[Editor’s Note: Last week I wrote about bipolar disorder, and dear Sophie from Sophie in the Moonlight wrote a comment in response to that post that she had no idea was going to turn into her very own guest post here on Postpartum Progress. But I think it’s so important to make sure that every mother who comes to this site feels somehow represented, and I want to make sure moms with bipolar disorder can find the info they need and feel supported. This is why Sophie’s comment has become a post. I’m so glad she shared more of her story.
Oh, and please note: this story has a very good ending. -Katherine]
Ah, crap, Katherine, this tiny little article made me cry. My postpartum psychosis after the birth of my first son (and over the top concurrent triple measures to commit suicide when he was two) is what FINALLY led to the diagnosis of Bipolar I for me. I was on Depakote (at the time it was for migraine prophylaxis) when I got pregnant with him by accident and FREAKED out about the risk of birth defects—so much that I called my neurologist and personally fired him for not warning me of neonatal risks. After meeting with geneticists and lots of tests, we learned little “Luigi” was fine. I stopped taking the drug the second I finished peeing on my third stick in a 15 minute period. I was about 3-4 weeks along.
Pregnancy was great except for puking every day. I had lots of energy and was very excited. However, the trauma caused by Luigi’s birth and emergency C-section and my subsequent inability to lactate at all to feed my child was my hook into PPD, the bone I constantly gnawed on and would not let out of my sight.
I firmly believed that both of my womanly failures to give birth and feed my own kid—two of the most basic components of being a mammalian mother—made me a less than zero. I called myself “the Babysitter” because I was only doing that which any other person could do. I wasn’t a mom. I was an abject failure. The day I realized I had to feed my newborn Luigi “sub-standard” formula and forgo the “breast is best” philosophy is the day I slashed my useless breasts with kitchen knives and gave up my sanity.
I was Super Mom on the outside meeting every developmental need for him with almost OCD-like fixations, lavishing him with love and attention and opportunities; but inside, I died a little every day and felt even more horrible that I was suicidal when I had this gorgeous sweet-natured gem of a boy. PPD cyclical thinking is so short-sighted and unrelenting. And I think many of us have a hook that our depressed brains recycle and recycle until the hook is the only thought we are capable of having: Bipolar or not, PPD is an ongoing loop of destructive thinking.
After a thorough two-year therapeutic treatment plan to treat the bipolar disorder following the aforementioned suicide attempt, my husband “Bowser” and I met with geneticists again, two pediatricians, our family physician, and my beloved Dr. Mean Old Lady (therapist who diagnosed me and made me work my butt off to rid my brain of old thinking patterns). We decided to try for a second child. Part of me wanted to prove to myself that I could do it right this time, bipolar or not, but mostly we wanted “Luigi” to have a sibling with whom to share holidays and rivalry for parental attention. They are very good at the latter.
We had a full team on board, a pregnancy treatment plan, a medication plan, and all sorts of written agreements on what to do should I get PPD (best case scenario) or PPP (worst case scenario) again up to and including my consent to ECT or inpatient facilities. I wrote a letter from my well and typical thinking self to my postpartum and possibly psychotic self and had my BFF mail it to me a week after “Mario’s” birth to remind me of who I was when I was most myself and repeated my self-soothing mantra, “It’s okay, Sweetie,” many times in the letter.
For weeks before Mario’s birth, I did what I called Psychological Calisthenics. Gratefully, Mario was a planned C-section (I have a small pelvis and grow huge-headed kids), plus Mario and I got super hypertension and the OB hospitalized me and whipped the little bugger out the moment I hit 37 weeks. As part of my mental exercises, I read all my journal entries from when I had PPD and from when I was getting well. I wrote down flashcards to come up with a battle plan to deal with Thought Monkeys [click here to learn what Sophie means by “Thought Monkeys“] and read them every day. I read and re-read and practiced and memorized.
I was aware Luigi would know something was wrong with Mommy if I got a bad case of PPD and was determined to do everything in my power to stay on top of things. I could not prevent it and he already knew Mommy’s feelings got sick sometimes, but I hoped for the best and really hoped he wouldn’t blame my sick feelings on the new squalling thing that moved in.
All doctors involved agreed that I could take my daily dose of Seroquel throughout the pregnancy (and I seriously researched every medical journal on mood-stabilizers during pregnancy), and they decided that I would start a small dose of Lithium when I hit 35 weeks (way after the point at which any damage could be done to the baby) to stave off PPD. We all assumed I wouldn’t be able to lactate anyway. Surprisingly I did, and not being able to nurse my kid because the lithium would be poisonous to him was so dang hard, but absolutely necessary. But, man, after trying so hard to breastfeed Luigi without milk and then making milk that I couldn’t use. Mama, wasn’t happy, but I did the right thing. Formula.
***Please note: these were personal decisions made with four doctors based on my medical history. I don’t want to be preaching the “right way” for anyone. However, there are options for most that can be evaluated on a case by case basis. Healthy Mom, Healthy Baby. This includes mental health.
And, you know what. It all turned out okay. About three weeks after Mario’s birth, I had a VERY bad 3-4 days of depression and then it was over. Of course, I’m still bipolar and I still cycle, but being prepared as could be for that pregnancy was incredibly empowering. I think even if I did end up with a few months of PPD, it still would have been okay. I would have been able to forgive myself, unlike before.
Katherine, I’m sorry for this long story and appreciate you allowing me to say all of this. I don’t know how many Bipolar moms are going to read this and I want them to KNOW it really can be okay, even more than okay. I’d like to also point out that severe PPD is often the exact thing doctors need to see (after pulling their heads out of their butts and realizing it’s not Baby Blues) to finally give a woman a diagnosis and treatment that can set her free to live life and not feel like a freak.
Unsolicited advice: If you haven’t been diagnosed as bipolar or as having any other mental illness and find yourself battling a war with PPD that refuses to budge no matter what anti-depressant your GP prescribes, please go to a mental health professional and talk with them. GPs are really only equipped to deal with standard depressive cycles. I’m not belittling them, I love my GP, but he should have moved me on to someone more qualified a long time before I hit Psychosis.
Now we’re all good and healthy and happy. My house is loud w/ 2 boys rough-housing all the time and driving me insane (in a good NORMAL way) and our long-term family prognosis is excellent. This is my prayer, wish, and blessing for all of you, too. Lots of hope out there. Lots of options. And keep reading Postpartum Progress. It’s a virtual encyclopedia of compassion and wisdom in all things postpartum.
P.S. BTW, Mario, Luigi, and Bowser are all names my now 9-year-old Luigi came up with as our family pseudonyms. Thank goodness I had already decided on my own name otherwise I’d probably be Princess Peach. Blech.
Thank you Sophie. I’m sorry I made you cry.