Never Say Never – Deciding to have a baby after PPD

The sun was shining brightly on a perfect Arizona day in early April. Our brains were set in relaxation mode, with no clue that a major shift in our lives was about to be set in motion. My husband and I had left our 3 year old back home in Wisconsin with my parents so that we could have a much needed vacation. We headed down to the resort’s pool complex to find that the only loungers available together werein front of the kiddie pool. I didn’t care; all I needed was the sun, a good book, and a fruity cocktail. I could tune out the noisy children like a pro (a survival skill that all moms learn). After some time, I glanced up from Big Little Lies and noticed a baby fast asleep in the shade two chairs down. She looked adorably peaceful as her mom and older sister played in the pool a few feet away. A voice inside my head said, “I could do that. I could have a second baby.” Followed by, “Where the f*ck did that come from?” My heart rate sped up and my chest grew painfully tight. I struggled to control my breathing as the anxiety attack took hold. The thought of having another child was shocking, foreign, and unwanted. It had popped up out of nowhere and needed to go away. Over two and half years ago, I had taken the possibility of more children off the table. My son, Adrian, would be an only child and that was that. It was a hard decision but I came to terms with it, locking any lingering baby-fever in a box marked “never open.” Close friends and family understood and didn’t blame me. Severe postpartum depression and anxiety had left its mark.

Four years ago, as a new mom-to-be, I had high expectations for myself and what life would be like as a parent. Immediately after Adrian was born, reality smacked me across the face. Instead of that post-birth feeling of euphoria, love, and joy that I had expected, I

 felt dead inside. As the days went on, that numbness was replaced by fear, hopelessness, and despair. I felt incapable of doing the one job I had to do: mother my son. Following a diagnosis of postpartum depression and anxiety, I started medications and weekly talk therapy, but my condition continued to worsen. Dosages were increased; medications were switched out; more therapy sessions were added to my schedule; radical treatment options like Electroconvulsive Therapy were attempted. It wasn’t working. About a year and a half passed and my mental health deteriorated further. There were periods of intense suicidal ideation that at times became irresistible. My husband had to hide all the knives and sharp objects in the house. My medications were locked in a safe and dosed out daily. I knew that if I somehow survived this illness, I could never risk putting myself or my family through it again. Having another baby was unthinkable at the time.

Eventually I found a relatively new treatment program that was proven to be highly effective for individuals with major depressive disorder and suicidal ideation. Dialectical Behavioral Therapy saved my life. As I started to improve and finally reached a state of full recovery, I still felt good about the decision to stop at one child. Life with my family felt happy and peaceful. Knowing that the risk of postpartum depression and anxiety is higher after the first episode, I felt no need to rock the boat. Hence, the anxiety that accompanied the thought of having another baby on that fateful day in Arizona. Reaffirming the belief that I was done having babies helped me return to a state of relaxation in that moment. Still the unwelcomed thought persisted.  For weeks I attempted to ignore it, not wanting to face the tough emotions it brought up. Therapy had taught me the importance of getting curious about my emotions. I knew this needed to be unpacked or it would continue to haunt me. I decided to bring it up with my husband, expecting him to look at me like I was crazy and reiterate that we were done having children. Instead, he loved the idea. He felt that we were ready and could handle whatever came our way. I was surprised again when my therapist said he thought it was a great idea. He was sure I’d be able to use my new skills to cope through the postpartum period in a much healthier way. My mom’s reaction was the same. Frankly, I was shocked. Why weren’t these people, who saw firsthand how bad it was, trying to talk me out of this? I know now that it’s because they believed in me, even if I didn’t fully believe in myself yet.

On a sleepless night while wrestling with the big decision, I grabbed my journal and made a three page pros and cons list of having another baby. Reading the list over and over again brought on a mental clarity that I hadn’t felt in more than a month. All the cons could be problem-solved. They were scary, but I was not about to let fear stand in the way of something my heart truly wanted. The pros made it obvious: baby #2 would never feel like a mistake, but not having him or her probably would. The list also helped me develop a sense of confidence in my ability to handle another baby and face the potential of postpartum depression and anxiety. I would do my research, talk to women who had done this before, learn from my experience, and make a comprehensive postpartum plan. Plus, my husband and I make a solid team; by working together to face any obstacles, we could have the family we’d always dreamed of.

