Navigating Your Perinatal Mood or Anxiety Disorder

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8363033986_503c7a47f3As a mom with bipolar disorder who blogs openly about my experiences surviving a postpartum mood disorder, people often ask my opinion on ways to deal with and manage their diagnosis. I am not a medical professional, so I hesitate to even answer these emails. But my heart tells me I need to address their questions.

Having been in the same shoes not long ago, I remember the desperate desire to connect with others who had gone through something similar. Back then, people weren’t talking as openly about mental illness, the stigma was thick and heavy, and I felt as though I was harboring a shameful secret. It wasn’t until I found Postpartum Progress that I truly felt I had found a group of women who understood.

So I get it when other moms, and sometimes dads, write to me about their story, asking for advice on what to do after receiving a diagnosis. They’re looking for the same connection I found. The same searching that led me to join this community.

Here are my suggestions: [Read more...]

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My Journey Through Infertility and PPD: Fighting My Way Through New Motherhood

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Please welcome Warrior Mom Kass to the blog today. She is a beautiful new mama who struggled in the past with infertility. Although she knew she was at risk for developing postpartum depression and anxiety because of her existing bipolar disorder, she was still surprised and disappointed to find herself in the fight of her life against PPD. She shares more about her experience with new motherhood over on her own blog, This Journey Is My Own. If you have any words of encouragement for this mama, I know she would love to read them in the comments.

Warrior Mom Kass

For nearly 5 years, my husband and I struggled with infertility. All we wanted was to get pregnant. After a round of IVF treatment, our longtime dream came true.

I was optimistic about my pregnancy. I planned to have an epidural-free birth at a birth center with midwives. I made the tough decision to stay on my mood stabilizer and antidepressant medications throughout my pregnancy. I knew we were committed to raising this baby no matter what the outcome.

 But things didn’t go as planned. The midwives were concerned about neonatal withdrawal syndrome from my mood stabilizer. Soon, it was discovered that I had 2 large fibroids, one of which had the responsibility of pumping nutrition and oxygen to the placenta. My baby turned breech, had slow weight gain, and needed to be delivered early via C-section. I ended up in the hospital with a spinal in my back.

 As soon as my baby was delivered, my hormones plummeted instantly. I gazed at my son in complete disbelief that he was real. I cried the night of his birth and nearly every day thereafter for 5 weeks. I was overwhelmed with the task of motherhood and suffered severe panic attacks. I endured scary thoughts. What should have been a joyous occasion turned out to be bleak and sad for me. The first week of my son’s birth, my husband was home with me to help me take care of the baby. The second week, he went back to work and I was on my own.

It really is a miracle that my son survived that second week. I was in pain and still struggling to wrap my head around the fact that I did not come home from the hospital with a doll. No, he was—and is—a living, breathing human being. I still suffered from scary thoughts regarding my son. Then, the scary thoughts turned on me.

I was on medication throughout my pregnancy so I didn’t have prenatal depression other than “normal” hormonal changes. I thought the meds I took during pregnancy would be sufficient to carry me through my early postpartum period.

They were not. I felt hopeless and worthless—all kinds of negative feelings applied to my mothering skills. I had issues bonding with my son. Because we were exclusively formula feeding, I felt as though he gravitated toward anyone who would feed him. I thought he didn’t love me and looked past me. I suffered extreme guilt. I had wanted him for so long and now that he was here, I felt as though I didn’t love him.

I stumbled upon Postpartum Progress and read through the symptoms of PPD. I thought my crying, anxiety, and obsessive thoughts might be the “baby blues,” but my symptoms were so severe that I nearly ended up in a psychiatric hospital. I finally admitted to myself that I might have postpartum depression.

I made the appointment with my psychiatrist that I hoped I wouldn’t have to make. He increased the dosage of my medications to combat my PPD and anxiety. He even diagnosed me with OCD-like tendencies. I began to participate in #PPDChat on Twitter. Thanks to my husband’s urging, I started therapy at the Postpartum Stress Center  in Rosemont, PA.

This was all within the first 5 weeks after my son’s birth.

I’ve struggled with depression and suicidal thoughts since I was 12. I was diagnosed with bipolar disorder at 24 years old. What in the world made me think at 32 I would not suffer from postpartum depression? I knew that those with a history of mood and/or anxiety disorders before the introduction of a child are prone to PPD and related disorders afterward. I was no exception.

I realize now that it’s never too early to get treatment. Many women wait 6 months to a year before getting help, but if the symptoms are tackled right away, they can feel better sooner.

 I’m now 11 weeks postpartum and still struggling with mood and anxiety issues. My son is alive, healthy, and thriving. At times, I still feel hopeless about my ability to be a good mom. I still cry when he cries. I get frustrated. The thought still crosses my mind, “Maybe I shouldn’t have had him.” Not because of him, but because I feel wholly inadequate to be his mother.

