Circuit Overload

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typewriter with blank paperThis is a guest post by Sharline Chiang, a writer based in Berkeley, originally from New Jersey. She is a proud, long-time member of VONA, an amazing community of writers of color.

When my daughter was born I had no idea that I’d go from ecstatic to fighting thoughts of trying to kill her, and myself.

I was high on Anza’s birth for exactly one week. I birthed her squatting, just like I wanted to. She was slippery and pink. I remember sitting there in my own pool of shit, blood, and mucous, shouting over and over again: “Oh my god, you’re so beautiful!” My husband, Ben, was so excited he could barely cut the cord.

She had curly reddish brown hair like his (he’s half Jewish) and twinkly dark eyes like mine (I’m Chinese). We named her Anza after Lake Anza where we had our first date. It also means “beginning” in Swahili, which seemed so right because we had three miscarriages before her. She was our miracle baby.

The first few nights I rode on pure adrenaline, basking in the joy of her little piggy lips sucking on my tits and the sweet taste of milk on my fingertips. But by the end of the first week I couldn’t relax, kept imagining that she was dead, that she had suffocated in her sleep. Because of the miscarriages, while I was pregnant with her I had prepared myself mentally for her to not make it to term. Even as the doctor caught her, I had steeled myself for the monitors to flatline and for the doctor to say: “I’m sorry; it’s a stillborn.”

I would watch her sleep in her crib, worrying that at any second she would die.

Sharline-Chiang

Over the next three weeks sleep deprivation started to destroy me. I shuffled through the days and nights of nonstop nursing, burping, and changing, attempting and failing to nap and feed myself. My nipples, two spots of shooting pain, felt like someone had scrubbed them with steel wool. My crotch burned with raw tears and stitches. I had hemorrhoids the size of plums. Every time the baby cried and fussed, I wanted to scream. Even with help from my husband and mother-in-law, I was more exhausted than I’d ever been. Every morning I prayed that ten p.m. would come so I could get that three-hour window of sleep before I had to do it all over again. I cursed all my friends who are parents. No one told me it would be this hard. They duped me into joining their club of misery. I hated nursing, I hated pumping. I started to hate the sound of the baby’s voice. I started to hate the baby.

I felt tethered to the rocking chair, a used red Dutalier I found on Craigslist, where I nursed Anza for hours. There was a mirror facing the chair. Each day I stared at myself in my dirty robe, my hair greasy and flat. I hadn’t showered in weeks. I smelled like rotting meat. I’ve made a terrible mistake, I thought. All these years, I thought this was what I wanted. I’ll never get a full night of sleep again. I want my life back.

I told my husband, “I’m so tired it hurts.”

“Of course you’re tired,” he said with a smile. “You’re a new mom.”

tree-in-water

By the second month I started to shake all the time. I was freezing even though it was September and we were having a heat wave. My clothes were always soaked with sweat and milk. I stopped being able to sleep and prayed for the wired feeling to go away. I would lie awake and think: I have to go back to work in a month. How the hell am I going to do that? I’m going tolose my job. We’ll lose our health insurance. I’m going to end up in a hospital and we’ll go bankrupt.

My mother-in-law went back to Canada so we were all alone.

I told Ben that I felt like I was dying. “What do you mean?” he would ask. But I couldn’t explain, couldn’t find a way to tell him I felt like I was going crazy and that I was so tired I felt I would die from exhaustion. I didn’t think for a second that I had PPD because I wasn’t depressed. I never cried. I just felt like I was going into shock. None of my friends who were mothers had ever mentioned that they had been so tired they felt like dialing 911. Everyone else seemed to handle being new moms with such grace. I was sure my unraveling was due to a fundamental character flaw. I was weak. I was spoiled, lazy.

I thought maybe I was experiencing diabetic shock so I got tested. My doctor said everything was fine. My sugar, iron and thyroid were all normal. She gave me Tylenol PM and benedryl to help me sleep. It worked for one night.

curve in the road

Soon I became OCD. At first it was just the bottles. I had to make sure they were boiled. Then I had to boil them twice. Then everything that touched the baby had to be boiled: pacifiers, toys, towels. If anything touched a “dirty” surface, I had to start again. I could barely handle holding the baby because I was sure I’d give her germs that would make her so sick she would end up in the hospital. I couldn’t afford for her to get sick. I thought: if I start sleeping again and then she gets sick that will be the end of me. So I boiled everything and only touched doorknobs with my sleeves.

