Postpartum Depression: A Feminist Issue

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Do not dismiss postpartum depression with a shrug and an eye roll, Ms. Albert.  It affects one out of every seven women.  Ms. Elisa Albert wrote a book After Birth that I will definitely not be reading.  Her main premise is that women do not have enough support for the choices that they are making.  I wholeheartedly agree with that statement and the overall theme of her book.  Based on an article with the Guardian, she then contradicted the primary theme of her book as she heaped judgement and shame on women who choose medication as an option to treat their postpartum mood and anxiety disorder.

I recognize the responsibility that I have as a Warrior Mom and as a mental health advocate.  I am not a trained professional.  I offer support and encouragement to moms who are struggling.  I share what worked for me to simply encourage a mom who is struggling to have as many options as possible.  Medication saves lives; my medication saved mine.  My medication was one of the tools in my toolbox.  I utilized many tools in my toolbox to help me recover: therapy, online peer support through Postpartum Progress, support from my friends and family, exercise, proper nutrition, sleep, journaling, singing, and sharing my story with other moms.

Postpartum mood and anxiety disorders manifest themselves differently because each mom is unique.  What worked for me may work for a friend, but it may not.  Making blanket statements does a disservice to all moms.  Ms. Albert made this statement.  “The only people I know who did just fine in the postpartum period are those who score the triumvirate: well cared for in birth, surrounded by supportive peers, helpful elders to stay with them for a time.” Guess what Ms. Albert? I had all of that, and I still struggled.  I spent my entire pregnancy anxious and depressed.  With time and perspective my family and I have been able to pinpoint how these symptoms manifested themselves immediately after I became pregnant.  My antenatal depression manifested itself in irritability and rage.  I had support from both my mother and my mother-in-law while I was on maternity leave for three months.  I had a supportive network of friends and family.  I still struggled for seventeen months until I finally got the help I so desperately needed.  My baby girl was seven months by the time I realized that I was not getting better.  Do not speak for me or for the community of Warrior Moms.  Let us tell our stories.

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A Tale of Two Moms: Postpartum Rage

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postpartum depressionI hid this side of my struggle with postpartum depression from everyone but my immediate family.  My postpartum depression and postpartum anxiety manifested itself in rage.  Postpartum rage made feel like I suffered from a split personality disorder. On the outside, I appeared mostly together, just a somewhat stressed and frazzled new mom.  Cut me off in traffic, and I would go from zero to sixty in two seconds.  Rage felt visceral to me.  I could feel the heat building up inside of my body.  The tips of my ears and my cheeks would flush with anger and frustration.  My vision became like a tunnel; I could only focus on the object of my rage.  I could feel my heart pounding in my ears.  I felt the need to hit something, anything.  I threw remotes, books and phones.  I slammed doors and drawers.  My rage turned me into an out of control monster.  I could barely recognize myself after one of these bouts of rage.  Anything and everything could set me off.  My poor husband, my sweet three-year old and my infant daughter took the brunt of my wrath.  I yelled and screamed until my throat was hoarse.  I had no idea at the time that these feelings were symptoms of postpartum depression.  I believed that I was simply a horrible person who did not deserve the beautiful family that she had.

I felt like a pot constantly about to boil over.  Everywhere I looked, I saw disorder and chaos.  If my husband forgot to set something out that I needed in the morning like the bottles for the baby, that minor infraction was enough to make me lose my temper entirely.  I felt completely unhinged when I was in the midst of one of my rages.  I truly thought I was losing my mind.

My lowest point came when I pushed my husband in front of my oldest daughter.  I wanted to provoke him into rage like I was raging.  After that incident, I realized how out of control my rage was.  I felt sick to my stomach realizing that my actions spoke louder than my words to my preschooler.  How could I expect her not to hit if I did it?  I was wracked with guilt and worry that I was damaging my child.  I have not hit anyone since that time.  I felt so much guilt and shame for my behavior that day.  I regret that explosion more than anything.

