Tag Archives: Postpartum Anxiety

This week’s Postpartum Voice: Miranda of Not Super Just Mom

Miranda of Not Super Just Mom, is sharing as this week’s Postpartum Voice. She’s been hosting guest bloggers on the topic of  PPD/PPA over at her place this week as part of Mental Health Month and the D-Listed Blog Hop. Miranda and I met via #PPDChat at Twitter (I’ve been meeting SO many new moms there lately!) and I’ve really enjoyed getting to know her.

Miranda’s story starts out with disappointment after delivery didn’t quite go the way she had planned. I’ll let her tell her story in her voice now….

Ask anyone who knows me and they will tell you one thing. I am an over-achiever. I expect my best from myself in all things. I do not settle. I never have. Slowly, however, I’m learning to accept that sometimes my “best” has to be “good enough.”

I began battling depression in late high school. I fought with anxiety and depression off and on for years.  Once I got to college, I had pressure to keep my scholarships, to not disappoint my parents, to make sure I paid my mortgage and car payments and insurance and utility bills on time. To maintain a social life and find the person with whom I was going to spend the rest of my life.

I finally got help during my junior year of college when I broke down and realized I couldn’t continue to live the way I’d been living. What I was facing was something bigger than me. The clinicians and psychiatrist who helped me were amazing and I owe them a debt of gratitude for teaching me how to “deal.” While I was in treatment, I met a wonderful guy, got married, and set out to suburbia. Eventually, we decided to expand our family.

I knew I was meant to be a mother.  I knew that I would be good at this.  It was my destiny.  How could I not be a natural?

So imagine my shock when, two days after having my beautiful plans of a natural, vaginal, med-free delivery shot down due to “failure to progress,” I found myself crying into my meatloaf.  Apparently, someone having an “inappropriate response to meatloaf” has become code-language in my doctor’s office for “watch out for this one.  She’s on the fast-track to medication.” Or something like that.  But see, that wasn’t normal.  And I didn’t know it.

And when I wrote that post, the anger over my C-section was definitely present.  I was angry.  I am angry.  Even now, 14 months later.

And that’s how my PPD/PPA started.  With anger.  And bitterness.  And resentment.

And then the anger and bitterness and resentment turned into sadness over how things didn’t go the way I planned.

And then I heard the words “you’ll have to supplement” at my son’s first newborn visit after being discharged and that’s where the no-no “F” word started creeping in.

FAILURE.

I had only been a mom for five days and already I was a failure.  I’d failed to get him here the way I’d envisioned.  I’d failed to keep him from losing 10% of his birth weight because my stress and anxiety over the surgery (and the pain! Sweet baby Jesus in a manger the pain) kept my milk from coming in.

And I just KNEW that supplementing would be doom for breastfeeding for us.

And then I’d be failing at yet ANOTHER thing and I was BARELY EVEN A MOTHER YET AND HOW CAN I ALREADY BE SO BAD AT THIS?!?!?

When my one-week postpartum check-up came around, Peggy-the-PA and Dan and I discussed my “inappropriate response to meatloaf” in the hospital while Joshua, ever the little stinker he is, slept peacefully in his carseat.  A carseat that he HATED for the first four months of his life (which effectively trapped me in the house because the sound of him screaming would send me into what I now think were mild panic attacks…WHILE DRIVING).

While we were at that visit, Peggy wrote me a prescription for an anti-depressant.  She thought it’d be a good idea for me to go ahead and start taking them.

But I didn’t.  Because I wanted to believe that I was stronger than that.  I wanted to believe that this was just the “Baby Blues” and that they’d go away and I’d realize that I was a natural at this.  That I was a PERFECT mother.

But I wasn’t.  I’m still not.  And the “Baby Blues” didn’t just evaporate.

It didn’t help that a mere seven days after giving birth, I was flying solo with this tiny bundle of lungs and poop.  I couldn’t drive because it still hurt to sneeze, so I still needed to take pain medication. But I couldn’t take pain medication and be home all day with the baby because what if he needed me and the medication made me drowsy and I was sent a baby who wouldn’t sleep so there was no “sleep when baby is sleeping” in this house for at least three weeks.

I resented my husband.  I resented the fact that he got to leave every day and go to work.  He got to get out.  He got to see people.  If I tried to leave, even to go to Target, I’d have the baby screaming his tiny baby lungs out the whole way there.  The whole time we walked around the store.  The whole time we drove home.  It just wasn’t worth it.  So I didn’t leave.  And when Dan left for work, I’d cry.

