It seems faux pas to discuss let alone admit to the possibility of having a perinatal mood disorder, most commonly postpartum depression. Let me be the first to proclaim it SHOULDN’T be. Many many many of us out there have been through it to varying degree.
70-80% of women experience SOME form of negative feelings following birth, and 1 in 7 women develops postpartum depression. You are not crazy or a horrible mom for feeling this way.
PPD and perinatal mood disorders can also affect new FATHERS. It is also the most under-diagnosed OB complication. Do NOT suffer in silence, there is help for you. A great resource for information is here.
My own bout with PPD & PPA
The Thanksgiving holiday was supposed to be a time of joy and getting together with family, everyone excited to have a new addition to celebrate with. What it turned into was a complete living hell that was upon me before I could even form the words to describe what I was going through. Long story short we were surrounded by the usual holiday craziness with a baby who was suffering from relentless gas from his formula. We had just switched his formula that morning but had spent the two nights prior up all night with a screaming baby, we were all exhausted. We ended up in the mountains as we usually do for the holidays, we had all of the baby gear jammed in the car, all of the dogs, we were ready to set up shop. Unfortunately, as hard as we tried to replicate our “home” environment it just wasn’t the same being away from our home, our nest.
The night ended up just as the past two had been, with a screaming baby who would drift off for 10 minute stretches and wake up screaming. Hubby and I were trying everything we could to comfort him. Top that with a dog that decided to start puking and having bloody diarrhea as soon as we arrived at our destination and it was a recipe for disaster. I was pleading to go home at 2:00 in the morning! We ended up leaving the following afternoon and I felt a sense of relief knowing that soon we’d be back in our home, with our routine, much more at peace. I bawled the entire car ride home about how I felt like I was a failure, I couldn’t even handle a weekend trip with a 3 week old baby, I must be the worst mom in the world. My feelings over the past days had intensified so much I just didn’t even know what to think. I was sure that “hormones” were playing a part in my misery but that’s as far as I took it.
We ended up back home, back to our routine, and it definitely eased my anxiety but the problem was far from fixed. Over the next couple of days I spiraled downward very quickly. I became increasingly agitated and restless, I couldn’t sit still and felt like my skin was crawling but yet I had no motivation to even pick myself up off of the couch. Going out anywhere was laughable so I continued to pace around the house, sit down, get up, fix a drink, get a snack, sit down, get up, it continued for hours. I finally took 3 Advil PM at 5:00 in the evening to knock myself out, I literally had no idea what else to do with myself.
I kept thinking that we’d made a mistake that we never should’ve had a baby. I would be out in public staring blankly at everyone with children from infants up to teenagers and I would think “How in the world did they do it? How does ANYONE have children? This is sooooo hard!” All I could think about was how hard this was. I had no desire to take care of my baby, I felt like a complete failure as a mother. We tried to go out and have lunch at a restaurant and I looked at my husband and kept saying “aren’t you anxious right now? Aren’t you worried about him?!” and he looked at me like I was completely insane! He kept telling me that the baby was FINE, he’s so easy, this isn’t hard. And I couldn’t wrap my head around that… to me this was NOT easy… I felt like I was on a different planet.
Every moment of the day I was anxious, I was worried. I was worried that he would wake up fussing, worried that he’d be up all night, worried about the next feeding, and changing, worried that he’d have gas, worried that we’d bother people if he cried. I was so anxious. It was awful, I literally hadn’t eaten anything in close to a week, NOTHING. I was dropping 2-3 pounds every other day when I’d get on the scale and this was weight that I didn’t have to lose, I was already at my pre-pregnancy weight.
I felt a huge sense of failure as a mother since I wasn’t handling it as expected. I mean here I was living the dream that I have always had, I had everything that I’ve ever wanted in life and yet I still wasn’t happy. Talk about guilt…. I would tell myself “You’re still not happy, what’s it going to take to be happy then?!!” I felt like I was letting my son down, my husband down, myself down, the dogs down. I mean I couldn’t even breastfeed my baby, that’s the ultimate sense of failure, I couldn’t even provide nourishment for my baby! What was WRONG with me??! The guilt was overwhelming.
I finally decided to start looking up Postpartum Depression online when my husband and I were discussing it. I was open to admitting it if that were the case simply because I knew there was treatment and that I could stop feeling so awful, that was my only saving grace to admit it. I had heard the term Postpartum Anxiety mentioned in a chat forum and I thought that the anxiety aspect more described what I was feeling. So I started researching PPA. I found the most amazing website that broke down the symptoms of PPD and PPA and actually a whole series of postnatal mood disorders that I never even knew existed. After looking over the symptoms I realized that I definitely had a handful of them on each list, and so I set out to get in with my doctor.
I was talking with the nurse practitioner about my symptoms, she agreed that I should go on an anti-depressant to help stabilize my mood. And right before our conversation ended, the nurse in me decided to ask her if the new medication would have any interactions with the Reglan I was taking to increase my milk supply. She promptly said “OH? You’re taking Reglan?” and proceeded to inform me that Reglan itself can cause depression! It was like a lightbulb went off, as I had been increasing my dosage of Reglan for my broken boobs I had started going downhill right into the holiday.