But the online support and in-person therapy I’ve received have given me hope. Motherhood is hard. It’s one of the most difficult things I will ever do. But many women who have suffered from postpartum illness have come out on the other side to encourage me. They say it gets better. They say I’ll make it through. So far, I have. And I hope that the tenacity and determination that led to overcoming infertility will carry me through.

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Educating mamas-to-be one story at a time

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I think of mental illness the same way I view cancer. It can strike anyone at anytime. For me, the time came at the age of twenty-six. I was blindsided. Two manic episodes two weeks apart; two stays in two different psych wards at the end of 2005.

If the first time was a complete and utter shock, the second reinforced what I guessed was happening to me. My family and I were in denial after the first incident, totally unprepared for the road ahead. The second bout of mania solidified the fact that this was real.

Even after living with bipolar illness for two years, I had yet to fully understand the disease. When my husband and I reached a point where we agreed I was stable enough to try for a baby at the end of 2007, I read everything I could get my hands on about postpartum depression, the only postpartum mood disorder I knew about. I had lived through a year of debilitating depression following my diagnosis of bipolar type one, and was terrified of falling into the darkness again. Especially with a new baby who would be depending on me for survival.

Impressed with what I thought was a great job preparing for my postpartum experience,  you can imagine my confusion when instead of the intense case of the baby blues I had expected, mania began taking over my mind in the weeks following my son’s birth.

The pressure I had placed on myself to succeed at breastfeeding made everything worse. Instead of turning over my sweet, swaddled little boy to my husband so he could give a bottle of formula and I could get some decent rest, I pushed my body further than I ever have, on top of having just given birth via emergency C-section after a sixteen-hour labor. I was not allowing others to help me care for my baby, which in turn contributed to the swift deterioration of my mental health.

It was only the third time in my life that I had felt full-blown mania, and now having been there four times I can easily say that it’s like an out-of-body experience. You have the strangest thoughts, such as the time I believed every song that came on the radio was a sign specifically meant for me and my life. Sleep and food became things I needed very little of to function, my energy level soaring through the roof. I felt invincible.

Until everything fell apart and I spent the fourth week of my son’s life in a psychiatric ward of our local hospital suffering from postpartum psychosis.

I’m very lucky in that I respond well (and fast) to medication, and so I was back at home before I knew it, returned to my precious baby who had no idea I had gone away. My recovery was slow and steady, and within a few months I felt like myself again, and was settling into my new role as a first-time mom.

These days I am so glad that Postpartum Progress is a community of women who share their experiences. I know there are people out there who have read these stories and who have become more educated about postpartum mood disorders (PPD, postpartum anxiety, postpartum psychosis, postpartum OCD, postpartum PTSD) from visiting the site. By sharing to educate and to inspire, we can prevent or minimize the occurrence of postpartum mood disorder hospitalizations by catching the symptoms early. Keeping more mamas and babies together by sharing one story at a time.

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A Story of Postpartum Bipolar Disorder

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After the birth of my 2nd child Ellie, my mental health changed dramatically. I started to have symptoms of mania, which until then had not presented themselves. After going through what I thought was postpartum depression and anxiety, I’ve come to understand that it was probably postpartum bipolar disorder.

It is a diagnosis that until recently had not been studied. But in 2012, here on Postpartum Progress, Katherine asked perinatal mood and anxiety expert Karen Kleiman, MSW, LCSW to write about this often misdiagnosed postpartum illness, and that information really made me think.

I’ve now seen this study from 2013 that shows women with clinical depression prior to childbirth have a much greater chance of being diagnosed with postpartum bipolar disorder, so I believe its time for the medical community to be more aware of this possible outcome, and take steps to properly diagnose and treat women who are fighting this illness.

Bipolar disorder background concept

Today, I’ve invited Dyane Leshin-Harwood to share her journey with Postpartum Bipolar Disorder. I’m interested to hear if you too identify with her experience like I do. Please welcome Dyane:

On a warm summer night, I was a sweaty nine months pregnant when my water broke. We immediately went to the hospital and I stayed up all night in labor, not sleeping one wink.

This innocent-sounding act — enduring one night without sleep — would be my biochemical trigger for postpartum bipolar disorder.

Despite a strong family history of bipolar, I didn’t have any inkling that mental illness was latent in me. My first daughter Avonlea had been born almost two years earlier, and I was incredibly fortunate that I did not have a postpartum mood disorder after her birth.

My second daughter Marilla was born at noon, on August 26, 2007. At first I was hypo-manic, exuberant with joy over the birth, but to others I appeared relatively normal. Sweet Marilla attracted most of the attention so no one saw that I was already in trouble. I began to sense something was off, but my fear of being an inept mother caused me to keep my feelings inside.

Since we didn’t have family members immediately available to us, my mother gave us the gift of a postpartum doula named Grace. She planned to be with us after Marilla’s birth, but an unanticipated allergic reaction delayed her joining us by four days. As Grace hadn’t previously known my personality, she didn’t realize that my manic behavior was quite different from how I had been before the birth. She had worked with over 150 mothers and while some of them suffered from postpartum depression, none had experienced postpartum mania like I did.

