Let’s Talk About Sex (and PPD)

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postpartum depression helpSex after baby. We all know the cliche about its nonexistance – after all, the sleepless nights, the leaky breasts, and the lack of personal space that accompany a newborn aren’t exactly aphrodisiacs.

But sex after postpartum depression? Is a uniquely difficult experience for many mothers.

With my husband’s permission, I wanted to take the time this week to share my own experiences with sex, depression, anxiety, and medications. I know I’m not alone – and I want you to know you’re not alone either.


At first, relations with my husband were slowed only by the physical limitations that follow a vaginal birth: pain, scar tissue, and sleep deprivation. You see, I started my first weeks as a mother with postpartum anxiety and it wasn’t until months later that the depression took hold. But as it slowly invaded my brain, my interest in sex waned. This is a common symptom of depression and, for me, the numbness I felt toward my child and my life spread into my marriage.

It took months for me to accept that I was suffering from postpartum OCD and postpartum depression and to seek help. When my doctors put into place both talk therapy and medication plans, I finally began to feel just the smallest bit like myself again. But as my happiness returned, my libido only diminished. And though I knew that couples typically experience a temporary drop in marital satisfaction after the birth of a baby, I couldn’t help but feel concerned. It was more than just a decrease in desire.  I found the thought of having sex completely repulsive.

After some research, I learned that the antidepressant I was using (an SSRI) is linked to sexual dysfunction in a high percentage of patients. I nodded my head as I read about the symptoms, including loss of desire and inability to climax. It felt like I was being punished for treating my depression, and I wondered how a marriage is supposed to survive both mental illness and celibacy.

So as hard as it was, I brought up my concerns with my psychiatrist. Over the two years that followed, we worked through a series of medication trials, finally settling on a mood stabilizer that seemed to alleviate the depression without such a severe impact on my sex life. When I became pregnant with my second child, however, I chose to return to my SSRI, knowing there was more research to support its safe use during pregnancy. I made that decision knowing I would be sacrificing my libido, but fully aware of the risks untreated depression carry for both baby and mother during pregnancy.

I wish I could tell you that the sexual side effects were limited to my first postpartum period. But, sure enough, they returned as the medication took hold and I felt the depression and anxiety lift. I also wish I could tell you that this is a story written entirely in the past tense, but almost 3 years postpartum, I still take the SSRI daily, and it continues to impact my desire and performance.

At times, it feels as if I have to choose between sanity and marriage. I hate that the medication that works so well — that allows me to feel like a calmer, more rational version of myself — takes something so important away from both me and my husband. But I am also grateful for the life it allows me to lead. My doctors and I speak about the sexual side effects of my medications at each appointment and are constantly balancing them with the therapeutic benefits – and we have tweaked dosages and timings to help as much as possible. (I won’t get into the details – that is something for you and your doctors to discuss.) For now, we’ve found a plan that, while far from ideal, allows me to continue treatment for my medical condition.

I hope that if nothing else, these last 6 years negotiating the world of antidepressants, mental illness, and sex allow me to help someone who may be suffering in the same way:

I want you to know that if you are experiencing sexual side effects from your anxiety, depression, or medications that you are not alone.

It’s important to be honest and open with your doctors about all side effects and symptoms you are experiencing, including loss of libido and lack of performance.

Finding the right medication and other treatments for postpartum depression (and other mood and anxiety disorders) can be a complicated process, but there are many options out there and probably one that will fit your needs.  Don’t give up.

photo credit: fotolia.com

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The Importance of Connecting

