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Saturday
Mar212009

My Postpartum Depression (1987)

I was 25 years old, had three very young children of my own, plus was co-nursing Sarah’s son. I’d had a couple of years of therapy when I was 20-22 years old, a diagnosis of depression, helped by talk-therapy only. 

So, when I found myself holding the Demerol pills in my hand, considering swallowing all of them while the kids banged on the bathroom door, “Mommmmmmy!”; I had to make a decision. 

I started crying when I was 12 (the year I started my period). I cried my way through the teen years, crying about the books I read, crying about the butt of even fake jokes and cried about my loneliness. I also wrote like crazy, pages and pages and pages of unending sadness... where was the end? I rarely seriously considered suicide, but it did cross my mind. 

When I was pregnant with Tristan, I felt better than I ever had even though I ended up gaining 70 pounds. My sex drive was insatiable! I was awake, but did cry plenty, though not as much as I had in the past. 

After Tristan was born, I felt in a fog for a long time. Having had a mediolateral episiotomy (that went into my thigh muscle), I can blame some of the fog on that... just trying to sit was incredibly painful for about 3 months. I am sure I had a touch of clinical depression, especially as I weaned him at 4 months old. I was perpetually exhausted, not wanting to even attend to his most basic needs. I didn’t know about attachment parenting back then (which would have helped loads), so did the nightly multi-runs to the crib and back, bottles, rocking, soothing a screaming baby; poor Tristan! I still apologize. 

During the pregnancy with Meghann, I opened my eyes to attachment parenting and natural birth. I was so high after my UC and my successful nursing experience... and she was born at the end of May, the beginning of the sunny season in Tacoma, Washington... I don’t remember any depression at all. 

Aimee’s birth, hysterically funny that she was born in the car, fed me for a long time. As a La Leche League leader and doula, I spent a lot of time with women and babies. I loved helping women! I hadn’t yet learned how to keep some of the energy (spiritual and physical) for my Self and my energy gradually waned over the first year of Aimee’s life. This was also the time when I left my former husband for Sarah, so there was plenty of strife and pain for everyone. 

Sarah and I were living together in military housing from the time the babies were 7 & 9 months old. Another stressor was the military’s view of homosexuals; hiding was very difficult and unfair. 

I slid into depression slowly, but it did start almost immediately after Aimee’s birth. The reason I consider it postpartum depression is 1) the timing of it (13 months after Aimee’s birth) 2) my history of mild depression 3) my family history of severe depression 4) the gradual slide down into complete despondency over the course of a year. The psychiatrist I saw also stated it was postpartum depression (PPD) – (it really was Postpartum Psychosis – PPP). 

PPD for me included complete apathy. I was nursing 3 kids for 6 months and then co-nursing 2; I often wonder if I would have died if I’d weaned the kids. I was a great mom. I could hold the kids, kiss their boo boos, read them stories, make peanut butter and jelly sandwiches and even make dinner most nights. Yet I spent nearly every waking hour crying, angry and so, so tired. I always wanted to sleep. I slept 12-14 hours a night. Where I was dysfunctional was in life as a woman. I couldn’t write, read for myself, drive or find any joy in life despite the wonder and beauty all around me. 

I also heard those “voices,” the whispers behind my head that said my name or “look!” “you’re worthless” (the voices transform depression into psychosis). I had “ants” crawling on my body, ants that no amount of slapping or scratching would eliminate. I was super-involved in my pain, spiraling deeper into the abyss of darkness and... death? 

Poor Sarah didn’t know what to do. She’d never seen depression before and at 23 years old, hardly had the knowledge of where to turn. 

The moment I had those Demerol in my hand and had to make a decision, I fell to the ground sobbing and threw the pills into the toilet. I crawled out the door and grabbed the phone, calling Sarah at work. She left immediately and came right home. 

I called the Psych department and was given an appointment for the next day. I only had to make it through until the next day. Sarah didn’t leave me alone for days. 

Sitting on the psychiatrist’s couch the next morning, I could barely speak through the sobs, yet was able to say enough that he wrote me a prescription for Elavil (a pretty archaic medication nowadays) before sending me on my way. He told me it could take weeks before the medication removed the depressed feelings. I think I took a pill while standing in the pharmacy. 

There is a trick we midwives teach mothers who have colicky babies. Take the calendar and circle the 3-month mark and by that date, things will surely be much better... X off the days and know that it shall pass. For me, I used the calendar to mark the days until I felt better. It only took 8 to feel the fog lighten slightly. The voices vanished when I’d been on the meds about 2 weeks.

If I had to draw what I was feeling, it would have started with scribbly pencil scratchings that gradually turned into charcoal on artist’s paper. The black and white etchings would slowly turn to faded colors, then the outlines would disappear, the colors brightening more with each passing week. By 8 weeks, I could see the world as it was again (despite the enormous hunger for sugar and dry mouth that the Elavil caused). I can always feel my slide into depression by the dimming of the “colors” of life.

Depression sucks, but Postpartum Depression is so horrid because we are supposed to be so in love with our babies. How can we give those babies/children the love they deserve when we don’t even care if we shower ever again? The kids might have their physical needs met (or not), but when emotions are absent, they are denied so much.

I didn’t have the voices that tell people to hurt their babies. My “voices” told me to leave. The urge to run away, disappear, was so great I planned where I would go and what my new name would be so no one could find me. In this sane state I am in now, it sounds absurd and totally bizarre to think I was in such a sick place, but I was – and plenty of women find themselves there, too.

I have begun using the Burns Depression & Anxiety scale to check on women’s mental/emotional states during and after their pregnancies.

I flat out ask women how they are feeling, do they have thoughts they wish they weren’t having? Do they feel ants crawling on them? Do they have panic attacks that make them want to stay home/crawl into bed/run away/fear for their lives? 

