Letting Go Of The Guilt

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shameI suffered from postpartum depression and anxiety with a side of OCD for two years after my first child was born.  And though I sought treatment and began my path to wellness after my baby had her 5 month birthday, it took every last day of that additional 19 months for me to feel like I wasn’t waiting for the other shoe to drop.  If you asked my husband, he’d tell you now that I’ve completely recovered from my PPD and from the antenatal depression that hit when my second child was still baking.  But he’d also tell you that I still suffer.

I know now that I suffered from anxiety and OCD symptoms for years before having children.  My anxiety diagnosis is not going anywhere – and I’ve made peace with that.  I see my doctors regularly, take my medications daily, and make a point to be mindful of my emotional health.  When I have a bad day – a panic attack, a  moment of anxiety, or a day of feeling like I want to just stay in bed – I have the tools and the support now to reach out and ask for help.  I can identify the anxiety and often stop it in its tracks.  My mental illness may always be there, but it’s managed.  And in the last 5 years, the most important thing I’ve learned is that I don’t have to wait to be perfectly healthy to be happy.  So though I still struggle with anxiety, that’s not why my husband would tell you I suffer.  He would tell you of the guilt.

No matter how hard I try, that guilt monster rears its ugly face.  I say “monster,” because that’s what it is – an ugly, twisted creature that deserves no place in my life or my thoughts.  It’s clandestine and voracious and likes to hide until just the right moments.  And though my rational mind knows that I did absolutely nothing to deserve or cause my PPD, I still find myself fighting to let go of the past.

The guilt was amplified when my second daughter was born and I experienced joy.  Unadulterated, life-affirming joy.  I was fortunate to work with an amazing doctor early in my pregnancy and not only was her delivery a happy time, but my pregnancy was too.  Postpartum, I found myself enamored with my new baby.  Bonding came quickly and easily and she brought me a sense of completion.  It was everything that was missing with my first baby, and the shame hit me in waves.  With each gentle nursing session and snuggly late-night feeding, I was reminded of the screaming and the detachment those early days and nights brought with my eldest.

Most recently, the guilt resurfaced while I was struggling with the idea of taking my 5 year old daughter to therapy for her violent outbursts and non-compliant behavior.  It was more than a feeling that I had caused her problems by failing as a parent – it suddenly hit me that she must be this way because of how I treated her as an infant.  I found myself sobbing and asking trusted friends, “how can this not be my fault?  Those early days were so, so ugly.”  And they were.  I have vivid memories of screaming at my 10-day old baby, “what the fuck do you want from me?”  Even now, typing those words is hard.

And then a good friend wrote me a letter and said this:

“I know right now you are worried about E.  Of course you are.  Your sweet, imperfect, first baby.  But you worry that it’s your fault.  It is.  It’s your fault she’s smart, emotional, a touch socially awkward, and painfully self-aware.  Let’s just own that for a minute because really, it’s wonderful.  But that lucky, lucky girl, she has the gift of a mom who sees her, who accepts imperfection, who asks for help.  You don’t know how much I longed for that. I bet you did, too.”

As the hot tears rolled down my face, I knew she was right.  I did not ruin my daughter.

I did nothing to deserve or cause my PPD.  The guilt monster will not own me with its lies.  If my daughter suffered because of my PPD, it was not my fault.  But the triumphant, sensitive, wonderfully imperfect little girl she’s growing into?  That’s all me.  I still regret that it took me so long to get help – but regret is not guilt.  There is no shame in regret… only a wish for the past to be a bit different.

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I think coping with the guilt that accompanies antenatal and postpartum mood and anxiety disorders is a common experience for many warrior moms.  I want you to know that, like me, you did nothing to deserve or cause your PPD.  You are exactly the mother your child needs and wants.  You deserve to be happy and healthy.

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How My Doctors Missed My Antenatal Anxiety

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antidepressants pregnancyI was in my first trimester of my first pregnancy when antenatal anxiety washed over me like the tide, insidious and unstoppable.  We were living on our own in the midwest at the time, and the loneliness was crushing.  I compensated for my irrational worries by donning a brave face and making light of my anxiety, to both friends and my doctors, and I assumed all newly pregnant women felt the same trepidation and slight panic I was suppressing.

