The Power of the Warrior Mom Community

Our small but might COTD!

Our small but mighty COTD!

On our way down, at the Climb Out of the Darkness, a miracle happened: I forgave myself for my prenatal anxiety. The power of the Warrior Mom community, right there in person, surprised me; I’m used to participating in our online community. As we walked, the other moms compared experiences, and each noted that she could mark the darkest time as the weeks she could hardly remember. For one Warrior Mom, pregnancy was a blur of anxiety, and she felt better “the minute she gave birth.” For another, pregnancy was a dream, but anxiety and depression had obliterated her memory of her baby’s first months. Then, a thoughtful pause allowed me to realize that there was a shadow over my memory, too. Next came a wave of understanding, as I forgave myself for taking so few pictures of my giant belly, never finishing that expensive and involved knitting project, and everything I can’t recall.

I remember few moments from my third trimester of pregnancy, and I need help from my husband to put those moments in any sort of chronological narrative. I have struggled with anxiety all my life, and it has always been at its worst during times of anticipation. In other words, I hate waiting. Waiting for my grades in junior and senior high, as well as college, gave me panic, anxiety, stomach aches, even bouts of depression. I had a fantastic pregnancy, right up until the HypnoBirthing course ended, the major baby growth milestones slowed, and the real waiting began. I needed to remain on my anxiety and depression meds while I was pregnant, so I wasn’t just waiting to meet my baby. I was waiting for his birth to reveal whether or not he had experienced “defects” that wouldn’t show up on any prenatal testing. I was waiting to find out whether I would experience the worst-case postpartum mental health crises that I could not stop imagining. I knew that I had may risk factors, but I had finished the work of educating myself and my loved ones. I had to “wait and see,” a phrase I loathe. Did I mention that I hate waiting?

As we completed our small but mighty Climb Out of the Darkness, swapping stories with ease and without judgment, moments of silent understanding reached the deep reservoir of guilt I had held onto for almost three years. These amazing, strong Warriors inspired me, of course, but they also allowed me to see myself from an outside perspective. Did I not deserve the kindness, empathy, and understanding that I felt for them? Of course I did! I deserved their empathy, too. I soaked it in. It may have rained that day, but I let some warmth and light into a cold, dark place inside that I had hidden away.

I am writing to you from the train, on my wait to Boston for the Warrior Mom Conference, and it just so happens that I have this chance, at this time, to reflect on the power of being together as survivors. Leaving my house, choosing what I will wear, anticipating having to talk to people in person at a hotel or a conference–these things trigger huge anxiety for me. But I know that I will find so much healing in this community. This time, excitement outweighs anxiety as I anticipate soaking up the power of all these Warrior Moms, together, in one place.

Note: if you are not coming to Boston, check our the Warrior Mom Conference Facebook page for updates on how you can still participate, follow our live tweets at #WarriorMomCon, look out for a giveaway post, and get together with a friend! Coincidentally, I lucked out and booked myself on the same train that Lauren Hale is riding–community can even find you, sometimes!

Antenatal depression and antenatal anxiety: Jen’s story

antidepressants pregnancyI struggled with undiagnosed antenatal depression and antenatal anxiety.  I felt like such a fraud.  My husband and I had planned for this baby.  I should have been overjoyed and glowing.  Instead I walked around in a fog of self-hatred, irritability, and unrelenting worry.  My internal monologue consisted of, “I should be happy, dammit!” Why couldn’t I enjoy this pregnancy?  It was my final pregnancy, and we were giving our nearly three-year old daughter a sibling.  Where was my pregnancy glow?  Why did I feel like all I did was complain, vent and whine?