I’ve had one woman with such severe PPD I took her to the hospital myself. I was afraid not only for her life, but for the baby’s. Her partner had to work and even though he understood the severity of the situation, there was nothing else he could do. The baby stayed with relatives while she was treated for a few days. Once she was home, I visited her every day for a week, then every couple of days for another week and gradually weaned away from her as she began feeling normal again. She’d had a really nice hospital birth with me as her doula. This seemed to be completely biological and not precipitated by any outward trauma, past or present. 

I had another client with severe Bipolar Disorder that required medication during the pregnancy and a sharp increase, and addition of another, medication within 15 minutes of the baby’s birth. While she didn’t avoid PPD altogether, it was much less serious than it could have been/would have been without the medications.

I know there are midwives (and others) who believe PPD can be treated homeopathically, with acupuncture, diet or with herbs and visualizations, but I am not talking about mild depression, I am talking about DO-something-or-this-mother-or-baby-is-going-to-die. There simply isn’t enough time for holistic care to take effect. This doesn’t mean a woman can’t do allopathic AND holistic care at the same time – in fact, I think that holistic support is really important, but to minimize the seriousness of PPD/PPP can cost the loss of a life. I believe the stigma of medication can keep women who need help from getting help. I beg midwives and doulas to learn about serious PPD/PPP and learn about the medications that can save women’s and babies’ lives.

Face your own pre-judgment of medications during breastfeeding (which is almost CRUCIAL during treatment for PPD/PPP); most medications can be used while a woman is nursing. Sometimes the only connection she has to her baby is through breastfeeding. I believe it keeps many babies alive, this invisible maternal/infant bond that runs as an undercurrent through even the worst depressions. If you or women have questions about medications and mothers’ milk, you can always check out Dr. Hale’s website... a marvelous resource for women on medications of all kinds. (My username is “msgardenia” and my password is “midwife”) If you are ever bored in your day, read through this site to familiarize yourself with the different medications and advice about taking them in pregnancy and breastfeeding. 

I know my own experience with PPD/PPP has colored my attitude towards helping women, including the use of medications. I don’t have the same phobia of allopathic meds that many in the natural community do. I trust that women will generally get what they need when they need it and if they don’t, I hope I am there to re-direct them onto a healthier path. 

I want women to write more about their depressive experiences, both after birth and unrelated to the pregnant or postpartum period. Even though the topic is not nearly as hidden as it used to be, there still remains a stigma that the person with depression is weak, weak-willed or a failure in some way. This is so far from the truth. We need to reach out to those in need so they can find their way out of the pain and sadness that swirls around their hearts. 

I remember when I held those pills in my hand... I didn’t want to die, but I wanted the crushing pain in my heart to end. I could not see a way out, but with love, support, therapy, medications and a lot of re-working my psyche, I found that way out, that way back to a color-filled world, the world where I was a great mom and a fulfilled woman.

I want to stand as an example to others who’ve fallen deep inside... you don’t have to feel that way any longer. Follow us. Follow us! Light is right over here.

 

References (2)

References allow you to track sources for this article, as well as articles that were written in response to this article.
  • Response
    - Navelgazing Midwife Blog - My Postpartum Depression (1987)
  • Response
    - Navelgazing Midwife Blog - My Postpartum Depression (1987)

Reader Comments (38)

Thank you for sharing your story ... I hope it supports many, many women to see what they or someone else is going through and to reach out. And what a great day to complete and post it ... many blessings to you on this transforming, equinox day ...

March 21, 2009 | Unregistered Commenterjanel

thanks for sharing this... i experienced my fair share of PPD and now - FINALLY - two and a half years after the birth of my last (and final) baby, i am starting to feel like a real person again... i am thankful for my journey to and through depression since it was a huge motivating factor in my having two babies at home and now pursuing midwifery as a life. i appreciate what you say about the stigma of the "natural community" against allopathic treatments and care - i struggle with needing medicationg to be "normal" and have worked to get off of it but for the time being, if that is what allows me to function as a mama, partner and person, that is what i will be thankful for...thanks for sharing

March 21, 2009 | Unregistered Commenterani

I was able to go on and then off meds the first few years I dealt with depression, but each time I went on, I was on meds longer and when I went off, I was off for a shorter time. Eventually, in 1998, I realized I would need meds for the rest of my life if I didn't want to die sinking into depressions that increasingly were harder and harder to climb out of.

I was also incorrectly diagnosed for 20 years, that old diagnosis being chronically clinically depressed. However, when I was correctly diagnosed in 1998 (Bipolar Disorder II) and I was put on the correct medication, the depressive episodes have all but vanished. I had a wonderful (to me) period of hypomania for 2 years (2001-2003) and then got sick with a chronic illness and the productivity and great feeling ended. I have only had one serious depressive episode (2005) since the diagnosis even though I have had minor slips downward that just required some medication tweaking. The 2005 episode lasted a year and was FINALLY resolved when it was discovered I had hypothyroidism and the depression lifted within a week of being put on thyroid meds. I was crazy angry I had been SO sick for SO flippin' long when the answer was so close and so easy to fix.

It is interesting, this speaking about my mental illness when I know clients are reading. I am sure most midwives would be horrified to disclose something so personal. I mean, no doctors tell us what meds (or drugs or drink) they are on when they treat us, do they? But, I am a different kind of midwife and my clients choose me - warts and all. In the same way I think it's important for all my clients to know about Sarah, this is a similar issue. Now, I don't sit in a consult and list out the meds I am on, but I get so many clients from my blog, if they have read not even that far back, you can see I have BPD and I am not ashamed... challenged, frustrated, even sad about it sometimes, but I refuse to feel shame for something I have ZERO control over. I am infinitely grateful I live in a time when there *are* meds to help me!! Otherwise I would have either been dead or in an asylum somewhere. I like being free - in body AND mind.

