Postpartum-Onset Bipolar II Disorder & OCD

[Editor’s Note: Today’s guest post comes from Kristen Lautenbach. She shares about her journey to diagnosis. -Jenna]

That Was Then, This Is Now: Postpartum Onset Bipolar II Disorder & OCD -postpartumprogress.com

It’s the spring of 2015, and I’m outdoors with my four young children, breathing in the long awaited warm weather as we walk to the playground. Life is humming along at a hectic pace, just as I’d imagined it would be when I’d found out, the year before, that my husband and I would welcome our fourth child.

But it’s not the challenge of parenting four little people that consumes my thoughts. As we walk along, the outward picture of a happy, carefree family, I’m preoccupied by the vivid images that have been too often flashing in my mind—images of my precious children coming to harm. Suddenly my three-year-old trips on a raised piece of sidewalk, and though he catches himself and continues marching along, in my mind I see him crashing face-first into the concrete. I try my best to push the horrible picture out of sight, but it will return to taunt and terrorize me throughout the day and even after the day has passed.

These graphic pictures of accidents that flicker and flash uninvited are what I now know to be intrusive thoughts, in my case caused by postpartum obsessive-compulsive disorder. They began shortly after the birth of my son, an autumn baby, who despite an intense birth experience was born healthy, beautiful, and completely adored. I had experienced these types of unwanted thoughts to a lesser degree following the births of my three older children, but the thoughts—and the anxiety and mild depression that accompanied them—soon diminished and then resolved with time. This time around, I am having a much harder time managing the chaos that seems to be both all around me and inside my very core.

During the first weeks of his life, my newborn son had difficulty breastfeeding, and after several days and nights of nearly constant nursing, a flurry of appointments with lactation experts revealed that an overlooked posterior tongue-tie and thrush, an excess of natural yeast in the body, were to blame. The tongue-tie was easily fixed with a quick clip of the skin under the tongue, but the thrush was more difficult to treat. Life became frantically busy as I fought to keep breastfeeding going while doing my best to care for my other children as well.

Stress and sleep deprivation wreaked havoc on my vulnerable postpartum state. One afternoon, as I hurried around the kitchen getting a snack ready for the older three, I glanced toward the living room to check on my two-month-old, who was lying on his play mat. His little mouth was purple with the gentian violet I had to apply to his tongue to treat the thrush. In my exhausted state, for a split second, I thought I saw blood pouring from his mouth. My body and mind constantly raced with anxiety. Around this time, I noticed my hands would frequently tremble, and my daughters commented that Mommy often dropped things while getting them ready for school in the morning.

Eventually, my baby settled into a predictable sleeping pattern, the thrush cleared up, and breastfeeding became easier. But while my children slept, I found it increasingly difficult to do so. Sometimes I would fall asleep while settling my three-year-old to bed, then wake up after a few hours’ rest and set to work doing laundry or other housework in the middle of the night. I couldn’t seem to settle down, and though I was worn out, I often felt restless and agitated by the energy I couldn’t get out of my body. My husband is a natural in his role as a dad, and he willingly took over with the children when I was unable to and worked extra hard to pick up wherever I’d left off with the housework. Still, I knew I desperately needed more help keeping up with the increased demands that weighed heavily upon me.

As much as I needed both practical and emotional support, I felt guilty when anyone besides my husband helped me. I had always been able to handle looking after my children, and I was determined to push through the difficult days, hopeful that life would settle down and I would soon feel more like myself again. With no family in town and a group of friends who were all busy with young children of their own, few came close enough to notice that I wasn’t my usual self. Those who offered to help, I all but turned away, insisting everything was alright. My husband could tell that I was struggling, but he had seen me come out of a similar, albeit milder, episode of postpartum depression after the birth of our second child, and he was optimistic that I would get better on my own.

I hoped my husband was right, though I feared this time he wasn’t. As time went on, I felt less and less like myself. When I looked in the mirror, I saw a sad, hollow version of the person I used to be. I started to wonder whether everyone could see how miserable I was, and whether they considered me ungrateful for my beautiful family. Still, most people didn’t even notice that I was having a hard time. Even when I finally confided in a close family member about some of the distressing symptoms I was experiencing, I was given the lighthearted advice, “Fake it until you make it.” I think the comment was meant to encourage me; the idea was that if I could just sit through the storm, I would soon be back into the sunshine. What I wondered but didn’t say was, “What if I don’t make it?” No one understood how deeply I was hurting.

I think that mothers, in particular, can be stoic. We’re used to persevering through all kinds of trials. In my case, I waited until my son was ten months old before finally getting help. I fumbled through the summer vacation with my children, becoming increasingly isolated without the daily interactions that go along with the school routine. I was able to go through the motions of caring for my family; having parented for eight years, I had my mom role practically memorized. Of course, I was only playing the part, a robotic mimic of my real self. Inside, I felt increasingly depressed, anxious, and emotionally fragile. I began experiencing frightening panic attacks and uncharacteristic, dramatic mood swings.

