How My Doctors Missed My Antenatal Anxiety

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antidepressants pregnancyI was in my first trimester of my first pregnancy when antenatal anxiety washed over me like the tide, insidious and unstoppable.  We were living on our own in the midwest at the time, and the loneliness was crushing.  I compensated for my irrational worries by donning a brave face and making light of my anxiety, to both friends and my doctors, and I assumed all newly pregnant women felt the same trepidation and slight panic I was suppressing.

I was 8 weeks pregnant when my OB called me into her office.  My fears and worries were suddenly compounded by a previously-undiagnosed kidney disease.  A giant mass in my abdomen.  And they had no idea what it was.  I taciturnly absorbed all the doctor said and then politely asked for a few moments alone.  When the door shut behind her, something in me broke.  I walked out of there a shadow of myself.  The next 6 months brought a multitude of diagnoses.  I was ultrasounded and MRIed (twice).  I met with several surgeons and had a cathertized void test done.  There were very few cases of pregnant women with my eventual diagnosis of severe unilateral hydronephrosis with 1% kidney function, and so few doctors could tell me exactly what to expect or how it would impact my pregnancy.  And that scared me to death.

Six months into my pregnancy, we moved to the North East.  My need for my family (who had moved up to the Boston area a few years before) outweighed my terror at the prospect of moving, but leading up to moving day, I had increased symptoms of panic attack.  I refused to drive while house hunting, irrationally fearful of the alien traffic patterns of our new-home-to-be.  I fought back waves of nausea at each apartment-hunting appointment, instead playing the part of the happy, expectant couple.  The night before our final flight out of the midwest, I became convinced I had a blood clot in my right leg – and the resulting (unnecessary) hospital trip ended in a 2am leg ultrasound for me and a busted blood vessel in my husband’s eye from the stress.  My husband tells me that when I fainted from panic on the 4 hour flight to Boston the next day, he took special notice of the halfway mark in the flight.  ”At least there was no turning back,” he says, only half-jokingly.

Unfortunately, arriving in Boston alleviated the anxiety only temporarily.  As I neared the end of my pregnancy, I began having irrational, intrusive thoughts about my husband leaving me.  ”He’s only staying until the baby is born,” the lies whispered, “he never wanted a baby anyway.”  I became increasingly irritable and emotional, and finally suffered enough to mention it to my OB, a high-risk, high-profile doctor at Massachusetts General Hospital.  With my mother in the room, I explained my heart palpitations and my trouble breathing.  I outlined my mood swings and my panic attacks.  It took every ounce of courage in my body to admit that I was struggling.

In return, she told me to “stop worrying.  Pregnancy is an emotional time.”

That was it.  We moved on to belly measurements and discussions of pain management during labor.

With only two sentences, she had me doubting my need for help. I suddenly “just wasn’t trying hard enough.”  And I believed her.

Throughout the course of my first pregnancy, I saw 5 different OBs, 3 surgeons, 2 primary care physicians, and a myriad of nurses and techs.  None of them EVER asked about my emotional well-being, and when I did speak up for myself?  I was ignored.  Dismissed.  And the thing that angers me the most is that MGH has a world-renouned Center for Women’s Health, run in part by the incomparable Dr. Marlene Freeman, an expert in the field of pre and post-natal mood and anxiety disorders.  Sitting in my OB’s office, I was one elevator ride away from help.

Instead, it took me 5 months after my daughter was born – five months of intrusive thoughts about shaking my baby or letting her slip in the bath tub (I would like to emphasize here that intrusive thoughts are distinguished from psychosis by a mother’s ability to recognize the thoughts as scary) – five months of obsessively folding and lining up burp rags and matching bottle tops to bottle bottoms by shape and color – five months of rage and of falling apart behind the scenes before I recognized I needed help.

It’s hard for me to think back through that time because I find myself so ANGRY.  My struggle was preventable.  Avoidable.  Not once during or after my pregnancy was I asked about my emotional well-being, and when I mentioned physical and emotional symptoms of my condition, they were ignored.  A few simple questions and an honest conversation with a trusted doctor was all it would have taken.

I want you to know that there are many wonderful doctors, psychologists, and social workers out there.  Many obstetricians and primary care physicians are well-educated and have amazing bedside manner.  But a large percentage of them are still grossly undereducated about antenatal and postpartum mood and anxiety disorders.  Advocates in the PPD community are working towards universal postpartum mental health screening, but in the meanwhile, each mama has to be her own best advocate.

