The Importance of Screening and Support : Jenna’s Story, Part 1

pregnancy depressionI’m welcoming a fellow Warrior Mom friend of mine today to share her story with the Postpartum Progress community.  Jenna and I met online through #ppdchat, and we became fast friends.  Since I only experienced postpartum depression and postpartum anxiety with the birth of my youngest, I really wanted the perspective of a mama who had suffered multiple episodes of postpartum depression.  I wanted to showcase the idea that all women should be screened for perinatal mood disorders throughout their pregnancy and all through the first year postpartum.  Thank you so much Jenna for sharing your story.  It is a pleasure to welcome my dear friend.

My longest lasting episode of depression began during my pregnancy with my second oldest child. It was marked by anxiety and irritation, and a loose cannon rage that would come out of nowhere over both big and little things. I was ashamed of my lack of ability to control my anger, and that I’d become a parent who yelled often. I attributed it to being pregnant and hormonal and having a high need 2 year old, but I didn’t connect it with depression at all. I didn’t make that connection because I wasn’t sad, tearful, lethargic, or unmotivated. How could it be depression if there were no tears?

After my baby was born, things only got worse. She had colic for 3 months, screaming from 11 pm to 2 am most nights, while I walked a groove into the living room floor. Once the colic abated, she was a terrible sleeper. She woke as many as half a dozen times a night for the first two years of her life, and I was the primary caregiver. Due to the chronic sleep deprivation, I was detached, full of rage, and anxious.  I also began having intrusive thoughts and paranoia, most often involving fear of home invasion or replaying the worst parenting moments of my day. Some were worse and more vivid than that.

I mentioned my anger and detachment to my ex (who I was still married to at the time) when she was about 10 months old, and he told me, “If you had a closer relationship with God, you would not be in despair.”  Medication and therapy would be a waste of money, he said, because the problem was in my head and was rooted in sin.  I was devastated and felt even more shame as I internalized this possibility.

When you’re already feeling worthless and ashamed, it’s easy to believe unkind words about why you feel the way you do. Because of his reaction and invalidation, I never told anyone about how I was feeling. I didn’t have the courage to admit to the intrusive thoughts and paranoia once he told me that I was the problem. But I knew my feelings were real, and I knew they weren’t normal.  I didn’t know I could look for support or help because I didn’t really know what to call my emotional state other than angry, detached, and overwhelmed. It didn’t seem like any depression I had ever heard of.

… tune in tomorrow for part 2 of Jenna’s story …

What I Didn’t Know About PPD

I thought I knew what to look for. I thought I’d educated my family–anyone who would be close to me after I had the baby–about PPD signs. I knew my history of depression and anxiety. I knew postpartum depression had been in my family through a few generations. Even though I was worried, I was so confident in my knowledge.

But BAM! It hit me anyway, and I didn’t even recognize it for months.

During the pregnancy was one thing–I coached myself and others on what I thought PPD was. But then I had a traumatic delivery culminating in a c-section that didn’t heal the way it should have healed, and all my attention turned to surviving the trauma, the pain, and the fog of new motherhood. I didn’t have time to think about postpartum depression for a even a minute. My high-needs baby couldn’t be consoled a lot of the time, and he didn’t sleep more than an hour at a time. Ever. At least not for me. He nursed every 90 minutes, and feedings typically lasted 45 minutes. I was exhausted and unable to think straight.

I didn’t know that PPD doesn’t simply mean crying a lot. I didn’t know that my rage was a symptom. I didn’t know that my intrusive thoughts (about illness and accidents harming my son) were due to postpartum anxiety. I wanted to quit my job because I couldn’t bear the thought of leaving my son’s side at all. That’s when I knew I needed to seek help, at least to prevent myself from making a drastic decision like leaving my job and jeopardizing my family’s financial safety. [Read more…]

Breastfeeding and Postpartum Depression: Treatment Options

breastfeeding and postpartum depressionMy father passed away in August. As I waited for news about his arrangements, I felt the pangs of anxiety building. Knowing that I have a history of anxiety, I called the only doctor I’ve seen in 2 years–my obstetrician.

I explained to the receptionist what I was going through and that I knew I needed to get in with someone, a therapist, for treatment, but that I didn’t know where to start and the wait time would likely be too great to treat my immediate needs. I asked if they could they prescribe something to help. The nurse practitioner called me back that afternoon.

“Are you breastfeeding?”
“Yes. A few times a day. My daughter is 16 months old.”
“There’s only one medication we can give you.”

