Sad mom holds her baby

The ‘What Ifs’ of Living With Postpartum Anxiety

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The “what ifs” of motherhood get the best of me at times. I have come a long way with my postpartum anxiety since my baby was born seven months ago, but nights like this rouse the giant that was nodding off.

My husband drove with my toddler in the backseat, strapped in properly, going below the speed limit through a small town. My son’s window was down, and a stray firework buzzed into their vehicle and popped in the backseat. It melted a two-inch hole into my baby’s car seat canopy.

She was with me and was safe. My son was scared but safe. My husband was safe too, but what if..? I shouldn’t go there but I do. What if my baby had been in the car? What if my son had been leaning up in his car seat? What if the car caught fire?

What if…

At times, I am able to ignore the background noise of the hypothetical chaos and at other times, I can’t navigate my way out of it. It can catch me by surprise and then hold me hostage until each scenario is considered.

I try and talk myself down by reasoning with my brain. Devastation can’t happen because I have taken preventative measures. But how can I prepare for random accidents? Aside from parading my whole family around in life-jackets and bicycle helmets (which after careful consideration I have learned that wouldn’t actually prevent many accidents) there isn’t much I can do.

We do helmets, car seats and vaccinations. We research and choose the safest, but I can’t prepare for everything. So really, I can’t prepare for anything. Now, I’m exhausted from living in my brain. My heart is weary.

I read blogs and “Go Fund Me” accounts, obituaries and newspaper articles constantly. Desperate for details, I obsess over what could have potentially been done to prevent each tragedy. Tucked away in my memory are dozens of things to do to prevent harm being done. Always ask if people have their guns locked up. Don’t step on electrical wires when it is raining. Wear life jackets. Watch my kids if they gulped too much pool water.

It’s nights like these, when a firework reveals my prevention method is a hoax and the universe has betrayed me with keeping the future a secret. I desperately want to preserve this life just as it is. This very desperation is what is keeping me from actually living it.

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Not Even My Closest Friends Knew I Had Postpartum Depression

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I gripped the wheel as I inched across the ice-caked road, my knuckles nearly the color of the falling snow. My thoughts bounced recklessly through my sleep-deprived brain.

What if I slide off the side of this bridge? How will I save them all? How can I get them all out? Who left me in charge of three children? How do I even have three kids? I don’t know how to do this. What if I am ruining them all?

Behind me, my 6-year-old son was chattering away about his day at kindergarten as his 5-week-old sister screamed like a baby Velociraptor on one side of him and her twin brother slept serenely on the other. I barely heard him talking. The heat hissed through the vents, a steady wave of false comfort.

The boy could probably swim, but the water would be so cold it would be hard to move. Would we be trapped beneath the ice of the frozen Mississippi River that had seemingly slowed to a halt below us? And my babies. My teeny, tiny babies. They aren’t even close to 10 pounds yet, I recalled, as though that arbitrary weight would somehow keep them safer in the icy blackness of the churning river below. How quickly could I undo not just one car seat, but two, in the subzero swirl of stunning darkness?

I was terrified — barely breathing, tears rolling down my cheeks.

That late January afternoon, I wondered how I could possibly be responsible for three children. I thought there was no way I could save them. I wondered if this was all some sort of mistake. And I deliberated the best possible ways to shield them from my anxiety-riddled mind.

Was I ever concerned about hurting my children? Never.

But I was unsure of how I could attend to their needs and be the mother they all deserved.

Every word and movement and thought felt like an affront. I was failing at the most important thing in my world — being a mom.

I won’t say I was overly surprised I had postpartum depression. There were prior decades of burying pain and trying to ignore all of the demons who haunted my sleep. But now here I was, surrounded by love in its purest and most reverent form — two babies and a joyful, compassionate 6-year old.

I thought my unending despondency was proof I did not deserve my children. I tried desperately to hold it together. To wish away the feelings of failure and emptiness and despair. I stared at the twins and breathed in their sweet sleepy skin and wished I could stop feeling so horribly sad in the midst of my little miracles.