March 21, 2009 | Registered CommenterNavelgazing Midwife

Thank you for posting again, I missed reading your thoughts, feelings, and inspiration! Thank you for sharing such intimate details of your life so you can help others. It does not fall on deaf ears.

I'm in NYC and feeling grateful there is so much awareness and help for PPD compared to just a decade ago.

Even the stupidest doctors know women can BF and take medications for PPD and where to send them for great support and help.

This has happened with a concerted effort from all parts of teh birth community and the great work from PPD advocacy groups and the NJ state commission on PPD. It's a very open subject, and the natural birth community is right there advocating that women do need psychiatrists with practices for PPD and medication and supportive intervention to help mothers when they are suffering.

I want to give much credit to Brooke Shields, she deserves a public service award for what she has contributed to women suffering from PPD.

March 21, 2009 | Unregistered CommenterDewi

I can't thank you enough for this post. Not from my own experiences, but because I feel like I've learned so much through you already. It's blogs like yours and the blogs of Baby Loss mothers who are helping me become a more rounded doula.

March 21, 2009 | Unregistered Commentermommy michael

Thanks for posting this, especially the parts about the antipathy within the natural birthing community to using allopathic treatment for PPD. I have had terrible PPD after both my births and was poo-poohed by other women in the natural birth community and told both that "PPD doesn't happen if you breastfeed" (at times while I was nursing my baby!) and "PPD doesn't happen to women who birth at home" after a perfectly normal and successful home birth. There was a bill in congress 18 months or so ago to provide funding to study PPD, to fund treatment, and to train pediatricians and GPs to be aware of PPD during well-baby visits. The natural birth community in my area mobilized AGAINST this bill, for fear that it would cause more mothers to use anti-depressants. I literally cannot think of a worse example of cutting off your nose to spite your face.

I was, luckily, never at a point where I was a danger to my baby but I most certainly was a danger to myself -- if only from self-neglect and abuse. I was also lucky that the Big State University here was a study site for a comprehensive study of whether group or individual therapy (in combination with meds as appropriate) provided better outcomes for mothers with PPD and their children. As a part of the study, I got free therapy (with childcare for my little guy), referrals to community supports, and access to free meds, if I needed it. This? Should be the standard of care for ALL women with PPD, everywhere.

March 21, 2009 | Unregistered CommenterBelleweather

I just recently discovered during a seminar of PPMD's that the phobias and strange tgouhts I had with my new babies were a symptom of PPD; I suddenly became terrified of heights, and especially bridges, and could "see", VIVIDLY, my baby being snatched from my arms by a gust of wind and tossed to his/her death.

I had thoughts like, "If I throw my baby against the wall, it would sound like this" and would shudder in horror and clutch the baby closer.

I thought the fact that I was soooo exhausted that I couldn't brush my hair was simply due to the fact that I had small kids and no help. It's no fun, and so isolating, and too scary to put to words.

March 21, 2009 | Unregistered CommenterColleen

You women are my heros. Thank you for staying alive.

I should have written an entire list of symptoms we can have during depression/psychosis, but I (stupidly?) assume women will know.

Ahhhhh, but it is SO much more than feeling sad or crying a lot. They talk about losing weight; I gained 100 pounds.

Vivid, unbidden, horrific images come to me when I am sick, too. There are repulsive, violent, blood-filled images that pervade my mind and I have NO idea where they come from. I do not watch horror movies, look at car accidents... have no clue where these images come from - except from the depression itself. It wasn't until YEARS in therapy that I learned that unbidden frightening/terrifying images were a sign of SERIOUS depression. Sometimes the unbidden thoughts are my second clue I am needing a med adjustment. (The first clue tends to be isolation.)

It is just such images and these horrifying experiences that validate/verify for me that my depression (most depression?) is chemically-based. There is a glitch in my brain that doesn't allow one synapse to jump across to meet the other. Medication acts as the bridge so the connections can reach each other.

I remember one depression (and they almost always present with something new and different each time) where I would be driving and fascinated with the flowers on the side of the road. I would see them -and KEEP staring at them, turning the wheel towards the mountain or drop-off in the meantime. Only when I had the kids in the car could I half-way control myself from this bizarre compulsion.

In depressions, sounds become amplified. It is like I am in an echo chamber and everything is so, so loud I want to crawl under a pillow to make everything be quiet. I can hear the sounds bouncing off the mountains here (the mountains are dry and bare), hear every car on every highway, hear babies crying blocks away, dogs *everywhere* barking, howling, people laughing, laughing much too loud.

There've been times when I can see words coming out of people's mouths. I see them as 3D images of the words themselves... "love" being all poofy, sweet, red and floaty. Hateful or angry words present as barbed-wire-looking, sharp, pointy, skinny words. Very weird. I can see the words float around the room after they leave the person's mouth. They bounce around, bouncing off each other and then rising to eventually evaporate.

I'm kind of laughing about sharing all of this... TMI for clients? Oh, well... it's a damn good thing I keep myself in meticulous control, right? Yes, it is.