I was 8 weeks pregnant when my OB called me into her office.  My fears and worries were suddenly compounded by a previously-undiagnosed kidney disease.  A giant mass in my abdomen.  And they had no idea what it was.  I taciturnly absorbed all the doctor said and then politely asked for a few moments alone.  When the door shut behind her, something in me broke.  I walked out of there a shadow of myself.  The next 6 months brought a multitude of diagnoses.  I was ultrasounded and MRIed (twice).  I met with several surgeons and had a cathertized void test done.  There were very few cases of pregnant women with my eventual diagnosis of severe unilateral hydronephrosis with 1% kidney function, and so few doctors could tell me exactly what to expect or how it would impact my pregnancy.  And that scared me to death.

Six months into my pregnancy, we moved to the North East.  My need for my family (who had moved up to the Boston area a few years before) outweighed my terror at the prospect of moving, but leading up to moving day, I had increased symptoms of panic attack.  I refused to drive while house hunting, irrationally fearful of the alien traffic patterns of our new-home-to-be.  I fought back waves of nausea at each apartment-hunting appointment, instead playing the part of the happy, expectant couple.  The night before our final flight out of the midwest, I became convinced I had a blood clot in my right leg – and the resulting (unnecessary) hospital trip ended in a 2am leg ultrasound for me and a busted blood vessel in my husband’s eye from the stress.  My husband tells me that when I fainted from panic on the 4 hour flight to Boston the next day, he took special notice of the halfway mark in the flight.  ”At least there was no turning back,” he says, only half-jokingly.

Unfortunately, arriving in Boston alleviated the anxiety only temporarily.  As I neared the end of my pregnancy, I began having irrational, intrusive thoughts about my husband leaving me.  ”He’s only staying until the baby is born,” the lies whispered, “he never wanted a baby anyway.”  I became increasingly irritable and emotional, and finally suffered enough to mention it to my OB, a high-risk, high-profile doctor at Massachusetts General Hospital.  With my mother in the room, I explained my heart palpitations and my trouble breathing.  I outlined my mood swings and my panic attacks.  It took every ounce of courage in my body to admit that I was struggling.

In return, she told me to “stop worrying.  Pregnancy is an emotional time.”

That was it.  We moved on to belly measurements and discussions of pain management during labor.

With only two sentences, she had me doubting my need for help. I suddenly “just wasn’t trying hard enough.”  And I believed her.

Throughout the course of my first pregnancy, I saw 5 different OBs, 3 surgeons, 2 primary care physicians, and a myriad of nurses and techs.  None of them EVER asked about my emotional well-being, and when I did speak up for myself?  I was ignored.  Dismissed.  And the thing that angers me the most is that MGH has a world-renouned Center for Women’s Health, run in part by the incomparable Dr. Marlene Freeman, an expert in the field of pre and post-natal mood and anxiety disorders.  Sitting in my OB’s office, I was one elevator ride away from help.

Instead, it took me 5 months after my daughter was born – five months of intrusive thoughts about shaking my baby or letting her slip in the bath tub (I would like to emphasize here that intrusive thoughts are distinguished from psychosis by a mother’s ability to recognize the thoughts as scary) – five months of obsessively folding and lining up burp rags and matching bottle tops to bottle bottoms by shape and color – five months of rage and of falling apart behind the scenes before I recognized I needed help.

It’s hard for me to think back through that time because I find myself so ANGRY.  My struggle was preventable.  Avoidable.  Not once during or after my pregnancy was I asked about my emotional well-being, and when I mentioned physical and emotional symptoms of my condition, they were ignored.  A few simple questions and an honest conversation with a trusted doctor was all it would have taken.

I want you to know that there are many wonderful doctors, psychologists, and social workers out there.  Many obstetricians and primary care physicians are well-educated and have amazing bedside manner.  But a large percentage of them are still grossly undereducated about antenatal and postpartum mood and anxiety disorders.  Advocates in the PPD community are working towards universal postpartum mental health screening, but in the meanwhile, each mama has to be her own best advocate.

  1. If you are struggling, tell the truth, the whole truth, to someone you trust.  I know how scary this is (really and truly), but it’s vital you are honest about your symptoms in order for you to get the best treatment possible.
  2. Keep telling it until you are listened to.
  3. Ask for help finding a therapist or doctor who has experience treating postpartum mood and anxiety disorders and seek support groups in your area.

You deserve to be well.  We’re here fighting with you and ready to help you find the care you need to feel like yourself again.

