Tag Archives: anxiety

Every little thing

I am beyond thrilled to introduce to you the very first regular contributor to My Postpartum Voice. Miranda and I met via Twitter and #PPDChat. She blogs regularly over at Not Super Just Mom in addition to hanging out on Twitter, teaching, being a Mom and a wife. I hope y’all will enjoy reading Miranda’s voice as much as I have. Welcome aboard, Miranda!

I spent the first year of my diagnosis alone and hurting, partly because I was too stubborn to reach out and partly because I didn’t know there were so many people to whom I could reach out. My only two sources of support were my mom and my husband, and neither had much experience in dealing with postpartum. (By “much experience” I mean “none experience.”)

And then I found Twitter. And Twitter brought me people like Lauren. And Lauren has given me the opportunity to help her help you.

Wow.

So here I am, nearly two years out. And the cool thing about this is that PPD/A isn’t a war I’ve lost. If anything, I’d say I’ve pretty well conquered my main demon—anxiety. I have WAY more good days than bad lately. I find myself rolling through toddler tantrums like a seasoned professional, despite the fact that he’s not two yet and the fun hasn’t really even begun (or so I hear).

But the relative goodness of my life right now doesn’t mean that I’m scott-free and that I never have to worry about anxiety. There are setbacks. I still fight battles. And those battles still frustrate me. And if I’m not careful, that frustration leads to nastiness and anger and guilt and ::insert your negative emotions here::.

As I write this, we’re on our first full day of a long-weekend getaway with friends. No internet. No cell phones. No noise. It’s quiet here. Peaceful. Relaxing. Or at least it should be.

We are WAY outside our normal routine, y’all. Way.

And that’s when things get hairy for me.

Joshua fought me on his nap yesterday. We spent the morning traveling, practically throwing Joshua in the car the minute he woke up. We arrived and he explored our cabin and then it was time for a nap. Dan and his friend were gone to the grocery store to get supplies. My friend was upstairs tending to her toddler. And Joshua and I were downstairs in our bedroom with me quickly spiraling into a case of Mama Fail because he wouldn’t settle down and take a nap, despite the fact that we both knew he needed to sleep.

He cried. I put a pillow over my head. He cried harder. I felt my throat clench up. I got up and patted his butt in the pack-n-play. He settled. My throat unclenched. I turned to go back to the bed. He cried again. My spine stiffened and my mind started racing. SLEEP SLEEP SLEEP! Wash. Rinse. Repeat. For nearly 45 minutes. And there was no one here to help me through it. There was just me and Joshua, figuring this out like we’ve done time and time again.

I can’t stand to let Joshua cry. It’s one of my triggers. Colic and reflux made sure that he spent the early months of his life screaming his little baby lungs out. And the early months of his life were, by far, my worst. When he screams, I go into fight or flight mode just like I did two years ago. I get irrational. And cranky. And angry. And hurt.

Why can’t I fix this!? What is wrong with me!? Why does he hate me!? WHY ME??

Do you see what’s wrong with those questions?

The questions are completely irrational, folks.

I can’t fix anything about this situation unless I never leave my house again or never break our usual, customary routine.

Nothing is wrong with me. I am not broken.

My son does NOT hate me. He’s too little to even know what hate is. And if I have it my way, he won’t know what hate is. It’s certainly not something I plan to teach him.

There is nothing I’ve done or not done to deserve this. Nothing. This is punishment for any wrongdoing in this or any other life I may have lived.

It’s times like this that I have to remind myself that I am a mother. A mother with postpartum anxiety and depression, yes, but a mother. I am not postpartum depression and anxiety first and a mother second.

Yesterday afternoon, I got a sippy of milk and brought Joshua to bed with me. I got him settled down and he eventually flipped over onto his stomach, head on my shoulder, and I sang to him the song I always sing to him when he’s crying.

“Don’t worry…about a thing. ‘Cause every little thing, is gonna be alright.”

And it was.

We napped together, Mama and son, curled up on the same pillow, for two hours. And when we woke up and he smiled, my soul smiled back.

It is.

I know that I have what it takes to cope with setbacks in my progress. I know that setbacks are going to happen. I never expected to just wake up one morning and POOF! no more postpartum. That’s unrealistic. But I also know that everything? Is pretty alright most of the time. And “most of the time” gives me the strength I need for the times when things aren’t okay.

