Postpartum-Onset Bipolar II Disorder & OCD

[Editor’s Note: Today’s guest post comes from Kristen Lautenbach. She shares about her journey to diagnosis. -Jenna]

That Was Then, This Is Now: Postpartum Onset Bipolar II Disorder & OCD -postpartumprogress.com

It’s the spring of 2015, and I’m outdoors with my four young children, breathing in the long awaited warm weather as we walk to the playground. Life is humming along at a hectic pace, just as I’d imagined it would be when I’d found out, the year before, that my husband and I would welcome our fourth child.

But it’s not the challenge of parenting four little people that consumes my thoughts. As we walk along, the outward picture of a happy, carefree family, I’m preoccupied by the vivid images that have been too often flashing in my mind—images of my precious children coming to harm. Suddenly my three-year-old trips on a raised piece of sidewalk, and though he catches himself and continues marching along, in my mind I see him crashing face-first into the concrete. I try my best to push the horrible picture out of sight, but it will return to taunt and terrorize me throughout the day and even after the day has passed.

These graphic pictures of accidents that flicker and flash uninvited are what I now know to be intrusive thoughts, in my case caused by postpartum obsessive-compulsive disorder. They began shortly after the birth of my son, an autumn baby, who despite an intense birth experience was born healthy, beautiful, and completely adored. I had experienced these types of unwanted thoughts to a lesser degree following the births of my three older children, but the thoughts—and the anxiety and mild depression that accompanied them—soon diminished and then resolved with time. This time around, I am having a much harder time managing the chaos that seems to be both all around me and inside my very core.

During the first weeks of his life, my newborn son had difficulty breastfeeding, and after several days and nights of nearly constant nursing, a flurry of appointments with lactation experts revealed that an overlooked posterior tongue-tie and thrush, an excess of natural yeast in the body, were to blame. The tongue-tie was easily fixed with a quick clip of the skin under the tongue, but the thrush was more difficult to treat. Life became frantically busy as I fought to keep breastfeeding going while doing my best to care for my other children as well.

Stress and sleep deprivation wreaked havoc on my vulnerable postpartum state. One afternoon, as I hurried around the kitchen getting a snack ready for the older three, I glanced toward the living room to check on my two-month-old, who was lying on his play mat. His little mouth was purple with the gentian violet I had to apply to his tongue to treat the thrush. In my exhausted state, for a split second, I thought I saw blood pouring from his mouth. My body and mind constantly raced with anxiety. Around this time, I noticed my hands would frequently tremble, and my daughters commented that Mommy often dropped things while getting them ready for school in the morning.

Eventually, my baby settled into a predictable sleeping pattern, the thrush cleared up, and breastfeeding became easier. But while my children slept, I found it increasingly difficult to do so. Sometimes I would fall asleep while settling my three-year-old to bed, then wake up after a few hours’ rest and set to work doing laundry or other housework in the middle of the night. I couldn’t seem to settle down, and though I was worn out, I often felt restless and agitated by the energy I couldn’t get out of my body. My husband is a natural in his role as a dad, and he willingly took over with the children when I was unable to and worked extra hard to pick up wherever I’d left off with the housework. Still, I knew I desperately needed more help keeping up with the increased demands that weighed heavily upon me.

As much as I needed both practical and emotional support, I felt guilty when anyone besides my husband helped me. I had always been able to handle looking after my children, and I was determined to push through the difficult days, hopeful that life would settle down and I would soon feel more like myself again. With no family in town and a group of friends who were all busy with young children of their own, few came close enough to notice that I wasn’t my usual self. Those who offered to help, I all but turned away, insisting everything was alright. My husband could tell that I was struggling, but he had seen me come out of a similar, albeit milder, episode of postpartum depression after the birth of our second child, and he was optimistic that I would get better on my own.

I hoped my husband was right, though I feared this time he wasn’t. As time went on, I felt less and less like myself. When I looked in the mirror, I saw a sad, hollow version of the person I used to be. I started to wonder whether everyone could see how miserable I was, and whether they considered me ungrateful for my beautiful family. Still, most people didn’t even notice that I was having a hard time. Even when I finally confided in a close family member about some of the distressing symptoms I was experiencing, I was given the lighthearted advice, “Fake it until you make it.” I think the comment was meant to encourage me; the idea was that if I could just sit through the storm, I would soon be back into the sunshine. What I wondered but didn’t say was, “What if I don’t make it?” No one understood how deeply I was hurting.