Not even my closest friends knew.

I smiled and carefully maintained a façade of stability as best I could until I was alone and able to collapse into myself. Acknowledging the hopelessness and melancholy that formed an edge around my every waking hour.

My constant companions were irritability, anxiety, an unending feeling of being overwhelmed and sadness. Pure, shoulder-sobbing sadness. I cried a lot. Sometimes for hours on end — seemingly without reason.

I had struggled for almost four years to get pregnant. Seemingly spreading my legs for every fertility doctor in a 30-mile radius. Broken and nonfunctional parts of my reproductive system were surgically removed. Medications were ingested. I willingly offered my then-taut abdomen as a pin-cushion to the hoards of needles that arrived at my home. A medical waste container assumed a position on top of my fridge.

For years the struggle was fruitless. And eventually, it became clear the IVF was our only option. And so it began in earnest. I ran, I ate healthy, I meditated, I wrote.

And then it happened.

I was pregnant. Not just one, but two sesame-seed-sized hearts were beating inside of me. I was elated and terrified. For 37 weeks, I did every possible thing I could to protect the lives I was now nurturing and incubating. And then they were born. My babies were here. Tiny hands and soft skin and inviting eyes. My heart grew immeasurably, as did my sadness.

It was a desolation that did not fit the attendant circumstances.

Yes, I was exhausted. Yes, I was anxious. Yes, I had the “baby blues” from the sudden surge of hormones (that were not administered by injection). But this was more than that. This was postpartum depression.

I was ashamed. Embarrassed. Worried about what others would think or say. Certain I was a horrible mother and my children would be better off without me. Unable to be away from my babies for any amount of time. Terrified of what would happen if I was not always vigilant.

I sat on my couch, in my car, in the shower, virtually anywhere — willing myself to feel better.

I thought I could fix it. That I could try harder, smile more, eat healthier, get a little sleep.

I was certain I had to take care of this alone and that no one could know how horribly I was failing my children by being depressed. I thought since I was the one who was broken in the midst of so much perfection, I could not tell anyone.

I felt utterly and completely alone.

And then one day, several months after the twins were born, my partner looked me straight in my bloodshot, swollen eyes and said:

“You need to talk to someone about this.”

After much hesitation, I picked up the phone and carefully dialed the number.

I hung up three times before I heard the entirety of the greeting on the other end.

My voice was barely audible. The person on the other end was clearly not in the mood to accommodate or calm my fears. Her concern was only with scheduling an initial appointment, and she fought to understand what I was asking for with my cracking, shaky words. Alas, an appointment was confirmed and the wheels were set in motion.

Close to two weeks later, I met with a psychiatrist. She empathetically engaged me and offered the kindness and understanding I needed. She heard me. She saw me. And she didn’t look away.

The psychiatrist mentioned medications that might help. After careful consideration and having my fears about antidepressants and breastfeeding assuaged, I elected to take a low-dose prescription.

It was an internal battle, and some days I hated myself for needing it. I thought I was weak. More proof I was incapable of being a good mother if I was not medicated. After a while, though, I came to see that nothing could be further from the truth. I had sought help.

I was able to take a step back and understand that even if I was depressed and struggling, my children needed me to be at my best, and I too deserved to feel better.

I was also referred to an incredible therapist who would become a proverbial hand to hold through the darkness.

Several weeks later, I carried my then 4-month-old babies into the waiting room of a clinic at a large public hospital. Each child was carefully cradled in a bulky and protective infant car seat.

I was nervous. Hesitant. Exhausted. Embarrassed. And desperate.

I checked and double checked to make sure I had not forgotten one of my babies — I never did, but I worried regardless. I made sure they were breathing and not overheating.

A bag full of accouterments that rarely needed to be used was slung over my shoulder. Diapers and wipes and hand sanitizer. Toys and clothes and burp clothes. A blanket or two. I tried to convince myself that if I brought the right things with me, I would be OK, they would be OK. We would all be OK.