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Postpartum Depression in Moms of Multiples: What It’s Like, Part 3

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multiplesPlease welcome Lisa Bicknell Madden for the final part of her series on dealing with postpartum depression as a mom of multiples

When my triplets were 18 months old I found out I was pregnant again. I was actually three months pregnant and didn’t know. I had been put on the “mini-pill” after I delivered due to hormonal headaches, so I got a period every month. And yet, I was pregnant! I called my best friend, not my husband. She cried with me. I didn’t know how I would survive this. My fourth child was born in October. The rage continued. I never got help. I never said anything to anyone. I was so ashamed. I loved my kids so much and it was so confusing to me to have these colliding feelings. I wish I had had Postpartum Progress to turn too at that time. I wish I had known I was not a monster, and that I was not alone.

I got better.  I truly got better with distance and with time. Once the triplets went to kindergarten each day and Caroline was in preschool I was able to breathe and the voices of self-hatred in my head got quieter. I was able to quiet them by surrounding myself with wonderful women who today are still my best friends. They never judged me even though they saw me at my worst.  I hid so much, so many feelings, so many emotions, so much of my life truly – that is how I got through it. I just faked it. I faked feeling okay, until eventually one day I did feel okay for a bit, and then a bit more.  The journey to recovery and being the new “Lisa” — because I am forever different now – took five years.  I was never treated. Never was medicated, never saw a professional, never told anyone.

In 2007 I was working on the postpartum floor in a hospital in Monmouth County, NJ, when an angel walked in named Pat Vena. Pat was a social worker and she was there to educate all the nurses on the floor about a “new” illness called Postpartum Depression. The talk included a free lunch. I sat surrounded by my friends and co-workers and listened and heard stories of moms. Moms telling MY story. I started to cry. In front of everyone. Big, Oprah ugly tears. Pat came over and walked me outside. She sat me down and we talked. I spilled. I talked, I cried, I confessed. She just listened and nodded.  That was the year I started giving every one one of my moms the Edinburgh Postnatal Depression Scale before discharge from the hospital. I became the PPD nurse of our hospital. I started working under Pat. Going to every conference available. Reading everything I could find. I wasn’t comfortable enough yet to share my story in public, but I did share it with the scared moms I spoke to.  Very quickly my cell phone number was being passed around like a secret hotline. OBs knew it,  moms knew it, nurses and lactation consultants knew it.  I got phone calls and messages all the time. The voices so sad and similar.

Pat and I still work together. Today I run a grant-funded program thru her consortium. Today I speak proudly of the past, knowing I’m helping to break the stigma. Today my kids know – to a degree – when mom’s phone rings and I hold up my hand it is a sad mommy she has to take this phone call. I started a support group at the hospital where I work for moms suffering with PPD, postpartum anxiety, postpartum OCD, postpartum psychosis and more. This group has at least five and often ten moms a week, and almost always a new face weekly.

I still see women in line at Target with that face, the face I know I had, and I go right up to them and I say, “It’s harder than you thought. No one told you it could be hard and lonely sometimes, did they?” They usually cry and so do I. And then I tell them about this really great group of moms just like them …

I hope Lisa’s three-part story this week is helpful to all the moms of multiples out there. Being a mother of multiples, being someone who has gone through infertility treatments, and being someone whose baby is in the NICU are ALL risk factors for PPD, as is having little social support and not being surrounded by people who know exactly what you’re going through. Please know you are not alone and that you can get better with professional help. Lisa never did get the help she needed and so it took her many years to recover. She wants you to know you don’t have to struggle for so long, alone. Ask for help. We’re here.

Photo credit: © Kathleen Perdue – Fotolia.com

 

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Postpartum Depression in Moms of Multiples: What It’s Like, Part 2

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multiplesLisa Madden has been through a pretty traumatic pregnancy and is now the mom of multiples – triplets. In part 2 of her story, she shares how her postpartum depression and anxiety unfolded. Here’s part 1 if you missed it. 

The next five weeks were a blur of traveling to and from the NICU. I never produced breast milk so breastfeeding was not an option. Elizabeth and Daniel came home after five weeks weighing in at four pounds each and Alec came home one week later. It was me and them, all alone, all the time.

My mom — sit down — had to help my sister with her newborn. She is nine years younger than me and her baby was full term, but she was really tired. My mom said I seemed so happy and on top of things that she had no idea I needed help. Just so you know, my mom and I are very close. I adore her and she does me. That’s how good I was at hiding what I was feeling and thinking.