I felt like I needed to rage and be angry against the whole world.  I felt so much loathing and self-hatred.  I could not understand what was happening to me as the rage took hold of me.  I felt powerless in the grasp of my rage.  I always dissolved into tears of shame and guilt after these blinding rage fits. Medication helped take the edge off of my rage.  Another key component in managing the rage was therapy. I had to put in the hard work to recognize the early signs of rage that threatened to overwhelm me.   I needed to identify the emotions that were my triggers.  I used exercise to help manage both the anxiety and the rage.  I welcomed company when I struggled with anxiety.  When rage started to build, I needed to remove myself from the situation.  Kickboxing, weight lifting and running were fantastic outlets for my rage.

Postpartum rage nearly destroyed my relationship with my husband.  I lost myself within that rage, and I needed to repair the damage that I did.  My husband and I went to counseling separately, and we went to counseling together.  It took love, support, and lots of communication to repair the cracks in the foundation of our marriage.   My husband reassured me that we pledged to love each other in sickness and health. That season of postpartum depression and postpartum anxiety was my season of sickness.  Postpartum rage brought me to my knees, and it threatened to consume me in its wake.  I rose again, armed with compassion for myself and others, knowledge of postpartum mood and anxiety disorders, and the belief that I would be well.

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New Study: Postpartum OCD and New Mamas

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washing my handsThe thoughts marched onto the battlefield when my daughter was less than a week old. They closed ranks around my brain and held on voraciously until they squeezed every bit of sanity out of me. Their arrows whizzed by, carrying horrid thoughts which would disappear as soon as the arrow sunk in – then the compulsions began. I washed my hands. I cleaned. I twitched. I watched movies. I read. ANYTHING, anything to make the whispers of danger stop.

I struggled mightily with Postpartum OCD during my first and second postpartum periods. With my second, my OCD was coupled with the trauma of being a NICU mama. All the pumping fed my compulsions, and quite frankly, may have provided some source of solace for me now that I look back.

Postpartum Obsessive Compulsive Disorder, or postpartum OCD, is an ugly stop on the spectrum of Perinatal Mood & Anxiety Disorders. It catches moms off-guard. We often wonder if the thoughts we have are normal – is this part of normal motherhood worry? When should we consider the possibility of having crossed the border into seeking help?

A new study out of Northwestern states that new moms are “FIVE TIMES more likely than their peers to experience OCD up to six months after their child is born.” Normal population rates of OCD sit at three percent. Among new moms? Eleven percent.

Dr. Dana Gossett had this to say regarding how to tell when mom needs to seek help:

“It may be that certain kinds of obsessions and compulsions are adaptive and appropriate for a new parent, for example those about cleanliness and hygiene,” Gossett said in a press release. “But when it interferes with normal day-to-day functioning and appropriate care for the baby and parent, it becomes maladaptive and pathologic.”

It’s encouraging to see researchers exploring additional stops on the spectrum. Postpartum Depression has been a catch phrase for so long that all too often, moms think that if they’re not sad or weepy, they aren’t experiencing a mood disorder after the birth of a child. Research like this, however, goes to show that a new mom doesn’t have to be sad to experience a mood disorder. Signs and symptoms of postpartum OCD, according to Postpartum Progress include, but are not limited to the following experiences:

  • You feel like you have to be doing something at all times. Cleaning bottles. Cleaning baby clothes. Cleaning the house. Doing work. Entertaining the baby. Checking on the baby.
  • You may be having disturbing thoughts.  Thoughts that you’ve never had before.  Scary thoughts that make you wonder whether you aren’t the person you thought you were.  They fly into your head unwanted and you know they aren’t right, that this isn’t the real you, but they terrify you and they won’t go away.  These thoughts may start with the words “What if …”
  • You are afraid to be alone with your baby because of scary thoughts or worries.  You are also afraid of things in your house that could potentially cause harm, like kitchen knives or stairs, and you avoid them like the plague.
  • You may feel the need to check things constantly. Did I lock the door?  Did I lock the car? Did I turn off the oven? Is the baby breathing?
  • You can’t sleep when the baby sleeps.