Needless to say I immediately discontinued using the Reglan and at the same time started taking the Zoloft. Within just a day or two I noticed an improvement and after a week now I am feeling back to my normal self. I have good parts of the day and still bad parts of the day but all in all I feel so much better. I am back to enjoying my baby and I’m not flipping out about him crying or having gas every waking moment of the day. It seems silly to my now how bad I was acting, how anxious I was, but it was very real at the time. My appetite is getting back to normal. I have motivation to get out and do things now and I’m soooooo incredibly thankful that I reached out to get help. I was bawling again as I read the list of symptoms to my husband, every one of them hit a chord in me and made me feel even worse of a failure. Just admitting that I had PPD/PPA was like a failure in itself, like “why can’t I just handle this like everyone else does?” Again WHAT is wrong with me.
I realize now that this is stupid, PPD/PPA and the like are the result of a CHEMICAL imbalance in your brain and nothing that is in your control! Without medication to regulate your hormones it will not “fix” itself no matter how much effort you put into it.
My main problem with the “illness” is everyone else’s judgment. When people hear “Postpartum Depression” they automatically think that you want to hurt your baby or commit suicide. It is SOOO much more than that! There is an entire spectrum of feelings related to PPD and many women never reach the end of this spectrum. I never wanted to hurt my baby or myself, never even crossed my mind, but I knew that something was definitely “off” and it wasn’t getting better. My goal in all of this is to educate people so that more women feel confident in getting the help that they need, so they aren’t ashamed to reach out. PPD and similar disorders affect 20% of women and this is only the ones that actually report it, the true number is likely higher. We aren’t alone here and there is no shame in getting help, I am proof that it does work and that you don’t have to “suffer it out.”
Postpartum Issues with Subsequent Pregnancies
After a few more pregnancies under my belt, these same similar feelings have appeared after each birth. I have not had the anxiety component but have definitely had a feeling of being off following each of my kiddos. The third time it wasn’t until about 5 months postpartum which I attribute to the decrease in my ability to breastfeed that obviously triggered some hormonal imbalances. Each time I experience sadness and depression to varying degree, a feeling of almost being trapped or that every day is Groundhog Day. I can clearly remember that I don’t feel like I used to, almost like I’m in an out of body experience watching myself go through life.
Despite having a super supportive husband I find myself wanting to be very secretive about my feelings when this happens, I try to hide it which I’ve obviously learned is a HORRIBLE idea. Just getting the words out that “I’m not feeling right” feels like a weight lifted off of my shoulders and he immediately jumps into action mode. What we’ve found together that helps is to keep busy, to have something (at least one thing) every single day to get OUT OF THE HOUSE to go do. It’s very easy to retreat and stay in the house avoiding the issue, it truly takes a tremendous effort to get out and do something. Many times my husband has almost had to drag me out of the house yet every time I feel SO MUCH BETTER after I force myself to do it. It doesn’t need to be anything fancy, just get dressed and get out of the house. Go on a walk, go to the grocery store, drive around, go to a restaurant for lunch, even doctor appointments were a welcome excuse to get out in the world and stop isolating. This is what has helped me.
I anticipate the same thing happening after baby 4 arrives and luckily I’ve experienced it enough to know what to look for and I’ve found a solution that appears to work for me. Each time it takes me about 2 weeks of feeling pretty miserable to keep pushing through before the fog starts to lift. It isn’t an overnight thing and requires effort. Thankfully I have had the willpower each time to put in this effort, not everyone can and that’s OK!! Lean on your support system, call a friend, call your OB, write ME a message, there is always somewhere to turn.
Some triggers I’ve noticed
–Pain meds from birth, this may be an obvious one, but don’t underestimate the effect of these on your brain chemistry. This can be something to tackle in and of itself. For me, following birth, I try to use them as sparingly as possible and move right to over the counter meds. I ended up having baby 3 naturally and I actually did notice a difference here.
–Breastfeeding, the hormones your body is pumping out and adjusting from pregnancy to feeding to not feeding and everything in between are NO JOKE. As I said, I didn’t notice any postpartum symptoms with baby 3 until after I was pretty much done nursing.
–MEDICATIONS, I emphasize this one because you MUST be an advocate for yourself and be careful of meds that can affect your mood. Even as a nurse it didn’t dawn on me with baby 1 that the breastfeeding medication Reglan could precipitate depression. With my struggles to breastfeed baby 3 I stupidly and knowingly opted (as my final resort) to get a Rx for Reglan again hoping it would help and thinking there may be a tiny chance it would be fine this time. 2 doses in and I IMMEDIATELY felt that weird depression “off” feeling creeping in and dumped those pills down the toilet. I strongly urge everyone out there to avoid these meds like the plague!!! That includes Domperidone and other off label prescription meds that have been traditionally used to stimulate milk supply. There are natural and herbal products out there that I would go to first, however, ONLY AFTER researching them extensively.
If you are unsure if what you’re going through is PPD please visit this website, it was a godsend to me and an excellent resource! And reach out to your OB for help, there are SO many things that can be done, you do not have to suffer or tough it out.