My Experience with Postpartum Depression
photo by Amy Patrice
Before I get into my experience (and recovery) from postpartum depression, I just wanted to thank all of you for your incredible response to Nell's birth story. I always knew that this was a community of strong, brilliant, kind women but that post really opened my eyes to the incredible people that have stumbled upon my instagram. I feel so honored to have connected with you all and so humbled by the stories you shared. Women are amazing and I wish I could tell you how healing it was not just to share my story, but to read all of yours. I wish we all lived close together so we could gather around with a few boxes of wine and a bag of pizza rolls and connect in person. Thank you.
Before giving birth to Nell, I didn't really have a lot of insecurities about motherhood. Call me naive, but I've always been very maternal, I grew up as the daughter of a NICU nurse/nurse midwife/women's health nurse practitioner, and I LOVE babies. As a pretty type-A person, I was surprised I felt so relaxed about everything but after a tough pregnancy, I felt like Nell's arrival was my chance to finally enjoy the process. I assumed we'd learn as we went and knew we had a great support system and postpartum care coverage between my mom and Chris' family.
Then Nell came, and things were different than I expected. She was a really tough newborn, even in the hospital. She screamed (not just cried - screamed) all day and all night unless she was nursing. I sent her to the nursery every night because I couldn't get any rest. I was still in shock from my delivery and recovery from major surgery and I just hadn't expected that she'd be so upset. The lactation consultant made me feel awful about giving Nell a pacifier (I literally started crying, from exhaustion and guilt and stress, and she said nothing... until the next day when she told me that her son had one in the hospital too. Why are people so unnecessarily tough on new moms?!) and I felt so helpless watching my tiny baby squirm and scream. She seemed miserable! My room was also so small and the food was awful and we pretty much stayed in quarantine because the flu was so bad. I think I started to go a little nuts. We ended up staying a full 5 days and then headed home. I felt nervous to go home but I swear, the second we left the hospital I felt better.
My mom was waiting for us at home and was such a blessing. Everyone told me to "let the house go" but I know myself and knew that that would actually make me even MORE anxious - thankfully my mom gets it (it's the military kid in both of us) and the laundry was done, my meds were administered on schedule, food was made, and the house was spotless so we could focus on Nell. Nights were tough but we started to get the swing of things and nursing was pretty effortless for me. C and I both admitted that we dreaded the sun setting and we still felt a bit "out of body" with Nell but everyone we know that is also a parent said it was totally normal. I think around day 3 of being home I broke down and cried, because I was so worried about visitors with the flu and germs and just felt so overwhelmed but my mom said that was TOTALLY normal and reminded me that my hormones were all out of whack. C also told me that in reality, even though I grew Nell for over 9 months and she was a little mini human of our own DNA, in reality she was a stranger and it would take some time to get to know her. That really resonated with me and I felt better.
Then my mom left, but C was still home and his parents and family were over daily. I still felt anxious about all of things we "didn't know" but it was all normal "new parent jitters" and in general we started to settle into a bit of a routine.
A little over two weeks (maybe three? I can't remember) after we got home we had a really bad night. C and I combined maybe got two hours of sleep - Nell SCREAMED for three hours straight the night before and we dealt with a very unsympathetic doctor on call who told us that newborns cry, and to either bring her to the ER or wait it out. The next morning an amazing nurse from the pediatrician's office called to check in on us and this is when everything fell apart. The nurse was giving us a few tips to help with what she thought might be gas and C put the phone on speakerphone. I guess in the background I said something like "I just can't do it" and the nurse on the phone paused. She said "Hey Chris? I'm going to need you to go the store and buy pre-made newborn formula. Then I need you to take the baby and leave the house. Your wife is dealing with a bit of postpartum and I need her to sleep. For at least eight hours." I have NO idea how she figured that out from our phone call but I am so thankful that she did. She's one of the reasons I was diagnosed and treated so quickly and I am so grateful she happened to be the one to call us back.
C did as he was told and packed up little Nell and headed to the store and then his parents house. All I remember is going to bed. I woke up here and there but I just slept. Probably for 10 hours. C called to check in but I told him I only felt worse - there was an awful weight on my chest and I couldn't even fathom taking care of Nell. He told me his family would take Nell overnight and to just go back to bed. We assumed I was just beyond overtired and needed to sleep. The next morning I woke up feeling even worse. I felt like I couldn't breath and I couldn't move. I laid there like that, staring at the ceiling, for a few more hours until I got myself together enough to take a shower. I couldn't eat and I couldn't stop crying and I texted a good friend that I knew had experienced PPD and she told me to call my doctor right away. I wish every new mom had an immediate resource to help them understand what was going on - she's one of my best friends so I didn't have to worry about judgement. It was a Sunday so I told her I'd call on Monday and drove over to C's house. I remember walking in the door and hearing Nell cry and the hair on my arms and the back of my neck stood up. I didn't feel like like I didn't want to see her or that I didn't love her, I just felt completely incompetent and overwhelmed and anxious at a level I had never experienced before. I sat on the couch and tears were just streaming down my face. I had a horrible, indescribable weight on chest and I was really struggling to breathe. My mother-in-law and C calmly told me that I needed to call the doctor on call and I am so glad that I did.