It is important to note that OCD symptoms may also appear during pregnancy. Note that symptoms would differentiate from that of nesting – if it interferes with day-to-day functioning, always see a professional.

The most important aspect of the symptom list above, for me, is this one:

“Moms with postpartum OCD know that their thoughts are bizarre and are very unlikely to ever act on them.”

When I had thoughts, I remember the immediate repulsion which followed them. I didn’t seek a higher level of help after my second daughter (once I was on meds) until these thoughts began to make sense and I started to rationalize them. OCD is frightening. But there is always help and you are absolutely not a bad mother if you have intrusive thoughts flitting through your brain.

One of the other interesting things which came out of this study was that of the 11 percent of moms who experienced OCD, 70 percent of them also experienced a form of depression, leading researchers to the following:

“There is some debate as to whether postpartum depression is simply a major depressive episode that happens after birth or its own disease with its own features,” Miller said. “Our study supports the idea that it may be its own disease with more of the anxiety and obsessive-compulsive symptoms than would be typical for a major depressive episode.”

In my experience, I also was depressed. But it was exactly as they posit in the second sentence – it was a depression heavily laden with anxiety and obsessive-compulsive symptoms. My experience was not solely depression, despite what the psychiatrist seemed bent on telling me.

Bottom line? If YOU think something is off with you, seek help. Know the signs and symptoms, know yourself, and if you’re not quite you and haven’t been for awhile, talk to a professional. You’re not alone.

photo credit: “OCD-Washing My Hands” by mstinas on flickr.
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Breaking Down The Privilege of Me Too

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women talking and woman standingThis past week, I had the privilege of speaking about Perinatal Mood and Anxiety Disorders with the Moms’ weekly group I attend. It was a bit beyond my comfort zone as I am accustomed to supporting and disseminating information in cyberspace more than in person, something I hope to change this year.

One of the things I love about sharing information is the inevitable “Me too,” which reverberates among the group, much like a pinball caught in a continuous loop in a pinball machine, refusing to exit until it has hit every available surface.

Me too.

Think about how huge that is for so many of us.

Despite the fact that up to 10% of new moms struggle with a Perinatal Mood & Anxiety Disorder, many of us don’t have the PRIVILEGE of having someone we can say “Me too” with at the end of a hard day with the baby in our arms and the struggling brain in our head.

“Me too” shouldn’t be a privilege.

It’s something we should be able to say without guilt, without fear, without shame, without stigma.

I have intrusive thoughts.

Me too.

I didn’t love my baby at first sight.

Me too.

I cried all the time.

Me too.

I was inexplicably and illogically filled with rage.

Me too.

I still wonder if my baby loves me.

Me too.

I am scared to talk to my doctor about what’s wrong with me.

Me too.

I wonder if I will ever be well.

Me too.

I worry about everything and think everyone who sees me knows I am a horrible mother.

Me too.

We all have these thoughts. They’re on parade in our head on a daily basis. For me, I even went as far to keep all the blinds down in my house because I was convinced that if anyone saw in, they would know I was a horrible mother. I felt as if I were living in a fish bowl. Saying “Me too,” finally, helped that feeling to fade and I finally allowed the sunshine into my life.

This privilege, this “me too” phenomenon, is why I started #PPDChat and why I will always listen when a mother begins to talk about the emotional roller-coaster that is motherhood. Because we ALL deserve to have someone with whom we can say, “Me too.”

What’s the one thing you wish you had been able to tell someone and have them respond with “Me too?”

Tell us in the comments. Or take to Twitter and use the hashtag #ppdme2.

 

photo source: “women talking and woman standing” by kalexanderson on flickr
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