My Postpartum Depression Adventure: Part One
My four week old lay playing on his blanket, pumping his arms and legs as he watched the mobile I made. It twirled in the gentle breeze blowing in from the open windows while I sat next to him on a floor pillow, talking to my mom.
“I just don’t think I feel right”, I said.
The second child is different, they said. Maybe it was just because I was balancing taking care of toddler and baby, they said. Maybe it was just the baby blues, they said. You’re just tired, they said. It will pass, just give it time, they said. Once your hormones settle down you’ll feel better, they said.
There it is: the ubiquitous “they”. “They” was everyone and no one at the same time. It was a “they” that was a supposed knower of things. This anonymous source, a catchall for advice, made family and friends feel like they were saying something helpful, something proven, something known. Well-meaning, I’m sure, these offerings of advice intended to make me feel better (or to make the person saying it feel better), but it did the opposite. All I wanted was some validation that I wasn’t any crazier than I was already feeling, for someone to acknowledge my suspicions instead of diminishing and dismissing them. It was incredibly disorienting to experience and I am not sure that even now I can accurately describe how it felt to feel something was not quite right and have it justified into oblivion by those around me.
As I had rounded the corner on postpartum week three, a subtle nagging feeling persisted. My intuition continued to nudge me. I was curious: did I have postpartum depression? Late night google searches led me to postpartum depression screening quizzes and blog posts and articles about extremes. No, I didn’t want to kill myself or harm my kids. Yes, I was still showering and brushing my teeth and eating. So, where did that leave me?
The symptoms of my postpartum depression were more insidious than I expected which made it harder for me and those around me to realize it, to accept it. I felt detached. Empty. Disconnected. Apathetic. Quick to anger. Irritability would roar up unexpectedly, so swiftly that it would take even me by surprise. I would retreat to cry; confused and bewildered and sure that I was just a terrible mother. A terrible wife. A terrible person. I didn’t want to harm myself. I didn’t want to harm my children. I was still diligent with toddler and baby: changing diapers and clothes and breastfeeding on demand and rocking to sleep and holding baby for hours when he didn’t want to be put down and doing bath time and story time and singing songs. But I felt like I was babysitting someone else’s kids. An empty robotic shell of a mother. Like a Stepford Mom: smiling and functional on the outside and dead on the inside.
There is a pervasive reference to “baby blues” in postpartum land. I argue that this term may do a disservice to women postpartum; that it opens the door to normalizing depressive symptoms and delaying recognition and treatment for women who are suffering. Suffering. For weeks. For months. I remember coming across this chart from Running in Triangles during a late-night Pinterest surfing session:
This is what helped me to start to see that what I was feeling was not normal.
Normal is a tricky word. I paused as I wrote it just now. Postpartum depression is not a normal physiological state. But it is common; so, so, so common. One in seven women, and one in ten men, have postpartum depression. And those are just the ones who manage to recognize their symptoms, and then share that with their provider, and who are then properly diagnosed. So, that number might be even higher. Like, way higher. I have been completely surprised by the number of women that I when I casually mention that I have postpartum depression, say:
“Oh, yeah, I did (or do), too. I remember…” and then proceed to tell me their story.
These stories fall on a spectrum as varied as the rainbow; anxiety to apathy, sadness to anger, eating too much, not eating enough. Insomnia. Crying all the time. Afraid to leave the house. Feeling trapped in the house, suffocated by a vague overwhelming pressure. And those are just the stories they shared in passing, in brief conversations. Some got by with great social support, others needed medication, or counseling. Or both. All of these women - all educated, most in the healthcare field in some way - had one thing in common: it took them weeks, sometimes months, before they realized that something was not right. Before they realized that this was not normal. Before they got up the courage, the strength, the will to seek out the support and treatment they needed. And they suffered, needlessly, because we are not talking about this the way we should be.
Five weeks postpartum, I headed out to the requisite one (yes, one!) postpartum visit – I’m looking at you with jealous eyes, Switzerland! – baby screaming all the way as I cranked the air conditioning to stave off the 104 degree heat beating down. I will pause here to mention, because I just can’t get over it on many levels, that my beautiful friend who lives in beautiful Switzerland with her beautiful husband and beautiful new baby gets sixteen (sixteen!) weekly postpartum visits. By a midwife. Of her choosing. To her house. TO. HER. HOUSE. For free. And I’m over here, sweating – and not so much because it was 104 degrees, but because I had (and still have) hormonal postpartum sweats that rivaled the combined perspiration of a thousand Ancient Roman foot soldiers – as I hauled a crying baby in and out of a car, up the stairs, to frantically try breastfeeding to calm baby while waiting in a waiting room to see the wonderful midwife of my choosing.
As I waited in the exam room, I looked down at the generic depression questionnaire the medical assistant had given me; holding the clipboard in one hand and my beautiful breastfeeding five week old in the other and, blinking through the tears that welled up in my eyes, I filled out the PHQ –9. It asked: Over the past two weeks, how often have you been bothered by any of the following problems? and I was to answer by assigning a frequency. As an old friend and I recently joked, not only was this questionnaire cold and disingenuous but the questions were definitely not postpartum friendly. One could almost muster a laugh. Feeling tired or having little energy? Uh, yeah. I have a 5 week old who cluster feeds all night. Poor appetite or overeating? Well, I am breastfeeding so I am basically Chris Farley’s SNL Gap Girls character in the fries sketch. Trouble concentrating on things? Yep. Mom brain is so real I’d lobby for it to have its own ICD-10 code. This is part of what makes it so hard to suss out what is normal postpartum because it is normal to be tired, to be emotional as your hormones surge and plummet, to feel urgently hungry while breastfeeding. When I finally finished the form, I was so overwhelmed and exhausted from the effort and stress to get there, nervous to broach the subject, and anxious of how what I had been feeling would be received that I just wanted to crawl in a hole.
Choosing a provider you trust is so important. In hindsight, my anxiety about this discussion was unfounded because the midwife I chose to see I knew to be kind and professional and good at her job. I tried to keep my brave face on, even for her in the privacy of the exam room, but it didn’t last long. Tears that had welled up broke free and rolled down my cheeks as I recounted the feelings of apathy, the irritability, the disconnection. She told me that too few women get the help they need; that she was proud of me for recognizing the symptoms, for speaking up, for asking for help. We discussed my social support, counselling options, medication. She thoughtfully and respectfully discussed my hesitation to take medication; I was (and still am) breastfeeding and concerned about what impact it might have on baby. Zoloft is one of the most, if not the most, well studied medication for postpartum depression in breastfeeding women. Assuaging my fears, Zoloft well surpasses the 10% threshold with only 2.5 to 5% of the medication reaching the breast milk. In the end, I left with a sense of relief, of validation, and a prescription for Zoloft. My intuition had been right – something wasn’t right. But it wasn’t my fault.
If you, or someone you know, is suffering from postpartum depression or other mental illness, please reach out for help.
CHECK BACK NEXT WEEK FOR PART TWO