Mommy Shoes – Parenting While Recovering From PPD

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Please welcome Mirjam Rose to Postpartum Progress today, as she shares her experience of parenting while recovering from PPD.

Mirjam is an elementary school teacher and blogger who lives in the Netherlands with her husband and three children. She has battled and survived 3 postpartum depressions. You can find Mirjam at her blog Apples and Roses, where she blogs about her ongoing battle with depression and finding beauty in the simplest of things. Mirjam is a contributor for World Moms Blog and can also be found on Twitter.


Mommy Shoes

It has been nearly two years since I asked for help.

Motherhood and life felt like too much of a burden for me. After years of thinking that the problem was me, it finally dawned on me that there might be something wrong. I started therapy and found out that I had suffered from postpartum depression. Not once but three times. I also found out that the feelings I struggled with in my early teens, were not just regular teen struggles. I found out that it was also depression that I had struggled with.

These past two years have been the most intense years of my life. I have experienced tremendous growth. I have opened new doors and have closed old doors behind me.

People talk about therapy lightly. They think therapy is nothing more than paying someone to listen and to give you advice. Therapy is no such thing. Therapy is facing yourself. Therapy is opening doors and looking into the dark corners of your soul. It is work. Hard work that sometimes leaves you exhausted. Being as courageous as walking into a lion’s den unarmed. Vulnerable. It is raw naked honesty and perseverance. Going down a steep, rocky and sometimes dark road, without knowing when you will reach the end of it. It’s knowing that you can decide to leave that road at any moment, yet not giving in to that thought. Because you want to get well.

For the past two years I have been going down this road. To say it has been a roller coaster ride, is to take a devastating hurricane and to call it a warm summer’s breeze. The hardest part? Being a mother at the same time.

There is no time off. No time to lick my wounds or to take a break. When I come out of therapy, I need to step quickly into my mommy shoes. Some days I come out of therapy feeling empowered. I stand tall and firm and switch roles like a pro. Other days I feel delivered, freed from a burden that has been carried for way too long. Those are the days that my mommy shoes feel like dancing shoes. Then there are days that I am exhausted from the hard work and I feel empty with little left to give. On those days my Mommy shoes are put on reluctantly.

Some days the carefully constructed bandages around my heart are ripped from their place and old wounds are exposed. My heart breaks and scatters into a thousand pieces. An hour passes as I work through the pain.  When the clock strikes reality, I hastily gather the pieces and put them back into place as best I can. I wear my mommy shoes, and though it is I that longs to be nurtured, it is I that gives the loving smile; it is I that spreads my arms in welcome;  I that carries and I that offers warmth and shelter.

On such days my feet struggle to find solid ground underneath my shoes. When my child reaches for me, my grasp is firm. And as I hold her little warm hand softly in mine, the ground underneath my feet gradually feels stable again.

 

This post was first featured on World Moms Blog, March 2014.  Shared with permission.

Photo credit: Mirjam Rose

 

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Mental Illness Didn’t Crush My Dream of a Family

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3347120739_0d840078faPhoto Credit: carf via Compfight cc

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.

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How Women of Color Can Manage The Impact of Acculturative Stress and Discrimination During Pregnancy

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dr sumner acculturative stress and discrimination during pregnancyToday I’m thrilled to have Dr. Lekeisha Sumner with us to share insight on two very common types of stress women of color may experience during pregnancy and tips on how we can manage both. Dr. Lekeisha Sumner, PhD, ABPP is a board-certified clinical psychologist with specialization in both clinical psychology and medical psychology. She is currently an Associate Professor in the Department of Psychology at Alliant International University and Assistant Clinical Professor in the Department of Psychiatry & Biobehavioral Sciences at UCLA. A frequent commentator on psychological science, she has written extensively on trauma and the intersection of culture and gender in health and well-being. Dr. Sumner maintains an independent practice in West Los Angeles where she was recently commissioned by the Substance Abuse and Mental Health Services Administration (SAMHSA), Center for Substance Abuse Treatment to serve on the Strategies for Improving Outcomes for Peripartum Women committee.

With so many changes in one’s body, daily routine, and responsibilities, it’s typical for many women to feel overwhelmed at times both during pregnancy and after the birth of baby. And yet, for some women, these feelings can be compounded by stressful experiences related to their cultural backgrounds or ethnicities, which increases their vulnerability for emotional distress.

Take for example, Olivia, a bright and compassionate 28-year old woman who was in the second trimester of her first pregnancy when we met. She had moved to the United States several years ago from her native country and was elated to finally have the opportunity to be with the man of her dreams and start a family. Her husband, a US native, was supportive of her adjustment to life in a new country and particularly attentive to her needs during pregnancy. She was especially grateful for the comfort he provided now that she lived without her extended family.

Despite all the wonderful changes that were happening in her life, Olivia felt chronically overwhelmed and was stunned by the recent discovery that she had developed hypertension during her pregnancy. She had already unsuccessfully tried the home remedies her mother suggested which included taking a walk around the block and listening to relaxing music. But, at the urging of her husband who observed her increasingly distressed mood, she decided to enter psychotherapy.