I think that mothers, in particular, can be stoic. We’re used to persevering through all kinds of trials. In my case, I waited until my son was ten months old before finally getting help. I fumbled through the summer vacation with my children, becoming increasingly isolated without the daily interactions that go along with the school routine. I was able to go through the motions of caring for my family; having parented for eight years, I had my mom role practically memorized. Of course, I was only playing the part, a robotic mimic of my real self. Inside, I felt increasingly depressed, anxious, and emotionally fragile. I began experiencing frightening panic attacks and uncharacteristic, dramatic mood swings.

As my condition worsened, I began to wonder if my loved ones would be better off without me. I imagined my husband moving on and marrying someone else—someone completely unlike me. My children might be better off with a different mother, I reasoned, and my family wouldn’t miss me for long. The intrusive thoughts that had begun after my son’s birth now ran rampant much of the day and flashed continuously as I fell asleep at night. While these images had originally focused on my children being accidentally injured, now they included pictures of me harming myself. I had difficulty expressing what was happening, even to my husband. Exhausted and confused, I considered hurting myself as a way to numb my pain.

I was fortunate that in my lowest moment I had someone to call, someone whom I knew would respond with love and without judgement. For me that person was a close friend, the woman who had coached me through my son’s birth and who, fittingly, came to my side and helped me once again. Another friend happened to notice me that same week and immediately snapped to attention, sharing with me her own story of postpartum depression and connecting me to the resources that had helped her.

I phoned the facilitator of the postpartum mood disorders support group at my local hospital and described my symptoms. Although I wasn’t eligible to participate in the group since my son was older than six months, I was given the name of a psychiatrist who specializes in maternal medicine, and I was instructed to see my family doctor urgently in order to be referred to her. I called my family doctor and arranged to see her the next day. Finally, I had taken the crucial first step of reaching out for help.

Driving to my doctor’s office, I literally shook with anxiety. It was incredibly scary to try to move my inner turmoil into the outside world, to finally say out loud what was happening in my unsettled mind. As I described my symptoms, my doctor listened compassionately, completed the referral I requested, and even set me up with a complimentary counselling appointment. She then prescribed an antidepressant, which I was to begin taking immediately. The medication, she explained, would allow me to start feeling better after a few weeks, and I was to return in four to six weeks to reassess how I was doing.

For some women with postpartum depression, that antidepressant might have been a lifesaver. For me, however, it resulted in insomnia, extreme anxiety, and mental confusion. By the fifth day of taking the medication, I was completely unable to think clearly. I couldn’t remember what I had done just moments before and repeatedly asked my children questions such as whether I’d already brushed their teeth. A friend saw me dropping off my children for school and, noticing I seemed anxious, insisted she stay with me through the morning. A few hours later, when I became faint and was unable to answer her questions, she called 911.

Of all the women who suffer from depression following the birth of their baby, approximately one in five is actually dealing with some form of bipolar disorder. I was one of those women. This is why the antidepressant actually worsened my symptoms, causing my shifting moods to cycle even more rapidly between racing highs and painful lows. Thankfully, it was only a couple of weeks before I saw the psychiatrist to whom I had been referred. She had the expertise to evaluate my full range of symptoms, and after several appointments I was diagnosed with postpartum OCD and bipolar II disorder. It was a lot to take in, but a relief to finally understand what was happening. With proper treatment that included mood-stabilizing medication, I gradually began to feel better: calmer, happier, hopeful, whole.

My baby boy is now an energetic eighteen-month-old. I can honestly say I’m delighted that I get to be “Mom” to him and his brother and sisters. While I never doubted my love for my children, it is a joy to be able to once again feel that love and not simply to know it. I am immensely grateful that I’ve been able to get professional help for my postpartum mood disorder. I continue to see the specialist who initially helped me, now on a monthly basis. I’m conscientious about taking care of myself, making sure to sleep enough, eat well, and make time for occasional dates with my husband. Medication continues to be a crucial part of my recovery, and I also use a mood chart so that I can track how I’m feeling and better identify what helps to keep me well. Most importantly to me, I have a caring family and a close circle of supportive friends who know what I’ve been through and who remind me of how loved I am.

