Let’s Rewind: The Isolation of Motherhood pt. 2

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My family and I headed to a castle. No big deal.

My family and I headed to a castle. No big deal.

Parenthood is, in a lot of ways, just a bunch of sleepless nights bleeding into long days. That sounds kind of bleak, but I’m not sure there’s a more complex state of being than that of being a parent. You’re always being pulled in multiple directions and overcome with conflicting emotions. And, honestly, I’m not sure that it’s ever as hard as it is in the first gritty-eyed months of having a freshly baked baby.

Throughout Archer’s first year, inertia carried me. Once I went back to work, the force of my footsteps was the only thing that propelled me forward. Daycare. Work. Pump. Coffee. Pump. Lunch. Pump. Daycare. Home.

And through it all, I felt alone.

Physically, distance crushed me. I was half a continent away from my family. Emotionally, disconnect destroyed me. Most of my friends did not have children of their own. If I could have articulated how abandoned I felt, my words would have been scarcely a whisper.

But, again, let’s rewind.

Breastfeeding came easily to Archer and me. Despite his time in the NICU, he latched quickly and nursed like a champion. The emotional trauma of his tumultuous birth experience was healed by our outstanding nursing relationship.

Nursing sustained us. It bonded us. It provided just the right dose of feel-good hormones to shield me from the undercurrent of isolation that tried so insidiously to steal my joy. When we weaned, the loneliness reached up from the deep below and quietly pulled me down.

Without realizing it, my body and mind were being realigned as Archer nursed less. The chemicals in my brain like tectonic plates, slowly and imperceptibly shifting to create entirely new and unrecognizable continents within my psyche.

I left my job to pursue a freelance writing and marketing career and I spent each day deafeningly alone. Just me and my deadlines and – I know now – my depression.

Despite having solid support systems and amazing friends, I was borderline non-functional by the time I admitted that I needed help. Depression is a liar and she told me that no one knew my plight – that such loneliness was the result of being undesirable by friends and family alike.

In my first postpartum counseling session, I sat across from my psychiatrist and psychologist – both specially trained to work with mothers with mood disorders – and told them how impossibly isolating motherhood was. My doctor pushed up his glasses, looked me in the eye, and said, “Liz, I am not here to belittle your experience, but I want you to know that every mother who has ever sat in that chair has said those same words.”

Now, let’s fast forward.

With a diagnosis of “post-weaning depression,” I restarted on my Lamictal and recovered, once again, quickly. And, again, we reveled in my stability.

Archer became our co-pilot on a new adventure and we moved from Baltimore to Germany for a three year assignment with my husband’s job. In our time here, the isolation of motherhood combined with the isolation of ex-pat life to create a sort of mecha-loneliness that has tried to cut me down many times. If I’m being honest, sometimes, it has succeeded.

Enduring a rough pregnancy an ocean away from family and friends did little to quell the rising tide of lonesomeness. Late night nursing and long days working ignite sparks of heartache that occasionally rekindle the flames of alienation.

But, in my worst days, I rewind to my psychiatrist’s office and remember that my isolation is not a unique condition of my experience with motherhood.

You see, motherhood is a weird thing in that many mothers experience the same things, but in different ways. There are times when all of us feel alone. Motherhood, on some level, breeds some amount of isolation. But, in that isolation, we are – in a twisted way – brought together.

 

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Overcoming Resistance in Therapy

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auggie bdayChanging our habits is one of the most conscientious things we do in our lives. It’s more than training yourself to drink eight glasses of water, or to exercise for an hour each day. Changing our habits means retraining our mindset, and not just our bodies. In how we process events, think about ourselves, and our self image. We know these are good things for us, but why do we resist suggestions to change? Are there strategies for overcoming our fixed reactions and coping skills that don’t serve us well?

Only to Just Begin.

When I was living through my postpartum depression, I was seeing my psychiatrist for medication prescription, and my mental health counselor, Susan, who worked with me, (heavy emphasis on work). Susan taught me through application examples, of how I had become who I told myself I was. She explained the tendency to resist cognitive therapy when we don’t see ourselves as being capable of getting better. I had to learn new skills if  I wanted to succeed, and I had to start seeing myself as someone who would recover.

I learned that a barrier to behavioral therapy, is lack of genuine introspection. Therapy was going to be work, and I had to be honest with myself and acknowledge what my challenges were. This meant examining issues about myself, not something flattering to do, that’s for sure. I had to admit that I was a pessimist, and I felt doomed at the start of any homework before I even gave it a try. For us to even bore an inch into my stubborn persistent negative self image, I had to be painfully honest. I had to face my dysfunctional emotions, maladaptive behaviors and cognitive processes. In Susan’s words, “To change a behavior, change an action.” This was beyond the petty advice given by friends and family of “mind over matter,” or “cheer up!”