As my condition worsened, I began to wonder if my loved ones would be better off without me. I imagined my husband moving on and marrying someone else—someone completely unlike me. My children might be better off with a different mother, I reasoned, and my family wouldn’t miss me for long. The intrusive thoughts that had begun after my son’s birth now ran rampant much of the day and flashed continuously as I fell asleep at night. While these images had originally focused on my children being accidentally injured, now they included pictures of me harming myself. I had difficulty expressing what was happening, even to my husband. Exhausted and confused, I considered hurting myself as a way to numb my pain.

I was fortunate that in my lowest moment I had someone to call, someone whom I knew would respond with love and without judgement. For me that person was a close friend, the woman who had coached me through my son’s birth and who, fittingly, came to my side and helped me once again. Another friend happened to notice me that same week and immediately snapped to attention, sharing with me her own story of postpartum depression and connecting me to the resources that had helped her.

I phoned the facilitator of the postpartum mood disorders support group at my local hospital and described my symptoms. Although I wasn’t eligible to participate in the group since my son was older than six months, I was given the name of a psychiatrist who specializes in maternal medicine, and I was instructed to see my family doctor urgently in order to be referred to her. I called my family doctor and arranged to see her the next day. Finally, I had taken the crucial first step of reaching out for help.

Driving to my doctor’s office, I literally shook with anxiety. It was incredibly scary to try to move my inner turmoil into the outside world, to finally say out loud what was happening in my unsettled mind. As I described my symptoms, my doctor listened compassionately, completed the referral I requested, and even set me up with a complimentary counselling appointment. She then prescribed an antidepressant, which I was to begin taking immediately. The medication, she explained, would allow me to start feeling better after a few weeks, and I was to return in four to six weeks to reassess how I was doing.

For some women with postpartum depression, that antidepressant might have been a lifesaver. For me, however, it resulted in insomnia, extreme anxiety, and mental confusion. By the fifth day of taking the medication, I was completely unable to think clearly. I couldn’t remember what I had done just moments before and repeatedly asked my children questions such as whether I’d already brushed their teeth. A friend saw me dropping off my children for school and, noticing I seemed anxious, insisted she stay with me through the morning. A few hours later, when I became faint and was unable to answer her questions, she called 911.

Of all the women who suffer from depression following the birth of their baby, approximately one in five is actually dealing with some form of bipolar disorder. I was one of those women. This is why the antidepressant actually worsened my symptoms, causing my shifting moods to cycle even more rapidly between racing highs and painful lows. Thankfully, it was only a couple of weeks before I saw the psychiatrist to whom I had been referred. She had the expertise to evaluate my full range of symptoms, and after several appointments I was diagnosed with postpartum OCD and bipolar II disorder. It was a lot to take in, but a relief to finally understand what was happening. With proper treatment that included mood-stabilizing medication, I gradually began to feel better: calmer, happier, hopeful, whole.

My baby boy is now an energetic eighteen-month-old. I can honestly say I’m delighted that I get to be “Mom” to him and his brother and sisters. While I never doubted my love for my children, it is a joy to be able to once again feel that love and not simply to know it. I am immensely grateful that I’ve been able to get professional help for my postpartum mood disorder. I continue to see the specialist who initially helped me, now on a monthly basis. I’m conscientious about taking care of myself, making sure to sleep enough, eat well, and make time for occasional dates with my husband. Medication continues to be a crucial part of my recovery, and I also use a mood chart so that I can track how I’m feeling and better identify what helps to keep me well. Most importantly to me, I have a caring family and a close circle of supportive friends who know what I’ve been through and who remind me of how loved I am.

If you are struggling with a perinatal or postpartum mood disorder, or if you aren’t sure but you just don’t feel like yourself, please reach out and tell someone what’s going on. You may have to talk to more than one person to be heard. You may have to volunteer the information to your family doctor if he or she doesn’t ask. Just please don’t suffer in silence. Getting help doesn’t mean you’re weak, or that your parenting will be called into question. In fact, it’s the opposite: It means that you’re strong, and that you’re devoted to being the healthiest version of yourself that you can be, for you and your family. As my dad said to me when I told him I was getting help, “There is a much prettier world out there, sweetie. And you’re going to see it.”

About Jenna Hatfield

Jenna Hatfield is the Online Awareness & Engagement Manager for Postpartum Progress. She is an editor and award-winning writer, having won a SWPA Media & Mental Health Awards in 2012, among others. She is an everyday mom to two boys and a birth mother involved in a fully open adoption with her daughter. She makes her home in Ohio.

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  1. Thank you for this very important, excellent article!

    For more information about bipolar, peripartum onset (a.k.a. postpartum bipolar) please visit my Huffington Post article, endorsed by Dr. Samantha Meltzer-Brody, PPD Act Research Study Team Member.

    http://www.huffingtonpost.com/dyane-leshinharwood/postpartum-bipolar-disorder-the-invisible-postpartum-mood-disorder_b_9419484.html#comments