The doctor on call (not even my doctor) was absolutely amazing and stayed on the phone with me for at least a half an hour. I was sitting on the floor in C's childhood bedroom just sobbing and she was calm, kind, and helpful. She called in Ativan, an anti-anxiety medication, to relieve what she determined was a full-blown panic attack, as well as a starting dose for Zoloft, a longer-term anti-anxiety and anti-depressant. She noted in the system that I needed to get in for an appointment the next day and told me to call her at any time that night if I needed to talk. C went and got my medicine and I'll never forgot that night - me, C, his parents and Nell just sitting silently in the living room. It was such a sad, dark night for our family and I've never felt so helpless. People with PPD always say that you can't know how awful it is unless you've been through it and sadly I have to agree.
That night (just like the night prior) C and his family rotated getting up with Nell all night to feed her and told me to rest. I get emotional still thinking about them, bleary-eyed in the night, caring for little Nell while her mom laid upstairs hearing her cries and feeling completely frozen and hopeless. The next day I called my doctor and they told me to come in right away at 10 am. One of my friends that is also a mom texted me asking how I was doing and I broke down and told her everything. She left her two kids with her husband and drove over with a green smoothie (I hadn't eaten in three days now) and told me she was there to take me to the doctor. It's really not possible to thank my family and friends enough for what they did for me that week. Of course I took about two sips of my smoothie and then Miles knocked the entire thing off the coffee table. I watched it slowly ooze and seep into my favorite rug and said screw it and just left it and went to the doctor.
My friend waited in the waiting room for me and the nurse had me take a post-partum survey. She took my vitals and I started crying when they weighed me - I already weighed less than I did pre-baby. I was just so beat, mentally and physically. The minute my doctor walked into the room I lost it. She just stood there and gave me a huge hug and told me that she knew this was absolutely awful but that she promised it WOULD get better. Once I sort-of pulled myself together, she asked me some questions (such as "did I feel like harming myself or my baby" - thankfully I didn't) and formally diagnosed me with post-partum depression. She told me that I was the "perfect candidate" with my traumatic delivery, etc. I was glad she shared that but I also wondered why no one said anything to me before I left the hospital - what to look for, what I might feel, etc. We have a long way to go in the US in proactively supporting new moms from a mental health perspective. On the other hand, she told me to stop worrying about Nell, because she was in GREAT hands and I had her whole life to be a great mom. She said I didn't need to feel like I had to cram it all in in the first month! I said that over and over again to myself for the next few months and it's so true! Nell and I have a great bond now and I highly doubt she has any clue I was MIA for a few days. Anyway, the doctor upped the dose on my anti-anxiety medication and told me to take that and to proactively stay on the Ativan for two weeks until the Zoloft started to kick in. They also prescribed talk therapy. Not only did they provide a list of providers specializing in PPD, the triage nurse called all of them FOR me and got me an appointment THAT day with a provider. Hearing stories from a lot of other moms facing PPD, I am so proud of my care team for being so sincerely proactive about getting me better.
I went to see the therapist who laid out my "qualitative" care plan - I was to attend therapy 2x week for the time being, and I could not be alone with Nell for the next two weeks. This wasn't because they feared I'd harm her, but instead so that I would get adequate sleep and rest while I regained my confidence and the meds ramped up. She recommended a doula or nanny and told me to get a plan in place by the time we met later that week.
Oddly enough, the day before the PPD hit hard, I happened to sit next to a nurse practitioner at the nail salon while my nails were drying. She was so sweet and we starting chatting about how unprepared women are mentally for motherhood and she shared that she'd worked with Birth Partners for birth and post-partum care. The second they told us I needed to hire help I sent them an email. Within a few hours they had assigned full-time day and night postpartum doulas to us, starting the next day, for the first week, and then 3x/week at night the following week when my mom was flying back up to help during the day for the week. These doulas were the single most helpful part of my early recovery. The first daytime doula told me that the reason Nell was so miserable was that she was extremely overstimulated (not a single Dr. ever mentioned this to us). She was born with her eyes WIDE open and it made perfect sense. We focused on quiet, calm environments and limited visitors and slowly but surely she improved. The second day the doula told us Nell needed to learn to connect her sleep cycles, otherwise she'd never nap for more than 45-minutes. We started rocking her when she woke up from her short naps and within a week she was napping for over an hour. The night doula cleaned our house and packed lunches for our week and made sure our laundry was done and that Nell's areas were tidy and organized. They left us detailed notes on her nights and taught us how to babywear and read all of Nell's little signals. In short, they taught me how to overcome my insecurities and helped me become a mom.