And because I was so mired up in my own grief, I didn’t feel connected to my son.  I’d read blogs written by women who would gush and gush about how when they saw their baby it was love at first sight and they knew instinctively what to do and what their baby needed and part of me screamed “THAT IS BULLSHIT” and then part of me cried.

Because that’s what I wanted.  I wanted that instant bond.  That connection.  That look from my baby that said “You are my mommy and I know this because I have heard your heart for 40 weeks and 5 days and it is the greatest sound in the world and I love you, Mommy.  And I promise to sleep all night long and save all the poop-splosions for Daddy.”

And I didn’t get that.  Even close to a year out, I still didn’t feel that.  Even now, there are times where I look at my son and go “WHAT PLANET ARE YOU FROM!?!?” because he and I just don’t seem to understand each other very well.

The times that I felt most at peace were the times when my mother came down to spend the day with me.  She’d get here early in the morning and do a load of laundry or dishes or sweep my floor.  And then?  Then she’d hold Joshua while I napped in the bed.  It was glorious.  But it was brief.  My reprieves from the resentment were short-lived.  I knew she’d leave soon, so when it would be time for her to leave, I’d get all anxious in the pit of my stomach and I’d feel the lump forming in my throat.  And then she’d walk out the door and I’d be choking back tears and trying to hold it together.

And in the midst of all of this, Joshua was diagnosed with reflux and a milk protein allergy.  Which meant mixing up little packets of Zegerid twice a day and me cutting out all yummy dairy goodness for as long as I planned to breastfeed.  Me and Oreos became BFFs because they are totally, completely dairy free.  And some days, I’d eat Oreos.  All day long.  That’s almost all I’d have to eat.  Maybe I’d sneak in a graham cracker and some peanut butter.  But I didn’t have much of an appetite, despite the fact that I was a dairy-free dairy cow.

(I think the fact that we finally got breastfeeding worked out is the only thing that helped me keep it together.  It’s the only thing I knew I didn’t totally suck at, even though it had its own set of drawbacks…like growth spurts, and nursing every hour, on the hour, all.night.long. AND GIVING UP CHEESE AND COFFEE CREAMER.)

At my six week postpartum visit, I finally admitted to Peggy, and my husband, and my mom, and myself, that I needed to fill the prescription she’d written me six weeks earlier.  I knew that this was not something I could do alone.  So, I drove to the pharmacy, filled the prescription, and started taking them that night.

And I didn’t feel instantly better.  I still have days where I don’t feel better.  I have days where I just want to cry.  Or where it physically hurts to move my body because I’m just so weighed down with my thoughts.  And there are times when Joshua screams (um..hello…he’s a Tiny Terrorist.  That’s pretty much all he does is scream) and I feel my heart start to beat faster and I kind of lose my train of thought and I become robotic.  GET.DIAPER.ON.NOW.PICK.UP.BABY.NOW. And I just sort of “do” it.

One of the things I’ve come to realize through my battle with PPD/PPA is that I have to take every day as it comes.  I’ve also had to abandon the quest for “perfection.”  Nothing is perfect.  Especially not me.  Which is the purpose behind this blog.  I’m not perfect.  I’m never going to BE perfect.

I’ll have perfect moments, and moments where I go “Hey, I don’t suck at this!” but I’m not going to have those moments all the time.  The “perfect” world of mommyhood that I envisioned for myself prior to actually being a mom doesn’t exist.

And slowly…slowly, I’m becoming more and more okay with the lack of perfection in my life.  And I’m finding something kind of perfect in the imperfection.  I’m finding me.

Miranda can be found at Not Super…Just Mom. She’d like everyone to know that she is not, in fact, a Supermom. But with a cape and a tiara she could probably save the world.

Sharing the Journey with Amber Koter-Puline

I had the pleasure of meeting Amber during an initial meeting for the formation of Georgia Postpartum Support Network. Amber is a mom, a working professional, a blogger and a dedicated Postpartum Peer support volunteer who facilitates two groups in Atlanta. She also serves as GPSN’s Secretary. Thank you Amber, for being a brave and courageous woman in adding your voice to the ever-growing group of advocates for PPD Support!
koter-10Tell us about yourself. Who is Amber when she’s not being a mom?

