Guest Author: Theresa Borchard of Beliefnet

Therese Borchard, who writes the Beyond Blue blog at Beliefnet, shares her postpartum anxiety story with Postpartum Progress today:

Although I can’t remember a time in my childhood or adolescence that I lived without depression and anxiety, I guess you could say that I officially joined the elite mentally ill club in 1989, my freshman year at Saint Mary’s College in Notre Dame, Indiana, when I went by the Counseling and Career Development Center to inquire about local support groups (I was just a few months sober). One of the therapists politely invited me back.

A few months later she rattled off a handful of diagnoses: obsessive-compulsive disorder, eating disorder, anxiety disorder, and depression. She strongly suggested antidepressants, but I resisted. Like fellow twelve-steppers, I thought they would compromise my sobriety. And with my Catholic friends and mentors, I regarded them as a crutch and a short cut from the pain that was necessary for spiritual growth.

“Life doesn’t have to be this hard,” my counselor told me, giving me a copy of Colette Dowling’s book, You Mean I Don’t Have to Feel This Way. A year and a half later, when I was experiencing suicidal thoughts, I finally cried uncle, clinging to the lifeboat (or prescription) God sent me. After a few trial and error experiments, my doctor and I stumbled on the combination of Prozac and Zoloft, which allowed me to concentrate enough to study, and relax enough to tell a dirty joke (one of my favorite things to do).

Then I got married, in 1996, and made small people (David and Katherine are now 6 and 4). After the two births, my hormones huddled together to ask each other what the hell they were supposed to be doing now that no baby was in the womb or on the breast. My neurotransmitters (the good guys responsible for feelings of well-being) caught an express train to another brain (the one content with instant oatmeal). Brain cells began to shrink (and I suspect croak) in my prefrontal cortex. A tumor grew in my pituitary gland (also in the brain). And I had a bona fide, genuine mental breakdown. There was nothing mini about it.

I lost twenty 23 pounds (I could wear an Ann Taylor size 2! That was the only perk.) because I had no appetite (this alone signaled a serious crisis, given my love of all things edible), I contracted one urinary tract infection after another because my immune system was breaking down, I breathed into a paper bag every morning during a panic attack, and I trembled and flailed like Linda Blair in the “Exorcist” because my anxiety was so acute.

Oh yeah, and the endless sobbing: in the deli line at the grocery (“No, it’s not the chicken salad, I just got my period”), in the waiting room at my gynecologist-obstetrician’s office (“I’m sorry, pictures of babies make me cry”), on the hayride at David’s class trip to the pumpkin patch (“I’m allergic to hay”), at Eric’s company dinners (“Please give him a raise”), at Katherine’s physical therapy sessions (“Will she ever walk?”), during sex (“Are you almost done? I have to blow my nose”), in church (twice as hard if we sang “On Eagle’s Wings” or “Be Not Afraid”), and yada yada yada.

It took two trips to the psych ward, seven different psychiatrists, one endocrinologist, 23 different medication combinations, and several MRIs over two years’ time to get me well again. In other words, I upgraded to the platinum club membership in Club D. Diagnosed with Bipolar II Disorder, I graduated beyond the casual, my-primary-care-physician-can-prescribe-me-my-meds to the critical, regular check-ins with a head doctor.

Although I have cussed out God too many times to count, asking him what kind of marijuana he was smoking the day he designed my brain, I agree with Kay Redfield Jamison, author of An Unquiet Mind, that “tumultuousness, if coupled with discipline and a cool mind, is not such a bad sort of thing. That unless one wants to live a stunningly boring life, one ought to be on good terms with one's darker side and one's darker energies.”

Postpartum Progress Beacon of Hope: Mary Jo Codey

Announcing the Postpartum Progress Beacon of Hope for March 2007 (drumroll please) … Mary Jo Codey!!!! If you haven't heard about the impact the former first lady of New Jersey has had on the issue of postpartum mood disorders, then you've missed a LOT!!

Mary Jo Codey was first introduced to postpartum mood disorders 22 years ago after she experienced postpartum depression with the birth of her son Kevin. Prior to that, she had no idea that PPD even existed or that she might be at risk. She also went through PPD again four years later with her second son, Christopher. Even though she had all the signs of PPD, no one seemed to know what was wrong with her. She checked herself into a mental institution for a month but found no help there. Eventually she began to see a psychiatrist who did know about PPD and was able to help Mary Jo. She began to experience scary, intrusive thoughts about hurting her son. For months she worked with the psychiatrist tying different antidepressants, but the intrusive thoughts increased until she finally decided to "just end it all". Fortunately, the psychiatrist had decided to try an MAO inhibitor as a last-ditch effort, and within a few weeks the intrusive thoughts began to decrease and finally disappear. All in all, it took a year for Mary Jo to get better.