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women connectingI recently got the chance to sit around the table with some amazing women and talk about what I do every day and how it has impacted my life and the lives of others. This might be one of my favorite topics, given how social media and blogging has changed my life. I feel like women used to be so disconnected. I mean, we had the neighbors down the street, the people in our communities of faith, our family members, yes, but what were the odds that among that group we’d come across someone who was having the exact same problem we were? Someone who could deeply understand and connect with us based on shared experience? Now we have access to women everywhere. There is most definitely someone out there to talk to who gets it and who can offer guidance and support, no matter the situation. In my line of work supporting pregnant and new moms with perinatal mood and anxiety disorders like postpartum depression, this matters. Mothers need to be able to talk to people who’ve been in the same exact boat. I’ve seen those conversations and connections reduce stigma, guilt, feelings of shame, and even, in my opinion, the burden of disease. I feel so fortunate to live in a time when we have technology that allows us to connect to so many people and their stories. I can’t see any other way that I would have had the opportunity to reach so many, and I see lots of other women in the BlogHer community who are able to have the same impact when it comes to the causes and issues they care about. We need each other, and now we can find each other, and it was great to sit around a table with other bloggers at the BlogHer Conference in San Jose and talk about that ability to connect across the ether and how it has made our lives better. I’m grateful to Stayfree® pads for recognizing the importance of that connection and giving us the chance to talk about it. I hope you’ll watch the resulting video and perhaps get some inspiration to share your own stories even more boldly than you already have and make the kinds of connections that can change your lives and theirs for the better.

 

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This Sweepstakes is open to legal residents of the 50 U.S./D.C. age 18 or older (19+ in AL & NE). Void elsewhere & where prohibited. Winners will be selected via random drawing, and will be notified by e-mail. The notification email will come directly from BlogHer via the sweeps@blogher email address. You will have 72 hours to respond; otherwise a new winner will be selected. The Official Rules, by which entrants are bound, are available here. This Sweepstakes runs from 9/10-9/30.

Be sure to visit the Stayfree® brand page on BlogHer.com where you can read other bloggers’ posts!

Sweepstakes is sponsored solely by BlogHer. Energizer Personal Care LLC is not a sponsor. Sweepstakes is in no way sponsored, endorsed or administered by, or associated with, Twitter. © 2014 Energizer.     Stayfree and all other trademarks are owned by Energizer. Bloggers were compensated for creating blog posts in this Stayfree® campaign.  

Photo credit: © bst2012 – Fotolia.com

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Taking an Active Role in Your Postpartum Recovery

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sfb groundbreakingBelief

Shared community

Information

These items are the beginning tools for a successful recovery from postpartum mood disorder. I say this confidently, because I believe in recovery being possible. I was once someone who never felt that I’d be normal again nor that I’d ever find my way back to who I used to be. But recovery is made up of small steps that lead us to a successful life of overcoming postpartum mood disorders — these steps toward wellness matter, because being active versus passive about your recovery greatly increases a positive outcome.

For me, a belief in the process, along with an open ear to advice, and full engagement in dialogue with your recovery team of your physician and your therapist, possibly a support group, is essential. I used to go to my appointments and sessions with a notebook filled with questions or thoughts that I had had during the week before the appointment. I wrote everything down of the information they gave me so that I could refer to it later. This helped, since it was difficult for me to concentrate and remember during my time of PPD and PPA. It also shows your recovery team that you see yourself as integral to recovery and that you are there to advocate for your mental health.

Life while in postpartum recovery can feel isolating. For that reason, you need a shared community. You can find a group through your area hospital, health clinic, checking out what’s offered in a local events calendar, or finding one online by searching postpartum progress. To hear others share their current struggles, or by listening to stories of those in recovery or recovered, is a lighthouse during this storm. You can feel encouraged and find ideas on ways to work toward your own eventual recovery.  You don’t have to be “fully recovered” to participate in any group and you don’t have to be fully recovered to start to feel better.

A few nights ago, I was talking with some postpartum warrior moms, some that were currently in postpartum phase, some on the way to recovery, some recovered. I asked them for suggestions on how to be active in PPMD recovery. Here’s what worked for us:

Define your goals. You decide what recovery would mean for you. For me, it was to once again smile, laugh, and enjoy my life.

Accept the importance of your role and the responsibility that you have in your recovery. That means being aware of how and where you spend your time, and who with. Sometimes it means guarding your environment and stimuli at a time when you’re not strong enough to take much negativity.

Know that you have power, and are not weak. You are the one in charge when you see your recovery team. Listen to what they say, but be honest about how you are feeling. If something doesn’t feel right, or you’ve tried and it hasn’t helped, let them know. I have heard cases of women being on the same medication for months with no alleviation or improvement of symptoms. Let your physician know, and work together.