If you are struggling with a perinatal or postpartum mood disorder, or if you aren’t sure but you just don’t feel like yourself, please reach out and tell someone what’s going on. You may have to talk to more than one person to be heard. You may have to volunteer the information to your family doctor if he or she doesn’t ask. Just please don’t suffer in silence. Getting help doesn’t mean you’re weak, or that your parenting will be called into question. In fact, it’s the opposite: It means that you’re strong, and that you’re devoted to being the healthiest version of yourself that you can be, for you and your family. As my dad said to me when I told him I was getting help, “There is a much prettier world out there, sweetie. And you’re going to see it.”

Mental Illness Didn’t Crush My Dream of a Family

Mental Illness Didn't Crush My Dream of a Family -postpartumprogress.com

I was diagnosed with Bipolar Disorder after experiencing two manic episodes in the same month, each requiring hospitalization. At the time I was devastated and felt as though my dream of having a family had been shattered.

I knew I wanted to be a mom from a young age. I adored babysitting and loved being in charge. In my mind I’d meet the man of my dreams in college, we’d get married soon after, and when the time was right, we’d start a family.

In reality, that all did happen, with one exception.

I met the love of my life while in college. We dated for four years before he proposed. At 24, we said our vows in front of family and friends, promising to love each other in sickness and in health. Little did we know sickness wasn’t far off. We’d have just over two years of health before mental illness knocked the wind out of our nearly perfect love story.

Madness struck me before I’d even had the chance to decide that I was ready to try for a baby. My diagnosis of bipolar disorder left me wondering if I’d ever be healthy enough to be a mother. A year went by as I struggled to keep my chin above water, my depression pulling me deeper and deeper into the ocean of despair. I felt like I had nothing to live for.

My husband and parents fought hard for me. I saw countless psychiatrists, and even a noted doctor from NIMH (National Institute for Mental Health) who told me, as I sobbed in his office with my husband by my side, that I could still have children if I wanted. It was possible, he said. And staying on medication under doctor’s supervision would be a good idea.

After a year of intense suffering, I couldn’t take it any longer and finally agreed to try a medication my doctor had been recommending. It took several months for me to feel the full effects, and for my old, up-beat personality to begin to reemerge. My husband and I took things one day at a time, and when the weeks added up to a full year of stability, the year of hell began to fade into the shadows of our minds. Thoughts of pregnancy began to fill my head, and all of a sudden I was pleasantly distracted from my illness.

I’d accomplish my dream of having a family; it was so close I could taste it.

Looking back now, with two healthy kids and six years of parenting behind me, sure, I’d do things a little differently.

I was medication-free for my first pregnancy and although I did fine and had no symptoms of my bipolar disorder during the 40-weeks, the same can’t be said for the four weeks after my son was born. Postpartum psychosis ripped me from my newborn, but I was fortunate it only took a week in the psych ward to return me to my family. In hindsight, part of the problem was the pressure I put on myself to be a “perfect” mom to my new baby. Maybe if I wouldn’t have been so insistent on breastfeeding, I wouldn’t have gotten sick. Maybe if I would have let family help more with the night feedings, my mind wouldn’t have lost control of itself.

Lessons learned, I agreed to do things differently the second time around. I thought I had all the proper precautions in place. I did my research and decided that since the medication I took had the greatest risk to the fetus during the first trimester, I’d work with my doctor to taper off the med once I got a positive pregnancy test. The plan was to go back on the med in the second trimester and remain on it for the duration of the pregnancy.

Unfortunately, the exciting news of the two little pink lines sent me into a manic episode after a week-long battle with elated insomnia. I spent five days in the psych ward at five weeks pregnant battling the most severe mania I’d ever endured. The doctors brought me back from my break in reality with powerful anti-psychotic drugs and I feared I might lose my baby.

Recovery from that most recent hospitalization in April of 2010 was the most difficult. I worked closely with my doctors and my baby girl was thankfully born completely healthy. My postpartum period with her was drastically different than that of my first child, due to the plan I had put in place before she was born. We formula-fed from the start, since breastfeeding wasn’t an option anyway due to my meds. Knowing she’d be a bottle-fed baby from the moment I became pregnant made it easier to get past the sadness over not being able to breastfeed.

Since my husband and I knew that lack of sleep was my number one trigger, he did the middle-of-the-night feedings in her first few months which allowed me to get a solid chunk of quality sleep. We even had my sister-in-law stay with us for the first two weeks since she was home on a break from her job at the time, and she took the night shift. Sleep was still a challenge in those first few months, but luckily she was a great sleeper and we made it through.