I was beyond tired.

My bones ached with exhaustion beyond what could be anticipated from caring for two infants simultaneously. My hands trembled from the constant barrage of being so overwhelmed. I gazed lovingly at my two tiny babies and hoped beyond hope I could do better for them.

What if the therapist thinks I am unfit? What if one of my babies starts crying and I can’t get them to stop it? What if I start crying and cannot stop either?

None of these things happened.

I hesitantly sat down in her office and desperately tried to hold it together.

Until she told me I didn’t have to be strong all the time.

Until she explained that my frightening new normal was not abnormal.

Until she said she understood — and I believed her.

It was only then that I let loose a torrent of tears I was not certain would ever end.

I rambled on and on as she looked at me intently with an empathy that spoke volumes. She held my gaze and assured me what I was thinking and feeling and saying all made perfect sense. She seemed to genuinely understand the desolation I felt, and she never assigned any judgment to it.

For months we met biweekly, and sometimes weekly. She provided a safe space where I could open up about my feelings of inadequacy and my concerns for the future.

Some days, I just sat down heavily in the chair, my babies playing at my feet, and said:

“This is really f*cking hard and I don’t feel like I am doing anything right.”

She had an endless amount of patience for my self-deprecation and was there to remind me it was entirely OK to feel simultaneously ecstatic and distraught. More than anything else, she listened and just let me speak — or cry — as needed.

And after some time, the intense sadness did begin to dissipate. I started to find my footing and not feel entirely leveled on a daily basis. It was hard-fought but well worth the effort.

Two years ago, a dear friend was pregnant with her first child, and she lamented her concerns about postpartum depression. When I mentioned I had experienced it and there were options available if it did happen, she was nearly flabbergasted.

“You did?! I had no idea.”

And that was entirely the point.

I hid my sadness and my despair and my tortured thinking from as many as I could. I was ashamed I was sad at such a seemingly happy time in my life. I wanted to let others know I needed help, but I also feared how weak and ungrateful I would seem if I articulated a need for assistance.

According to the American Psychological Association, up to one in seven women experience postpartum depression in the weeks and months after giving birth, but not everyone seeks treatment. Many go through it alone in silence, wondering what is wrong with them.

Depression tells you no one else will understand. It coerces you into believing you are alone and you should be alone. It silences you when all you want to do is ask for understanding and kindness.

Postpartum depression offers the same delusions, with the added variable of a new baby (or babies) and all of the attendant duties, responsibilities and expectations placed on mothers by themselves, their families and society.

It is an equal opportunity offender, catching new mothers off-guard in the midst of what they have been repeatedly told is “the happiest time in their lives.”

Was my childbirth experience the perfect storm for postpartum depression? Possibly.

After years of fertility treatments, the physical and emotional stress of a multiple pregnancy, an extremely difficult delivery with significant blood loss during an unanticipated cesarean section, issues with milk supply, and no family within nearly a thousand-mile radius, I was already running on close to empty.

Did all of these factors contribute to the tidal wave of postpartum depression that left me struggling to breathe? Probably.

Was any one of them the tipping point? Perhaps.

Does it really matter? No. There doesn’t have to be a reason. Sometimes it just is. And that is OK.

Having postpartum depression does not make someone a bad mother. It does not make them broken or a failure. There should be no shame in talking about it, no harm in letting other women know it can and does happen.

Years later, I am still not sure if I am doing anything right. But now I also know that is OK.

Do I worry that my children were irreparably influenced by my postpartum depression? Of course.

Were they? I will never know.

What I do hope is that they were more influenced by my decision to acknowledge that something was not right and to seek the help I needed to be a better mother to all of them.

Postpartum depression is valid. It is real. And it can feel devastating. Those who are struggling with it need and deserve to be recognized.

We can start the conversation. We can hold the hard truths. And we can offer support. Providing small reminders to let one another know that there is no place for shame, and we don’t have to be alone.