Getting better is not just through pharmaceutical aid. Recovery can take longer than we want it to, and the easy way out is to think that just taking a daily pill will fix us. But other things need to be part of your lifeplan: sleep, diet, exercise, state of mind. Incorporating what spirituality is to you, and a mindful practice, like meditation, creativity, maybe yoga. Only you can discover what centers you, so search new activities out. For me, waking up 15 minutes earlier so I could deep breathe and have a mind free of thought was the cornerstone to my day.

Your social network and friends and family support are what will hold you up. Let people know how they can help you, as well as what is detrimental to your recovery. Relationships and community provide a feeling of belonging and lesson isolation. Isolation can be a huge trigger for PPMD, so reach out and ask for support when you need it.

PPMD recovery is possible with treatment and identification. It comes slowly, and is a growth process because your life has changed. You are no longer someone without a family or children. We have to learn skills and ways to adapt to our new normal. Allow room and space to understand setbacks, transitions, bad days. We learn from what works and what doesn’t work. No one does everything perfectly, and the best way to learn is by paying attention and being aware.

Write in a journal, especially days that feel good. It’s too easy for us to internalize that we are always depressed, or tired, or manic, or incapable. But we are more than that. If and when you have a good day (you will, trust me, they come…) write down what that feels like. See if you can figure out what led to the moment, even if it’s just a flash. In my case, my son was ten weeks old and he suddenly kicked his legs and giggled. I found myself smiling for the first time in a long time, and I believed then, I could get better one day. For you, it might mean a task completed, or standing up for yourself in a situation, maybe having face to face time with a friend. Remember them, write them down, refer to them to help you believe better times are on their way. Find out what promotes a positive feeling in you.

Prepare a list of go-to activities that make you feel better. When your mind is muddled, it’s hard to find a way out of dark thoughts. I kept a list taped to the inside of my kitchen cabinet, on it were things like a trip to the bookstore or a walk. I also had “watch SNL” because laughter was and still is, important to me. Be sure to exercise, sleep adequately, eat right, drink water, take your medication, talk to someone at least once a day. You could list creativity, cooking, photography, writing, nature walk, yoga. Whatever is part of things that need to happen every day for you to recover. I still refer to a daily list for my mental health, it includes sleep, exercise, good food, and water.

If you have a bad day, tell yourself that it’s not permanent. The feelings are not here forever, and tomorrow is a fresh start. Have a plan for a bad day, whatever that may be. For me, I have a close friend whom I trust. She always knows what to do, she just listens.

Recovery from PPMD is possible. After a long time of being depressed, we have trained ourselves to think that’s who we are and it’s easy to fall into old habits, with thoughts of discouragement and hopelessness. I don’t make light of the challenge it will be to be active in your recovery, but the result is one of hope and empowerment.

There will be better days, but they won’t happen by magic.

Medication and therapy are an important part, but reframing how we talk to ourselves and being open to change and implementing suggestions for lifestyle changes by our recovery team, are just as integral. I know it’s not easy, especially at a time when you have never felt more lost or overwhelmed. Recovery is an arduous process that feels endless on some days — there were times when I thought I would never get better,  but I assure you, the day will come when PPMD will be behind you. The way to increase your chances on the path to recovery is to take an active role in your personal journey. It’s a lot of work, but there are many people here to help you, and it’s a thousand times worth it.

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When You Compare Yourself To Mothers Without Postpartum Mood Disorder

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alec the babyFrom my viewpoint, everyone around me had it together.

I saw the dark-haired mom seated on the other sofa in the gathering room. Her hair was smooth and fell neatly to her shoulders. Her three-month-old daughter looked up at her from her knee, dressed in a spotless blue one-piece. Next to her sat another mom. Short hair, obviously clean, as were her clothes. In her lap, a cooing infant, he was fresh and shining, I was sure he had been bathed just that morning.