One thing is certain: I didn’t let mental illness rob me of my dream of a family. My family is everything to me.

Parenting is no easy task. Throw in mental illness to manage, and it can get intense. Intense, but not impossible. There are resources out there, there is support out there. My kids are worth it all, no doubt about it. I share my story—our story, really—so that other women out there can find hope.

Triggers and How They Affect Recovery

Triggers and Recovery from mental illness

Knowing is half the battle. I found this to ring true in my experience with managing my mental illness during my pregnancies and postpartum.

I was diagnosed with Bipolar Type 1 in 2006. It took over a year for me to find the right psychiatrist, the right combination of medications, and the right techniques through therapy to allow me to begin to manage an illness which had taken me and my family completely by surprise. After months of anguish over what was working and what wasn’t, we finally found a medication that stabilized me and I started to feel pieces of my old self emerging from the darkness.

Once I had been stable for about a year, my husband and I decided we were ready to start a family. I was scared of a recurrence of my illness, but wanted to be a mom more than anything, so we started trying and I was able to get pregnant rather quickly. Unfortunately, our joy was fleeting as I experienced an early miscarriage and had to have a D&C. I was afraid that the medication I had been taking for my bipolar disorder caused the miscarriage, so I convinced my psychiatrist to allow me to taper off the med so that we could try again after I healed from the surgery.

We became pregnant again fairly soon after, and since I was doing so well off the medication and had no recurrance of symptoms, my doctor continued to see me as a patient but allowed me to stay off my medication for the duration of the pregnancy.

This was a terrible decision on both our parts, but I didn’t realize this at the time. Four weeks after delivering my son I experienced a severe episode of postpartum psychosis and had to be hospitalized for a week. It was arguably the worst week of my life, having been ripped from my child, having to abruptly stop nursing, and it took an incredible toll on me both physically and emotionally.

I was stabilized quickly by the team of doctors at the hospital by resuming my course of medication I had been on before my pregnancy. The recovery from the trauma of being taken away from my newborn for a week would take much longer.

I learned through my postpartum psychosis episode that my triggers are: lack of sleep and lack of medication in my bloodstream. These two facts would prove essential to me creating a much more positive postpartum experience with my second child. But not without another lesson first.

Once stable again after my PPP hospitalization, my husband and I began to talk about completing our family with one more baby. Even with my three hospitalizations (two before our first child and the PPP episode), I still didn’t know enough about my illness to know that the benefits of me staying on my medication during the pregnancy and exposing the fetus to the medication, although not the most ideal situation, far outweighed the risks of not being on medication at all given this was one of my top two triggers.

Doctors can advise patients, but it’s up to the patient to follow through with the prescribed recommendations. My doctor had agreed to let me stay off medication during the first trimester due to a heart defect risk, but after week 12 we decided I would go back on my medication for the duration of the pregnancy.

Tapering off my medication in just week 5 of the pregnancy, combined with my excitement and mounting loss of sleep over how excited I was to see those two pink lines on the pregnancy test, landed me in the psych ward again. My baby was barely the size of an orange seed and I had to be hospitalized for almost a week and put on antipsychotic medication to bring me down from the mania I had been struck with.

Because of lack of sleep and lack of medication. Two things I learned I could control.

Recovery from that episode took months; experts say that each subsequent episode is more difficult and takes longer to recover from, and I’ve found this to be true. But I emerged from that setback a much more informed and capable mother, ready to truly manage my illness so that it did not cause me and my family any further pain.

My husband and I talked about how we could handle my postpartum period differently with our second child, and we made plans to take charge over my triggers so that I could stay in recovery long-term. I stayed on my medication for the entire rest of the pregnancy and beyond because my medication kept me stable. We made plans that I would bottle-feed and my husband would take over the middle-of-the-night feedings between 2am – 5am so that I could get a long stretch of sleep at night, keeping my nocturnal clock in check.

I’m not saying it was easy. But my postpartum period with my second child was so much more enjoyable and relaxed compared to my first because I took the upper hand over my triggers. With my family’s support, I made it through. And I continue to keep a firm grip on my dedication to the medication that keeps me stable and getting the appropriate amount of quality sleep each night so that I can stay steady on my recovery path.

Bipolar disorder is a condition I’ll live with for the rest of my life. Learning my triggers and techniques which allow me to stay on top of them so they don’t throw me into a manic episode has been a learning process, but it is one which has empowered me to live well even with a mental health disorder.

