Why Moms With Postpartum Anxiety or PTSD Are Often Missed

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postpartum anxietyWarrior Mom Alyssa R. reached out to share her story of why no one believed she was suffering when she had postpartum anxiety and postpartum PTSD. It’s a common problem, since most of us who’ve had it (including me) take a look at the short lists of postpartum depression symptoms most websites and books provide and quickly conclude we don’t have PPD, so nothing must be wrong. Alyssa had a strong bond with her baby, so she was very confused by the symptoms she was experiencing.

Hiding in the quiet of a dark room, alone, I brought up a Google search. I typed in, “signs of postpartum depression.” The list read, “…insomnia, intense irritability and anger, overwhelming fatigue, lack of joy in life, feelings of shame, guilt or inadequacy, severe mood swings, difficulty bonding with the baby, withdrawal from family and friends, thoughts of harming yourself or the baby … it’s important to call your doctor if the signs and symptoms of depression: make it hard for you to care for your baby, make it hard to complete everyday tasks, include thoughts of harming yourself or your baby.”

I hastily clicked the red x, my mind already made up. I mistakenly assumed that because my symptoms didn’t look like that list, nothing was wrong. My symptoms were not there. Not the big ones—the anxiety, the compulsion, the flashbacks.

It was easy to believe it. The bond I shared with my baby was strong, unbreakable even. I’d never dream of hurting her. I loved every second I spent with her, and loved my life overall. My house was clean, dinners were cooked. I was showered and put together. I enjoyed being a mother. I was more sociable than ever in my life!

As time passed, and my intrusive thoughts didn’t fade, I used her. I used my baby. My husband, or friends, would ask if everything was ok. I would reply, “Our relationship is so strong. I don’t melt down when she cries. I love to be with her and can care for her easily! Clearly there’s nothing wrong.”

But on the inside, I worried. I stayed up wondering what might hurt her and how I could prevent it. I had terrifying visions of her being hurt, in pain, without me. I could see them, sometimes, in the dark, rocking her. I could see black widows crawling on her, or her little head splattering open like an egg. It was also very hard for me to focus. I was always on the move. Her room wasn’t neat enough, the laundry wasn’t washed enough. I was always thinking about what to do next. At work, I would melt down when daycare called or texted because something terrible WAS going to happen, wasn’t it? I felt compelled to plan my day in ritualistic fashion. Everything had to happen at just the right time. I did things in the same order and would have a huge crying spell otherwise.

The flashbacks were worst of all. I had a traumatic c-section. After 24 hours of labor and nearly five hours of hard pushing, the baby wasn’t coming. During the surgery, I felt the cutting. The pulling. The stitching. I felt pain, not pressure. Frantic to knock me out, they pumped me with drugs that would work temporarily, only for me to wake a few minutes later, screaming. In recovery, I didn’t recognize her. The first precious moments I laid eyes on my daughter, I was confused and terrified. I still feel a huge amount of guilt for that. The constant flashbacks caused night sweats, and panic attacks. I was effectively afraid of everything.

All of this told me that something was wrong. I knew it. But I ignored it, and I used her. If things were fine between us, if I could happily care for her, everything was fine, right? I wasn’t depressed.

And I wasn’t depressed. Instead, I was suffering at the hands of PTSD following my birth. And pretty severe postpartum anxiety and a touch of postpartum OCD.  Yet few people talk about these. The hospitals and the OBs only talked about depression. After a particularly absurd fight with my husband over the vacuum of all things, I finally agreed to talk to someone. My primary care physician seemed flippant and said “anxiety isn’t a postpartum concern.”

Thankfully, the OB social worker she referred me to and I shared a deep conversation where she validated me, and I went on to find a great therapist. I have done one session of eye movement desensitization and reprocessing (EMDR), a common treatment for PTSD, and am already feeling better about my birth. But the other things? They’re still there. Maybe even stronger, as now that we have tamed my brain of its trauma, the other emotions are pouring out. The anger, the fear, the guilt, the compulsion, and oh, the postpartum anxiety. And now we are working on taming those.

It was easy to use my baby. It was the perfect façade—a strong bond, and a flourishing relationship. Postpartum mood and anxiety disorders like postpartum anxiety can manifest in so many ways and I wish that there was more information out there. I wish I hadn’t been so quick to disregard my own emotions, and had trusted my instincts. Regardless of a strong bond, don’t ignore the voice that says there is something wrong. Don’t hide in the dark.

~ Alyssa R., Everyday Isha

Photo credit: © kentoh – Fotolia.com

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  1. wow this bought tears to my eyes. I experienced some of the same symptoms as you from the C-section trama and those heavy narcotic. I agree there defintely needs to be more education about all affects of postpartum.

    • I am so sorry that you had a similar experience. I have scoliosis and the epi never fully took, so I wish I would have been more vocal about it. Thanks to the EMDR, the fear aspect of the csection has lessened but I still hate thinking about it.

  2. Excellent article. I pray it goes viral! People do not realize how PPD manifests, let alone that a woman can suffer PTSD! I’ve never understood why people didn’t recognize this as a factor in recovery since science talks about the trauma of giving birth.

    Thank you Katherine for bringing this to light, thank you Alyssa R for telling your story! Please, please keep telling the story!

  3. So glad you shared this, Alyssa. That’s one of my big complaints about most sources – they’re just not complete enough. If I had seen “intense irritability and anger” on the list I found, I’d have had help sooner too.

    • this is so true! I never saw any of my symptoms listed and as a resulted i got soo nervous/ anxious/ paranoid i was admitted to a psychiatric hospital without my baby :/

      • Our hospital has great resources–even had a social worker stop by before we were discharged. But everything they talked about and gave us was centered just on depression. I have had a bout of depression before, and it was just nothing like it.
        Rae, I am so sorry for your experience.