March 21, 2009 | Registered CommenterNavelgazing Midwife

Thank you for sharing this post. I too had PPD, partly exacerbated by the Reglan I was taking to boost my meager milk supply. (Herbs, extra nursing and pumping didn't work.) My husband was working 3 jobs, one of which had 24 hour shifts, and was rarely home. I was by myself mostly with an extremely needy and colicky baby (which lasted way longer than 3 months!). We kept our basement door open for the cats to access their litter box, and I had to walk past that open door and stairwell many times a day as it was in the center of the house. Each time I passed it, I would "see" myself falling into it with my baby in my arms. Other times, I would "see" myself hurling her down the stairs and wondering what the news reports would say. I would come up with the most vivid storylines, transforming a passing thought into a full-on crime drama like Law and Order. It would take on a life of its own. If I saw a news report on a child being harmed, I would immediately become part of teh story. I would imagine myself as the child, and wonder what it must have felt like to die the way they did. This would inevitably lead to a bout of hysterical crying and the fear that I would do something like this to my daughter. I still struggle with this, and try not to get sucked into stories like Caylee Anthony's. One day, after my daughter had been crying for over 3 hours straight, I had the strongest urge to throw her out the front door. Instead, I tossed her (forcefully, but she wasnt' hurt, thank God!) into her crib and slammed the door shut with such force that the house rattled. I went into the kitchen (farthest away from her screaming) until she cried herself to sleep (the only time I let her CIO). Finally one day I just woke up crying. It was right before my birthday, and I just couldn't take it anymore. I was struggling with grad school, caring for a needy colicky baby, without much support from my husband, trying to breastfeed what little I could, and I just snapped. I wanted to quit school, run away and never come back. I think then my husband realized how bad the situation was. I had NEVER told anyone what I was feeling. I am a Psych major and can fake my way through the screening tools. I can fake a smile with the best of them. NO ONE KNEW. I could have killed my daughter. I think God kept her alive. After a couple days of crying and severe depression that I let others see, I went off the Reglan, and my mood improved almost immediately. I could think clearly, but took some time off of school. I weaned my daughter because I needed to stop stressing out about how much milk I was (and wasn't) producing. Things gradually began to get better. My husband quit one of his jobs and was home more often. My daughter finally seemed to be over this colicky business and was sleeping more than 20 minutes at a time. She finally started sleeping through the night at about 6 months. The loneliness still hung around. I went back to work when my daughter was nearly a year old, and although it broke my heart, I needed adult conversation and distraction. I feel so much better when I am home. With my next child, I plan on at least going back part time when my baby is about 6 months or so. I think the mental stimulation is so important for me, even though my heart really is at home. Just talking to someone lowered my stress levels. I hope every woman gets good screenings, and doesn't "fake it" like I did. I wish I had talked to someone, anyone, about how bad I was feeling, months before I fell completely apart. Please, ladies, be honest with yourselves and your care givers, and talk about how you are feeling.

March 21, 2009 | Unregistered CommenterJen B

I certainly think those scary thoughts of throwing the baby, deliberately dropping the baby, or seeing the baby get harmed are probably the least lkely to get disclosed to a care provider. Who wants to admit they're thinking, or FANTASIZING, about harming their baby? I could barely admit to myself having those thoughts, and honestly, it wasn't until recently that I even allowed myself to remember again. I was so horrified by my own thoughts, and felt so incredibly GUILTY, the weight of that guilt pressing me down, down, down, so heavy I could barely move some days.
And Oh! How I loved those babies! I loved them so fiercly, I couldn't even imagine how I could think about harming them. And I took GOOD care of them, they grew, and thrived, and were contented little souls. And I think this is why it is so hard for others to recognize the symptoms in their loved ones, we seem to pull it together and put on a happy face when others are around. And I know I would have denied to the death that I was thinking about harming my own baby.

And then there was anger, too. I remember being criticized for my messy house, with a new baby and some todddlers running around, and being SO ANGRY, thinking, "Can't you see I need HELP? Can't you see I am barely keeping it together?" but not being able to say anything, being totally unable to ask for help.

March 22, 2009 | Unregistered CommenterColleen

You are all so brave and strong for dealing with PPD - how lonely ad terrifying. My good friend just dealt with PPD this year and fortunately her husband works from home so he was able to be very hands on and supportive. I think she confided in me because I'm biploar (rapid cycling manic) but I haven't had an episode in a long time (fall 2000) and am on good meds. Having any mental illness, temporarily or long term, is so scary and the judgement/stigma we must face to get help is overwhelming sometimes. Sharing these stories takes so much... you are all inspirational. I am often scared that I will never get to be a Mom because my drugs are so toxic and I don't know what else is out there to take that would allow me to experience pregnancy without endangering a baby... but as with all things, that bridge will be crossed and maybe adoption will be the only way... and I will have to be ok with that. Or another option will be found and that will be thrilling... I digress :) You are all awesome and I send you all a lot of love and strength as well.

March 22, 2009 | Unregistered CommenterMel

colleen said: "and could "see" VIVIDLY, my baby being snatched from my arms by a gust of wind and tossed to his/her death. "

I had moments like this!!! i still have moments like this. but i've never attributed it to PPD at all. which makes me wonder.

but yes. i've definitely had things like this. stupid thoughts sometimes. (well i've felt they were stupid..) for instance my husband was joking around that a dinosaur was eating our newborn. *don't ask, like i said..stupid* and i burst into tears and held him so close because it was so vivid and i could just SEE it happening.
but it's gone beyond that to being so tired with my second, crying at night and i got the vision of just throwing him from my position on the bed to across the room because the crying was just non-stop. and i immediately held him closer and cried so hard for even THINKING it.

March 22, 2009 | Unregistered Commentermommy michael

Thank you for this post. My daughter is 4.5, and I have only felt recovered for about 8 months. I started having terrible toughts about gruesome things happening to my baby when she was about 1 month old. I remember one day just sitting there crying, and my husband didn't even ask what was wrong. He just walked out and shut the door leaving me with the baby. It was all downhill from there. At my six week check-up, my midwife asked me if I felt like crying a lot. this was the extent of ppd screening for me. Of course, I told her everything was fine, because I had an irrational fear of having my baby taken away if I were found to be at all mentally distressed. I have been blind since birth so I wasn't able to just pack up the baby and get out of the house. Everyone seemed to think I couldn't possibly have a child and raise it so I was terrified of revealing the depression to anyone. Food became the only thing that gave me any pleasure. My family doesn't believe that women should have any mental illness after childbirth. They should also just suck it up and deal.

March 22, 2009 | Unregistered CommenterAndalusians of Grandeur

It's funny. I don't know *what* drove me to write about this topic. I have several other posts waiting in the wings, half-written, but this post just flowed out of my fingers onto the page. I didn't even consider any of my words "a risk," but as you all are speaking, I HEAR what a risk it is.