After Adrian was born, I went into battle naked, unarmed, and blind to the demons I was about to face. This time around, I will enter the arena wearing a full suit of armor, carrying a sword made of Valyrian steel, and with eyes wide open. I know exactly what my demons look like and how to defeat them.  The fear is still there, though not as intense, and it feels like a natural human reaction given the stakes. There’s also a sense of courage and strength that comes from knowing that I have what it takes to survive. The postpartum period will be hard. And it will be worth it.

Written by Megan Nazaret

A POST OF HOPE: Stephanie’s Story

Trigger warning: Postpartum Depression, Suicide14923873_10105919234159177_486371098_o

A little over a month ago I saw another story about a new mom taking her life. This mom was four months postpartum and her loved ones had no idea she was suffering the way she was. Some may wonder how a new mom with a supportive family, comfortable life, and beautiful new baby could want to take her life. I’d like to share with you how.

Some of the things I felt right after birth seemed to fall in line with what I had heard other new moms confess. As soon as my baby came out, all I wanted to do was sleep. I didn’t want to snuggle, I didn’t want to talk. I wanted everyone to leave me alone and stop touching me so I could turn off the lights, curl up on my side, and try to makes sense of what had just happened to my body. In the nights that followed I asked myself “what have we done?” “what were we thinking?” I entertained scenarios where I would put my baby up for adoption, and wished that one morning I would wake up and maybe he wouldn’t be there. When I’d challenge myself on these thoughts, I’d realize that no, I didn’t actually want to give away my baby, or wake up without him there, but I also felt incredibly trapped.

Two weeks was the timeline I had heard. That the first two weeks are terrible, and then things get a little better. At the two week mark I was entrenched in my battle with nursing. Setback after setback had me consulting several spreadsheets, calling anyone I thought could help, telling anyone who would listen. Pumping, and nipple shielding, and battling thrush, and trying to heal nipples damaged by a tongue tie and lip tie all while not producing enough, and not being able to hold my baby to my chest because it was too painful. It’s incredibly hard to explain to someone who hasn’t been through it, but not being able to nurse the way I wanted, ripped me in half. I still shed tears as I write this over the missed bonding, and the feelings of inadequacy. Much like postpartum depression, the pain of wanting to nurse but not being able to, is something we should talk about more.

Weeks passed and I continued to feel incredibly ill-equipped to care for our baby. Even though our baby was sleeping well, I started waking up very early in the morning only to lie awake waiting for his cry, crippled with anxiety over irrational things. I was convinced that I wouldn’t remember how to do simple tasks like hold him or change his diaper. I chastised myself. “What is my problem? Why can’t I deal? How can I whine like this when I am so privileged? Other moms get through this and much worse. What is my problem!?” At six weeks I officially stopped trying to nurse. I hoped that eliminating this daily stress (and daily failure) would help to raise my confidence. I also reasoned that if I could spend more time with our son and less time with my breast pump, I might finally feel the bond I so desperately wanted.

I crept out of the acceptable “baby blues” period and did not start to feel better, but actually began to feel worse. My anxiety was now creeping into other areas. I was afraid to go outside or be around people, to drive a car, or to go to work. My appetite was nonexistent and I was nauseous a lot of the day. My destructive thoughts were now not only in my head, but were coursing through my body. I’d wake up in the morning vibrating with anxiety. It was like the feeling you have when you drink too much caffeine, times ten, and without end. Up until this point I had been vocal with my husband about how I was feeling, but I could see him bending under its weight. We had envisioned that it would be getting easier by now, not harder. We made some changes to help with my anxiety. My husband took night duty and woke up with our son in the mornings which helped me get more rest. I reached out to my midwife and began taking a variety of herbal supplements. I tried to do yoga again. I kept a gratitude journal. I’d go for a walk around the block first thing every morning. I was diligent and motivated, and then I really really wasn’t.

The first time I noticed a shift was when I woke up one morning, and rather than being anxious about the day ahead, I was devastated that I had to face another day at all. I started to draw inward. I couldn’t seem to access any of the coping mechanisms I had learned throughout my life. I felt as if I had tried everything. As someone who traditionally processes my emotions by talking to others, the thought of doing this seemed like such an utter waste of time. I was convinced there was no getting out of the pit I was in.