I didn’t like this part of therapy.

Who likes to think of themselves as dysfunctional and negative? Yet, that’s the truth that I had to accept. With plenty of reading from books that Susan recommended, and from months of honest answers to questions in therapy, I began to turn my self concept around and talk to myself in a positive way.

I thought twice before saying, “Not me.”
I didn’t automatically begin to think, “That’ll never work.”
I stopped myself from saying, “Yeah, but…”

“Yeah, but” was the biggest obstacle we had to overcome together. “Yeah, but, I tried that,” and “Yeah, but, that didn’t work before,” and “Yeah, but, I’ve tried everything.” Self-condemning was the biggest road block to possible improvement. Without the door to my mind and trained thoughts even open a crack, what light would ever get in?

We resist when someone asks or tells us to do something because our self talk makes us lose the war before we even march onto the field. The thing is, without change, there will be no change. Doing things my way hadn’t been working for me… so why did I persist with pessimistic negative thought patterns?

I know I didn’t want to be that way, but I had trained myself over a lifetime. The cost of continuing in that way was becoming evident. We lose friendships, without understanding why. We exhaust family members, unclear why they have no patience. Our marriages barely hang on by a thread from the emotional fatigue of supporting a person who never has hope and is always down.

My question to anyone “stuck” and wanting to change, is this. Examine the impasse. Do you need to find a more pro-active physician? Is there a therapist that’s been recommended to you, but you haven’t sought out yet? Have you resisted suggestions of medication, or continued talk therapy? Work with your medical team and be open to their suggestions for change. Our trained minds are stubborn. My default setting of pessimism was stubborn enough to not even consider suggestions by my therapist. I would think, Why try? Nothing ever works anyhow. Susan taught me how to change the way I view and experience events, ideas, concepts and emotions to find more positive alternatives.

Over a lifetime of negative thought patterns and reactions, our default is set. In my case, comfortably, to see myself as always being anxious, depressed, low energy, and being that one in a thousand who will never get better. The thing is, we can get better. Postpartum depression and anxiety are mental health disorders, but with treatment, people with PPD and PPA  do recover. But as in anything, work and commitment are required to deconstruct ingrained and automatic behaviors.

I once saw myself as eternally depressed. I once saw myself as that one with postpartum depression and anxiety that would never get better. After 11 months of weekly therapy sessions, I began to improve. I saw success and that made me try again, and try harder. It wasn’t an overnight process, and it wasn’t an easy process. It was work, and it’s still not my nature to be hopeful, but through honest dialogue with myself, I had a starting point of recognition and awareness of this about myself.

I had to begin, with difficult questions. By asking others to support and help me. I had to put my ego aside, and ask myself how I talked to myself. I asked trusted friends to be patient with me while I grew in a new, beneficial direction. I had to listen when my therapist told me that I was allowing no room for positivity, or change.

None of this was fun, but all of it was life saving. This work made me feel uneasy, vulnerable, raw. It was hard. I felt shaky, as a new me began to battle with the old me. Much of the time, my new thoughts didn’t feel like mine, so unfamiliar that triumph was hard to imagine — I was not a positive person, remember? But with time, and repetition, as my new thoughts grew to become my own thoughts, I felt capable and stronger. And I began to feel that victory was possible.

My self concept now is of someone who has overcome things that she thought she never would. And it began, by beginning.

*If you’d like to explore more, these are the books that Susan had me read. My therapy wasn’t based solely on positive thought, but together with medication and talk therapy, challenging my self concept was an integral part of my treatment plan. Once my therapist and I worked on (it took a year!) helping me see that recovery was possible, hope set in. Before then, I was resistant. Medication helped, talk therapy helped, eating sleeping exercise support and friendships helped, but it wasn’t until I changed my inner talk, that things began to look hopeful.

Learned Optimism: How to Change Your Mind and Your Life by Martin E. P. Seligman
Optimal Thinking: How to Be Your Best Self by Rosalene Glickman
Optimism: Learn the Power of Positive Thinking. Our Thoughts Shape our Attitudes  by Abe Kass

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Taking an Active Role in Your Postpartum Recovery

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sfb groundbreakingBelief

Shared community

Information

These items are the beginning tools for a successful recovery from postpartum mood disorder. I say this confidently, because I believe in recovery being possible. I was once someone who never felt that I’d be normal again nor that I’d ever find my way back to who I used to be. But recovery is made up of small steps that lead us to a successful life of overcoming postpartum mood disorders — these steps toward wellness matter, because being active versus passive about your recovery greatly increases a positive outcome.