  1. If you are struggling, tell the truth, the whole truth, to someone you trust.  I know how scary this is (really and truly), but it’s vital you are honest about your symptoms in order for you to get the best treatment possible.
  2. Keep telling it until you are listened to.
  3. Ask for help finding a therapist or doctor who has experience treating postpartum mood and anxiety disorders and seek support groups in your area.

You deserve to be well.  We’re here fighting with you and ready to help you find the care you need to feel like yourself again.

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Defining Recovery

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The biggest question I am asked about Postpartum OCD on a regular basis is also the one I dread the most: “Do intrusive thoughts go away?”

My heart breaks when I am asked if the thoughts go away because I know where they are – how they’re feeling. How FRUSTRATING it is to want to be with your child and not have any intrusive thoughts flit through your head as you drink in that sweet angelic baby smell in the dusk of the evening.

I know it goes away.

I know it fades.

Those asking, however, are still rocking the thoughts right along with their precious little one, and that beats me up inside.

What stays, and what is difficult for those of us who live with OCD to differentiate, are typical parental fears – the nagging fear that something might happen to your child when you’re not watching. THAT stays forever. It’s not intrusive, it’s a normal heightened awareness which comes with parenting. When you have survived or struggle with OCD, however, it is extremely difficult to keep these normal heightened awareness type thoughts from spiraling into intrusive thoughts. We constantly battle to keep them from growing into giant monsters. For some of us, it turns into a Boy Scout motto type life – always be prepared for EVERY LITTLE THING.

Recovery, at least for me, is not a cut-off date. It’s a constant involvement in awareness of my feelings, reactions, and coping methods in regard to the ever changing world around me. It’s ensuring that in addition to my daily requirements, I’m taking care of myself as well. Recovery is not a discharge notice from a hospital, nor is it the last pill swallowed at the end of a prescription. It’s not the final therapist visit nor is it uttering the words, “I’m okay.”

This is how the dictionary defines recovery:

Recovery Definition

What is recovery in the living world?

Recovery is life.

It’s living, it is moving forward with a tenacity learned in the depths of hell, a grip on enjoying all the little things and a determination to not go back into the abyss. It’s knowing that even if you do go back, you have a road map to lead you back out again.

tumblr_mtag5zve3g1st5lhmo1_1280Recovery is self-care, self-compassion, and self-respect.

It is knowing it is okay to not be okay sometimes. Recovery is living with ups and the downs. It’s getting to know yourself SO well you recognize the difference between yourself and depression/mental illness. Recovery is knowing exactly what to do when the ugly beast stirs to keep it from waking completely. It is about arming yourself with a cadre of weapons guaranteed to slay the succubus. Recovery is having a plan in place in case you start to slide down and a plan in place to celebrate even the smallest sign of progression. Recovery is seizing the day and any sliver of joy within. 

Recovery is acceptance.

It’s being okay with the tough days and providing yourself a soft place to land when they happen. It’s having a support system in place for the bleak days, one that will also be there for the good days. It’s understanding that sometimes, you’re gonna feel angry about your mental health and that’s okay. It’s learning the range of healthy and unhealthy emotions and knowing when to reach out for help as well as celebrating milestones indicating progress.

Recovery is being imperfectly perfectly you.

According to Alexander Pope, “To err is human.” Perfection is a fallacy (so is control). It is an impossibility we set up in our minds, a standard most of us will not reach. Do the best you can with what you have. There’s a special kind of joy (and peace) to be found when you let go of any expectations you, life, or anyone else may have forced upon you. When you are truly yourself, you shine.

Recovery is personal.

We cannot compare our journey to that of others. There are similarities, sure, but we each carry our own luggage and travel our own road. Our stories are as different as we are from each other. Knowing someone else has traveled a similar road helps. But it is absolutely important to remember that just because someone was at point X by a certain point on their Y timeline does not mean you will also be at point X at the same time. There are SO many variables to every story. It is impossible to compare so stop doing just that.

Recovery is…..

Your turn. What is recovery to you? Share below.

Photo Source: http://unsplash.com/post/61559907711/download-by-zwaddi

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Andrea’s Journey in Healing From Postpartum OCD & Anxiety

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Every mother’s journey through postpartum mood and anxiety disorders like postpartum OCD is her own.  And it is a journey, for sure, complete with struggle, setbacks, joy and triumph.  Today, Warrior Mom Andrea tells her about her journey from fear and pain to healing, and reminds us how important it is to reach out for support and to have above all, HOPE.

Thank you so much, Andrea, for sharing your story here.

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AndreaIn an instant, that once perfectly put together puzzle shattered in a million pieces on the ground all around me. Alone, I grabbed the pieces and tried to make sense of how I was ever going to put them back together; the millions of tiny pieces surrounding me were overwhelming. It took a long time to put that puzzle together again-from the missing pieces and not asking for help because I thought I should be able to do it alone, to paralyzing thoughts that maybe I would never put the puzzle back together.