I stopped being able to dress myself, I was so tired. Ben would help dress and feed me. It was like I was the baby. Most of the time I was too tired to eat. Ben did pretty much everything except nurse the baby: he did all the laundry, the dishes, took out garbage, cooked (well he tried his best), all while running his own business building websites. At night I’d lie in bed sweating feeling my heart race like I was having a heart attack. He would hold me and say, “Just try to relax and sleep. You’re going to be okay.”

By the third month I started seeing a therapist who specialized in postpartum depression. While she was helpful, it didn’t stop what was happening to me. My behavior was increasingly erratic. I felt less and less in control of the “real me” and watched with terror as some other woman, a “crazy” Sharline, took over. I would mutter and talk to myself loudly. People in stores would look at me with concern and step away. I had trouble connecting thoughts when talking to Ben, who was becoming increasingly concerned. I had to fight with all my will strong urges to do inappropriate things: grab some woman’s hair in the store, plunge my hand in a box of used needles at the doctor’s office.

We hired an amazing woman named Sara to help take care of the baby and with much of the housework. My mother-in-law and brother-in-law moved in with us from Canada to take care of me.

lamppost-snow
Ben and I still didn’t realize how seriously sick I was. “Everything’s going to be okay,” he kept saying. Like good Berkeley-ites, we chose to take the natural route. We didn’t trust antidepressants. I was terrified of them, terrified that drugs would take away the last remains of my brain that seemed to be the only threads left preventing me from hurting myself, Anza or someone else. We didn’t trust Big Medicine, white man’s medicine, and we wanted to make sure I could still breastfeed. For weeks, Ben took me to all sorts of natural healers who tried endless remedies on me: acupuncture, Chinese medicine, massage, reiki, B12, spirulina, breathing exercises, meditation, and even crystals and chimes. Many of them helped me relax in the moment, but none stopped the downward spiral, and worst of all – no one diagnosed me.

One day, I rolled around on the sidewalk outside our house. It felt good. I didn’t want to get up for a long time. People just walked around me. (It’s Berkeley after all.) I shouted over and over, “No! How did this happen?” The next day, I had a major panic attack in the car and tried to jump out while Ben was driving. When I was home, I spent a lot of time crying. Now I was depressed. Also around that time I started having nonstop dark thoughts, of how to kill myself, and Anza. I started having urges to stab her, drown her, throw her off the deck, crack her head open, bite her cheeks off. I told Ben and my mother-in-law everything. They assured me that I wouldn’t actually act on my thoughts, and that they would watch me and Anza carefully and keep us both safe. Still, I felt like a monster. I told Ben, “I can’t be alone with the baby. I don’t trust myself anymore.”

We finally decided to try medication, and the bigger, harder decision: we switched to formula (which felt like giving our baby Diet Coke). I felt like the worst mother in the world. A total fucking failure. My OB and family doctor put me on Xanax, Ambien, Klonopin and Zoloft. The drugs helped me sleep a bit and calmed panic attacks but I was still mostly an insomniac wreck.

I called a few friends to let them know what was happening to me. Some of them visited and it helped me immensely, having people to talk to and just give me a hug. They felt sad for me, and helpless. It was so difficult to get anyone to understand when I said I wanted to live but I couldn’t bear to be in my body one more second, that I felt like I was being tortured.

Each night I would get up and search the house for my sleeping pills. (I was only allowed one a night. Ben hid them from me.) I tried to find ways to keep myself busy until morning. With a shaky hand, I wrote thank you cards to people who had sent baby gifts. I tried yoga. I tried meditating. But mostly I would lie on the couch and feel my body tremble and pray to make it through one more night. The OB had asked if I had plans to kill myself, and I remember thinking, as I shook my head no, Yeah, I’ve got plenty of plans: pills, razorblades in the tub, kitchen knives. How can I buy a handgun? Does putting your head in an oven really work? If I slice my wrists, how much will it hurt before I pass out? I fought images of going into Anza’s room and smothering her.

At a friend’s urging, we decided to find a psychiatrist. After calling 20 psychiatrists, we finally found one who would take a new patient and could see me right away. Her name was Dr. Cedars and she asked me a bunch of questions. I paced the room, told her I felt like I was dying or that I wanted to die. She asked me if I had plans to kill myself. I whispered, “Yes.” “What kind of plans do you have?” she asked. I told her.

She immediately called Herrick, the local mental hospital, and asked them to reserve a spot for me. “I highly recommend that you go tonight, but I can’t force you,” she said. (Later, when we got home, Ben convinced me that it was worth trying to get better at home. But I  packed a suitcase just in case.) Then she prescribed Seroquel, an anti-psychotic.