Olivia began experiencing stress on her job long before she became pregnant but things only intensified once she disclosed her pregnancy to her boss. Since that time, she began to experience difficulty sleeping, little appetite, constant worrying, and difficulty concentrating and had even begun to grind her teeth during sleep. Given the severity of the symptoms, Olivia was concerned that they would negatively impact her pregnancy. As she began to delve into the underlying sources of her stressors and the contexts in which they occurred, it became clear that many of the experiences she described are common among women from some ethnic and cultural groups (especially women of color, refugees, immigrants, etc.) yet rarely discussed: acculturative stress and discrimination.

Acculturative stress typically refers to the emotional strain of having to alter one’s cultural attitudes, beliefs or behaviors to adapt to and navigate a distinctly different culture. For Olivia, acculturative stress presented as the strong social pressure she felt to quickly learn English and lose the accent of her native language. She also experienced discrimination on her job as her boss would often humiliate her by making snide comments about immigrants within earshot. He would keep constant tabs on her, would make embarrassing “jokes” about people of color and her accent, and routinely give her lower performance evaluations than her colleagues even though her productivity was equal too or greater than theirs. After disclosing her pregnancy, these incidents worsened. Although working in a hostile climate resulted in her having performance anxiety, ruminative thoughts and nightmares, she was too intimidated to report this behavior to human resources and believed she would have been labeled as being “too sensitive,” “playing the race card” and perhaps worse, risk further alienation and stigmatization.

Over a period of time, intense and chronic stressors like the ones Olivia experienced can wear on a person and leave them feeling emotionally drained and depleted. The stress brought on by discrimination and acculturative strain during pregnancy can quickly erode one of the most sacred and enjoyable periods of a woman’s life and render women at risk for symptoms of depression and anxiety, and poorer lifestyle choices (e.g. eating habits, nicotine use) as they attempt to cope. For some groups, these stressors may alter the release of bodily hormones that may affect the outcomes of pregnancy. For example, African American women across the economic and educational strata have the highest rates of preterm birth in the United States. Studies confirm that these findings are in part due to the high levels of chronic stress and ethnic discrimination they are exposed to throughout the lifespan. While research shows that these stressors do not affect everyone or every group of pregnant women exactly the same, they can certainly diminish mood mood, energy, and confidence in caring for baby.

There are some ways to help lessen the impact of acculturative stress and discrimination. For instance, women who use healthy coping strategies (e.g meditation, walking, journaling, asking for help), those with a strong belief in their ability to overcome obstacles and those who have pride in and a connection with their cultural heritage and cultural values all seem to have better emotional responses in the face of these types of stressors than those without. Also, women who feel a sense of belonging and receive support from their partners throughout pregnancy and post-partum also tend to respond better. For Olivia, getting involved in an on-line support group, a local church that appreciated congregants from diverse backgrounds and engaging in psychotherapy were all beneficial in helping to restore her well-being and equipping her to improve her ability to cope.

For all women, the pregnancy experience is shaped not only by biology but also by psychological and cultural influences. While you may be limited in eradicating all stressors during pregnancy, given the suffering that severe culture-specific stress during pregnancy can cause for you and baby, it’s a good idea to discuss with your doctor as soon as possible any concerns in your life.   You will also want to monitor your stress levels not only during pregnancy but also in the many months after your bundle of joy is delivered. Taking a few extra steps can help you better prepare to be the best warrior mom you can be.

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Dealing With Grief, Trauma, and Intrusive Thoughts

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Trigger warning: This post contains references to miscarriage, D&C, and intrusive thoughts. If you are feeling vulnerable, you may want to skip this post for now. 

Last year, I posted about my experience with the emotional aftermath of a missed miscarriage. Quick recap: I was carrying fraternal twins as a gestational surrogate. At my 8w5d ultrasound everything was good. At my first OB appointment a few weeks later, I was told neither one had a heartbeat and they had both stopped growing a couple of weeks prior, shortly after the ultrasound where everything was good. The end result was a D&C.

It was rough. It was REALLY rough. Not only was there the guilt and grief and normal hormonal nonsense of a miscarriage, I had the added emotional complication associated with miscarrying as a surrogate. However, I pushed on and kind of stuffed it all down as my intended parents (IPs) and I moved forwards with the checkups and testing the reproductive endocrinologist (RE) recommended to clear me to try another round of IVF and have a second go at making my IPs parents. Unfortunately, my anti-thyroid antibody labs came back (ridiculously) highly elevated which my RE said could potentially indicate an increased risk of miscarriage so he recommended they find a new surrogate.

As was their right under our contract, my IPs terminated the contract. Unfortunately, they did so in a very abrupt manner that violated trust and hurt me badly. It really ripped the bandaid off the wound from the miscarriage. I told a friend that it felt emotionally like I was experiencing the miscarriage all over along with the sudden and unexpected loss of another relationship I had been assured would last no matter what.