6 Ways You Can Be an Empowered Patient During Pregnancy When You Have Bipolar Disorder

The best person on my care team? My OB. Hands down. When we found out I was pregnant (far sooner than we had planned), my husband and I decided right away that no matter what course of treatment  we decided upon after speaking with my doctors, our number 1 priority was my mental health. Still absorbing the shock, I remember my husband standing in our bedroom with his fingers lacing their way through mine, saying, “Health and wellness, Addye. That’s our focus, ok? Your health and wellness. No guilt, no shame, no matter what happens. YOU and your health are what’s most important. We’ll do whatever it takes. We’ll get through this together. I promise. Let’s do this.”  I’m pretty sure I was fighting back tears and a whopping dose of fear in that moment as I high fived him and agreed: We could do this. I could do this.

And I did. I have. I’ll be a year postpartum next month, and as I watch my youngest son crawl into the room he shares with his two older brothers, I think back to that moment in my bedroom and feel proud of that promise we made, and the treatment option I chose.

Given my previous history with PPD, the nature of my illness, and the increased risk of relapse I faced because I have bipolar disorder, we decided staying on two out my three medications was what health and wellness would look like for me…as well as for the baby and the rest of my family.

That was my choice, but I know many other mothers with bipolar disorder who opted to go without their medications during their pregnancies and remained healthy throughout. No matter what course of treatment you and your care team decide upon, the important thing to remember is that you DO have options. There’s nothing I hate more (aside from stigma) than coming across an article on the internet that gives women with bipolar disorder incomplete information regarding their treatment options during pregnancy and breastfeeding, doesn’t point to what resources they can utilize to make informed decisions, and doesn’t tell them how they can navigate the unique challenges they’re faced with.

So let’s talk about how to do that, shall we? (This post is going to a bit long, but bear with me, I believe what I’m sharing with you is important)

1. Build Your Care Team, Create a Treatment Plan

I cannot stress the importance of this enough: You MUST have people on your medical team who have experience in treating pregnant women with mood disorders. Think of this as your Dream Team. People you want on this team are your OB, your psychiatrist, therapist (if you have one), and a pediatrician. It’s possible your obsectrician will also want a reproductive psychiatrist and maternal fetal medicine doctor on your team as well, especially if their experience on this front is minimal. Thankfully, my OB had extensive experience with caring for women with bipolar disorder during their pregnancies and knew pretty much everything that’s out there regarding medication use during pregnancy and breastfeeding. He was up to date on the latest research available and proved to be my most invaluable resource on my care team. Seriously, he’s the one who gave me the confidence that all would be well, and that choosing to stay on at least two of my medications was a safe and healthy choice. Both he and my psychiatrist spent a lot of time going back and forth, weighing the risk vs. benefit of staying on meds or going without, and although they disagreed on a few minute points, they ultimately decided staying on medication would be healthiest for me, and ultimately, baby.

Also be sure to find a pediatrician to consult. You’ll need one anyway after the baby is born, so you might as well find one who knows about medications, postpartum mood disorders, AND does depression screenings at well visits. (Our pediatrician does and it has been incredibly helpful to me this past year.)

Finally, ensure that the team you build has your mental health as their top priority. As soon as a woman becomes pregnant, the focus tends to immediately shift toward the health of the baby and stay there. In the past, I’ve dealt with OB’s who only cared about how I was doing physically and what impact any physical conditions I had would have on my baby in utero. Not once did they focus on my mental well-being, let alone have it guide my prenatal care. Listen: I completely agree that baby’s health is a priority. I do. But I’m going to just come right out with it and say that a mother’s mental health is what’s most important and should be the foundation of her prenatal care, and if no one on your team shares in that philosophy? They shouldn’t be on your team or in charge of you and your baby’s care. Period. Same goes for the person treating your mental health condition. My first psychiatrist through the VA was woefully uninformed and unhelpful when I told her I was pregnant. It took a lot of pushing, but I was finally able to have my care transferred to a psychiatrist with a background in pharmacology and reproductive psychiatry, and it made a significant difference in my overall care.

2. Communicate and Advocate

Everyone on your care team should be in constant communication with you and each other through every phase of your pregnancy and delivery. They should also be able to come to an informed consensus (with you) about your treatment. There is nothing worse than having two of your doctors at an impasse over a part of your treatment plan because they just disagree. It’s incredibly frustrating and the last thing you need to be worried about. If this happens, don’t be afraid to speak up and advocate for yourself, reminding them that they are there to help care for you and your baby, and you need them to work together.