Without support, one *would* expect your kids to be taken away if we said anything about throwing the child down the stairs or against the wall, even if we'd never do it. Even in a state of un-reality, we grasp somewhere that we don't want to do anything/say anything to lose our kids.

One thing I want to say to women is IF THERE ARE THE VOICES THAT SAY or COMPULSIONS TO HURT THE KIDS, CALL SOMEONE TO TAKE THE KIDS AND GET HELP IMMEDIATELY! Even if you are hospitalized, it is better to keep the kids safe and get yourself the help you need than to risk ending up in prison and having a dead baby. THIS IS AN ILLNESS THAT CAN BE FIXED. Even if you think no one understands... we do. Oh, how we do.

But, for most of us with PPD/PPP you *can* remain with the children while receiving help. Do NOT quit nursing... insist on meds that are compatible with nursing (again, Dr. Hale's site!). Quitting nursing throws the body into an even more chaotic state and can toss you into psychosis if you weren't there already.

It's hard when we have "ideal" births and still have the cruelty of PPD/PPP. People expect it from birthraped or birth traumatized women, but what's our problem? To me, it PROVES the biochemical aspect of mental illness. I come from a long history of mentally ill women (maternal side), suicide/attempts, alcoholism, drug abuse, mental hospital hospitalizations, etc. Was I destined to have PPP/BPD? Who knows. It doesn't even really matter to me now. I just keep myself alive and well. It's what we all need to do.

AoG (and the other women who couldn't tell anyone), my heart goes out to you. I cannot imagine how horrid it must have felt to have your husband walk away without any acknowledgement of your pain. I am so sorry.

Question for all of you. What would your midwife have needed to say to get you to ask for help/tell her what was going on in your head? I want to make SURE my clients feel safe telling me so I can get them the help they need AND DESERVE.

March 22, 2009 | Registered CommenterNavelgazing Midwife

I always say the "new" best things about being a midwife currently are cell phones and SSRIs. I've taken people to the hospital too! Scares me. Thanks for the post!

March 22, 2009 | Unregistered CommenterLaura

Thank you for your blog today - I am a doula who suffered severe PPD after the amazing homebirth of my second child. I had it lightly (although didn't know until later) after my first birth too. I ended up being hospitalized from the time she was 10 months until after her 1st birthday, for my own and her safety. I was a doula before her beautiful birth - and still, with all my knowledge, it didn't help, I couldn't get out of it on my own. It is so important to share the symptoms and HOW another doula, midwife (or partner or family member) can identify what's going on and help!! Thanks - Sarah Vine

March 22, 2009 | Unregistered CommenterSarah Vine

For me it wasn't stairs or dropping or throwing the baby... it was the car. I was terrified that someone would hit us while we were driving and that the baby would die. I would imagine sliding on the ice, going off the road, getting T-boned, or driving into the lake; and it wasn't like non-depressed imagining, it felt REAL. I could feel the icy water or the impact and imagine what my baby would look like dead. I literally could not leave the house. And didn't, until I got therapy.

The single biggest thing that my midwife did that helped was to bring up PPD EARLY. She talks about PPD with all her clients during their second trimesters and worked up a sort of "action plan" with us, so that my partner knew what to look for, I knew what to look for and we knew what we'd do if things started spinning out of control. It really, really helped because it normalized PPD since this was something she did with all her clients, and because once it got bad enough I just was not capable of thinking clearly enough to go through the steps to get help and my partner was at his wits end. By putting the plan into motion I didn't have to say anything about being scared of driving into the lake -- it let me admit that things were bad without having to have the strength to say too much about how bad they were.

March 23, 2009 | Unregistered CommenterBelleweather

I'm not sure, Ngm. I took a Bradley class, and the only mention of ppd was when the educator told us that nursing would prevent it. My cnm never said anything about it, and it wasn't going to happen to me anyway. I had a great birth and nursing was a cinch so what did I have to be down about? Some days I just wanted to lay in bed and sleep, but I was even afraid to nap in case the baby woke up.

March 23, 2009 | Unregistered CommenterAndalusians of Grandeur

Belleweather, that's a great suggestion- a PPD action plan. that would have helped loads, but it may not have gotten me to admit that I was sick. I think, for me at least, if my midwife had taken me by the hands, looked me straight in the eyes, and said to me "You know its OKAY IF YOU FEEL THIS WAY." Not confrontationally, but accepting and acknowledging what I was feeling. I know that I would have just had a complete breakdown right there in her office if she said that to me. She asked me all the "right" questions, did the screenings, every time I talked to her, but I still would have never had the balls to admit that I was feeling the way I was. Having worked in the mental health sector (and hated it), part of me knew what it would mean to others if I let myself fall apart like I wanted to. After all the time I spent comforting my very colicky daughter, I just wanted someone, anyone, to comfort me for a change. Just having a shoulder to cry on may have been the best form of therapy for me.

March 23, 2009 | Unregistered CommenterJen B

looking back I know I had PPD with my first but in our family it is taboo to be in therapy so I went twice and quit. The only thing that kept me from suicide was the guilt that my kid would have no mother. Did fine with my second, but now, preg with number three I worry, I feel it creeping in. I told my husband to watch me this time, I will have him read this post and hope it helps him see....Thank you for your words.

March 24, 2009 | Unregistered CommenterAnon

i love the idea of integrating eductation about PPD into prenatal care - break the ice before it gets thick...
i can laugh about this in the daytime but at night, usually after i am up nursing the "baby" i have terrifying thoughts of being outdoors with my kids and a cougar coming and dragging one of them away... i have to make a choice everyday to live my life and not succumb to the fear...maybe its depression, maybe it isn't but it has gotten in the way plenty...
With my second and third babies who i had at home with midwives, i was very straightforward with them about my experience with PPD and my extreme anxiety over it happening again. we created a plan all together along with my partner to do everything possible to avoid it again. One major thing i did that i feel really worked well for me was to make capsules out of my placenta and take them everyday postpartum... i think it helped out a lot immediatly postpartum - at least i felt like i was DOING something, not just waiting to be consumed... not sure how many women are up for eating their placenta but its worth the try. obviously (?) not a replacement for meds when necessary. We were really counting on this remedy though - so much so it was my partner who prepared the placenta - true love!