Time went on and I tried to go on with my life since there wasn’t really anything else to do. Unfortunately, I dealt with it by continuing to stuff everything. Really, I didn’t deal with anything. You would think that by now I would know that’s a really bad idea and that not processing things and not getting help just makes things worse, but apparently I have yet to learn that lesson as thoroughly as I would like. As time went on, I wasn’t sleeping well. I was stressed and irritable. I was moody and cried a lot and was really grouchy and short-tempered. I put it all down to stress and normal fatigue from taking 16 credits in college along with dealing with 3 small children, a husband in the military, and a generally full plate.

One night though, it got really bad. It was September 28, 2014. I was driving on a windy road in the hills and suddenly started to have some really nasty and terrifying images and questions/thoughts pop into my head. I beat it back and hightailed it out of there and started to head out to a particularly beautiful scenic area to take some pictures, but the thought of the windy roads along the coast that I was about to encounter had thoughts and pictures in my head again. I turned around and headed home. Suddenly I realized, “These are intrusive thoughts and I am changing my activities and behavior to avoid the trigger. This is familiar… @#%$!!! This is a symptom of postpartum OCD.” Let me tell you, the thought of going through PPOCD again had me terrified. And I do mean terrified. Like, pulled over in a parking lot sobbing and hyperventilating, unable to breathe, having an honest-to-goodness, would-take-an-Ativan-if-I-had-a-prescription-and-one-on-me, panic-attack terrifying. I started pm’ing my short-list of Warrior Mom friends trying to find someone I could talk to and help me get calmed down and worked through it. I got ahold of Lindsay Maloan. I adore her. She talked me through it, helped me formulate and talk out my plan for calling a therapist ASAP, and sent me funny links/pictures to help me laugh until I got ahold of a friend who lives near me (who was kind enough to let me come cry on her couch). Katherine Stone and Lauren Hale were also fantastic over the next few days about helping me talk through things and generally supporting me. All 3 of them kept telling me that it wasn’t my fault and that it was GOOD that I recognized what was happening and got my butt in to see a professional to deal with it.

I was fortunate to find a therapist who has quite a bit of experience and specialization with grief and loss, postpartum adjustment/PPMD, and infertility. It’s been a great combination and nice to not have to explain everything like I would with someone who doesn’t have experience with infertility or PPMD. We’ve done a combination of eye movement desensitization and reprocessing (EMDR) and talk therapy and it’s been working great. At this point, we’re pretty sure that my problem this time isn’t PPOCD or any other type of PPMD so much as it is just straight grief and trauma. She told me that it’s perfectly normal to need help working through what I went through. The official diagnosis for insurance purposes is postpartum adjustment, or needing help adjusting after pregnancy (specifically with the loss of the pregnancy and everything that’s happened since). She also pointed out that lack of sleep can exacerbate or even cause intrusive thoughts, so that combined with some other anniversaries/milestones (such as my due date) may have been the culprit behind that nasty little bugger.

I think there are a couple of main points I hope people take away from this post.

  1. Even without postpartum mood and anxiety disorders, it’s perfectly normal to need some help working through thoughts, feelings, and emotions, especially after a miscarriage.
  2. Don’t put off seeking help.
  3. Have a network of at least a few people you know you can turn to if you start to have a rough time. For women who are postpartum, especially those with a history of PPMD, it can be especially helpful if you have a few women who have experienced PPMD themselves, who are educated and know what’s up, who understand where you’re coming from. Lindsay was my lifeline that night. She got me through a REALLY bad spell where I was having trouble breathing (you know that whole my face is getting tingly and it’s making me panic even more thing? Yeah. I was there). And she, Lauren, and Katherine, and my friend here at home, and another friend who is working on becoming a social worker, gave me support. I can’t even express the value of that in words. I would love to give them all huge hugs.
  4. When you seek out a mental health professional, try to find one with experience/training in your situation. Having seen mental health professionals before who were PPMD clueless (it’s disconcerting to be explaining postpartum depression to the person who’s supposed to help you work through it), it has made a HUGE difference to be working with someone who knows her stuff.

I’m still not totally “there” yet, but I’ve made a lot of progress with my therapist, and it’s been a big relief to feel power in actually dealing with things on MY terms instead of just letting it happen to me and not have anything in my arsenal of “what to do.” When I had PPMD after my first baby was born, I felt so helpless and powerless. This time, I took control. That alone has made a difference.

If you are reading this and you’re in a bad place, know that you have a community ready and waiting with open arms, wanting to support you. We send you our love. I send you my thoughts, prayers, warm vibes, crossed fingers, and whatever else helps. There are resources. There are people here to support you. You are not alone. You do not have to go through this by yourself. We are here for you, we want to help you. Let us help you. As we support each other, we learn how to better support and help ourselves.

What advice do you have in how to help yourself or how to help someone else?

Photo credit: Esther Dale

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