Always be open and honest with your care team about what you’re feeling and experiencing throughout your pregnancy, so they know how to help you as soon as possible. Part of my treatment plan involved staying off of my mood stabilizer during my first trimester, but remaining on my anti-depressant. At 11 weeks, I called my OB and told him my mood was starting to take a nosedive and I was worried about a depressive episode. He moved my NT ultrasound scan up to the start of week 12, and as soon as he reviewed the results, gave me the all clear to start back on my mood stabilizer.

3. Do Your Own Research, Knowledge is Power

There are books out there on  medication use during pregnancy and breastfeeding and the variety of treatment options available for women in our situation-get your hands on them and read as much as you can, being sure to talk with your care team about what you learn as you do. When researching my treatment options and discussing them with my team, books I read included Pregnant on Prozac by Dr. Shoshanna Bennet, Medications and Mother’s Milk 2012: A Manual of Lactational Pharmacology by Dr. Thomas Hale, and The Complete Guide To Medications During Pregnancy and Breastfeeding: Everything You Need to Know To Make the Best Choices for You and Your Baby by Carl P. Weiner MD and Kate Rope.  I also read everything I could on the MGH Center for Women’s Mental Health blog, which has a wealth of information on research studies and how to use their findings to make informed treatment decisions with your clinician.

4. Create a Birthplan That Takes Your Mental Health Into Account

Initially, I considered going without pain meds for my delivery. I read all I could about natural child birthing methods, and had it in my mind that I’d hypnobirth my way through labor and delivery, even if  I wound up crying uncle and utilizing some form of pain medication. But at 28 weeks, I landed in L&D with contractions that wouldn’t stop without magnesium. In fact, they didn’t really stop the rest of my pregnancy. I contracted every day of my third trimester without ever dilating more than 2 centimeters. Previous experience reminded me that neither of my labors with my older two progressed without intervention, despite having intense, painful contractions that were off the charts for a week. Looking back, I’m positive this contributed to the panic and anxiety I had during both deliveries and afterward. With this third go around, I was miserable, exhausted, starting to have anxiety attacks, and was starting to cycle between nesting induced hypomania and depression.

At week 38 I told my OB I was done and worried that continuing would put me over the edge and trigger a depressive episode-and I hadn’t done all of this preventative health and wellness work to be in a dark place when my baby boy was placed on my chest. I knew my limits, and wanted a bit more control. I wanted an induction. He agreed, and a week later I was in the delivery room smiling and laughing as I stared lovingly at my newborn-100% anxiety free. It was a calm and beautiful experience and in my opinion, gave me the strong start postpartum I needed.

Whatever your birth plan is, make sure it’s flexible, realistic, and compliments your treatment plan.

5. Have a Support Network

Having the love and support of friends, family, and your partner is so important. Lean on them when you need to, and don’t be afraid to ask them for help. Inform them of ways they can be a support to you. My friends (fellow Warrior Moms) and my husband did an amazing job of supporting me during my pregnancy and this past year. I couldn’t have made it without them to call, text, and share this experience with. A therapist can also be an invaluable resource to you during this time; they can help you process all you’re experiencing and develop coping strategies for managing your postpartum period. Consider finding support online in a private forum for pregnant and new moms with mood disorders (like Postpartum Progress’ Smart Patients Forum or the #PPDChat private group on Facebook), or find what’s available to you locally through organizations like NAMI or DBSA.

6. Self Care

Try to find ways to incorporate rest into your day as much as possible, even if you already have other children. Do not go without sleep. Create manageable to-do lists, and reconstruct your expectations about how much you can get done each day-especially if you’re working. Practice deep breathing exercises, and engage in physical activity that is both safe for you and baby and feels good. Engage in activities that are calming and nourish your soul-even if it’s binge watching your favorite show on Netflix. Keep track of your mood either in a journal, or with a mood tracking app on your phone; this will help you be able to communicate to your care team and support network how you’re doing. (I use iMood Journal) Prenatal massage, mani/pedis…whatever self-care looks like and is for you, be sure you do it and do it as much as possible.

 

I hope this is helpful and gives you a good starting point for creating a plan that works for you. Remember-You have options when it comes to treatment. You can do this. I promise. You got this, mama.