Within one week of all three babies being home I was so tired I was literally hallucinating. The babies had to be fed every three hours around the clock. It took around two hours to feed them, and then you had to change their diapers, and if they spit up change their outfits … blah, blah, you get the picture. Sleep, if it happened at all, was for about 20 minutes every three or six hours. My husband — now my ex — told me I was now a stay-at-home mom and this was my job. He had to be rested to go to work and he would try to help me on Friday and Saturday nights but that was it.

My anxiety started with the “Are they breathing?” checks. Then it was the “Wash your hands. They could get sick,” thing.  Let’s add in taking their temperatures to see if they were too hot or cold. And soon it was just like an avalanche of worries and checking and thoughts. The thoughts were mostly focused around death. I couldn’t watch the news because suddenly every single story hit too close to home and I just couldn’t handle it.

Because I would put makeup on and brush my hair when anyone would come by no one could see that I was feeling kooky. The racing thoughts in my head prevented me from sleeping even when my dad, God bless him, would come and rock three bassinets for hours so I could get some sleep. The thoughts were constant and random and racing. I knew they were not normal. I finally got up the nerve to mention my symptoms to my OB, who happened to be a friend of mine, at my eight week checkup. He told me it was just hormones and that I should find some time to go shoe shopping. Shoe shopping! With that, I never told anyone again what was going on inside of me.

Over the next few months the thoughts became increasingly hard to handle.  Driving the babies to the only place I wanted to be, my mom’s house, meant crossing a bridge, and the recurring thought of my Suburban going over the bridge and into the icy water was so vivid that I would only drive in the middle lane and hold on with both hands and tell myself repeatedly, ” I can do this. I can do this.” Eventually, I just stopped going to her house. I didn’t trust myself.

By now the babies were around three months old (they were born 10 weeks early so they were technically only 2 weeks old). Colic was setting in with one of my sons. Now the tears started. I was not only exhausted, having crazy thoughts and filled with anxiety over their daily care, but now I had to wear a baby for 4-6 hours every afternoon and evening just to help him the little I could and still take care of the others. My then-husband was little to no help. My family was no help, except for my 72-year-old father who would drive up most days and just hold someone or rock someone or bring me food.

The isolation started then and that is the worst memory of the whole thing to me. I was alone. I was so alone. I have never before or since felt so alone. Each day was exactly the same, I could handle the babies really well during the day when the sun was out, but as soon as it became dusk the heaviness would start. The dread of another 12 hours in the dark, alone, feeding, changing, burping, crying infants – over and over again. And always feeling like a failure. Like I was not looking in their eyes when I fed them, not touching their hands when I fed them, not blowing bubbles on their tummies when I changed them because there were two more waiting all the time. It was a very heavy load and I was alone. I had no marriage to speak of. All my friends were at work. My family lived over that damn bridge and it rarely occurred to them to come to me. If you came to see me, I couldn’t finish a sentence or a thought, both from fatigue and the PPD fog I was in.

Finally, my mother-in-law noticed something. She started coming every Wednesday night and staying with me on her one day off. I waited all week for that wonderful woman to come. She was the only ray of hope I had. One Wednesday nights I had a person with me, and it meant so much to me. When the babies were six months old we sold our house and had to move into my mother-in-law’s house while our new one was being finished. I was so happy there, I felt like the real me. I had people. I had someone around me. It was great.

In February we moved into our new house and I only knew two people in the new town. One is still one of my best friends. She “gave” me her group of friends. We all had kids the same age so I started going to parks, play dates, libraries with my trio. Even so, I felt a new symptom taking over – rage. This one was ugly and often public. I had three 15-month-old children, running in different directions at parks, wanting three different things at play dates, never letting me sit at story time. Gymboree couldn’t even handle these multiples. Rage was my new nemesis. I was ashamed. I yelled at my precious children for, well, acting like 15-month-olds. I cursed at them. I hurried them along roughly. These are very hard things to write, very hard things to say and even sadder things to remember. Then at night, when they lay so sweetly in their cribs, I would stand over them and sob silently, apologizing for my disgusting behavior. For my words, for my harsh touch. For being the adult and not being better. This went on day after day, night after night.

Stay tuned for part 3 of Lisa’s story tomorrow, with one big surprise in store

Photo credit: © Kathleen Perdue – Fotolia.com

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