March 24, 2009 | Unregistered Commenterani

Thank you so much for writing this. So much resonated with me... I wish I had seen this 7 years ago... Thank you also for doing what you can to help women with PPD. You are so much my hero for that!

March 24, 2009 | Unregistered CommenterKarelle

My birth experience was wonderful. I breastfed.
But I too come from a maternal line of schizophrenia/depression. I too have questioned if I was 'meant' to get sick just from my genes!?

What would someone have needed to say to me? "You are not well." I needed someone to confirm it. That it was real that I was unwell, it wasn't just in my head. (So to speak!)

For some reason, someone else vocalizing that I'm actually sick takes away the guilt that I'm just not trying hard enough, and opens up the possibility of getting help to get better.

Is anyone else like that? Or would those words have been appropriate only for me?

March 25, 2009 | Unregistered CommenterSarah Vine

One thing I wonder about is whether there are specific cultural factors that predispose women in our culture to PPD, moreso than women of other cultures or historical eras. Do Papau New Guinea highland tribeswomen or Chinese women living in Shanghai get PPD, did women in medieval France get PPD, or pioneer women on the Nebraska prairie in 1880? Are there environmental factors that are protective or that predispose women to getting it?

I had an amazing unmedicated birth, beyond fabulous. But then I had, what was in retrospect, crushingly terrible PPD (visions of pummeling the baby until he was bloody, hysterical whole-body shaking fits, self-harming behavior that I thought I had outgrown 15 years ago) It ruined my first year as a mother. I think it was brought on by chronic sleep deprivation and then being separated from the baby when I had to go back to work at 10 weeks postpartum (he got to stay at home with papa), coupled with reading too many AP books and having unattainably high expectations about what I should be doing as a mother (Martha Sears can hand express 7 oz. of milk in 20 minutes, Amanda Soule knits sweater sets for her baby, Ruth Yaron makes home-made fruit leather, mothering.commune mothers NEVER get angry or lose their patience, babies should never be put down before they can ask for it, etc.). I wanted SO, SO BADLY to be the absolute best mother I could be, and I felt like all I ever did was fall short (this, despite doing ALL the AP nurse on cue, cosleep, babywear, responsive to cries, learn baby sign language, yadda yadda yadda)

I went to two different counselors, one of whom was too slow about really addressing the pressing issue of my black mood and was content to talk about my relationship with my parents, and the other of whom made me feel like an idiot by asking, "So, what do you think I can do for you?" I felt like screaming at her, "Please, give me some tools so that when I am descending into a rage so powerful that I punch myself in the face and blacken my own eye so that I don't hurt the baby, when voices inside my head are telling me that my baby would be better off without me, when I am wishing that I could just get hit by a bus on the way home from work or that my husband could get hit by a bus, when the internal screaming that I am a worthless piece of crap stupid idiot horrible mother are all I can hear, can you tell me how to get them to shut up?" I didn't want meds because I knew that my mental state wasn't my "normal" baseline, and I felt like I should be able to haul myself out of the hole cognitively. Luckily, once the baby's nursing cut down to once or twice a night, it lifted.

One thing I think is lacking in our PPD screening is that I only saw my MW immediately after the birth of my son and at my 6 week visit. 6 weeks out, I was still on maternity leave and still riding the last of my birth high. I felt pretty good. 6 months out, different story entirely. Plus, the screenings are pretty cursory, just a little list of questions with a 1-5 scale, not delving much. I also thought I was weird/bad/not normal for sometimes HATING the baby, and who wants to admit that they are 33 years old and have so little self control that they are bashing their own head against a wall? What mother wants to confess that she is dealing less than perfectly with the demands of an infant, a fulltime job, and a house that needs cleaning, especially when anybody else's meltdowns are pretty well hidden away from sight? I wouldn't have wanted my midwife to think less of me. So, I would say that giving the mom and her partner a list of symptoms/thoughts that are warning signs of PPD before the birth, then going through them again on a postpartum visit is good, as is checking in with the mom at 6 weeks, 12-14 weeks, and around the 6 month mark, and maybe even again later than that. And, it is important to let the mom know that this is COMMON, and she is not a weak, weird, aberrant freak if PPD symptoms are occuring.

March 25, 2009 | Unregistered CommenterKC

Thanks for sharing your story of depression! Women need to hear this.

March 25, 2009 | Unregistered CommenterCiarin

Oh, KC you brought it all back for me with your comment. I felt a lot like you described. The saddest thing about the AP craze is we are supposed to respond to the nneeds of our children, but nowhere do the books talk about us women needing to be responded to when we have needs.

March 25, 2009 | Unregistered CommenterAndalusians of Grandeur

I had some of the awful thoughts mentioned as well with my first ( a home birth). I was afraid the lamps would off the walls, I had terrible dreams of loosing him, him falling into a canyon and those dreams stayed vividly with me all day, and became day dreams. I was crying, crying, crying and throwing baby out the window crossed my mind quite often.

I had a great midwife whom I could talk to about this, and to this day when I ask women how they are doing after they have had a child, I make a point of telling them it is normal to have these types of feelings but get help, talk about it with a professional and see if you need something. I was glad that herbs were enough for me, and they worked rather fast, but I would not have hesitated to take medication if need be.