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When My Son Grasped a Concept About Mental Illness Some Adults Don't Understand

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This morning on the way to nursery:

Me: Sorry if Mommy was a bit too cross yesterday. She wasn’t feeling well.

My son: Yes, you were a bit too cross.

Me: Yes and I’m sorry. It wasn’t your fault. It was mine.

My son: No, it wasn’t. Why were you being cross?

Me: Because I wasn’t feeling well.

My son: Then, it wasn’t your fault. It was because you weren’t feeling well.

My son in his childish brain managed to grasp a concept many of us postpartum depression (PPD) and mental health sufferers forget constantly. It is not our fault. Being ill means sometimes we act or feel a way we shouldn’t, and instead of feeling guilty and placing blame on ourselves, we should remember that.

You may also notice I explain a bad PPD day as “not feeling well.” I know my 4-year-old might not be able to grasp mental illness entirely, but I know he understands what it is like to not feel well. So for now that is how I explain my PDD to him. As he gets older, I will explain in more detail in a way he can understand, but for now it is just, “Mommy doesn’t feel well.”

On the way home from dropping him off, I thought back over that conversation and it made me remember how that was how my mother had explained mental illness to me when I came into contact with it at a similar age. She described it as someone not being well, and it is the truth. Although physically the person may not be sick, their mind is in a state of being unwell. It is a simple truth people don’t always seem to understand, which in some ways fuels stigma around mental health issues.

I also realized this might be why my mind was so open to empathy and understanding around the issue of mental health. From a young age, I had been taught mental illness is an illness that happens to regular people, not something to be ashamed of. This made me think even more. The stigma of mental health is often due to lack of awareness and understanding. If I wasn’t suffering from PPD, I don’t know if I would have even thought to discuss it with my 4-year-old, as my mother had with me. Yet as an illness, it is just as important and common as physical illnesses.

I think sometimes we don’t give children enough credit for how much they understand. In some ways, they can learn concepts better because their unbiased thinking hasn’t been tainted about issues. Maybe one way of beating the stigma of mental health is to start discussing mental illness with our children, who we consider to be the future. They will one day be adults who will be more understanding and empathetic toward mental illness and will know not to be ashamed to talk about these issues. That is definitely a future I would want for my children. How about you?

Much love,

LGL x

This post originally appeared on Little Girl Lost.

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To the Brave and Tired Mama Just Diagnosed With Postpartum Depression

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Dear brave and tired mama,

I saw you walk out of our doctor’s office today. You were carrying your crying newborn with one arm, and dragging a stubborn 2-year-old with the other.

Your face revealed your utter exhaustion. You tried to hide it with makeup, but I’m a mom too, and I could recognize the truth: six weeks postpartum means you’re still not sleeping more than a couple precious hours at a time each night. And that busy toddler who’s pulling at you and asking you for juice? I’m betting she doesn’t let you rest much during the day.

I heard the nurse at the front desk hand you a prescription for Celexa, and tell you to schedule a follow-up appointment for next month. Your eyes were filled to the brim with tears, threatening to spill over at any moment, and I read both shame and relief in your pained expression.

I wanted to run up to you, hug you and let you cry on my shoulder, and tell you I’ve been there too.

I wanted to tell you how, even though I know you don’t see it, you really are a good mama.

I wish you could see who I saw this morning: a woman in anguish who was still strong enough to get up today.

A woman who was overwhelmed with fear, but still brave enough to ask for help.

A woman who didn’t know if she was going to make it through the day, but still puts one foot in front of the other.

That’s what warriors are made of. That’s what heroes do.

Oh, brave and tired mama, I know. I know your feelings of frustration and defeat. I know how often you say to yourself, It’s not supposed to be this way. I hate myself. I can’t do this.

But you can. You can. You already are.

Stay in the fight.

No matter how hard it is now, keep fighting. I promise you, it will get better.