A group of friends also set up a meal train for us and it was the reason I finally starting eating again. Every night for a week a meal would show up on our doorstep. They were also all dairy-free because I will still nursing and had been told to cut dairy. All of these friends have their own babies, dogs, husbands, kiddos... the fact that they made time to do this for us was just so thoughtful. One of the toughest parts of PPD was definitely accepting so much help. I wasn't in the headspace to feel like talking to anyone yet they all seemed to know just what we needed. I actually mentioned to my therapist that I was having a hard time accepting so much help and she asked me if I'd take off work and stay with my in-laws to care for my Father-in-law if he had emergency surgery and needed help. I said "of course!!" without hesitation and she told me that I need to remember that this is the same thing - this is a crisis, and everyone genuinely wanted to help. Mental health crisis takes you a bit to wrap your head around but I found that comparison to be really helpful.
I have to be honest that the first four weeks post-diagnosis were still the worst for me. Zoloft didn't end up working for me and even with the night doula my mind wouldn't let me sleep. Thankfully my therapist sent me to a mental health medication Nurse Practitioner and over time we decided Cymbalta was the best fit for me. I was much more anxious than I was depressed and this helps more with those symptoms. I am still on the Cymbalta and we are still working on getting me to sleep. I take Klonopin as needed but as all of the "pieces of the puzzle" have come together I've needed it less and less. The one really tough decision that came from my medication plan was stopping breastfeeding. I struggled with this because it was the one part of motherhood that had come naturally to me and I knew it was "best" for Nell. As you might expect, no doctor was willing to tell me to stop breastfeeding. They all told me I shouldn't feel guilty and that it was up to me. Which in turn made it impossible for me to decide. The nurse practitioner finally told me that he could get me better faster but I needed different meds. I asked him if I could keep breastfeeding and he said no but that he doubted it was a very good experience when I was this anxious anyway and that he was confident Nell would get just as much from me bottle feeding her as a calm, happy mama. He was completely right. Sometimes we just need someone to make tough choices for us. I felt guilty giving it up but the first night that C could feed her without me pumping or waking up was HEAVEN and the guilt quickly subsided. The other thing that helped tremendously was that C called my therapist after my first appointment to learn more about PPD and to ask what he could do to support my recovery. It's hard for men to understand all of the changes a woman faces when becoming a mother and I think this extra little step made it much easier for us to be on the same page regarding my recovery.
Because recovery took time, we kept our night doula until Nell was three months old. By the end she only came once a week, but it was our way of knowing I would get a full 8-hours of rest and so would C. He was back at work and took all feeds before 2 am. We just kept the same set up as the doula with Nell in a separate room and one of us sleeping on the couch. At 2 am he'd come get me and I'd do that feed and get up with her again at 5 for her last "night" feed so he could be generally well-rested for work. By three months she was sleeping through the night and I was feeling like myself again.
I went to therapy 2x per week until the three month mark as well and then dropped to once a week. I now go 1x/week when possible but no less than 1x/every other week. Through extensive therapy and with the help of the meds, I have learned that while post-partum is 100% chemical and cannot be prevented, I had a LOT of deep-rooted issues that needed to be addressed in order for me to fully recover. Essentially, I've had un-diagnosed anxiety for most of my life, but like many high-functioning type-A people, I've channeled that "angst" into pushing myself to be my very best in my personal life and especially my career. The way they described it, I basically self-manage my anxiety at a 7-8 out of 10 daily. Then something like PPD comes along that pushes me to an 11/10 and it sends me into an extreme spiral because I can't self-manage it. I was so scared to tell C and my mom this diagnosis but their reaction was almost laughable...they BOTH said "yeah, that sounds about right" immediately! I had no idea I'd been channeling my anxiety into my life for so long.
I decided to commit myself to digging in on my mental health while I had the luxury of time on maternity leave. I prioritized therapy, I met with my medication NP once a month to perfect my plan, and I let Chris in to my headspace. Once I gained confidence as a mom and I really started enjoying it (this was the BEST milestone!) I let myself acknowledge that I still felt anxious and through therapy we nailed down those triggers. One of them was finance - hence my new series and commitment to learning how to manage money :)
Where I am now: I am so much better. Dare I say I'm better than before I was even pregnant, because I went "deep" into my recovery and really feel like I'm committed to getting better as a person overall, both mentally and medically. I still prioritize therapy, I will continue on my medication plan, and I am honest with myself when I can't "self manage." Sometimes I just need a break, and I'm not as scared to ask for one. I've had a few setbacks along the way and they've been tough but also good reminders that recovery is not finite.
I have to also thank this community for your unbelievable support when I shared what I was going through several months ago. There is perhaps nothing more therapeutic for those suffering from PPD than hearing from others that it IS the worst thing they've ever felt but also that they DO get better. I remember fighting with my therapist around week 2 that I DID NOT FEEL BETTER AT ALL and really didn't believe that I ever would. But here I am. I want to volunteer myself to any and all of you - if you are suffering, if you just want to chat, if you're in the throws of PPD, if you feel alone...please email me. I was so lucky to have a friend that understood, but I know not everyone does. It broke my heart to hear from so many that suffered weeks, months, YEARS to finally even admit that they were suffering. There is a better way and all women deserve the care they need, especially as new moms.
Thank you again for your support - cheers to being on the up and up!