I knew that I had some risk factors for postpartum depression which is why I started seeing a therapist during my pregnancy. I was also open about my concerns with my midwife and primary care physician. During one of our appointments for our son, I mentioned to our primary care doctor how I had been feeling, he wrote me a prescription for 50mg tablets of Sertraline (Zoloft) saying it might be good to have on hand, just in case – but I had absolutely no intention of taking it. I have a bachelor’s in Psychology and still I couldn’t accept that this was something I couldn’t conquer on my own. Still I was afraid of what psychiatric medicine would do to me. I feared it would change who I was, that it would stunt my feelings, or make me numb, that it would ruin the relationship I had with motherhood and this precious first year with my baby.

So I worked and took care of our baby, as I alternated between vibrating with anxiety and struggling to get out of bed. My second panic attack came when I accidentally opened a folder on our computer of pictures of me while I was pregnant. I realized it was the last time I had felt happy, and was positive it was the last time I ever would. I sobbed and hyperventilated my way out of work and all the way home that day, and I realized I didn’t have much more fight in me. I felt on the verge of something bad. I was still holding it together (well enough) but I didn’t have much left. That day I filled my prescription for Zoloft and that night I took the first 50mg dose.

I fell asleep fine but woke up throughout the night with body tremors. Shivering without being cold. I slept fitfully until the sun rose and was faced with another morning. The same demons were there, but now my mind was racing out of control. I was thrashing and tossing, unable to calm my body or my mind. I told my husband I didn’t think I could walk down the stairs. I told him I had to stay on the bed in order for everyone to stay safe. My eyes were wide and my speech was fast, as if I were in shock. My husband woke up with our son and headed downstairs.

The morning wore on, and slowly my mind started to clear. I went downstairs and started calling people I thought could help me through this. I started with my therapist who said that the Zoloft would be out of my system by the evening, and that I shouldn’t take any more at that dose. I contacted my primary care doctor, I called my parents. By nightfall I had returned to some semblance of normal and had sworn off psychiatric medicine.

The next day was mother’s day.

Hope was now officially gone. The meds had been my lifeline – my last resort. I lost motivation for everything. I’d look at my toothbrush and wonder how I hadn’t already been crushed under the weight of brushing my teeth twice a day for the last 31 years. I couldn’t fathom an existence where things like getting ready in the morning were anything less than monumental. Miraculously the one thing I could do was care for our son. When he needed me, my mind cleared. I smiled for him, I sang to him, I fed him and played with him. I put him down for naps, and once he was asleep, I laid on the floor and cried.

Then I started wishing I didn’t exist. I’d open my eyes in the morning and groan “noooooooooo” almost whimpering at the fact that I was still here. Things were getting worse. I tried to keep talking. I talked to my husband, and my family, and my therapist and a few close friends – robotically reciting what I was feeling. Not because I thought any of them could help….I was way beyond that …. but I needed them to take action if things got out of hand, because I didn’t trust myself to know.

Not wanting to exist and wanting to take your life are two different things. As the days wore on, I started to cross that threshold. One morning I made a pact with myself that if I did end my life, I would do it at night because I tended to think more clearly at night – I thought I at least owed myself that. Another morning I woke up and my first thought was of a bottle of pills in the medicine cabinet downstairs. The following morning, I had the same thought, but this time I told my husband. When he asked if he should take the pills to work with him, my next immediate thought was of a plan B. This was bigger than both of us, and we needed help.

Another call to my therapist linked me with a psychiatric nurse practitioner who had worked with a lot of moms suffering from Postpartum Depression. I was still so turned off by psychiatric meds, but this had now become a life or death situation, and there really wasn’t another place to turn. I had become 100% convinced that everything would be better for everyone if I wasn’t alive. I remember sitting on our porch arguing with my sister, that if I killed myself, my husband could grieve, then move on. Clean break. This was undoubtedly better and more humane than putting him and my son through a life with the joyless, endlessly anxious person I had become.

I set up an appointment with the psychiatric nurse practitioner for the end of the week, and my husband, family, and friends banded together to get me there. Visiting, sleeping over, sitting with me while I cried, helping with work obligations, loving our sweet son, going for walks, bringing me food, sending me texts, and loving and loving and loving and loving.