I am a friend, a wife, a sister, a daughter, and also a career-oriented woman.  I enjoy my work in service as Director of Intergenerational Ministries at my church.  I also provide one-on-one and group volunteer peer support to women with Postpartum mood disorders.  I do this through email, meeting moms in person, the telephone, and also a support group in Midtown Atlanta that I facilitate twice a month.  I also host a playgroup and mom’s discussion group at the church, each once a month.  I serve as Secretary of GPSN and I hope that this role will allow me to help bring awareness and education to Georgians and all Americans someday.

Share with us how your Postpartum Experience unfolded. Did you feel prepared for childbirth and the postpartum period prior to giving birth?

I was commited to a natural birth, but after 36 hours of labor I had to get an epidural and then after ten more hours I had an emergency c-section.  My birth was completely different than I had planned or hoped for, and I was devastated.  I began my postpartum experience filled with regret, shame, and completely sleep-deprived in addition to being physically unwell.  I utilized the Hynobirthing method in preparation for and during labor.  I did feel completely prepared for a natural, vaginal birth.  Unfortunately, in my desire to be commited to natural methods I didn’t even consider the possibility of it not unfolding the way I wanted.  This left me disappointed and shocked.

What prompted you to seek help – what wasn’t going well and what helped you get on the road to recovery?

After 5 weeks of exclusively pumping breastmilk because my son would not latch on and not getting more than 2 hours sleep at night I felt completely a wreck.  I was scared, unhappy, exhausted, and I had so many unsettled feelings leftover from the birth.  On top of that, I was still recovering from major surgery.  My head was filled with obsessions and anxiety.  I knew that I needed help.  I was thankful that I had the business card of a psychiatrist my OB-GYN had given me early in my pregnancy (it was a surprise and I was not sure how I felt about it when I first learned I was pregnant).  What helped most was the medication.  After two weeks on anti-depressants I knew I was still very unwell and we added a couple of other meds to my regimen.  This helped SO much.  I really needed something to help me sleep and quell my anxiety.  Talking with my doctor who is an expert in this field made me feel normal and less alone.  The biggest thing I did to help myself was to admit to everyone how sick I was.  I told my parents and husband the truth about my obsessions, my depression, my lack of sleep, and how helpless and hopeless I felt.  Because of my truthfulness, they were able to be fully aware of my situation and to act appropriately to care for me and my son.  During the 4th week postpartum we had begun utilizing the nanny who had planned to be with my son once I returned to work.  After I was diagnosed and through my early weeks of treatment she continued helping several days a week.  Knowing my baby was well cared for was reassuring.  During the most difficult time (weeks 6-12 postpartum) my husband was my rock.  I am not sure how he was able to keep a positive outlook while living with someone who was so depressed, but he did.  Returning to work at 13 weeks postpartum was healing for me.  I found the me that had something to offer other than diaper changing and rocking.  Lastly, I have a best friend that was there for me in every way on an almost daily basis.  That support rounded out my treatment and allowed me to recover much faster. 

I know that you’ve had some Postpartum Thyroid issues. Share with us some of your experience and how your physicians uncovered the Thyroid factor.

It is still unclear as to the severity of the thyroid issue or whether it has had any role in my postpartum struggles.  I have had fairly moderate gastic pain and also sleep difficulties and fatigue since I first gave birth.  In my efforts to explore what was wrong physically and emotionally in the 2nd month postpartum we learned that my thyroid was functioning in the hyper spectrum, if only slightly.  One year later, the results are the same.  I will be having a thyroid scan on Monday to determine how my thyroid is functioning on the whole.  I do know for sure that thyroid issues can have an extreme impact postpartum, though, and recommend that thyroid tests be done on anyone experiencing a PPMD.

At what point in your recovery did you feel the desire to turn your journey into support for other mothers? How empowering has the experience been for you?

I knew from the moment that I began coming out of the darkness (around 11 or 12 weeks postpartum, after 6 or so weeks on medication and with therapy) that I felt called to serve other women and to educate all people about PPMDs.  In my darkest hours I never felt alone and always knew that God would make good out of a truly horrific experience.  He has opened so many doors for me.  I am still amazed at how women find me…it feels very spiritual at times.  Being able to help others makes me feel purpose in my pain.  It allows me to relate to others and provide true empathy.  It is a precious gift.  As I often share; it took me 31 years to find my calling and spiritual gift.  I never was good at sports or music, and though I did well academically, I believe that this work is my true passion and area of giftedness.

Share three things that made you laugh or smile today.