“You mean I’m psychotic?” I said.

“Well, marginally so,” she said.

I was scared shitless about what was happening, and ashamed. I had an Ivy League education, was a director at a national nonprofit – and I was cracking up, headed for the nut house.

I was diagnosed with extreme postpartum depression with anxiety with intrusive images.

Dr. Cedars referred me to Dr. Alexander, a leading expert on PPD. Dr. Alexander doubled my Seroquel and had me continue taking Klonopin and Zoloft, and that’s what did the trick. What I learned was that each person’s brain is different. I got lucky that it didn’t take long to find the cocktail that worked for mine. In a week I began to dramatically stabilize. Ben noticed the difference right away. “Your thoughts are more organized. You seem more calm, more like yourself,” he said. I started sleeping through the night, stopped having bad thoughts.

The truth is science still doesn’t fully understand PPD – why it happens, why it happens to some women and not others, and why it manifests in different ways in different women. Most experts agree that the sudden change in hormones and brain chemistry are partly to blame. The woman’s body and brain is flooded with hormones during pregnancy and the minute a child is born those chemicals plummet. “Your brain didn’t like that,” Dr. Alexander told me. “It’s like a computer that had a circuit overload. We need to do a hard reset.”

In December, I started going to a support group for women with PPD. Some of them were in worse condition than I had been in. One mother had been in and out of Herrick. Another had OCD so bad she accidentally burned her kid with hot water in the bathtub. We talked about our shame, our guilt, and the myth of motherhood.

I was sure that I would get worse from the drugs before I got better, but I didn’t. I didn’t have any bad side effects. I didn’t completely lose my mind though I suspect it’ll always be broken. The therapist who led the support group said that some people believe PPD “cracks women open, in a good way.” I don’t know about that, but I do know that it changed me forever. I still have fears about having survived a major mental health crisis. I’m grateful that I’ve survived, but wonder: will I always be damaged, my brain like a car that’s been rammed once too hard? Will I always be prone to crazy? And if so, what does that mean? Is that who I am?

train tracks

I couldn’t go back to my previous job because I was too sensitive to stress. By the following summer, I had weaned off the Seroquel and Klonopin and stayed on Zoloft for another six months. Right now I’m not taking any medication. I try to manage my stress and anxiety by trying to get enough sleep (still hard since she still wakes up each night), eat well, try to stay active, make time to go out and have fun with friends, write, and meditate when I can. I’m really lucky that Ben has supported my decision to stay at home for now so I can focus on getting better. It has also given me more time to spend with Anza, who is now a spirited, book-obsessed toddler. Sara comes to our house twice a week so I can take walks and write. I am forever grateful to her, and my husband and in-laws, and many good friends for supporting me during my darkest times.

While my PPD was happening, I didn’t tell my parents and to this day they still don’t know. For many reasons, largely cultural (they’re Chinese immigrants), I didn’t want to them to know because I didn’t want them to worry. They’re older and live in New Jersey and they would either have tried to fly out and help or spent sleepless nights of their own feeling helpless. The reason why I still haven’t told them? PPD isn’t discussed enough in any society or culture, and I fear that they might blame me or make me feel like I’m exaggerating about my experience.

Looking back, I wish my doctors and infant care teachers had spent time talking to me and my husband about the serious nature of PPD, how to look for signs and get help. I wish they had told me that PPD is now also called Postpartum Depression Spectrum because it manifests in so many ways, including intense prolonged anxiety, and rage. I also wished people had shown me articles written by survivors, especially women of color like this African American mother, and this Asian American mother.

I hope to keep sharing my story, to be part of a movement to put PPD in our collective face, so we can see the whole picture of motherhood. As women, as a society, we need to talk about these experiences, the dark side of motherhood. We need to take PPD out of the darkness.  I want us to tell each other it’s okay, that there is no such thing as being a perfect or normal mother, that it’s okay to say I’m really fucking tired and I need help, to say I’m sick and I need help, to say there are ways to get better and we don’t need to feel alone, and most of all, we don’t need to feel ashamed.

 

This article originally appeared on Mutha Magazine.

Image credits: Sharline Chiang and Unsplash

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When You Are Thinking About Suicide

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suicideSuicide is a terrible thing. The loss of actor and comedian Robin Williams is a somber reminder to all of us that depression is a horrible disease and it can drag anyone down. That is why we try to be ever so vigilant here at Postpartum Progress in encouraging you nonstop to take care of yourself and your emotional health and seek help when you need it. Suicide is never the best answer, even though we know and understand why and how someone could get to the point she believes it is the only answer.