In my experience, the people who are adamantly against medication for PPD are far few and between, even in the natural birth communities. Most will agree that when you need help, you seek help and take medication. I have never heard someone saying that you don't get PPD if you give birth at home. I do think that the kind of birth it was can exacerbate PPD, and that perhaps women who have a traumatic experience are more susceptible, but it can happen after any birth.

Also, most women have some type of pp blues set in. I knew after my first birth (and it was a great autonomous birth with a hands off midwife, so why would I even get PPD, uh?), anyway, I knew it was possible that my hormones would play a trick again after each birth, and taking herbs from the start helped me to even avoid those blues to get any worse, like with my first.

March 28, 2009 | Unregistered Commentermaria

thanks so much for writing about this! my mother committed suicide when I was i8 months old. She was diagnosed as schizophrenic but it sounds like PPP from the stories family members have told me, at least when compared to other stories of PPP. I just had a wonderful homebirth with my first child who is now 10 weeks old and have been very watchful of myself--so far so good. What your post reminds me of, though, is that we're post-partum for awhile.

March 29, 2009 | Unregistered Commenteresharie

I am so sorry, esharie... how sad about your mom. It isn't unusual for those with the schizophrenic gene to come into it during the postpartum period -and yes- usually with PPD/PPP. You are so right to keep a CLOSE eye on your own mental status. I always said I watch mine as if I could look down at my watch and see the time, it was that clear, that precise... at any given moment, I can "see" where I am. Thank you so much for writing.

March 29, 2009 | Registered CommenterNavelgazing Midwife

Ok, how did I miss this incredible post, Barb?

Well, yeah, I had this, probably every baby, but with my first c section/colicky baby, oh lord I had the voices, the ants, flying shadows outside my windows, disgusting thoughts such as something/someone breaking my legs by forcing my knees to bend the wrong way....the household sounds ALL "talked" (the dryer, the furnace, the baby swing, etc) and I would have the equivalenty of when you are falling alseep and then just JUMP--but all throughout the day.

I only thought: Two kids is so hard! I am so sleep deprived! Im seeing shit!

Now I know alot more and have five kids. I feel badly that me and my husband suffered so much when I could have used some meds. But I had a strong case of not even knowing how to ask for help, and when youre that whacked out of your mind, the simple things like dealing with health insurance (lol) to see if you have mental health coverage was just---too much

and btw, I also was pissed off that I never had the losing weight kind of depression! Alwasy seemed to make me eat and eat and eat.

I admire you so much, wish you blogged more, gotta go check out this Facebook I suppose...
Joy/Housefairy

April 27, 2009 | Unregistered CommenterHousefairy

I wanted to thank you for writing this post. It really speaks out me, as I have just started writing about my experience with ppd, and I find it incredibly hard to be honest even with myself. I guess there is still such a lack of support out there even though acceptance has come a long way. Thanks again!

May 4, 2009 | Unregistered CommenterLMac

"What would your midwife have needed to say to get you to ask for help/tell her what was going on in your head? "

Anything. I've now been to 3 HCP's since the birth of my son (pp check up with the OB, IUD insertion with a CNM, and pp checkup with my rheumatologist) and not a single one has asked anything about my mood. And I feel weird bringing it up.

This leaves me wondering when do I _HAVE_ to bring it up. When I hit 21 on the Burns questionairre you linked to? Sooner? Later? How does one know when the attitude should be "this too shall pass" and when it should be "get thee to an apothecary?" (absent thoughts of suicide or harming baby, of course.)

-lpnmon

May 8, 2009 | Unregistered Commenterlpnmon

I'm sorry no one has asked you how you are feeling. I'm really sorry. Please call someone... the CNM is a good choice. Even if they haven't reached out to you, please reach out to them.

(And you write beautifully!)

Please let me know when you get help. I will be thinking of you.

May 8, 2009 | Registered CommenterNavelgazing Midwife

I took your advice and finally brought it up to the CNM (at the IUD recheck). Am now 2 weeks into Zoloft. And feel.....better. Not obviously, dancing in the streets better, but subtly, imperceptibly, better. A bit more me. Thanks. :)

-lpnmon

June 12, 2009 | Unregistered Commenterlpnmon

Reading both your post and the following comments has made me realize that what I experienced after the birth of my son five months ago was not just baby blues, but something much more like PPD, and even hovered around PPP for a few days. I had a natural birth with a midwife, breastfeeding was great, but I never felt the "birth high" people describe. When he came out after three hours of pushing my first thought was "oh thank god this is over", but it wasn't. I had a very hard time with the concept of being pregnant and a mother, and it never seemed real to me. I avoided purchasing any baby items, naming the baby, or acknowledging my growing belly as a baby. I was sure he would never be born alive, I would never have a baby. I don't know why. (This was a well planned pregnancy)
Within the first few days I began to view it as a punishment for something I had done before. "good job stupid, here's the baby you wanted, you made your bed so lie in it for the rest of your life" was my attitude. He was not a particularly colicky or fussy baby, although I was sure he had reflux/colic/high needs. The second day home I bought a pack of cigarettes and smoked them all in 10 hours. Baby preferred my husband (or so I thought), so I just hung out outdoors in the cold, chain smoking, and coming in to feed the baby. I would make up projects and errands I had to run to get away from them. Nights were the worst. I would be kind of ok during the day, then as it got dark I would begin to have a feeling of dread. I remember rocking in the chair with baby and just sobbing. I don't think I was getting more than 2 or 3 hours of sleep a day, and baby wanted to nurse constantly. Around 6 weeks I started to hallucinate and have horrible, violent thoughts. Thoughts of cutting up and dismembering the baby, of smothering him, and I would feel so GUILTY and like such a monster for thinking this. I loved him so much! While nursing I would look down and he was EVIL! He had a mouth full of teeth, like an adult, and he rolled his eyes and chuckled at me. Pulled him off the breast and screamed for my husband, and told him I was sorry, that I had to sleep, that I thought I was losing my mind. After that we set up a system of DH staying up and wearing the baby from 8 to midnight, and I would sleep. Slowly the problems started fading, and today I feel great and am deeply in love with my husband, my son, and my life. So maybe it was just lack of sleep. But it scared me, and another episode like that I would have checked myself into the hospital.
At my 6 week PP appointment my midwife seemed to feel something was up. I gained 71 lbs in my pregnancy and at 6 weeks had lost 64, so I was not eating. It's a miracle I didn't lose my milk. She asked me "Erin, how do you FEEL?" and I said ok, tired, but I'll get over it. I mean, how the hell do you admit that to somebody?