It will take hard work. You will want to give up. But if you persevere, you can be well again.

You will be yourself again, and you will be better than you were before. I know; I’ve been there, twice.

And I promise, no matter what your demons whisper to you in the darkness, you are needed, you are loved, and you are worth it.

Love,

Another brave and tired mama

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You Don't Need to Justify Your Postpartum Depression

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Today, I stopped making excuses for my postpartum depression and anxiety.

I had all the reasons in the world to be depressed and anxious. I had a preemie baby in the NICU. Due to preeclampsia, I suffered under magnesium sulfate treatment for days before delivering my son at 32 weeks by C-section. Then, I developed a massive hematoma that caused my incision to open, sending me to the emergency room twice before proper wound care was administered.

None of those things could have happened, and I still could have experienced postpartum depression and anxiety. Postpartum disorders plague between 10 to 15 percent of mothers. Mothers who have perfect births. Mothers with traumatic births. Mothers with all the support in the world. Single mothers without a support network. Mothers who successfully nurse, struggle to nurse, exclusively pump and formula feed. Mothers of their first, second, fourth (and beyond) child. Mothers of all races, creeds, life experiences and situations. Some of these groups are more at-risk than others but that doesn’t matter to mental illness.

Yes, certain scenarios will increase the risk of developing postpartum disorders. I should know. I checked off nearly every box on the list, but I didn’t have to. Postpartum disorders don’t care how many risk factors you have or don’t have.

For a long time, I felt like I had to justify my postpartum depression and anxiety. I blamed it on my prenatal illness, my premature delivery, my surgical complications and the trauma of having a baby in the NICU. I also had a history of depression and anxiety, conditions that kept my husband and me from trying to conceive for several years, thinking I needed to be “better” before we should have a baby. (The joke was on me, but that’s another post for another time.) I was the perfect candidate for developing postpartum disorders. I thought I could point to those and say, “See? This isn’t my fault. I was set up. I was programmed for failure.”

Then, I realized: It doesn’t matter. No, it isn’t my fault, but I don’t need to say so. I shouldn’t need to claim I was at risk to make anyone believe me or listen to me. I never failed, and no one and nothing was to blame. I was sick. I wouldn’t need to justify a cold or a broken leg. I didn’t need a reason to have depression and anxiety. I just did.

What was always the strangest part was I would never ask another person to justify their disorders. I reserved doubt only for myself. My stigma only applied to me. I was the only one who ever offered excuses, explaining my damage as if doing so would release me from the responsibility of my illness. I was trying to fight depression and anxiety with logic and that isn’t at all how it works. You can logic postpartum disorders all day long, upside down and backward, and it will never make sense.

My history was only good for one thing: understanding what I needed to heal. My traumatic birth experience caused post-traumatic stress disorder (PTSD), which I understood was fueling my depression and anxiety. I knew I needed to deal with that before I could truly climb out of the darkness of postpartum disorders.

So I eagerly sought out therapy to ease the flashbacks and trauma, and I found success. I knew that in the past, I’d been a healthier person when I was on medications for depression and anxiety. So I sought out great doctors and therapists, which I was lucky enough to find! They provided me with the guidance I needed, and got me to a place where I could start to help myself. I finally realized hanging on to my “reasons” for being sick was not helping.

I have postpartum disorders. Maybe it’s because of my experiences and history, maybe not. The only reason my experiences and history matter is because they’re tools to help me recover and maintain a healthy self. I don’t need an excuse for who I am, how my brain and body work or what I think and feel. Neither do you.

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5 Destructive Myths About Postpartum Psychosis

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Three days after giving birth to my daughter, I energetically went to my 6 a.m. spin class and had an intense workout. I had just given birth, but I felt like I could take on the world. This high quickly wore off, and I felt dead tired, yet I couldn’t sleep at night.

My sleep deficit got worse and worse. I became exhausted from a non-stop feeding and pumping cycle to help my daughter regain her birth weight. In this foggy state, I started to get confused, like when I thought my sleeping eye mask was my daughter in the middle of the night. There was the time when I forgot how to put the pieces together for the breast pump I had used dozens of times.