Seven weeks after my daughter was born, terrifying intrusive thoughts took over my mind. Suddenly, I was terrified of the knives in the house, afraid to give my daughter a bath, shocked at what my mind was capable of thinking, unsafe in my own body. The harder I tried to push these thoughts away, the stronger they fought back. I was suffocating and wanted so desperately to go back to the week before where everything in my world was perfect, where I was elated with only happiness, where my dreams had come true, back to that life where intrusive thoughts didn’t exist. Overnight, I became someone that I didn’t know and didn’t want to know. My entire world changed.

That evening, I called my mom to bring me to the Emergency Room. I didn’t know what I needed but I needed something to make the horrible thoughts disappear. Arriving in the parking lot of the hospital that night I was filled with fear of being locked up if I told a doctor about the thoughts I was having, so I convinced my mom that I was fine and we turned around to go home. For the next few years I would search alone for answers and for a quick fix: a vitamin, alternative medicine, an appointment where I would walk in and come back out me again. [Read more...]

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How To Beat Postpartum OCD

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postpartum OCD, postpartum obsessive compulsive disorderThere are a lot of scary things in life that I’m happy to say I’ve never experienced. I’ve never been chased by a bear, for instance. Or fallen off a cruise ship. Or accidentally eaten poisonous mushrooms. I have, however, had postpartum OCD and while postpartum OCD is not something most people walk around fearing, I’d argue it’s at least as scary as the things they do fear, if not more so.

I was never more terrified than when I had intrusive thoughts. Having your brain revolt against you with the most Steven King-like scenarios it can dream up is shocking. Until it happens to you, you can’t believe it’s even possible for your brain to go haywire. I was always sure I was in control of my mind, until the day I learned I wasn’t. I’m grateful to say that all these years later, the trauma those intrusive thoughts caused me has faded away. I don’t feel guilty about them. They were a symptom of an illness, and they don’t haunt me any more than a sore throat would haunt me if I ‘d had a cold.

If you’re going through postpartum OCD right now, I understand how completely paralyzed you are with fear. I know I was. My whole world turned upside down, and I felt I didn’t know myself anymore or what I might be capable of. I have walked in your shoes. I’m here to tell you, though, that you will walk right out of those shoes one day and leave them behind.

Until that day comes, I wanted to share two key things with you that I recently saw on the Beyond OCD website that I think are important for you to know:

1. It’s normal to be overwhelmed with doubt when you have OCD.  Fred Penzel, PhD, the author of the article, wrote, “Two of OCD’s main features are doubt and guilt. While it is not understood why this is so, these are considered hallmarks of the disorder.  Unless you understand these, you cannot understand OCD. In the 19th century, OCD was known as the ‘doubting disease.’  OCD can make a sufferer doubt even the most basic things about themselves, others, or the world they live in.  I have seen patients doubt their sexuality, their sanity, their perceptions, whether or not they are responsible for the safety of total strangers, the likelihood that that they will become murderers, etc.  I have even seen patients have doubts about whether they were actually alive or not.  Doubt is one of OCD’s more maddening qualities.  It can override even the keenest intelligence.  It is a doubt that cannot be quenched.  It is doubt raised to the highest power.” I just LOVE this paragraph because it describes perfectly how I felt. The fact that you doubt yourself right now doesn’t mean you should be doubted or deserve to be doubted. It just means you have OCD.

2.  It’s not your fault if you can’t shut off the intrusive thoughts. Penzel explains: “… you cannot refuse to think an obsessive thought. Obsessions are biochemically generated mental events that seem to resemble one’s own real thoughts, but aren’t.  One of my patients used to refer to them as ‘My synthetic thoughts.’  They are as counterfeit bills are to real ones, or as wax fruit is to real fruit.  As biochemical events, they cannot simply be shut off at will.  Studies in thought suppression have shown that the more you try to not think about something, the more you will end up thinking about it paradoxically.” The thing to do is recognize what they are and accept that they are not real and allow yourself to move through them. You don’t have to run and hide from your life or your fears.

Postpartum OCD is a real illness and it requires real treatment. Don’t try to wish it away or pretend it’s not there. It’s there all right, and it needs attention and professional treatment. If you have it, you are likely miserable enough that you are willing to get professional help even if it means telling another person out loud the awful things that have been going through your mind. Penzel notes that the best treatment for OCD is cognitive behavioral therapy (CBT), and that medication can also help, though he believes it’s best used in combination with CBT.

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