to admit to yourself, let alone others, that you feel so fragile you needed help in a big way.  Like a lot of things I was also afraid of the stigma, which is strange because I have friends and family who deal with depression and I certainly don't think they're weak.  In fact, quite the opposite.  But part of the problem of having something like PPD is that the very thing you need in order to reason--your brain--is the very thing that is not working correctly.  Lastly, there was a part of me that wondered how it was going to help--I mean it's just a pill, it's not going to take the difficult parts of having a newborn away.  The fact that it took me this long to realize a pill could have such a drastic effect on my overall well being tells you how little faith I had in medication.

So what does medication do for me?  How does it make me feel?

Normal.  Medication makes me feel like my normal, usual self.  That's all really.  For me, at least.  As I mentioned above it doesn't take away the hard things about having a baby, it just releases me from constant anxiety and irrational thoughts that seem to surround me after I have a baby.  Instead of feeling overwhelmed I know I can handle it.  Immediately after having this little one I was still shaky--and I mean physically I felt jittery and shaky.  It took a couple weeks, but once the medication kicked in I no longer felt those sensations.  Admittedly this baby is our easiest baby so far, which also helps immensely!  But she's still a baby and we still have our difficult times--unexplained fussiness, difficulty falling asleep, etc.  In the past a bad day or a bad morning would fill my mind with doomsday thoughts like this baby is never going to nap again or I would imagine a crying, fussing baby all day long for months on end.  After Lamp was born those thoughts built up a well of anxiety so deep and crippling I was no longer able to see my way out of it.  Now if I have a bad day I can rationally understand that it's just an off day, it's not forever.  If baby doesn't stay down for a nap, I know she will another time.  Clarity, the ability to reason and the confidence to know I can do it... that's what medication has given me.

Additionally with the mental barriers of anxiety removed I actually enjoy my baby and this newborn stage.  In between the feeding, burping, cleaning and napping I stare into her dark eyes, talk and coo, and know that my ability to feel the wonder and joy of getting to know this new little person is a gift from the modern medical gods.  

I've talked to a few friends who have dealt with PPD--3 that I can think of specifically.  All of these women were seasoned mothers having depression with their 3rd or even 5th child.  Yet all their situations were different and like me they each had reasons for not going on medication, anything from wanting a more holistic approach to not realizing they were dealing with PPD.  Each one of them said that in hindsight they wished they would have gone on medication... which is why I wanted to share my experience with you today.  Perhaps you've thought about medication but have fears and reservations about taking the next step.  Perhaps you worry what your friends or family might say or think... perhaps you think you can handle it on your own.  Whatever your situation I just want you to know you're not alone and hopefully sharing my experience will give you the push you need to explore your options.  Truthfully, medication may or may not work for you, it may or may not be the right decision but it's a blessing to even have the option to explore it.  

For me postpartum is hard.  And while it will still be hard, I learned that I don't have to suffer.    
And even more importantly, the removal of that suffering allows me the freedom to feel joy.


I would love to hear from anyone else who has also combatted postpartum depression with medication.  I know medication works differently for different people--sometimes it's necessary to change doses or even the type of medication.  Was your experience as positive as mine?  Did you even notice a difference?  Or have you thought about seeking help medically but have had reservations about doing so? Please share!  


15 comments:

  1. I love that you've been so open and honest about what you've dealt with and what you are going through now. I'm currently 39 weeks pregnant. A little over a year ago, I went on medication to deal with anxiety. While I was only on it for about 4 months, it was life changing, in a good way. Just as you've stated, it allowed me to be myself. I didn't feel altered or different. I was just myself, without the terrible repetitive thoughts and fears and physical sensations of stress. I know that I could have a baby any day now and it's been on my mind on and off that I am more likely to deal with this issue again than someone who hasn't dealt with depression or anxiety. I had a really hard time the first time going on the medication, as I just couldn't fathom how a pill could change my outlook and because I didn't want to have to rely on something other than myself to fix my situation. I was also afraid to tell anyone because I was afraid to be seen as a failure. I am so glad I went ahead with taking it anyway. It allowed me to see above the fog and handle my situations without the crippling thoughts, fears and sadness I had before. There is no failure in allowing yourself help, in whatever form. I'm glad I've had the experience and that I'll be more aware of what to look for once the baby is here. However, I've still asked those around me to help me watch for the signs as well, in case I miss them. If I need to go back on the medication, then I will. This time around if I need it, it's not just for me. I'm looking out for the best interests of this baby and my family. My mental health is important and needs to be given priority for me to be the best mom I can be.

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    1. So glad you're aware and open of your mental health needs and that you too had a positive experience with medication. It really is amazing that a little pill can help stabilize our mental outlook so much. Good luck and congrats!

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  2. I had pretty much the same experience as you. The thing is the medication is so subtle. For me I also just feel normal, so it's hard to tell it's really working because you just feel like you. I did not know for sure my antidepressant was working until I stopped taking it. I am kind of excited to take it from the beginning with baby #3. I did not start taking it until baby #2 was four months old and never took it with baby #1. I would love to actually enjoy the newborn period instead of just endure it.

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    1. MJ--Exactly! It's so subtle that when I just felt "normal" again I didn't recognize that the medication helped me to feel that way. I'm excited for you as well as enjoying this newborn stage has been the best part of it all.