My confusion turned into full on delusion and I became paranoid as time went on. I remember being convinced my house was bugged and the police were coming to arrest me for a crime for which I was wrongly accused. I was so confused and paranoid. I thought the only way out of my crisis was to kill myself. So I told my mom and husband I was going to go jump off the Golden Gate Bridge.

This landed me in the psychiatric ward on 24-hour watch, as the doctors and my family patiently waited for the medications to stabilize my mind.

In the hospital, I remember my husband bringing me a printed copy of the Postpartum Support International website so he could explain I had a disorder called postpartum psychosis (PPP). I thought my husband had created a fake website for me to make me feel better about myself. I didn’t realize postpartum psychosis was a real thing.

I had all of the symptoms ranging from having delusions, strange beliefs, hallucinations, paranoia and suspiciousness to feeling irritable, being unable to sleep, having rapid mood swings and difficulty communicating. I’m fortunate to have gotten support early, and to have recovered fully. Sadly, many women are not getting the help they need because of the fear and stigma associated with maternal mental health issues.

Sadly, only 15 percent of women with postpartum depression ever get professional treatment. I know we can do better. There’s a lot of confusion and misinformation surrounding postpartum mood issues. This is especially true for postpartum psychosis, which is the rarest, occurring in about one to two out of every 1,000 deliveries. Unfortunately, postpartum psychosis only receives airtime when a tragedy occurs, oftentimes resulting in the loss of a mother or her baby’s life.

We rarely hear about the “Warrior Moms,” the survivors, those of us who weather past the storm, those of us who seek help, those of us who recover from this infrequent yet extremely treatable and temporary postpartum mood disorder. Postpartum mood issues cast a pall against the stereotype many women have about new motherhood: the idyllic glow, the joyful time that’s believed to be filled with sunshine and rainbows. These stereotypes are not only inaccurate, but they are harmful. Oftentimes, they prevent women from getting the help they need.

These five misconceptions around postpartum psychosis need to be put to rest once and for all:

1. Having postpartum psychosis means you want to hurt your baby or babies

Most women who experience postpartum psychosis do not harm themselves or anyone else. Many women experiencing psychosis are in fact trying to protect their babies from imagined danger. Immediate treatment is necessary for this serious illness because your judgment is impaired and you are experiencing a break from reality, but it is completely treatable and temporary for those who get professional help quickly.

2. Having postpartum psychosis means you’ll be “crazy” forever

This is simply not true. Postpartum psychosis is temporary and treatable. Mothers experiencing postpartum psychosis “can seem perfectly normal one moment and psychotic the next,” according to Teresa Twomey, author of “Understanding Postpartum Psychosis: A Temporary Madness.” With proper treatment, postpartum psychosis goes away and you return to your old self.

3. Having postpartum psychosis means you’ll lose custody of your children

Many women are scared to get help because they fear they’ll be labeled unfit and their children will be taken from them. Getting the help you need from a trained healthcare professional is the best way to ensure you get better and are able to be there for your child or children. It’s true you’ll likely be hospitalized in order to get proper treatment, but as soon as you’ve stabilized, you will be able to return home.

4. Having postpartum psychosis means you don’t love your baby and are generally unfit to be a mother

No, this has nothing to do with how much you love your baby. It is not your fault if you suffer.

5. Only people with past mental health issues are susceptible to postpartum psychosis

Though risk factors for postpartum psychosis include a personal or family history of bipolar disorder or a previous psychotic episode, for many women this is not the case. Postpartum psychosis is not your fault and has nothing to do with your character. It’s a temporary illness, which comes about from a combination of sleep deprivation, stress and hormonal changes after birth.

If you or someone you know needs help, see our suicide prevention resources.

If you need support right now, call the Suicide Prevention Lifeline at 1-800-273-8255.

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