It will be.

This may have been the past two years of my life. This may be my now from time to time. But postpartum is not my forever. It’s not yours either.

Every little thing is going to be alright.

Miranda is a wife, mother, teacher, daughter, friend, and NOT a super mom. At best, and worst, she’s average. But with a cape and tiara? She could probably save the world. She blogs about life as a mom and wife and PPD/A survivor at the blog Not Super…Just Mom.

Postpartum Anxiety Delays Puberty in Offspring

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In another study with mice, researchers have discovered that a low level of Prolactin in early pregnancy translates to a delay in puberty. The results were revealed yesterday at The Endocrine Society’s 91st Annual Meeting in Washington, D.C.

The most interesting aspect of this research was the discovery that regardless of environment (ie, raised by an anxious mouse or non-anxious mouse), the offspring of the “anxious” mice still experienced a delay of puberty when raised by a controlled non-anxious mother.

Here’s a snippet of the press release:

Women have an increased rate of anxiety during pregnancy and for 2 years after giving birth, said the study’s lead author, Caroline Larsen, PhD, a postdoctoral fellow at the University of Otago in Dunedin, New Zealand.

“Postpartum anxiety disorders are poorly understood and difficult to treat,” Larsen said. “There is growing evidence that untreated anxiety disorder during pregnancy may contribute to premature birth and also can have major and lasting adverse effects on the infant’s development and behavior.”

Prolactin is a hormone that may protect against anxiety. Recently Larsen and her co-workers found that mice with induced low levels of prolactin in early pregnancy displayed substantial anxiety after they gave birth. Because the researchers also noted that daughters of the anxious mothers had delayed onset of puberty, they conducted the current study to learn what causes this late physical transition to sexual maturation.

Daughters of female mice made anxious by low prolactin were raised either by their birth mother or by a mouse who was not anxious (control mother). Another group consisted of daughters of nonanxious mice, and these mice were raised by either a control mother or an anxious mother. There were at least six mice in each of the four groups. The researchers determined onset of puberty by examining when the vagina opened and noting the time of first estrus (equivalent to the first menstrual cycle in humans).

“Remarkably, puberty was still delayed even if the daughters of anxious mothers were raised by nonanxious mice,” Larsen said. “And delayed puberty also occurred in daughters born to nonanxious mothers who were raised by anxious mothers.”

This result demonstrates that hormonal changes in early pregnancy, as well as changes in maternal behavior caused by these hormone changes, can alter brain development in the offspring and delay puberty, she explained. Larsen believes that their work, with further study, may translate to people.

“Finding the hormonal mechanisms that trigger the timing of puberty in mice may help identify potential targets for the prevention and treatment of delayed or early puberty in humans,” she said.

Late puberty in humans is linked to shortened height and psychological problems that can persist into adulthood.

Natalie Dombrowski radio interview on May 8th @ 9am Central

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"Speak up" by Aaron Michael Brown @ flickr

(I received an email from Natalie this morning informing me that her interview had been rescheduled to air tomorrow instead! Tune in!)

Natalie Dombrowski, author of Back to You, Founder of S.P.E.A.K., and fellow blogger, will be on-air with Chicago Public Radio this Thursday Friday at 9:00a Central time.

She’ll be sharing her experience with PPD, anxiety, and motherhood just in time for Mother’s Day.

“I know that the more we talk about our experience the more mothers out there seem to relate and feel the burden of isolation, guilt, and shame lessen.” says Natalie about her upcoming interview. AMEN to that!

If you’re in Chicago, you can listen live on WBEZ 91.5 FM. If not, you can listen online by going to the WBEZ website and clicking the “Listen Now” button at the top of the home page.

Thanks Natalie, for continuing to share your experience. With the comfort of your courageous voice, many mothers will no longer feel alone.

The Confusion of Ante-Partum Depression: To Medicate or Not?

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Finding yourself faced with depression during pregnancy is a confusing prospect indeed. How do you treat it? Do you tough it out and hope there is no effect on your pregnancy? Or do you risk medication and the potential effects that course may have on your baby as well? In addition, many care-givers are hesitant to medicate a pregnant mother for depression or even worse, are not familiar with ante-partum depression and negate the mother’s concerns over her mental health. If your caregiver brushes aside your concerns as normal pregnancy ups and downs yet you know in your gut it’s more, get a second opinion or ask for a referral to a therapist at the very least.