Why couldn’t  I relax?  I felt so much pressure to get my oldest potty trained before the new baby arrived.  I felt like all loose ends needed to be tied up.  I had to finish my toddler’s baby book before the new baby arrived.  I had to make sure I was exercising daily.  I had to maintain a tight control on my blood sugar.  I had gestational diabetes with my first pregnancy, so I spent my final pregnancy watching my food intake.  Every time I heard a comment about “eating for two”, I wanted to rage.  I did not have that luxury of eating whatever I wanted.  The meal plan made me miserable.  If my numbers weren’t within the expected range, I immediately panicked.  I was terrified that my daughter would struggle with complications from my gestational diabetes.  Not even the ultrasound showing a healthy twenty week baby girl diminished those fears.  I felt like I had no right to complain or worry.  I knew what to expect.  I needed to just suck it up and deal with it.

Like postpartum depression, antenatal depression looks different for each mama.  My lovely friend Susan describes her antenatal depression like this.  “I just remember feeling a crushing weight and numbness. I wanted to not be pregnant anymore and had thoughts of throwing myself down the stairs. That’s what sent me to a perinatal psychiatrist. All my joy left like I was in a vacuum – and I was suddenly convinced a new baby was the end of everything as I knew it.”

My experience of antenatal depression differed from Susan’s.  My depression manifested itself in extreme irritability, bordering on rage.  I had no patience for anything – traffic, my husband, my daughter, my parents and my sister, my friends, and my co-workers. One of the triggers for my rage was my daughter’s refusal to take naps on the weekends.  I could barely control my reaction.  I would yell and scream at my husband.  I would need to leave the house to give myself an adult timeout.  I still cringe when I remember an epic tantrum that occurred during my seventh month of pregnancy.  I was at a concert at an outdoor venue.  I cut in front of everyone waiting in line for the bathroom and for water, simply because I was pregnant.  I was rude to everyone that day. I took out my rage on anyone in my path.  This irritability and rage manifested itself in full-blown postpartum depression and postpartum anxiety after my youngest was born.  I wish I had recognized these signs sooner.  I could have treated this during my pregnancy when my initial struggle began.

Antenatal depression and antenatal anxiety are not as widely known as the other perinatal mood disorders.  We do moms a disservice when we fail to screen for depression and anxiety during pregnancy.  We need to focus on both the needs of the mother and the needs of the baby.  Mothers are vulnerable during both pregnancy and the postpartum period.  Ask the pregnant mom how she is doing and really listen.  I read this amazing piece that Andrew Solomon wrote regarding depression in pregnancy.  Thank you Andrew for speaking up for both the mothers and the babies.  If you are feeling fragile, do not read Andrew’s piece.

Pregnancy Anxiety and Family History of Miscarriage

Pregnant BellyFirst-time mothers can find many things to be anxious about when they become pregnant. What will pregnancy be like? Will my baby be healthy? Did I start taking my prenatal vitamins early enough? Am I really ready for this? But some women may have an additional fear that seems more relevant than it might to other pregnant women: Will I be able to stay pregnant, knowing that my mom had a history of miscarriage?

This anxiety was something that I had to deal with when I discovered I was pregnant with my son shortly after beginning infertility testing. After a year of trying to conceive, I had been getting rather depressed about failing each month, and the beginning of that year of trying may or may not have started with a miscarriage I was too afraid to see my doctor about. I know now that that was a bad decision, not telling my OB/GYN about the three weeks of heavy bleeding that had forced me to reschedule my initial annual exam where I’d intended to ask for a prenatal vitamin prescription, but I didn’t bring it up because I didn’t want to know for sure. My mom had suffered three miscarriages when I was a kid – the reason why there ended up being eight years between the births of my two younger brothers – and I was trying to shield myself from the emotional aftermath of knowing for sure whether it was a miscarriage or just an exceptionally heavy period. My periods were awful and unpredictable when I went off the Pill. I still have plausible deniability.

So there I was with a positive pregnancy test around Christmastime 2004, overjoyed that I was finally pregnant, but haunted by the shadow of a possible miscarriage. Some of these things are genetic. Some are due to environmental factors. Some don’t seem to have any reason whatsoever. Were those genes passed on to me?