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  3. When I got on medication with my 5th baby (was I the friend you were talking about??), my doctor required that I see a therapist so she could recommend medication or not, whatever... Anyway, I went and we spoke and one of the most helpful things she said was while it's true that we can experience depression because of situation or biology, there is no way for any of us to know which weighs heavier in the balance for us. They're so interrelated in us anyway. I feel like having a baby sends my mind and body both into shock. I'm just not *right.* I have good moments, but I feel just off and pretty down for a substantial period of time. Like you, I felt the medication helped me to see things as they really are, it didn't immunize me from annoyance or frustration or fatigue. I was able to see myself as I would see my friend if she were experiencing the same thing. If my friend had said something like, "If I were a better mother, my baby would....," my usual self would tell her, "Nonsense, babies are just like that, has nothing to do with you." Medication made it so I could extend that courtesy to myself, too. It's good to want to improve and to recognize when things are wrong, but before the meds, I felt like *everything* needed to improve and *everything* was wrong, and it was just emotionally overwhelming and exhausting.

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    1. HeidiAnn--Ha! No I wasn't talking about you. While I knew you struggled with PPD, I didn't know you went on medication ever. Good for you. Glad you had a good experience as well and I like how you described it as extending the same courtesy to yourself as you would to a friend.

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  4. I am so happy you are so open and forthright about PPD.

    I had it with my oldest, but not my youngest. My doctor gave me medication when I had it 8 years ago (he knew, within minutes of hearing me talk, that I was grappling with PPD) then my husband drove me straight to the pharmacy to fill the prescription. But when I got home I just couldn't take the pill; I threw the whole bottle out. I was so afraid that medication would numb me, or make my feelings less real.

    I think a lot of people are scared of this, and I wish I had more resources available to me back then to help me see that it's just not true. I was fully prepared to take medication when my daughter was born four years ago, but I ended up not needing it. It never occurred to me to take the medicine proactively, but if it had I might have.

    The stigma surrounded PPD and medication is really unfortunate, because imagine all the heartache and stress it would alleviate! This is such a great conversation to be having, Miggy. xo

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  5. I was on a half-dose of my anti-depressants during my first pregnancy, and in postpartum I was so miserable and overwhelmed and had similar thoughts that the hard things would NEVER end. NEVER! I didn't realize at the time that didn't have to be my normal life. My psychiatrist was worthless and never caught on, even during our regular meetings to check my meds. Then she left her practice suddenly and I went off my meds. I came to realize my experience was not necessary, that I could have tried another mediation or dose and actually enjoyed my daughter's infancy.

    I'm now nearly six months pregnant with my second (four years later) and I'm very nervous about postpartum. But I'm meeting with my OB this week and I'm hoping to talk strategy with him! I'm not going to let my tendency toward depression completely wreck me this time around. I'm more aware of what can happen to me this time, and I'm more open than before. I don't let the judgmental comments of others (like that I'm ungrateful to be able to have children) bother me anymore. This is my trial, and I am entitled to feel it!

    Thank you for sharing your "game plan" and for being so encouraging. It has motivated me to take action and be proactive.

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  6. Brilliant post Miggy, I particularly liked the paragraph starting "Normal". You have articulated the difference between PPD and "normal" just beautifully. I am glad you have been able to enjoy the baby.

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  7. thanks for your post! I love hearing open honest women… mothers.. sharing an experience so honestly!! love ya!

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  8. I have been so interested in all of your PPD posts and encouraged in my experience as I struggle with PPD. I didn't take it with my first, but wish I had, and my midwife convinced me to take it with my second and it has made an enormous difference in my life and in the entire tone in our home. One of the craziest symptoms of my PPD/anxiety was anger. I would get crazy angry over the smallest things and was scaring (and probably scarring) my children. Since getting on medication and finding the right one for me (I tried one that didn't work and then tried another that worked, but the dosage had to be increased a few times) I no longer feel like I'm about to explode all of the time. It has seriously changed my life and my sweet girls' lives. We are considering having another child soon and I'm feeling so torn about what to do about the medication (since I am still taking it). I don't know if I should take it while pregnant, but am scared to go off of it. So, yeah, I'm definitely pro-medication, though a few years ago I would never even consider taking meds. Thanks for talking about this-- so important!

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    1. Lucy, Definitely talk to your OB about this. It might depend on the type of antidepressant you are taking, but my OB has okayed me continuing to take mine (zoloft) while trying and pregnant. I'm planning to go off in the last trimester since that is when its most likely to cause the baby to have withdrawals at birth (nothing extreme -- just extra fussiness, which no thanks).

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  9. You are very brave to write about PPD and share your experience -- I certainly could have used this info 10 -15 years ago (when I was having babies....). I was highly anxious with each of my kids -- I wish I knew that anxiety (at least to the extent I had it) was not normal and was a sign of PPD. I thought PPD meant depression and I was not depressed but super crazy anxious. I, too, was afraid of medication -- thought I was supposed to "tough" out the hard parts -- not realizing that my mental state was what was making them so tough. I also think I had PTSD after my last child's birth due to a devastating second trimester loss the previous year. I wish I had known to ask for help or been able to recognize that I needed it. Raising awareness is so important and so is reaching out a helping hand to the new moms around -- offering support, care, love and not judgement. A warm meal and a smile can change someones day.

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  11. Thank you so much for posting about this topic.

    I had experienced depression/PTSD after a traumatic even in early adulthood, and needed to take medication for depression for approximately 2 years. When I became pregnant over five years later, I knew that I was at risk for PPD. After I had my daughter, I tried to manage on my own, but at my six week postpartum appointment, I asked for help. I was worried about medication getting into my breast milk and feared exposing my daughter to the medication. However, in my case, I felt like she would have more negative effects from a mother who was unable to smile, a mother who wept constantly, a mother who was barely able to meet her needs. I am so glad that I decided to take medication. As you mention, my medication allowed me to not suffer. I was still tired and days were still hard, but I no longer felt as though I were dying. Taking medication allowed me to experience the joy of a baby. It allowed me to connect with and fall in love with my daughter. I needed to take medication for approximately 8 months after my daughter was born, and then weaned from it successfully. I have no regrets.

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