My son trying to “swiffer” my hardwood floors at 16 months old.
Realizing that I endured 36 hours of labor naturally…and that really, I shouldn’t feel guilty or embarrassed…that’s not a bad track record!  (It only took me 16 months to get to this point!)
The thought of sitting on the beach reading a book in complete peace and quiet.

What has been the most challenging aspect of parenting so far? The least challenging?

For me the loss of identity initially was devastating.  I had a very difficult transition into motherhood that I believe they now call Postpartum Adjustment Disorder.  I simply could not accept that my life entailed changing diapers and trying to entertain a completely helpless being.  Finding a way to find myself again and then balance the “new normal” with fulfilling my own personal needs was a challenge.  I believe that it is only in the past 3 months that I have found my way again.  I typed the sentence, “the least challenging for me…” three times before I finally erased it and decided to share that I don’t think there are any aspects of being a good parent that are easy.  That’s the deal…you reap what you sow.  I know that each time I face a choice when it comes to my son that the “harder” option in the short term will be the better one for the long term.  That which takes effort is rewarding.

As you recovered from Postpartum, how much of a part did your faith play?

As you can tell from my previous answers, my faith was everything to me.  I am not a fundamentalist and I don’t feel like an extremely “religious” person, but I do believe that God can be seen so many times in my day, each day.  His hand touches my life with great blessing.  I am not rich, powerful, or even close to perfect, but overall I have a good life.  There was a time that I didn’t, so I think I appreciate my life now even more.  I believe that being in conversation with God through prayer during the difficult childhood I endured and the horrible PPMDs I overcame made the difference in who and how I am on the other side of all that.  Faith defines who I am.

Tell us about your blog. What should readers take away from your writing there?

My blog began as a way to talk about what I was doing with the mom’s groups and what I hoped mothers would get out of those groups.  I also wanted to document my experiences in an organized way and once I read another blog I realized that was a free and easy way to do so.  That was almost a year ago.  Since then, I have developed it into a much more comprehensive site.  I post news and research, personal stories, support group info and more at www.atlantappdmom.blogspot.com.  Had I realized that I would be writing in the long term there and that the readership would grow, I would have chosen a different web address.  In order to have a more educational site with a name that will appeal to everyone I created a website, additionally.  www.postpartumhealing.com has specific information for those who are just discovering postpartum health topics.  I hope that readers of my blog will find honesty and integrity in what I share about being a mother.  I try to tell it like it is, even if I am only feeling that way for a short period of time.  I know a few things I have shared have made people cringe, but I never was good at hiding the truth.  Maybe there are women who LOVE every moment of it.  But, I think that most of us dislike a lot of aspects of being a mom.  It doesn’t mean we love our children any less, though.

And last but not least, if you had a chance to give one piece of advice about Postpartum Depression to an expectant mother, (new or experienced), what would it be and why would it be important for her to know?

My advice to everyone, postpartum or not, is to have and to offer REALISTIC expectations of motherhood, especially the first 3 months.  It is normal not to fall in love with your newborn.  It is ok to feel inept and scared.  It is not really easy or fun to care for such a little person when they can’t even provide a smile to thank you for your exhaustingly hard work to keep them alive and well.  Being a new mother is a journey with challenges that match each joy.

Thank you for inviting me to share my experience with your readers.

Mondays with Pec Part II

Today we finish up last week’s post with Pec by looking at signs and symptoms of various mental health conditions that can occur during the postpartum period. As always, discuss any concerns you may have with your caregiver.

How do I know if I have postpartum depression or anxiety?

Symptoms can vary from woman to woman. Here are some of the most common symptoms:

  • Sadness (sometimes comes in waves-women feel “up and down”)
  • Guilt (often women feel like they aren’t good moms, “maybe I just wasn’t cut out to be a mom”)
  • Irritable, less patient than normal (women often say they are snapping at their partners, or not enjoying their older child/children the way they did before)
  • Sleep problems (often hard to fall and/or stay asleep at night)
  • Appetite changes (may eat more or less than usual), often rapid weight loss
  • Lack of feelings toward baby (“I can bathe her and feed her, but I don’t really feel what I thought I’d feel towards her)
  • Worrying about every little thing (“it feels like my mind won’t shut off”)
  • Lack of fun or pleasure (I often hear things like, “I used to sing in the shower or with the car radio…. I’m not singing anymore”).
  • Overwhelm (“I just can’t cope”)
  • Lack of focus and concentration and difficulty making decisions

Postpartum Obsessive-Compulsive Disorder (OCD)

About 3-5% of new moms get postpartum Obsessive Compulsive Disorder. Women who have a history of OCD or a family history of OCD are at a higher risk. I find that in my practice women who describe themselves as “worriers” or “anal” (have a high need for order and things being “just right”) are at a higher risk.