I couldn’t see to the next day, much less the end of the week. But it came. My parents came over to watch our son and my husband and I headed to my appointment. On the part of the paperwork where they ask about current medications, I wrote vitamins and herbs like skullcap, raspberry leaf and vitamin D. I knew we needed to be there, but I was NOT hopeful about meds. We were called into the office and I recited my story once again.

The first thing the psychiatric nurse practitioner said after listening to my confession was that it sounded like textbook Postpartum Depression. That felt good. She had strong opinions about what I had been prescribed, its dosage, and why I had reacted the way I had. She also had strong opinions about what would work best for me, and what works best for moms with Postpartum Depression in general. In regard to my suicidal thoughts, she was confident, almost flip – saying what she was prescribing should take care of those thoughts by the end of the week, and if not, I could go on a mild antipsychotic which would kick them right out until my new medicine was able to take care of them. Above everything else, she said with absolute certainty that if this didn’t help, we WOULD find the answer together. She gave me her personal cell phone number, told me to call anytime with questions, and again assured me that what I was feeling now wasn’t permanent.

There must have been a part of me that believed her because after my husband and I left that appointment, I ate an entire cheeseburger and french fries at one of our favorite diners. A bigger meal than I had eaten in months.

That night I started on 10mg of fluoxetine (Prozac), and I cried. I cried because it had come to this, and because it felt like such a long road, because I felt like a failure, because of my guilt, because this was my last hope, and because I was very very tired.

My husband and my sister noticed a difference within days. By the end of the week, I was no longer feeling suicidal. Over the next two weeks I started to wake up without feeling anxious. I would get ready in the morning without remembering every painstaking movement, and on May 24th I had a craving for good ramen and made plans with my husband to get some. I not only believed I could feel a little joy, but could also see into the next week. This was huge.

Last week I was rocking my son to sleep, and had to stifle my giggles. I was hit with one of those rare moments when you don’t laugh for humor, but for happiness. A happiness so pure it bubbles up inside, and releases in a laugh and a grin of awe and gratitude.

I am happy. Not simply functioning without overwhelming anxiety and depression (which is a true gift in itself, and was all I strove for months back) but am actually happy. Happiness was a feeling I was convinced I would never see again, and here it is. Here I am – myself again.

Three months ago I would have started this by listing the reasons I was a prime candidate for postpartum depression – trying to prove to you (and me) that it wasn’t weakness, laziness, or unpreparedness that caused this illness. Hoping you (and me) would see that I wasn’t unfit, whiny, coddled or anything else I accused myself of during those first months. But I don’t accuse myself of those things anymore. I was sick, and now, I’m feeling better.

While there are factors that increase the risk for Postpartum Depression (history of mental illness, family history of mental illness, nursing struggles, being over 30, a difficult birth, medical complications during or after birth for mom or baby, etc.) it can happen to anyone, and it does happen to more than 15% of moms making it the most common complication of childbirth. Dads, non-birth moms, and adoptive parents can also suffer from Postpartum Depression. New parents need support. Period.

In my darkest time, I devoured success stories. I didn’t think I would ever have one, but somewhere in my subconscious, it helped knowing someone else had. And so, here is mine.

This isn’t easy to share so publicly. Many times I’ve thought about the people who will read it. High school acquaintances, former employees, people who have seen me a certain way, and will now see me a little differently. But words are powerful. Vulnerability is powerful. Writing this has been therapeutic, but my hope is that it will also serve as a thank you, a PSA, and an apology for anyone to whom I gave the impression that I really had my shit together. It was not my intention to hold back information or to put on aires. This was just something I didn’t feel strong enough to talk about until I could see the other side. Maybe you’ll read this as a new mom and get some validation for what you’re feeling. Or maybe you’ll think, “I feel terrible, but at least I don’t feel THAT bad,” which is valuable too.

Life isn’t perfect now. I still feel stress, I still get overwhelmed, sometimes I still feel shame, but most of my days are filled with smiles, calm breaths, and noticing beauty – which is such an incredible gift.

You or your partner or your sister or your friend or your cousin might have a baby one day. Please remember this story. Put some of these resources in your phone. I write this as a method of healing, a beacon of hope to those suffering, and an appeal to loved ones of mamas and parents everywhere to please ask the questions, give the support, be aware, offer the help, give encouragement, and reserve judgement. I am someone you know who has been there. Reach out.

It WILL get better.