A recent study by Dr. Katherine Wisner, M.D., M.S., found that continuous exposure to either SSRI or Depression during pregnancy results in pre-term delivery rates in excess of twenty percent while mothers with no exposure to either depression or SSRI over the course of their pregnancy experienced rates of pre-term delivery at six percent or lower. The study looked at 238 women with no, partial, or continuous exposure to either SSRI treatment or depression and compared infant outcomes. They found that exposure to SSRI’s did not increase birth defects or affect infant birth weight but the importance of this study lies within the finding that the pre-term delivery rates were the same with depression exclusive of SSRI treatment, leading the researchers to state that it is “possible that underlying depressive disorder is a factor in preterm birth among women taking SSRIs.” You can read more about this study by clicking here.

“This study adds evidence that depression in pregnancy can negatively affect birth outcome. Although women treated with SSRI’s throughout the pregnancy may experience pre-term birth, the factor causing the problem may in fact be the depression and not the SSRI. More research is needed to tease out what is causing the changes in the uterine environment. As research comes forth, what continues to be clear is that treatment for depression in pregnancy is important. ‘Treatment’ doesn’t necessarily mean medication, but for everyone’s sake the pregnant woman needs to receive a plan for wellness.” Dr. Shoshana Bennett shares when asked about her take on Dr. Wisner’s research.

You may recall a recent study posted also regarding birth weight of infants. The study concluded that Prenatal Depression restricted the fetal growth rate. This study concluded that depressed women had a 13% rate of pre-term delivery as well as a 15% greater incidence of lower birth weight. This study’s results examined cortisol levels to determine risk of pre-term delivery and birth weight prediction, which leads us to another study examining the reliability of cortisol to predict short gestation and low birth weights. The study concluded cortisol levels were indeed a reliable manner in which to predict both.

So what’s a pregnant depressed mama to do?

Throw her hands up in the air?

Scream?

Cry?

Tough it out?

None of the above – she should work in partnership with her doctors to weigh the risks. There are other treatments available for depression and anxiety during pregnancy besides SSRI’s. Therapy is always an option. (Yes, more studies to be quoted ahead) A study examining the effectiveness of a Mindfulness based intervention for pregnant mothers found women receiving the intervention experienced less stress and anxiety during their third trimester and postpartum period. There was no data collected regarding pre-term delivery or birth weight in relation to this particular study.

There’s also a wonderful article at wellpostpartum.com that discusses how cortisol impacts mothers. Included in this article are some terrific (and natural) suggestions on how to keep cortisol at bay.

Alrighty now. You’ve shared your precious studies with us. What about some real life advice? What did YOU do when faced with the Hamlet conundrum of medicating during pregnancy?

I read.

Voraciously.

The two biggest sources of help for me were Karen Kleiman’s What Am I Thinking? Having a Baby After Postpartum Depression and Kornstein/Clayton’s Women’s Mental Health. Karen’s book allowed me to realize my emotions were right on target for a woman facing pregnancy (expected or not) after surviving a PMD episode while Women’s Mental Health laid out the risk factors in a no-nonsense manner. I was convinced to stay on medication after I read my risk for relapse went up by 50% if I discontinued my medication during pregnancy. With my risk factor already 50% higher than women having never experienced a PMD, there was no way I was giving myself a 100% risk of traveling down that road.

I stayed on my medication. I stayed in therapy. I talked to my family and developed a postpartum action plan, spending more time on preparing for my possible fall than for my son’s arrival. And you know what, it paid off big time. I did not experience a PMD the third time around, even though (yes, more studies) having a boy may put you at a higher risk for developing a PMD and the risk for experiencing a PMD after two episodes is almost 100%. I beat the odds and don’t think a day doesn’t go by that I don’t give thanks to God for carrying me through.

I always encourage women I come in contact with to weigh their options with their caregivers. To educate themselves and make the best decision possible with the information at hand. Your doctor is on your team and should be willing to listen to your plan and at least consider your requests. If he/she does not respect your wishes, it may be time to find another physician for care during the prenatal period.