These are only the things I remember, most of the first 8 weeks and the birth are very fuzzy to me, like a movie I watched a long time ago and can't recall any details of. We plan on another baby, and I'm torn on whether or not to share this with midwife/hubby. I fear their judgement, and don't want to scare my husband, but I think someone might need to watch me a little more closely next time.

April 30, 2010 | Unregistered Commentererin

I just began reading your blog, and I am in love with it! Thank you for posting this, and many of your other entries really speak to me. I'd like to share my PPD story.

When I found out I was pregnant I was 15. I was young and scared. I didn't tell anyone until I was 7 months pregnant- I received no prenatal care of any kind until that point. The doctors were surprised at how healthy my baby and I were- no preeclampsia, diabetes, or Rh problems. The only problem they saw was that I had chlamydia- thanks to the father of my son cheating on me. I continued my prenatal care until the birth of my son.

I was treated alright at the hospital- thankfully an intern was my attending OB and my nurse was very compassionate. My mother was by my side the entire time. The day my son was born I immediately fell into a depression. I wrote in my journal that day, at the hospital "He's absolutely beautiful. Maybe someone else would want him. He's healthy. Maybe they'd take better care of him then I will."

Things only got worse when I got home. I tried to breastfeed, I wanted to so badly. I had no help. No lactation consultant, no la leche league, not even my own mother could help me. After 2 weeks I gave up- feeling even more inadequate. I was in a sleepless fog most of the time. When I was awake I was crying, when I was asleep I wished I wouldn't wake up.

On occasion when my son would fall asleep I'd stand over his crib with a pillow in my hand, thinking how easy it would be... once I even sat the pillow on his face. Immediately I grabbed it back and threw it against the wall. How could I think such terrible things?

Looking back I know I had severe PPD, and should have received some sort of medical care. I don't feel that I ever bonded with my son the way I should have, he's 4 now and a wonderful active child. I love him more than words can describe, but I feel like it's different than with other mothers- I still feel slightly detached from him.

I am pregnant now with my second, very much wanted, child. I've already begun looking for a psychiatrist just in case I have PPD again. I plan on having more help than I did before. I have a wonderful midwife and plan on delivering at a birth center.

Thank you for sharing your story, as well as all the other women who have.

January 29, 2011 | Unregistered CommenterDeja

I've had a particularly low day today, just feeling guilty that I feel no bond with my baby, that I feel so physically ill (with a stomach dysmotility) constantly and all I can focus on is my upper abdoment where the bloating and discomfort is as opposed to stroking my baby belly and concentrating on him or her.
My first pregnancy with my daughter was perfect, I never felt so healthy or happy in all my life yet with this pregnancy I have never felt so physiclly ill and so unhappy.
I'm having increasingly negative thoughts about the rest of the pregnancy and the birth itself, I'm finding it's getting more and more difficult to control these negative thoughts from becoming more disturbing for me. Those close to me (my husband and Mum) who know about my pre natal depression try to say the right thing to support me but I find myself putting on a brave face for them so that they don't worry so much about me.
I've felt like this for the past 20 weeks or so of pregnancy and I'm struggling today to see how I'll cope for the remainding half of the pregnancy. I just want to be happy

May 16, 2012 | Unregistered Commenterglenna Jean Keller

glenna, oh hon... I know what you're feeling, though mine was more afterwards. I have been with women who felt the way you do, though and know they needed help. Hon, you have got to get help. Right now. Please, please know that the sadness and depression isn't going to go away by itself at this point. Getting some help can transform the pregnancy and most certainly, the postpartum period.

If you have insurance, you can call your primary care, but your OB can offer recommendations, too. If you have Medicaid, there are emergency Psych places that are able to take you immediately. You do not necessarily need to be hospitalized, but I would say that unless you get help soon, you might be headed that way. Being in the hospital isn't the worst thing... can certainly help get you on medications fast and furious to get you feeling better faster... but since you have another child, I would suspect staying out might be a better option for you.

UNLESS the idea of being in the hospital sounds like a relief, a time where you are completely taken care of for a few days or so. If it feels like you would be safer and need the mental break, don't hesitate to go into the hospital. They are wonderful when you need them.

Sweet girl, please promise me you won't hurt yourself. I feel you reaching out, looking for help and perhaps not knowing where to get it. It seems you are Googling "prenatal depression" and looking for answers. The answers aren't online, but are in real life help, including medications.

And I know that medications while pregnant is completely counterintuitive and can be terrifying, but they are there for exactly this reason... to save a life... yours and your baby's. You might only need to take something during the rest of your pregnancy and the first few months postartum, so it might not be forever, but if you're able to stay in the moment and not look so far in the future, that might be helpful in considering medications.

Feel free to email me. NavelgazingMidwife@gmail.com. I am not a therapist, but have had more than my share of therapy and can help guide you to resources in your area.

My heart goes out to you. Please continue this reaching out by reaching out in real life to someone who can help. If you can't call your doctor, at least call a helpline/warmline (Google "emergency helpline <your area code>) and get some ideas of what to do from here.

I know it seems exhausting, reaching out for help. But take some of my energy and love and stretch to get the help you need. You can do it; I believe in you.

Please let me know what you do and how you're doing. I will send you much love and healing light.

May 16, 2012 | Registered CommenterNavelgazing Midwife

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