She became angry, as so many of us do, that it took so long for her to get the help she needed, and that until then no one recognized the signs. She realized that people needed to know and care about this disorder, and she didn't want anyone else to have to go through the self-blame and shame she experienced. To that end, she became an advocate extraordinaire. She has publicly shared her story with a wide variety of audiences, from health care and mental health professionals, to women's groups, PPD support groups, the general public and the media. During her husband's tenure as governor, New Jersey created a comprehensive postpartum depression awareness campaign called "Recognizing Postpartum Depression: Speak Up When You're Down". The campaign — which made New Jersey the first state to commit resources to uninsured new mothers for PPD screenings and treatment — features a 24/7 helpline and a bilingual website with valuable information and contacts for women and their families, as well as for medical professionals. The campaign includes literature and radio and TV PSAs. Mary Jo is very proud to be the spokesperson for that campaign, and was instrumental in its development.

Of all the work she has done, she is most proud of New Jersey's Postpartum Depression Screening and Education law, which took effect in October 2006 and is an outgrowth of the efforts that began during her husband's administration. Now every pregnant woman in New Jersey is educated about maternal mood disorders before giving birth; the mother of every baby born in the state will be screened for postpartum depression; and all licensed health care professionals who provide pre- and post-natal care will be educated about maternal depression. There is a budget of $4.5 million for education and screening.

As for the future, most of all Mary Jo wishes for New Jersey's law to become national law. The MOTHERs Act is actually based on the New Jersey law and is soon to be reintroduced in the Senate. She says it's time for it to come out of committee and get passed!!

Her biggest concern is that too many women are slipping through the cracks and going untreated. PPD is one of the most common complications of pregnancy, and progress is being made on raising awareness and increasing screening, she says. But the latest study published by JAMA shows we need to do more. There are lives at risk, she explains, and we owe it to women and their families to provide more education, screening, treatment and support.

Thank you, thank you Mary Jo Codey for your willingness to speak out, your courage, your honesty and most of all for your commitment to women like us! You are definitely a Beacon of Hope!

Profoundly Alone: The Disconnection of Postpartum Depression

Profoundly Alone: The Disconnection of Postpartum Depression

When you suffer from a postpartum mood or anxiety disorder like postpartum depression, you walk around in a haze while trying to seem as normal as possible. You try to make yourself feel as connected as you can to your child and those around you. Perhaps your dearest friends and family can tell that you don’t seem like yourself, but then they just brush it off as normal baby blues. And you soldier on, trying to pretend—sometimes successfully, sometimes not so successfully—that everything is cool.

When my son was a little over two months old and I was in the throes of postpartum obsessive-compulsive disorder, I tried to host a ladies’ luncheon at my house. It was mid-December, and I guess I thought it would make me feel better to have a half-dozen women over and make them a nice little Christmas lunch. I decorated the house. I made goat cheese salad and butternut squash soup and little lemon tarts with sugared blueberries for dessert.

When the women came over, I’ll never forget having one of the oddest feelings I’ve ever had. I felt like I was inside of a bubble. Or like I was hovering over the party watching it but that my guests couldn’t see or hear me. I was shocked at how disconnected I felt from the world, and it seemed like it didn’t really matter whether I was there or not. I tried to make small talk, but it seemed like the sentences just didn’t come out right and that I wasn’t making any sense; it was almost like all the air had been replaced by water that blurred my vision and muffled my sound. Everyone seemed to have a great time, and they were chatting and eating away. I kept trying to connect with them, to feel present, but no matter what I did it didn’t work.

To this day, I don’t think they had any idea what I was thinking or feeling. They definitely didn’t know I had postpartum depression. They seemed to have a lovely time. After everyone left and my son went down for a nap, I remember laying down on the couch in my family room and sobbing. I had tried to do something to make myself feel better, to be a part of the world, and it had only broken my heart. I tried to be close to others and it only made me feel further apart.

One of the truly awful feelings you experience during postpartum depression or anxiety is that sense of disconnection from the world, from your friends and family, from your baby, and most of all, from yourself. I felt so deeply, deeply alone.

Profoundly alone.

This is why it’s so hard for us to say anything. We’re ashamed, of course. But we’re also disconnected. I didn’t think anyone would hear me, or believe me, or perhaps even care. I didn’t even have myself to talk to anymore. Myself had up and left and this new person I had become was clearly NOT my friend. I had lost my ability to speak clearly and calmly and with reason. I felt like I couldn’t even communicate love to my own child. How could I have been expected to understandably explain THIS?

I hope the people we love can try to understand why it is so easy for moms with postpartum depression to turn away. It’s much easier to run and hide, or give up, than to try and speak through the cement wall that life just erected between us and the world. We try our best, but you may have to fill in the blanks for us until we find our words, and ourselves, again.

