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

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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 …

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Finding Art in the Dark

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“Perhaps it’s good for one to suffer. Can an artist do anything if he’s happy? Would he ever want to do anything? What is art, after all, but a protest against the horrible inclemency of life?”

~Aldous Huxley~

 

Artists are often characterized as moody, dark, misunderstood. We are a suffering sort, regardless of the form our art takes – whether it be digital, acrylic, collage, words, wood, and so on. Our ability to create something phenomenal comes from the way we view and respond to the world. Sometimes, this interpretation may even involve a tango or two (or more) with a mental health struggle. For some of us, it may involve a lifelong diagnosis.

A friend of mine posted a link recently to an article about highly sensitive people. I found myself nodding in response to most of the traits listed. It hit home. Highly sensitive people notice details in everything – noise, texture, scent, emotion, and are easily over-stimulated. This can lead to labels like “shy” or “snobby” or “anti-social”, when all we are doing is protecting our very sensitive souls.

This got me thinking about mothers and fathers who struggle with a mental health diagnosis after the birth of a new child. There is a heightened sense of awareness which comes with this experience. I know that I tried to overcompensate for the lack of emotion I felt (and failed miserably in the process). Fake it till you make it, right?

Art is the interpretation of the world around us, putting it to paper or whatever your chosen form, to present to the world for their interpretation, right?

Isn’t parenting the same thing? It’s your interpretation of the world around you, presented to a tiny human, in the hopes they will grow up and interpret the lessons (art) you’ve created for them over the years properly. Parenting is a museum bigger than the Smithsonian with an even more complicated floor plan replete with trapdoors, false walls, and trick couches ready to fling you under the bus at any moment.

It’s okay to fall through the trap door.

Original Sketch

Original Sketch

The key to finding your way out is to find the silver lining once you fall through that trap door and turn it into art, whatever that means to you. For some of us, that might mean cooking. Or it might mean knitting. Or painting. Or writing.

There’s a reason art therapy is a popular form of therapy. It’s a way to release emotion and express ourselves in a healthy way which re-frames the pain we may feel through the creation of something beautiful. I attribute my creativity to all the pain I have experienced throughout my life. Now, not all of my creations are inspired by pain -some of them are inspired by love- but they are all inspired by intense emotion.

Oddly enough, when I am in the throes of deep emotion, I find myself unable to create. It is only when I am coming out of it, much like the sunshine after a storm shining on a newly soaked field of flowers, I am able to create and it typically happens in a rush. For me, the ability to create again is a sign of wellness. My art is not a form of protest, exactly, but rather, a celebration of the richness which exists just below the surface of the world in which we live.

I remember seeing a quote once (and I am not sure where I saw it) which said that without “art” the Earth would just be “Eh”. So very true – art fuels everything around us, even down to the labels on products we buy at the store. Yes, there are other forces at work but when you peel all the other forces away, it is art. Without it, we would live in a very “eh” world.

My primary form of creating is words. I also love graphic art and find it very soothing. Painting is another form I will often use to let things go. Lately, I’ve been sketching with pencil on printer paper. Pretty darn basic but it’s been quite wonderful to watch things take shape, particularly as I challenge myself to do more and more difficult sketches.

What about you? Do you create art to process your emotions? What form does it take for you? Anything you have created that you’re particularly proud of? Share with us!

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Postpartum Psychosis Doesn’t Equal Failing as a Mom

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A few days ago, I walked into the grocery store holding hands with my three and five-year-olds. The delicate scent of baby powder overwhelmed my nostrils the second we stepped into the diaper-filled walkway of the baby aisle for pull-ups. Immediately and without warning, my memories drifted back to my first postpartum experience. A fresh pack of Pampers always does it.

In September of 2008, I was eagerly awaiting the impending arrival of our first child. I thought we had prepared for everything – nursery, diapers, clothes, breastfeeding supplies – we were ready. I had even read up on postpartum depression. I thought I might be more susceptible to the illness since my mom had a touch of the baby blues after my brother was born and I had been diagnosed with bipolar disorder two years before becoming pregnant. Little did I know it would be the complete opposite end of the spectrum that would grab ahold of my mind the day after our son was born.

I ended up having a C-section because my progress stalled after the epidural and the baby’s heartrate was becoming deeply affected by the contractions. My OB made the quick decision to do the surgery and get him out, to be safe.

It was scary, but over quickly and seeing my son for the first time was a dream come true. I was shivering uncontrollably from the epidural meds, but gave him a kiss and stared at him for a good ten minutes while a nurse took pictures for us and then whisked him off to the nursery. I was wheeled into Recovery for a few hours where I called our friends and family with the good news. The mania hadn’t set in yet, but by this time it was 1am and I had been in labor since 5:30am the day before. By the time I got settled into my room and my son was brought to me so we could try nursing, I had been up for a full twenty-four hours and I was yearning for rest.

But at the same time, I couldn’t take my eyes of my baby boy. This little life grew inside of me for nine months and I finally had the chance to hold him and feel his teeny fingers in mine. I was awestruck by what had just happened, and sleep was the last thing I wanted to do in that moment. I wanted to get to know my baby. I tried nursing him, and we did some skin-to-skin, but by that point I was dizzy with exhaustion. My best friend who is a labor and delivery nurse and who had been with us the entire time, urged us to send him to the nursery so I could try to sleep. I took her advice the entire time we were in the hospital, but with the hourly checks on my vitals, there was no way to get any real rest.

I had been medication-free during my entire pregnancy and planned to stay med-free so that I could breastfeed him. We were sent home after three days in the hospital, and even though I had felt the onset of mania while we were there, I didn’t dare tell anyone because I didn’t want to fail at my first attempt at being a mom to my son.

We arrived home and after the initial wave of exhaustion had passed the morning after he was born, it became fuel for the fire of the vicious escalation of my symptoms. I remember being so anxious about my milk coming in that I would wake up from short stints of sleep covered in burning hot, puffy red hives all over my legs and mid-section. The baby’s schedule made sleeping long stretches impossible, so my sleep deficit grew with no end in sight.

I wasn’t willing to let anyone take over night feedings and my symptoms kept getting worse. From the intensity of my anxiety over not being able to provide my baby’s nourishment, to my sudden sense that I could be supermom and extremely productive on barely any sleep, to auditory hallucinations which eventually were what tipped off my husband and parents that I needed to go to the hospital. I was admitted on October 22nd for Postpartum Psychosis.

Being taken from my four-week old son two days after he was baptized was one of the most grueling events of my life. Nothing can bring back that week we lost. I saw him grow and change so much in one short week via photos my family brought me in the hospital. It broke my heart to be away from my newborn.

But believe it or not, looking back now I can appreciate what we went through. I have embraced my past because it has brought me here. My hope is that sharing my story will help educate people so they can understand that postpartum mood disorders are brain illnesses are like any other illness that can affect the body. We can treat them and we can recover from them. And we will emerge stronger because of them.

No one should ever be afraid of admitting and asking for help. Help starts here. You are not alone.

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