The deceptive part of postpartum mania is that people often think the new mother is simply happy to have a baby. After Marilla’s birth, I was filled with an overwhelming amount of joy and energy. However, not one of my state-of-the-art maternity center nurses, OB-GYNs, or our pediatrician detected my mania right away. My father had bipolar one disorder, and I had suffered clinical depression ten years prior to Marilla’s birth, but still no one noticed.

During my hypomanic state, I could feel my brain thinking much, much faster than it had before. I also had a very rare condition triggered called hypergraphia, which is compulsive writing. I had been a freelance writer for years, but this kind of writing was totally different.

Once I returned home from the hospital, I simply could not stop writing. I wrote at every opportunity, even during breastfeeding, and it was completely bizarre. I went online and typed lengthy emails to friends. I didn’t realize my friends would see the actual time I sent their emails, and some of them later told me they were puzzled that I was writing such lengthy epistles in the wee hours, night after night.

During my sleepless nights postpartum, in a well-meaning effort my husband hid my laptop. As he slept, I cleaned for a good part of the night as quietly as I could. While I scrubbed countertops and organized drawers at 3 a.m., I yearned to have some semblance of peace and balance in my life.

After I barely slept for many days in a row, I was feeling much the way I imagined a coke addict would feel. I was revving with energy, but I also felt exhausted and on the brink of an emotional outburst. But even then, no one thought I should consult a psychiatrist.

During that fateful postpartum week, my brain chemistry was markedly awry in every part of my body. Apart from cleaning the house, I had the other classic signs of mania: tons of energy, pressured speech, no appetite and weight loss. I couldn’t sit still, so my mania also affected my ability to adequately breastfeed my baby. At Marilla’s one-week check-up we discovered her weight had dropped almost a pound.

After almost a week without sleep, I knew that I was sinking fast and something needed to change. I called my OB/GYN and told her medical assistant I couldn’t sleep and was given a sleep-aid. I then called our local Postpartum “Warmline”  and found the number disconnected! I was incredulous that such an important hotline had vanished. I called information asking if they had some kind of a postpartum support line. The operator couldn’t find a number and I got even more discouraged. Finally, I called our local maternity hospital’s lactation center and they gave me the number of the Postpartum Support International (PSI) Bay Area hotline.

The PSI volunteer encouraged me to take the medication to help me sleep. I felt so comforted in speaking with someone who understood how difficult the postpartum period was, and I took that first sleeping pill. I got the first decent night’s sleep in five nights and I felt a little rested the following day.

A month after Marilla was born, I knew I was still manic; after all, I had witnessed mania firsthand in my Dad. But before I told anyone, including my husband, I surfed the internet looking for anything related to postpartum mania. I located a statistic that one in one thousand mothers who give birth will have postpartum mania. Then the name “Dr. Alice W. Flaherty”appeared in my search results. She was a neurologist at Massachusetts General Hospital, a Harvard professor, and author of The Midnight Disease, an examination of the drive to write, writer’s block and the creative brain.

In her book, Dr. Flaherty courageously shares her own experience with hypergraphia, the heartbreaking death of her newborn twins, and her hospitalization for a postpartum mood disorder. I had the gut feeling that this woman could help me. After contacting her, she shared how medication had helped her postpartum mania, and suggested I consider supplementing with formula for my mental health, which I did.

At Marilla’s six-week checkup, her pediatrician listened to my racing voice and and blurted out “You’re manic!” and I burst into tears. While I felt embarrassed and ashamed, a part of me felt relieved that he figured out what was happening with me. From that point on, my mental condition deteriorated and it was clear I needed hospitalization. It broke my heart to leave my family, but I admitted myself into our local hospital’s mental health unit. It was there I was officially diagnosed with bipolar one disorder and I took my first mood stabilizer.

I feel that it’s imperative the doctors and other caregivers who assess women for postpartum depression also screen them for hypomanic or manic symptoms. My two daughters and husband have suffered immeasurably due to my postpartum bipolar disorder. But they have also witnessed my hard-won recovery.

After several years of trying many medications, multiple hospitalizations and even two courses of electroconvulsive therapy, I am finally stable. Bipolar disorder ravages many relationships, but Craig and I have been married for fifteen years. With the guidance of counselors and psychiatrists, our marriage is stronger and more precious than ever before.

With any mood disorder, community support can be incredibly helpful. That’s why I’m so glad you’ve found Postpartum Progress. Life will always be a challenge living with bipolar disorder, but my girls have inspired me to work on my recovery with every ounce of my being. I hope you will too.

Dyane is member of the International Bipolar Foundation’s Consumer Advisory Board and IBF blogger at ibf.org. She is working on her first book Birth of a New Brain – Healing from Postpartum Bipolar Disorder and blogs at “Birth of a New Brain” at www.proudlybipolar.wordpress.com.

P.S. March 30th is World Bipolar Day. Visit here for more information on how you can become involved.

 

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