In 2010, 38,314 Americans died from suicide. By way of comparison, there were 16,238 homicides in the US in 2011. I’m willing to bet most people have no idea that suicide happens more than twice as often as homicide. We have to talk about it. HAVE TO. I received a post today from a friend, a single mom who is a social media professional and PPD survivor, about her recent thoughts about suicide.  I think her words are important and I’m glad she’s allowing me to share them anonymously with you today:

In the past weeks I’ve wanted to speak up, speak out, shout to the world that I am not okay. That I am most definitely and certainly not okay. But, aside from a trustworthy few in whom I’ve confided, I’ve stayed silent. Why? Why is someone who wants to be helped so afraid to be helped?

We live in a self-help society. There are books and shows and podcasts and platforms of every magnitude telling us how we can help ourselves and that we should, in fact, help ourselves. But we can’t always do that. I can’t always do that. I have spent weeks trying. Staying silent while switching medications. Telling only a select few even though staying quiet to so many others felt so wrong.  I have spent more than 4 years being an outspoken advocate for maternal mental health as a postpartum depression survivor. But this? This general depression and anxiety that was swallowing me up in darkness? I couldn’t shout out about it. Why?

In the last 7 months I have been told things like, “You have so much to be grateful for.” And, “You have the life you wanted.” And, “Things are good in your life – what do you have to be anxious about? You have a good job. Your kids are healthy. You have friends. You should be more grateful for those things!” I am sure if you’re reading this and you’ve been in a dark place you have heard similar phrases and they always feel like a punch in the gut. They smother me with guilt and just intensify everything that feels wrong. Why couldn’t I just be happy with what I had? Why was I sad? What was wrong with me? Why would anyone want such a self-loathing unappreciative jerk in their life?

The darkness came suddenly and swallowed me. I haven’t been well in months but when the blinding darkness came it came quickly without warning. I was completely lost and could visualize taking my life.  That was the first time I’d ever found myself in such a dark place. I was familiar with self-harm thanks to the time I lost to postpartum depression. But the idea of suicide was new, and I always imagined I’d be scared by it and yet instead I found peace in it. A sliver of peace in this hell I was living in, this hell in my own head. The idea that suicide is an easy way out, a permanent solution to a temporary problem, or selfish (all things I have seen people refer to suicide as over the last 24 hours regarding Robin Williams)? Not one of those things felt applicable to that moment when I stood in my bathroom and tried to grasp at anything to pull me away from ending my pain. From a pain I realized I’d likely feel again even if I got out of it this time, a pain that it seemed no one understood, a pain that was so sharp, real, and intense that even the most horrible ways to end it seemed like they would be a relief. [Read more…]

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On Bei Bei Shuai & How We Don’t Help Pregnant Mothers With Depression

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pregnancy depression, antenatal depression, depression during pregnancyA pregnant woman tries to commit suicide. She lives. Her baby does not. Now Bei Bei Shuai is being charged with murder.

Yesterday on Babble, I wrote about how our society speaks out of both sides of its mouth when it comes to pregnant mothers and depression. We want a pregnant woman to stop all medication for depression and anxiety so she can protect the health of her baby, despite the known risks of untreated depression and anxiety during pregnancy to the fetus. And then, if, God forbid, something goes wrong, we threaten to send her away for the rest of her life as is the case with Bei Bei Shuai.

Stop treatment, but don’t do anything wrong. It doesn’t make sense.

Here’s an excerpt:

While not everyone needs medication for the treatment of antenatal or postpartum depression or anxiety, those of us with moderate to severe cases sometimes do. Having gone through severe postpartum depression and OCD with the birth of my first child, I chose to stay on my antidepressant medication during my pregnancy with my second. I knew there were risks. Risks to my baby girl for taking any sort of medication while pregnant, and risks to us both if I had become depressed and anxious during my pregnancy. When she was born, I’m happy to say she was just fine, and I didn’t experience PPD at all the second time around. I would have preferred not to have to take any risks at all. I love my darling girl. But I had to think of my family and my firstborn as well, and how he would have been affected had I suffered PPD again. How she would have been affected had I had depression while pregnant. How both of them would have been affected had I killed myself.

I hope you’ll go read my piece and let me know what you think.