I would also encourage you to get a couple of books, the first being Dr. Shosh’s Pregnant on Prozac, in which she examines the relationship of psychiatric medications to pregnancy. It’s a must have resource for mothers facing the decision of psychiatric medication for an existing condition or a newly diagnosed condition. Also pick up a copy of Karen Kleiman’s Therapy & The Postpartum Woman. While this book is ultimately aimed at clinicians and the postpartum woman, pregnant women facing a mood disorder would glean quite a bit from this book as well and may consider gifting it to their caregiver as well, a paying it forward action if you will.

And if you’re interested in complementary or alternative treatment methods that don’t include SSRI’s, a great place to start researching is over at Well Postpartum. Run by Cheryl Jazzar, this blog has just about everything you could ever want to know about alternative care during the Perinatal Period.

The final thought on all of this? Do your homework. Don’t be afraid to ask questions or stand up for yourself (and your child). Above all, make the decision and agree not to second guess yourself or blame any outcome on yourself. As long as you make the best decision with the best information at your fingertips at the time, there is no blame. (And hey, the fact that you’re reading this article right now speaks pretty highly of your motivation to educate yourself!)

No matter how alone you may feel in that dark pit of depression during pregnancy or postpartum, you’re not. There are plenty of other women there with you and there are lots of us reaching our hands down to help you out. All you have to do is reach out and grab.

The Great Return

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Tomorrow we go to Atlanta with Charlotte for follow up with the Cleft Palate Clinic.

I would be lying if I said I was not nervous.

This appointment was supposed to have taken place when she was nine months old.

She’ll be three years old next month.

Charlotte in the NICU

It took me this long to get to the point where I could even think about facing the hospital where she spent her first 21 days of life without having an anxiety attack.

This is the same hospital in which I tucked myself into a corner of the sleep room in the NICU area, blasted Linkin Park over the MP3 player and checked out. No desire to come back. Just wanted to stay curled up under the blanket and pretend none of this was happening. Nope. Not to me. I didn’t have a baby in the NICU. She wasn’t downstairs having major jaw surgery at just nine days old. We weren’t doing this. I was stuck in the middle of a really bad dream and I’d wake up at home with a normal baby.

I can still see that hallway, that sleep room, my nostrils fill with the scent of the surgical soap that killed my hands as I washed them every time we went into the NICU, every time i pumped, every time I went to the restroom there.

I remember the pumping rooms in which I spent most of my time staring at the clock wishing I could nurse my daughter instead of shoving my breasts into hard cold flanges, flicking a switch on a massive antique pump, adjusting the suction to just below Holy Crap that Friggin Hurts.

But tomorrow is the day we finally go back.

Chris is going with me as a safety. I don’t know how I will handle this. I’m hoping for the best. Praying for the best. I keep thinking about how far we’ve come since then and how lucky we are that we don’t have a lot of the problems a lot of parents have with their Pierre Robin kids. She’s talking, using sentences nonetheless. She’s breathing on her own. She eats – oh lord, she eats – she’d eat herself sick (and has) if we let her. No oral aversions here.

But she does have a fistula – an opening in her palate repair. It’s at the back of the throat. And her enunciation is off – it’s nasal. She can’t say “s” without blowing air through her nose. Chris and I understand maybe 75 – 80% of what she says and it breaks our hearts that we can’t even understand our own child all the time. It’s led to frustration on both sides and is now turning into a discipline issue.

I’m afraid we’ll be told she needs surgery. I’m afraid of what that will mean for us and for her. I’ve talked with her about the possibility of surgery. She knows that they would give her some medicine to help her go to sleep and fix her mouth while she was asleep. That she might be owwwy when she wakes up and that they’d have medicine ready to help with the owwwy.

She seems cool with it.

I’m not.

I have forgotten how to let her go with the doctors – I got so good at it when she was in the NICU but she’s been all ours for almost three years now. I don’t want to hand her over to be taken to surgery. I want to go with her! That’s my baby you’re taking!

But now I’m thinking too much and need to stop and let God do all this worrying for me.

Please pray for us as we face tomorrow.

Pray for a peaceful heart and soul for me.

Pray for a pain-free and comfortable day for Chris as he goes with us.

Pray for a positive evaluation.

Pray that I am able to handle any news of surgery with strength and grace and truly give it to God.