(This is the second segment in my personal series regarding my struggles with Postpartum Depression. Click here for the first segment. Please know that Postpartum Depression is a very real illness that is treatable. The stories I am sharing deal only with my personal experiences. There are many women who experience different symptoms than I had. This post is a bit longer than usual because it includes some additional resources below.)
Better Off Without Me
Some maladies are easily defined. If my arm bleeds, I know that somewhere on it exists an open wound. After quick examination I know if the gash requires a simple bandage or a trip to an ER for stitches. Postpartum Depression is not so easily defined and often presents itself differently in women. The list of possible symptoms easily fills two sections of a basic tri-fold brochure, and ranges from insomnia to fatigue. Even the name can be misleading. I always thought depression accompanied unfathomable sadness and despondency. Those weren’t the feelings that first surfaced during my battles.
Within seconds of whispering “You were so worth it,” and holding my precious infant girl in my arms, I laid mesmerized by her newborn spell. The trance was only broken for a few seconds. I noticed a look of concern on my midwife’s face and felt a needle jab my leg.
“Is something wrong?”
“You’re hemorrhaging. We’re trying to stop the bleeding now. If we cannot, you’ll need to be transported to the ER, but I think we can stop it.”
“Can I keep holding my daughter while you work?”
“Yes. For now.”
I didn’t waste another minute inquiring about myself. I went back to caressing Pumpkindoodle’s scaly cheeks and counting her graceful fingers. Her feistiness evident, my little girl latched to my breast and gulped her first meal without hesitation, or with even much assistance from mommy. I was amazed by her loveliness. She was vibrant. So pink. And I was in love. All the fears I carried the previous months vanished. As my sweet daughter and I locked gazes I chalked the bad feelings of the past up to pregnancy hormones and for a brief moment in time, felt safe. With the bleeding under control and Pumpkindoodle scoring a perfect ten on the APGAR, we were deemed ready for release 12 hours after my baby girl bellowed her first cry.
The first few weeks of Pumpkindoodle’s life are blurred. I remember feeling as if I were in some sort of walking coma. My body ached with exhaustion and physical pain. My mind sheltered an array of confusing thoughts and contradictory emotions. I cried on moment and felt elated the next. I loved my baby girl and found her aroma addicting; cradling her in my arms as she slept opened a new room in my heart.
Unfortunately, peaceful moments were not commonplace. Riddled with colic, Pumpkindoodle screamed more than she slept. She cried for hours at a time and I felt a failure for it. I thought that a better mother would be able to console her child. Surly I was deficient. My brain was overworked and undernourished. It hadn’t the sleep it needed to properly function and help me discern that my thought process, not my parenting, was faulty.
To write I felt edgy would be like stating that Roberto Benigni felt pleased after winning the Oscar for Life is Beautiful. What an understatement. The walls of our teeny 600 sq ft., one bedroom apartment in the suburbs of Washington D.C., which also doubled as the Professor’s research office, closed in on me. The fact that hundreds of water bugs forced themselves in as our new roommates nudged me closer to the edge of sanity. I obsessed over cleanliness and order, but both were unattainable. I cleaned with bleach only to discover a crew of bugs on the same countertops I cleansed mere minutes earlier.
I had no control. Not over bugs, The Professor’s clutter, my baby’s incessant demands, or even my own thought life. I was irritable, angry, and afraid. The fears that haunted me before her arrival reentered my life, but this time they invaded more than my slumber. Every time I bathed my darling girl I feared drowning her. Whenever we walked near our open stairwell that led to our second story apartment, I’d clutch my baby tight to my chest as I thought “What if I threw her over the railing?” As I nursed her by an open window I imagined myself tossing her high in the air.
I need to pause and make a very clear distinction here. I never wanted to do those things. I knew they were wrong. I desperately loved my baby. This added to my shame and confusion. I didn’t know then what I now know. I didn’t know that the fact that I recognized that those thoughts were wrong meant that I was not insane. I didn’t realize that my hormones were out of control and that I had a very real condition called PPD. Instead I thought I went crazy. I thought that there had to be a monster lurking inside of me. I thought that if I could think those thoughts that I was capable of atrocity.
One afternoon, around week eight of my daughter’s life, The Professor was working late at a neighborhood restaurant. For four solid hours I nursed my infant. Whenever I tried to remove her from my breast she screamed. I circled our small apartment with her in my arms trying each of the 5 S’s technique. Nothing comforted her. The compassion I felt toward her waned. “Why won’t you stop crying,” I shouted? Rage consumed me and I put my baby in her crib and walked out of my apartment.
I stood outside the door grasping the railing and looking at the concrete floor below. Again, thoughts of failure forcefully flogged my consciousness. And then one cadence drummed through my mind. “She’d be better off with no mother, than with you as her mother.” “She’d be better off with no mother, than with you as her mother.” She’d be better off with no mother, than with you as her mother.” Over, and over, and over, again this phrase repeated itself until it was tattooed on my cerebral passages.
I thought about hurling myself over the railing, but thankfully, there were a few logical cells left in my body. Those few rational cells and the voice of the Holy Spirit saved me at that moment. Only I wouldn’t have recognized His voice at that time. I thought He too was disgusted with me. What stopped me from jumping was knowing that my husband would have found me. I loved him too much to place that horrible sight on him. Plus I didn’t want my baby to think this was her fault. No, there had to be a better way.