For me, a belief in the process, along with an open ear to advice, and full engagement in dialogue with your recovery team of your physician and your therapist, possibly a support group, is essential. I used to go to my appointments and sessions with a notebook filled with questions or thoughts that I had had during the week before the appointment. I wrote everything down of the information they gave me so that I could refer to it later. This helped, since it was difficult for me to concentrate and remember during my time of PPD and PPA. It also shows your recovery team that you see yourself as integral to recovery and that you are there to advocate for your mental health.

Life while in postpartum recovery can feel isolating. For that reason, you need a shared community. You can find a group through your area hospital, health clinic, checking out what’s offered in a local events calendar, or finding one online by searching postpartum progress. To hear others share their current struggles, or by listening to stories of those in recovery or recovered, is a lighthouse during this storm. You can feel encouraged and find ideas on ways to work toward your own eventual recovery.  You don’t have to be “fully recovered” to participate in any group and you don’t have to be fully recovered to start to feel better.

A few nights ago, I was talking with some postpartum warrior moms, some that were currently in postpartum phase, some on the way to recovery, some recovered. I asked them for suggestions on how to be active in PPMD recovery. Here’s what worked for us:

Define your goals. You decide what recovery would mean for you. For me, it was to once again smile, laugh, and enjoy my life.

Accept the importance of your role and the responsibility that you have in your recovery. That means being aware of how and where you spend your time, and who with. Sometimes it means guarding your environment and stimuli at a time when you’re not strong enough to take much negativity.

Know that you have power, and are not weak. You are the one in charge when you see your recovery team. Listen to what they say, but be honest about how you are feeling. If something doesn’t feel right, or you’ve tried and it hasn’t helped, let them know. I have heard cases of women being on the same medication for months with no alleviation or improvement of symptoms. Let your physician know, and work together.

Getting better is not just through pharmaceutical aid. Recovery can take longer than we want it to, and the easy way out is to think that just taking a daily pill will fix us. But other things need to be part of your lifeplan: sleep, diet, exercise, state of mind. Incorporating what spirituality is to you, and a mindful practice, like meditation, creativity, maybe yoga. Only you can discover what centers you, so search new activities out. For me, waking up 15 minutes earlier so I could deep breathe and have a mind free of thought was the cornerstone to my day.

Your social network and friends and family support are what will hold you up. Let people know how they can help you, as well as what is detrimental to your recovery. Relationships and community provide a feeling of belonging and lesson isolation. Isolation can be a huge trigger for PPMD, so reach out and ask for support when you need it.

PPMD recovery is possible with treatment and identification. It comes slowly, and is a growth process because your life has changed. You are no longer someone without a family or children. We have to learn skills and ways to adapt to our new normal. Allow room and space to understand setbacks, transitions, bad days. We learn from what works and what doesn’t work. No one does everything perfectly, and the best way to learn is by paying attention and being aware.

Write in a journal, especially days that feel good. It’s too easy for us to internalize that we are always depressed, or tired, or manic, or incapable. But we are more than that. If and when you have a good day (you will, trust me, they come…) write down what that feels like. See if you can figure out what led to the moment, even if it’s just a flash. In my case, my son was ten weeks old and he suddenly kicked his legs and giggled. I found myself smiling for the first time in a long time, and I believed then, I could get better one day. For you, it might mean a task completed, or standing up for yourself in a situation, maybe having face to face time with a friend. Remember them, write them down, refer to them to help you believe better times are on their way. Find out what promotes a positive feeling in you.

Prepare a list of go-to activities that make you feel better. When your mind is muddled, it’s hard to find a way out of dark thoughts. I kept a list taped to the inside of my kitchen cabinet, on it were things like a trip to the bookstore or a walk. I also had “watch SNL” because laughter was and still is, important to me. Be sure to exercise, sleep adequately, eat right, drink water, take your medication, talk to someone at least once a day. You could list creativity, cooking, photography, writing, nature walk, yoga. Whatever is part of things that need to happen every day for you to recover. I still refer to a daily list for my mental health, it includes sleep, exercise, good food, and water.

If you have a bad day, tell yourself that it’s not permanent. The feelings are not here forever, and tomorrow is a fresh start. Have a plan for a bad day, whatever that may be. For me, I have a close friend whom I trust. She always knows what to do, she just listens.

Recovery from PPMD is possible. After a long time of being depressed, we have trained ourselves to think that’s who we are and it’s easy to fall into old habits, with thoughts of discouragement and hopelessness. I don’t make light of the challenge it will be to be active in your recovery, but the result is one of hope and empowerment.

There will be better days, but they won’t happen by magic.

Medication and therapy are an important part, but reframing how we talk to ourselves and being open to change and implementing suggestions for lifestyle changes by our recovery team, are just as integral. I know it’s not easy, especially at a time when you have never felt more lost or overwhelmed. Recovery is an arduous process that feels endless on some days — there were times when I thought I would never get better,  but I assure you, the day will come when PPMD will be behind you. The way to increase your chances on the path to recovery is to take an active role in your personal journey. It’s a lot of work, but there are many people here to help you, and it’s a thousand times worth it.