Mom Shares Her Postpartum Depression Story

This is from a mom out there who shared her postpartum depression story with me, and I thought you'd want to read it. I highlighted my favorite sentence, since it is so descriptive about how many of us feel while we're experiencing postpartum mood disorders. Many of you will recognize yourselves in her:

I found this website the other day. I too have had a hard time talking to anybody about this. I have 3 very young childen (ages range from 3 months to 3.5 yrs). I was diagnosed early thanks to the pediatrician who insisted I go see my dr for PPD. I reluctantly went and now am ever so grateful because while I am not 100% yet I feel soooo much better than I did 3 months ago today. I was put on Paxil and at first I did not get any better. It turns out that the dosage was too little for me so I had to double it. I can tell you that getting help for this disease has been the hardest thing I have ever done. I had to admit to myself and others that I no longer had control of my feelings and actions on a regular basis. At first I was ashamed. I did not want to admit that at any point I could sink to such lows that I did not feel I would ever get back up again. I used to lay on the living room floor wishing that I would get sucked into it so I could disappear. I wanted to climb into bed and lay there until I disappeared. I would stay in bed for hours during the day. It would take me 4-5 days to change my clothes and take a shower. Sometimes when it was time to make dinner I would lay on the kitchen floor for over an hour until I would be able to stand up and cook. I have had thoughts of suicide. I have put a knife to my wrist with a full hand of pills. My subconscious was reaching out to my husband but the right words for him to understand still have not come out of my mouth. He still does not understand exactly what goes on inside of me. He has tried many times but just can't. I think that the only people who truly understand are the ones that visit this website to post their own experiences with this disease. I used to get so tense that I would try to reach into my arms to pull the bones in my forearms out. I would get in the car and drive to get away. I could not focus. When I went back to work I would lay my head down on my desk for sometimes an hour at a time. I just could not get my act together. I have been seeing a therapist who has helped me tremendously. Since my kids are so young and so close to each other in age I have a tremendous fear of being alone with all 3 of them. I can't face the responsibility for taking care of all 3 of them. I am so afraid that I will be busy with the baby and something will happen to the other 2…they will fall and get hurt, they will do what kids their age do and just get into kid-type trouble. I have been slowly getting better. It helps tremendously that my baby is a very calm baby. She does not easily cry. She will cry and fuss with a dirty diaper and/or when she is extremely hungry. In the beginning of my depression I felt so guilty…I thought that God had given me such a good baby because he knew I was going to have a hard time and that I would not be able to handle a generally fussy baby on top of my 2 and 3 year olds. That guilt still stays with me. I have been lucky that I have not had too many thoughts/feelings of hurting the kids. When it comes to those feelings my mind focuses on myself. I just want the depression to go away. Last week I convinced myself that I wanted the feelings to go away so bad that I almost didn't care about whether my family missed me or not. Today as I was getting my daughter ready for her first dance recital I looked around the house as I was trying to get all 3 kids dressed and thoguht out aloud…"this family could not survive without me". My husband instantly agreed knowing that the responsibility of work and taking care of all 3 kids and their numerous trips to dr's for checkups and dance class and soon preschool would be too much for him to keep up with. I admitted to him that I had put together a calendar loaded with all activities (regular and sporadic) as well as the birthdays of all our extended families' birthdays so that he would be able to carry on in case I did commit suicide. He didn't say it in so many words but I could tell that he was shocked, confused, and touched all at the same time. He doesn't understand me…my mother tells me to "hurry up and get over your baby blues"…and in the meantime I feel like a sinking ship. I was quietly laying on the living room floor tonight…resting, not because I was having a meltdown moment. My husband asked if everything was alright. I responded with…"yeah, just tired". He said he was asking because he did not think I was having a meltdown but wasn't sure if something was wrong. For the first time in forever it felt like he might be slowly picking up on my feelings. He went on to state…"usually if you are having a meltdown you have a blank you are an empty shell". My response was…"that's funny…that is exactly how I feel when I have a meltdown". Meltdown is what I call it when I am having a hard time dealing with my depression. I feel like I am on the way up the ladder back to who I once was. I think that I may even end up better for having this disease. It has changed how I view things. I think I manage the kids and their behavior better now. I'm not sure if it is the antidepressants or if it is just me maturing as a woman. My 10-11pm obsessive cleaning sure has left my house in the best shape it has ever been in. I have started exercising. I have lost all the baby fat but still would like to lose another 60 pounds.

I know this was a long comment. I know that every woman's experience is different. I just hope that some of the words I have left tonight may help somebody else in the future. Good luck to all of you who suffer from a form of PPD or whose partners suffer. The best advice I was given during the past 3 months has been…"if everything else is too hard to face…focus on making it through the day. Whatever it takes to physically get through the day. Don't worry about anything else than ending the day with the same headcount you started it with".