The word obsessive refers to repetitive thoughts. Compulsions refer to the behaviors people do to avoid or minimize the anxiety produced by the obsessive thought. In the movie As Good As It Gets, Jack Nicholson portrayed a character with severe OCD.

Postpartum, some women get obsessive worry, often about things happening to the baby. Sometimes women get frightening thoughts or even mental pictures of something bad happening to the baby; often the pictures may be about the mom herself hurting the baby. These pictures can seem vivid and horrifying. Unlike women with psychosis, who are not in touch with reality, these women are painfully in touch with reality. These women know they do not want to hurt their babies, and we call these thoughts “ego alien”. Women with postpartum OCD are horrified, “how could I have these thoughts? I love my baby. I would never hurt her. I feel like a monster”.

These thoughts may just pop into her mind- we call them intrusive, and they are repetitive. Sometimes women have behaviors or compulsions that help them feel safer. These are may include things like hiding the kitchen knives or avoiding being alone with the baby.

Postpartum Panic Disorder

About 10% of new moms experience panic disorder. Some of these women have had panic before, sometimes even in pregnancy.

Symptoms of Postpartum Panic include episodes of extreme anxiety or worry, rapid heartbeat, tight chest or shortness of breath, choking feelings, dizziness, restlessness, and irritability. Panic attacks can happen without any specific triggers, even in the middle of the night. Women often feel a sense of doom or that they are going to die. They worry about when the next attack will happen.

Postpartum Posttraumatic Stress Disorder (PTSD)

Posttraumatic Stress Disorder can occur after birth. PTSD is seen in about 1-6% of women. Symptoms of PTSD include recurrent nightmares, extreme anxiety, reliving past traumas, avoidance of reminders of the trauma (for example, the hospital). Women with Postpartum PTSD often feel that they were abandoned, not well cared for, and stripped of their dignity during the birth. Another common feeling is that their voices were not heard and that there was poor communication during the labor and/or delivery. Some women with Postpartum PTSD state their trust was betrayed; they felt a sense of powerlessness and lack of protection by their caregivers.

Postpartum Bipolar Disorder

Bipolar disorder is often incorrectly diagnosed as depression. It is not uncommon for people with bipolar disorder to suffer over 10 years with an incorrect diagnosis, and therefore, inadequate treatment. Women taking medication for bipolar disorder are often told to stop medication before getting pregnant. Some, but not all, medications used for bipolar treatment can cause birth defects. Unfortunately, up to 80% of women who stop medication become ill during the pregnancy. Postpartum, bipolar disorder puts women at risk for a manic or psychotic episode. Women with bipolar disorder need to be working very closely with a psychiatrist trained in reproductive mental health.

Symptoms of postpartum bipolar episode can include

a decreased need for sleep and severe and rapid mood swings. Often there is a family history of bipolar disorder.

Postpartum Psychosis

Postpartum psychosis is considered a medical or psychiatric emergency. There is an increased risk of a woman hurting her self or her infant or children.

Symptoms of postpartum psychosis can include:

  • Difficulty relaxing
  • Incoherence
  • Decreased appetite
  • Paranoia and confusion
  • Hearing or seeing things others do not (hallucinations)
  • Inability to differentiate reality from hallucinations
  • Difficulty sleeping
  • Delusional thinking (lack of touch with reality)
  • Manic behavior (hyperactivity, impulsive behavior)

These symptoms come and go (she may be fine one minute, and acting strangely the next).

All of these postpartum mood disorders can be treated. If a mom is not well, the family is not well. We now know that untreated maternal illness can cause long term consequences for the infant, as well as other children in the home. Postpartum mood disorders also contribute to marital/relationship stress and discord.

Unfortunately, these postpartum mood disorders do not always go away by themselves without treatment.

You are not alone.

You are not to blame

You will be well again.

Seek treatment from someone trained specifically in postpartum depression and postpartum mood disorders. To learn how to screen a potential therapist, go to http://www.pecindman.com.

Important resources:

http://www.MedEdPPD.org (a very informative website)

http://www.postpartum.net Postpartum Support International 1.800.944.4PPD

Beyond the Blues, A Guide to Understanding and Treating Prenatal and Postpartum Depression (2006) by Bennett and Indman