These fears led to a tearful call to my OB/GYN just after New Year’s. I was spotting. They tried to reassure me over the phone as they set up the appointment for me to come in. Spotting can happen in a normal pregnancy. It doesn’t mean anything is wrong. But predisposed as I was to anxiety, this was no consolation. I saw the CNM I liked at my OB/GYN’s office for a pelvic exam and a urine test. The blood was brown, though, old blood, and my pregnancy test was positive. My cervix was inflamed, though, so they sent me to the local women’s hospital for an internal ultrasound because they didn’t have any ultrasound techs in the office. I was only five weeks along, so all they could see what the egg sac and yolk sac, which was good enough for them to reassure me my pregnancy was fine. Only if I started seeing red blood along with cramping should I worry and give them a call.

I didn’t have to make another call like that, but my anxiety didn’t go away.

My inflamed cervix ended up needing to be treated, and I was prescribed MetroGel for it. MetroGel is considered Category B for pregnancy risk, but I was still in my first trimester, and I was terrified that something bad would happen if I introduced this foreign substance so close to where my baby was developing at such a crucial period. I ended up waiting until the first day of my second trimester to actually use the MetroGel. That decision in itself was risky, as an untreated infection can also potentially harm a developing fetus, but it was what I considered the safest route at the time.

Thankfully, my anxiety levels decreased appreciably once I reached 24 weeks. That was the magic number in my head where I felt I could stop worrying about a miscarriage, because about 50% of babies born prematurely at that fetal age survive. And with each passing day, I knew my son’s chances of surviving and being born relatively healthy were just getting better and better.

Unfortunately, my anxiety came back with a vengeance after my son was born, alongside my undiagnosed postpartum depression. If I’d known then what I know now, 10 years later, I would have talked to my doctor. I would have tried to get help. I know I would have avoided taken any medication during my first trimester, but I might have considered some of the lowest-risk medications during my second and third trimesters according to the best available information at the time. I certainly wouldn’t have waited until my son was three before finally seeking treatment from a psychiatrist.

I know I couldn’t have stopped worrying about losing my son, but I could have had someone to talk to about it if I’d looked into therapy. But that’s why I think Postpartum Progress is so important – so people like me can encourage other women to get the support we never had.

Rethinking Antidepressants and Birth Defects

20150507_112831Ruta Nonacs, MD, PhD, of the Massachusetts General Hospital Center for Women’s Mental Health, posted a very important blog post yesterday regarding a large new study published in the British Medical Journal regarding SSRI’s (the type of antidepressant medication very commonly prescribed) and venlafaxine (marketed as Effexor in the US). The study focused on children in five Nordic countries and their exposure to any SSRI and venlafaxine. They were looking at whether babies born to moms who take these antidepressants during pregnancy are more likely to have babies with birth defects.

The results?

According to Dr. Nonacs, “To summarize, this large Nordic study found no substantial increase in the overall prevalence of birth defects among infants exposed to SSRIs or venlafaxine in utero.” And we’d point out that this study looked at more than 2 million births in Denmark, Finland, Iceland, Norway, and Sweden. TWO. MILLION.

This study, in addition to having a large size with an even larger control group, also “… restricted the study population to women with at least two children and were able to conduct sibling controlled analyses by looking at sibling pairs who were discordant for exposure to SSRIs or venlafaxine.” (source: MGH blog)

A quick Google search for any news of this study being reported by mainstream media provided no results. Surprising, given that the study was published in mid-April. We looked everywhere, considering this would be huge news to the hundreds of thousands of women who are pregnant and unsure how to treat their mental health issues. It seems the media would prefer we continue to believe antidepressants and other medications for mental health are harmful.

Granted, we should all do our due diligence when taking meds that may affect the precious little ones in our lives. But we also need to take care of ourselves and not allow fear-mongering to prevent us from doing so when research aplenty has proven that we can do so without greatly increasing risk to the most precious little folks in our worlds.

But it seems, for now, we can breathe a little easier when we do need to take our meds to keep ourselves moving forward through life. And this, this is a good thing.