Currently, there is only one medication on the market specifically approved by the FDA for use in breastfeeding mothers, and it isn’t the medication with which I’m most experienced or even the best one for treating anxiety. It also isn’t the only medication that has been proven safe for breastfeeding mothers in study after study.

I was sort of crushed by the lack of options given to me by my doctor’s office. I felt like I was being told to choose between the extended breastfeeding relationship I have with my daughter and treating my anxiety with a medication I knew to be safe and effective. I was angry for other moms who might find themselves in similar situations.

I had taken another medication while breastfeeding my son and had no issues. I knew how it worked and that it worked for me. I was comfortable with the heaps of research that said it was a safe choice.

I went in the following week for a visit and asked why they wouldn’t prescribe anything else to breastfeeding mothers. Their answer was that the practice is a one doctor show and since he isn’t an expert on mental health he prefers to defer to those who are. He will triage issues like PPD and generalized anxiety, but he likes working in conjunction with a psychiatrist for treating PMADs to make sure moms are getting the best care possible.

I felt that was a fair enough answer. It didn’t help me in that moment, but I could understand their reasoning. Of course we want all moms to receive the best possible care. I walked out of the office with the name and phone number of a therapy practice in my area.

But then I thought about all the other doctors who don’t make it a habit of handing out referrals and will only prescribe one medication to breastfeeding moms, regardless as to whether or not it’s the best medication, when there are others which are also safe. I wondered how many of those doctors don’t follow up to see if the medication is even working or who tell moms they have to stop breastfeeding if they want to get better. [Read more…]

6 Reasons Having A Baby After PPD Is Easier

postpartum depressionI’m so happy to have Warrior Mom Robin Farr here today, sharing how having a baby after PPD can actually be easier, at least in her experience. I have to point out that Robin, who writes the blog Farewell Stranger, was recently named among the top Canadian blogs about family and parenting in the 2012 Canadian Weblog Awards. (Go Robin!)

 Six Reasons Having A Baby After PPD Is Easier

1.    You know what to look for.

Having experienced postpartum depression once makes it easier to catch it if it happens again. You know the symptoms of PPD, including the surprising ones, and you can take action as soon as it starts to darken your nursery door.

When I was pregnant with my second, someone told me it couldn’t possibly be as bad this time because I know now. I know what PPD feels like and I know what triggers it for me. And so does my family. That one piece of advice did wonders for my anxiety before my baby was born.

2.    You’re better at asking for help.

Asking for help is never really easy. But a mom’s gotta do what a mom’s gotta do, especially when she’s struggling. The second time around you know that asking for help when you need it can make the difference between getting through a hard day with the ability to carry on and sliding into a pit that takes weeks (or longer) to get out of.

3.    You know the tough baby stages are temporary.

The early days (and weeks and months) of having a baby are hard. It feels like he’ll never sleep through the night. You estimate that you’ve put her soother back in 2,365 times in the last week. You contemplate letting your little cherub play naked in the bathtub just so you don’t have to change one more diaper.

The second time around, you know there’s an end to these tough phases. It might be a ways away, but you can see that end, and that alone can get you through. Knowing it’s temporary makes those days your baby refuses to nap just a little easier to manage.

4.    You have a community to look to for support.

Obviously you’ve found Postpartum Progress, which is a huge step in the right direction. Having other PPD moms for support when you need it is a critical part of surviving and it’s another thing that can make a world of difference if (not when) you experience PPD again. There are lots of ways to connect to the postpartum depression mom community. Take advantage of it!

5.    You have professional resources.

Surviving postpartum depression the first time often involves professional support. Whether you’ve talked to your family doctor, a therapist, a psychiatrist or someone else, that person (or team of people) will be there to support you the second time around as well. For a lot of people, finding the right support can be tough, especially when you’re struggling to get out of bed in the morning. Having that support already in place makes the idea of having another baby after PPD much more manageable.

6.    You have more confidence that you’ll recover.

If you’re having another baby, or thinking about it, chances are you’ve recovered from your first experience with postpartum depression. You know the answer to one of the most common questions women with PPD ask: “Will I ever get better?” The answer – for them and for you – is YES. And you know it firsthand.

Having had postpartum depression once doesn’t mean you will inevitably get it again. But if you do – or are worried you will – these six things are almost sure to make having a baby after PPD a little bit easier.

~ Robin Farr

Editor’s note: I had a great experience with my second child. It’s hard to know if it’s because I chose to stay on my medication throughout my pregnancy, or if it was because I just wasn’t going to get postpartum OCD again. I do know that if I had gotten it again, I would have been grateful to be aware of where to get help and to have had the knowledge that I could and would get better. What do you think? Do you agree with Robin, or did you feel it wasn’t easier?