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An Explanation of Suicidal Thinking In Plain Mama English

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postpartum depressionLast week, Katherine received the following question from a Warrior Mom:

What is considered a “suicidal” thought, ideation or gesture? I remember being asked by my physician if I was having suicidal thoughts and I honestly didn’t know if I should say yes or no. I wasn’t making plans in my head on killing myself when I was in the deepest of depression, but I was having fleeting weird thoughts about things like “what would it be like to throw myself down the stairs?” and “my family would be so much better off without me here because I cause them so much stress”, etc. There were many days that I know I just kept holding on because my baby needed me and loved me and I couldn’t bear the thought of leaving him. But was this considered being suicidal? I honestly still don’t know. When you look up “suicidal thoughts” on medical websites, there’s no plain mama English description on what this could be, it is focused on the emergent and description of planning and/or acting on these plans to try to kill yourself. I figure other moms out there may be just as clueless as I am and it could be useful to have a plain mama description of this so we know if we should say yes or no to that scary question from our doc.

It is a terrifying place to be when the thought of suicide or harming yourself comes into your head.  Moms who suffer from postpartum depression do not always go to this place even though they may be suffering greatly.  But those who do are usually dealt an additional level of uncertainty and fear: Does this mean that I am really crazy? Will I be locked up for these thoughts that I am having?  Will my baby be taken away?  Will anyone even notice if I am no longer here?  Usually, for these moms, the thought of harm and/or suicide comes from one of two places: either the belief that her family will be better off without her or the feeling that she is in so much pain that she can’t go on.

And, there is of course a spectrum with respect to the nature of these thoughts.  There are the moms who are in such distress that they have fleeting thoughts of wanting to escape it all.  There are the moms who have fleeting thoughts about putting themselves in harm’s way.  There are the moms who know that, despite their thoughts, they would never choose to follow through with these actions.  There are the moms who wonder if they might follow through if things get bad enough.  There are the moms who have a plan about what they would do to hurt themselves.  And there are the moms who have already made a commitment to do so.

So, as for the question above: What, in “plain mama English” is suicidal thinking?

Technically speaking, a mom is having “suicidal thoughts” if and when she begins to think about hurting herself and/or ending her life. These thoughts are, indeed, red flags and a very necessary reason to seek out help.  It is true that not every mom with postpartum depression having these thoughts will act them out, but any time that the thoughts occur, those of us in the field of postpartum depression treatment and mental health will pay attention and note that a mom is really, really suffering.  In my practice, any time a mom talks about having had thoughts like this I put my “medication talk” in a whole new category – medications are a very important part of treatment for moderate to severe cases of postpartum depression and are usually a relatively quick way to reduce symptoms.  My lead towards medication in these instances are NOT because I think these moms are “crazy” or “insane” or “unfit” to be moms, but rather because I know from their thoughts that they are suffering greatly, and I simply don’t want them to have to struggle like that.

Clinically, a “suicide assessment” has to be done any time that a mom discloses that she is having thoughts of hurting herself or ending her life.  When moms, like the one above, disclose these thoughts and then assure me that they have no intention of following through, I will make a verbal commitment with them that they will let me know if they do begin to think seriously about acting upon these thoughts or if these “thoughts” become “urges” (meaning that they are being drawn by an impulse to act upon their thoughts).  And, if they are not already, I will let them know that I think medication treatment is imperative.  For moms who have a plan or who fear that they really may put themselves in harms way, hospitalization is a necessary part of her treatment simply in order to get her immediate relief and to protect her.

The Mayo Clinic lists the following as “warning signs” for suicidal thinking:

  • Talking about suicide, including making such statements as “I’m going to kill myself,” “I wish I was dead” or “I wish I hadn’t been born”
  • Getting the means to commit suicide, such as getting a gun or stockpiling pills
  • Withdrawing from social contact and wanting to be left alone
  • Having mood swings, such as being emotionally high one day and deeply discouraged the next
  • Being preoccupied with death, dying or violence
  • Feeling trapped or hopeless about a situation
  • Increased use of alcohol or drugs
  • Changing normal routine, including eating or sleeping patterns
  • Doing risky or self-destructive things, such as using drugs or driving recklessly
  • Giving away belongings or getting affairs in order
  • Saying goodbye to people as if they won’t be seen again
  • Developing personality changes, such as becoming very outgoing after being shy

Any time a mom with postpartum depression is struggling with the above symptoms, it is absolutely important for her to reach out for appropriate support, even if it is hard to do so.  In fact, acknowledging suicidal thoughts, answering, “yes” to the question “are you having suicidal thoughts” and being honest with yourself and others is usually the hardest part.  But please, please know that you do not need to suffer in this way.  Even if you have gotten very used to doing so.   You owe it to yourself to live your life without these (even fleeting) thoughts or fears.  And your babies and families do need you.

~ Kate Kripke, LCSW

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