Everywhere I looked, I saw put-together and neat as a pin mothers. In unstained clothing with faces dewy and bright from their morning shower. I couldn’t bear to look up and meet their sparkling eyes. Neither could I bear to look down, into my stained three-day-old T-shirt. My baby, my life, really, nursed blissfully in my arms. Alec was always clean, so beautifully well taken care of by me. But that’s all I could manage to do during these first days of new motherhood, just tend to this precious child of mine.

I was in the throes of newly diagnosed postpartum depression and anxiety. Alec was four months old, and my therapist had recommended that I get out of my house at least once a day. And that’s how I came to be at this morning’s Diaper Bag Club at a local hospital. From my end of the sofa, I saw no one like me there. Stringy hair, with the same clothes as yesterday and without a shower since the Sunday before when my husband had been home to hold the baby.

Alec, my precious baby boy, screamed anytime that he left my arms. I had grown so used to his cries, that even when he napped, I still heard them. I adored this child, but he was all-encompassing, and with the days without sleep piling one on top of another, even thinking felt difficult and impossible.

The gathering room on this Wednesday morning was filled with women who could do what I couldn’t do. That’s what I believed, and what I told myself. They were who I compared myself to. Women who looked together with babies who barely sniffled. I sat in the middle of this group of nine women, and my eyes began to fill with tears.

I couldn’t even mother.

What I was doing, was one of the worst, and yet, most common things that we do as postpartum mood disorder moms: we compare. We compare ourselves to mothers who are living in a different world than we are. But I didn’t know that, and I didn’t understand it enough to help myself. It was my therapist who helped me see my way out of this dangerous unproductive mindset.

“What you are doing, thinking that you should be right where others are now, and comparing yourself to them, is apples and oranges,” she explained to me at a therapy session later that week. “You haven’t even started the recovery phase and yet you want to live in another land without crossing the bridge to get there.” She talked to me firmly, but not brusquely. She explained how I was still on this side of the world, with my goal being to get across the ocean to get to that side of the world, and that our sessions, my medication, along with support of family and friends, would be part of the bridge over those waters that would get me there.

She took a pencil and drew on a piece of paper. There was me, an “x” over here, and then a dotted bridge, with my destination, me, another “x” over on the other side. I folded this paper and carried it with me. I thought about the “x” of me thinking I could do what the other women on the other side were doing when I didn’t even have one foot on the bridge yet.

Comparison to others will always engulf us. When you have postpartum depression, postpartum anxiety, or any other mood disorder at this time, you’re not at the same starting point as those without. Some of the women I sat with that morning entered into motherhood with their feet set and ready to go. They had no postpartum repercussions. Add to that, many had “easy” babies. Some had husbands who worked out of the home and were there with them during the day to combat the loneliness and some even had mothers or mothers-in-law, friends or siblings who came at least once,maybe more, during the week.

It was a vastly different world from mine, and yet… I held myself up to the same standards and results that they had. I thought I should be marching along in their identical unencumbered rhythm.

What my therapist did for me was help me feel pride in all that I was doing, and overcoming. When I said to her with tears in my eyes, “But these women are better mothers than me!” She laughed softly and asked back, “Really? Let’s see what happens when I try and hand Alec off to one of them.”

When I said that these women looked so good and that I looked so disheveled, she countered with, “Problem solved. Put on a fresh shirt before you leave home.” That sounded so easy, and yet? I never thought of doing it. I know it’s hard to understand, but with postpartum depression and anxiety, along with fatigue and a colicky baby, you can’t see your way out of the simple things.

No matter what I volleyed at her, my therapist smiled at me warmly and helped me to see that I was the best mother at this time with what I was surviving. Her comforting reassurance of how Alec seemed to be in love with who his mother was brought me to grateful, gushing tears.

My baby loved me, I could see that. And all I had to do was tell myself that I could get to the world I hoped for me and my baby. With small things to help me along the way, like a change into a fresh shirt before I left home and with big things to help me, like our  continuing therapy. My therapist had me check my reality. And more important than anything, she gave me a map, one I could look at and envision the me on this side, on the way to the me on the other side, and to be patient with the bridge that would get me there.

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