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When You Compare Yourself To Mothers Without Postpartum Mood Disorder

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alec the babyFrom my viewpoint, everyone around me had it together.

I saw the dark-haired mom seated on the other sofa in the gathering room. Her hair was smooth and fell neatly to her shoulders. Her three-month-old daughter looked up at her from her knee, dressed in a spotless blue one-piece. Next to her sat another mom. Short hair, obviously clean, as were her clothes. In her lap, a cooing infant, he was fresh and shining, I was sure he had been bathed just that morning.

Everywhere I looked, I saw put-together and neat as a pin mothers. In unstained clothing with faces dewy and bright from their morning shower. I couldn’t bear to look up and meet their sparkling eyes. Neither could I bear to look down, into my stained three-day-old T-shirt. My baby, my life, really, nursed blissfully in my arms. Alec was always clean, so beautifully well taken care of by me. But that’s all I could manage to do during these first days of new motherhood, just tend to this precious child of mine.

I was in the throes of newly diagnosed postpartum depression and anxiety. Alec was four months old, and my therapist had recommended that I get out of my house at least once a day. And that’s how I came to be at this morning’s Diaper Bag Club at a local hospital. From my end of the sofa, I saw no one like me there. Stringy hair, with the same clothes as yesterday and without a shower since the Sunday before when my husband had been home to hold the baby.

Alec, my precious baby boy, screamed anytime that he left my arms. I had grown so used to his cries, that even when he napped, I still heard them. I adored this child, but he was all-encompassing, and with the days without sleep piling one on top of another, even thinking felt difficult and impossible.

The gathering room on this Wednesday morning was filled with women who could do what I couldn’t do. That’s what I believed, and what I told myself. They were who I compared myself to. Women who looked together with babies who barely sniffled. I sat in the middle of this group of nine women, and my eyes began to fill with tears.

I couldn’t even mother.

What I was doing, was one of the worst, and yet, most common things that we do as postpartum mood disorder moms: we compare. We compare ourselves to mothers who are living in a different world than we are. But I didn’t know that, and I didn’t understand it enough to help myself. It was my therapist who helped me see my way out of this dangerous unproductive mindset.

“What you are doing, thinking that you should be right where others are now, and comparing yourself to them, is apples and oranges,” she explained to me at a therapy session later that week. “You haven’t even started the recovery phase and yet you want to live in another land without crossing the bridge to get there.” She talked to me firmly, but not brusquely. She explained how I was still on this side of the world, with my goal being to get across the ocean to get to that side of the world, and that our sessions, my medication, along with support of family and friends, would be part of the bridge over those waters that would get me there.

She took a pencil and drew on a piece of paper. There was me, an “x” over here, and then a dotted bridge, with my destination, me, another “x” over on the other side. I folded this paper and carried it with me. I thought about the “x” of me thinking I could do what the other women on the other side were doing when I didn’t even have one foot on the bridge yet.

Comparison to others will always engulf us. When you have postpartum depression, postpartum anxiety, or any other mood disorder at this time, you’re not at the same starting point as those without. Some of the women I sat with that morning entered into motherhood with their feet set and ready to go. They had no postpartum repercussions. Add to that, many had “easy” babies. Some had husbands who worked out of the home and were there with them during the day to combat the loneliness and some even had mothers or mothers-in-law, friends or siblings who came at least once,maybe more, during the week.

It was a vastly different world from mine, and yet… I held myself up to the same standards and results that they had. I thought I should be marching along in their identical unencumbered rhythm.

What my therapist did for me was help me feel pride in all that I was doing, and overcoming. When I said to her with tears in my eyes, “But these women are better mothers than me!” She laughed softly and asked back, “Really? Let’s see what happens when I try and hand Alec off to one of them.”

When I said that these women looked so good and that I looked so disheveled, she countered with, “Problem solved. Put on a fresh shirt before you leave home.” That sounded so easy, and yet? I never thought of doing it. I know it’s hard to understand, but with postpartum depression and anxiety, along with fatigue and a colicky baby, you can’t see your way out of the simple things.

No matter what I volleyed at her, my therapist smiled at me warmly and helped me to see that I was the best mother at this time with what I was surviving. Her comforting reassurance of how Alec seemed to be in love with who his mother was brought me to grateful, gushing tears.

My baby loved me, I could see that. And all I had to do was tell myself that I could get to the world I hoped for me and my baby. With small things to help me along the way, like a change into a fresh shirt before I left home and with big things to help me, like our  continuing therapy. My therapist had me check my reality. And more important than anything, she gave me a map, one I could look at and envision the me on this side, on the way to the me on the other side, and to be patient with the bridge that would get me there.

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