Pumpkindoodle’s howls could be heard from the hallway. I opened the door to our apartment and tried once more to sooth my baby. Failed again. At this time, she was so angry that she wouldn’t even nurse. I laid her back down and collapsed on the hardwood floor. My body, wracked with grief, sobbed violently. A small puddle formed beneath my swollen eyes as I began to hatch a plan. My mind raced with ways to end my life. Ways that would seem like an accident so that no one would hate me. There were many bridges in the area, there had to be one that I could drive off without hurting anyone else.
As I lay on the floor concocting my plan, the door knob turned and The Professor entered. The poor man didn’t know whom to help first, his wailing daughter or his toiling wife. Scooping me up off the floor and placing me on the couch he asked me what had happened. I could only answer him with three words. “I. Need. Help.”
May your unfailing love be my comfort, according to your promise to your servant. Psalm 119: 76 (NIV)
Below is some additional information about PPD from Postpartum Support International. If you or any new mother that you know may be experiencing these symptoms, please contact a health care professional. PPD is a real and no-fault illness. One does not do anything to cause it, but there is something that can be done to treat it. To help you feel less alone, I have put a * next to the symptoms I experienced.
During pregnancy, hormone levels are increased to assist in creating an environment for the growing infant. In the postpartum period the mother’s body experiences further dramatic changes in hormonal level. Within 24 hours after birth, the progesterone and estrogen levels drop to a level lower than before conception. The body’s reaction to this sudden drop in hormone levels is further intensified by the complex changes the mother’s body undergoes to prepare for milk production. Many other psychosocial stressors such as financial problems, difficult partner relationships, poor health, preterm delivery, and a history of other mood disorders are also thought to increase risk. With the common addition of broken sleep cycles, the stress on the mother’s physical functioning is often overwhelming. Thus, new mothers are at risk for developing a postpartum depression (PPD) or, more correctly, a perinatal mood disorder.
When Is It More Than Just the Blues?
Up to 80% of new mothers cry easily or feel stressed following the birth of a baby. When this happens within the first two weeks following birth, it is called “baby blues.” However, some women experience a deep sadness that doesn’t go away or comes and goes. For other women, these feelings sometimes occur months after childbirth. In any case, it is important to recognize the warning signs. These signs are different for everyone, but include:
*Difficulty sleeping, even when the baby is sleeping
Sleeping too much
*Feeling irritable, angry, or nervous
*Lack of ability to enjoy life as much as in the past
Lack of interest in the baby
Lack of interest in friends and family
*Lack of interest in sex or even being touched
*Feeling guilty or worthless
*Crying for “no reason”
*Feeling as if you are a bad mother
*Difficulty concentrating or focusing
*Thoughts of harming self or the baby
It is estimated that 8.5 to 11 % of pregnant women will experience moderate to severe symptoms of anxiety or a mixture of anxiety and depression during their pregnancy. Following birth, these symptoms may begin or persist and usually require specific interventions. These women may be troubled by unpleasant thoughts (intrusive thoughts) about harming their babies, or extreme concern about the baby’s health. Shakiness, nausea, and inability to sleep are symptoms that may occur in this disorder.
Along with the anxiety, a mother may experience symptoms of a postpartum panic disorder. Postpartum panic disorder occurs in up to 11 % of new mothers. The three most common fears that occur during a postpartum panic episode are: fear of dying, fear of losing control, and fear of going crazy.
*Postpartum Obsessive Compulsive Disorder
This disorder is one of the most under-recognized and under-treated types of perinatal mood disorders. It occurs in approximately 3 to 5 % of new mothers, yet it can be most alarming for a new mother. The symptoms include intrusive and persistent thoughts or mental images and a sense of horror about the thoughts/images. The thoughts are typically accompanied by behaviors to reduce the overwhelming anxiety that accompanies the thoughts. These compulsive, ritualistic behaviors often include checking baby frequently, obsessively searching for information on the internet/books, etc. For example, a mother may have an irrational fear that she is going to drop the baby down the stairs. Consequently, she may avoid using the stairs or even going near a staircase. These mothers are NOT in danger of harming their infants and are disturbed by these troubling thoughts.
Postpartum Traumatic Stress Disorder
An estimated 1 to 6 % of women will experience a postpartum traumatic stress disorder. The primary symptoms of this disorder include: trauma re-experienced (through dreams, thoughts, etc.), avoidance of stimuli associated with the event (thoughts, feelings, people, places, details of the event, etc.), and persistent arousal (irritability, difficulty sleeping, hypervigilance, and an exaggerated startle response).
Occasionally, a woman may have a more severe disorder which is know as postpartum psychosis. There is a 10% infanticide/suicide rate associated with Psychosis and thus immediate treatment is imperative. This disorder occurs in 1 to 4 of every 1000 babies born (Gaynes et al., 2005). For more information, click on the link to postpartum psychosis.
What To Do
All of these feelings are upsetting, so it is important to remember that it is not your fault and that you will feel better. Whether symptoms are mild or severe, with proper treatment, most mothers can quickly recover from PPD or perinatal mood disorder. If you think you or someone you know may have PPD, find someone you know and trust to talk with about how you are feeling. There are healthcare providers and licensed counselors who can help a woman find the treatment that is best for her. This treatment includes finding the right therapy, the right medication, and the right support group.
“The positive aspect of my getting help for PPD is that I am a stronger woman now.” Elizabeth Roebling, NJ.
(Adapted from Speak Up When You Are Down, a postpartum recovery program in New Jersey).