  4. “I knew it. But I ignored it, and I used her. If things were fine between us, if I could happily care for her, everything was fine, right? I wasn’t depressed.”

    Wow. Superb. My experience was very similar. The argument with your husband over vacuuming made me smile in recognition. I had the same arguments with my husband over, strangely enough, water droplets on the kitchen floor. “There. THERE IS ANOTHER ONE. CAN’T YOU SEE THAT?” “Where? I’ve wiped the whole goddamned floor!” Yeah, rough times for our relationship. But I was fine because Motherhood wasn’t “it,” everything else was. Sigh.

    • Ohmygosh the fight we had. I left the vacuum at the bottom of the stairs to remember to take it upstairs the next day. In the dark, my husband accidently kicked it. It was totally my fault. I was so upset that for the first time in.our.marriage I slept in the guest room. And when I woke up the next day, I realized, this is not ok. I am sorry that you had a similar silly fight :( They aren’t fun, but I am at least thankful that it gave me the wakeup I needed.

    • Thank YOU for being so vital in my recovery, and for being so open with your own story. Your courage inspires me on a daily basis <3

  5. I can totally relate to this…I also put up a pretty successful facade of happiness, organization and the idea that I’m keeping it all together. I didn’t have typical symptoms either. My second son had colic, and I swear my husband and especially me have PTSD from it. Even though the baby is over it now and just turned one, we still kind of walk on eggshells. And I swear I can hear him crying. All the time. Even when he’s not around or I’m in the car alone. I also had the horrific images of him being hurt in the most absurd scenarios (what if his brother pushes him into the dryer?). I went on a crazy spell and barely ate for four days once, and then snapped out of it and have been okay since. I tried calling to set up an appointment with a therapist and the phone conversations with the staff were such a turn off I never called back.

    Not enough people talk about this, and it’s RIDICULOUS that medical professionals aren’t more knowledgeable and prepared to treat it. This was a great article.

    • I am sorry that you had such a poor time with the staff. It’s interesting to me that so many doctors seem…out of the loop? No one would ever treat depression as the only mental illness. Why are we so stuck on depression in post partum?

      I continue to have visions of my daughter being hurt in absurd scenarios. It’s terribly frightening. I hope that yours has improved, as I don’t wish it upon anyone.

  6. I can relate to this post in so many ways. After a traumatic birth experience, I still have flashbacks caused by PTSD. And although I was diagnosed w/ PPD (and had many of the symptoms), I’ve often thought I might have had PPA and PP-OCD as well. Thank you for sharing your story.

  7. Thanks for sharing this, Alyssa — I, too didn’t have classic depression symptoms; mine were based on massive anxiety (like cannot sleep anxiety), panic attacks, and crazy OCD rituals related to baby things — bottles, diaper bags, etc. Nobody ever warned me to look out for those symptoms, and since I wasn’t sitting around crying all day (well, eventualy I was…but in the beginning I wasn’t) nobody initially thought anything was wrong. More information needs to be made available to expecting parents about PPA and PPOCD for sure.

    • This! This was me exactly! It was SO horrible how I was treated as well. I actually got looks of disdain, instead of concern from my doctors. They wanted to ship me off to the psych unit for panic attacks and insomnia, never once mentioning antepartum depression/anxiety. I think I still have PTSD from that. After I recovered, I could not (and still cannot) believe that they were not educated on this illness. There is no way that I was the first patient they had seen who was suffering in this way. They are an unbelievably busy practice. I could have been spared months of suffering had they explained to me what was happening. Shame! What you said about not crying all the time at first but eventually ending up that way, really resonated with me. It doesn’t take long for the insomnia to take it’s toll and leave you a sobbing mess. I’m still ashamed that my daughter, now 3, heard her Mama wailing almost everyday for those last weeks of my pregnancy. I lost 4 lbs. a week towards the end. Thank God for healing and finding joy again! We made it! :)

      • I am SO sorry you were treated that way :( There is simply no excuse for that. I am glad to hear you are finding joy again. It’s not an easy road for any of us, but it is comforting to know we are not alone.

  8. OCD is weird. And anxiety. I was fortunate in one way b mine were sudden onset and so obvious. But some of the symptoms had been there for ages and so I dismissed them as just related to other childhood experiences. The fear of hurting your child is one of my OCD symptoms. I don’t have the rituals. I just have the intrusive images that, now I am getting better, no longer have such strong emotions attached to them. I am much more able to think…”oh poop oh well, that’s just one of my symptoms”. And if I get more of them, or they are more terrifying, then I know I am getting worse, and to take certain meds, or to get some space, or do a grounding exercise, or to talk with my psych etc.

    Billy Conolly (rude angry very funny scottish comedian) had a hideous childhood, and he had a dream, sometime in his teens I think, where he was underwater, walking, swimming, breathing and fine. And he realised that even tho he was supposed to be drowning (figuratively) and in fear of his life and sanity, actually it turned out he could do the impossible, breath and be ok underwater. Well, long story, its a bit like that. The feelings for me have subsided in strength, but I realise I am much better at being in the middle of those feelings, that felt they would destroy me, and looking around, and breathing and checking things out. And that other people are down there too. And there are people visiting too, in scuba gear, to check out that you are OK, and help you breath underwater and get to the surface. Sharing your story is so reassuring and its good to see someone else learning to swim. Hope your journey continues well.

  9. my son is almost 2yrs old now, but some of the things you mentioned about constant worrying and imagining anything and everything that could happen all the time i had and still have constantly and have been ignoring it thinking that was just me and that was that. I still will sometimes cry if something doesn’t go the right way or become furious for no reason, and constantly feel like im so tense like a wire could break at any second, im glad to know there is something that can be done and that im not just “crazy”, and not alone.