Author: Alexis Bruce

I Didn’t Ask to be a NICU Mom

Posted on by Alexis Bruce

I didn’t ask to be a NICU mom. No one hopes that the first time they see their baby that he or she is tangled in a web of medical tape and tubes. No one wants the first time they’re able to touch their baby to be through the portholes of an isolette or that the first time they feed their baby is by helping to connect a G-tube. 

I also didn’t ask for my son to be 7 weeks premature. I can finally (yes, he’s almost 2) admit to myself that it wasn’t my fault. I didn’t eat or drink the wrong foods, use harmful substances, behave inappropriately, do ANYTHING to put my baby at risk…nonetheless, Leo was born at 33 weeks.

If I’m being honest, it took me longer to bond with him. Even after he was home, my subconscious told me I couldn’t get attached for fear that he’d be taken from me…his health too fragile. 

But well before he came home, I assumed the undesirable role of NICU mom. I spent countless hours at my baby’s bedside while he lay lifeless. I listened to the staccato of alarms…his heart rate slowing, oxygen dropping, his inactivity all signaling alerts. While the alarms sounded, I sat, helpless and unknowing, waiting for staff to tell me if my son was okay, when to intervene, how to intervene. In these moments, I felt utterly and completely inadequate as a mother. I told myself how much Leo needed me but, truthfully, I don’t think I believed that. I watched nurses and neonatologists give him the care that I should have been able to give him. I showed up. I sat with him, read to him, pumped for him and held him when I was allowed but inside, I felt like I had already failed him. 

He wasn’t the only one I thought I was failing. The pressure to balance it all was intense. With two other children at home, I constantly felt pulled in multiple directions feeling I should be home while at the hospital and at the hospital while at home. My husband, who also experienced trauma from my son’s birth, also tried to balance work, family and hospital life (albeit much better than I did). We’d steal a short kiss in passing as we’d switch roles allowing the other to go be with Leo. We had neither the time nor the energy to nurture our relationship or to comfort one another. My house was a mess, laundry piled up and we rarely ate regular, healthy meals (besides those so generously dropped off by friends or our church…which was a HUGE help!). And while all these wheels kept turning, I was silently…falling…apart. 

And during those countless days, hours and minutes at my son’s side, not a single NICU or hospital staff member asked how I was doing. There was no acknowledgement of the traumatic birth I experienced, no sympathy, kindness or care. I tucked away the “do you know how lucky you are?” and the “this could have ended tragically” comments and slowly, they accumulated. I ridiculed myself for the fleeting thought that perhaps I did experience trauma and that I might also be deserving of some compassion. The thought seemed selfish and I forced it out of my head preserving all mercy for the baby in the crib labelled “Bruce”…the baby I felt I barely knew.

So it makes sense that studies consistently show that mothers of infants in the NICU experience PPD at higher rates with more elevated symptomatology than mothers of healthy infants. While more research is needed, these studies suggest that up to 70 percent of women whose babies spend time in the NICU will experience some degree of postpartum depression, while up to one-quarter may experience symptoms of post-traumatic stress disorder (International Journal of Women’s Health). Let’s also not forget the impact on a mom who’s suffering with postpartum anxiety. Caring for a premature, or special-needs baby, comes with unique (and sometimes critical) responsibilities. After my son came home, I realized just how dependent I had become on those nurses, monitors and alarms to tell me he was okay. When that responsibility was transferred to my husband and me, my anxiety skyrocketed.   

It’s time to recognize that a NICU mom needs specialized care and attention just like her baby. We are doing a disservice to NICU moms and, consequently, their babies by not using time spent in the NICU to check-in with moms regarding their mental and emotional health. Sharing support, resources and implementing routine screenings (along with a clear plan for moms who screen positive for depression) should be standard of care. 

While I may not have asked to be a NICU mom, it was a part of my journey as a mom and part of my special journey with my son. It took time, but what we experienced together cultivated an indestructible bond that serves as both a testament to our strength and resilience as well as a new understanding of unconditional love. 

–Written by Alexis Bruce

A Post of Hope: Kiah’s Story

Posted on by Alexis Bruce

Crying tears of joy, relief, gratitude, and everything in between, I looked at my newborn baby girl and said, “WE did this together.”

While I have suffered from anxiety for as long as I can remember, perinatal mood and anxiety disorders were something that I didn’t consider when having kids. After my first child was born, I was all consumed with assuring his health was good.  Over the top? Probably. But what first time mom isn’t?

Pregnancy was easy.  I was one of those “I’d be pregnant forever” type of women. I got pregnant with my second child when my first was only 6 months old and things were beautiful and simple.  Life was good. After my second daughter was born, postnatal mood disorders took on a personal meaning for me. When she was 2 months old, I began to suspect that she had some underlying health concerns.  I became extremely anxious, and though I didn’t realize it at the time, depressed. I had panic attacks for a year and lost so much weight that people were becoming concerned. I could not find joy in anything I did.  I distinctly remember taking the kids to a park and staring at my family laughing and playing, thinking, will I EVER feel happy again? 

Every thought that crossed my mind was an obsession about my daughter’s health or whether or not something bad would happen.  Followed closely were compulsions of checking her body (if I just looked ONE more time), information seeking (hello google), and seeking reassurance (are you SURE that is what the doctor said? Tell me one more time that you believe she will be okay). Sometime in the interim, my anxiety crept from concerns about my daughter to concerns about my own health.  What IF. WHAT IF something happens to me and I can’t be here to take care of her? Anxiety is like a drug. A drug you know you hate but feel you can’t exist without. My brain literally felt addicted to worrying and obsessing and engaging in compulsions. And it all got so out of hand before I even had the chance to realize it. 

After seeking some much needed professional help, the next couple of years were better.  Lexapro became a close friend and Xanax became a distant acquaintance that I no longer relied on. I was really feeling good.  I was, dare I say, happy. My husband and I started to discuss having another baby.  The thought of relapsing lurked nearby, but I didn’t put too much thought into it.

Quickly becoming pregnant, my anxiety/OCD remained at a distance for the first 20 weeks. I had gone off my meds and was somehow coping beautifully. Around 20 weeks, everything hit me, or should I say, gut-punched me. Weeks 20-40 were weeks from hell. My anxiety returned with a vengeance. I was lost, scared, and sick. My husband feels that it was the worst he has ever seen my anxiety. I fixated on various components of my health for weeks at a time.  I could not escape the pain and I had no where I felt safe. I felt helpless and alone. OB referred me to psych, and psych referred me to OB. It was like everyone was scared to make med changes for a pregnant woman. Friends would casually ask, “Are you SO excited about the baby?” I would smile and politely make up something along the lines of “Oh you know, I am excited and just so busy I barely have time to think about it.” Busy was code word for anxious.  Excited was code word for “I haven’t bonded with this baby at all and sometimes think I wouldn’t even be sad if it all ended today.” (While I certainly did not WISH for that to happen, my brain couldn’t get past the fact that I was so miserable inside.) On top of it, I had well-meaning people in my life who said things such as, “You just need to be strong. You have two kids at home to take care of. Just stop worrying.” (PSA: Telling an anxious person “just don’t worry” is like telling mountain to “move just a little”…. correct me if I’m wrong, but this has never been effective as far as I am aware.)

When my baby girl was born, I somehow bonded with her more than I bonded with my first two right away.  I don’t know if my motherly instincts took over and made me realize that I was indeed excited to have a new baby, or if it was truly my hormones finally allowing me some peace.  My mental health was not great for the first few months, and I am still working daily to conquer some of my demons, but I am feeling SO much better than I was during pregnancy. I recently decided to wean my daughter from breastfeeding because I wanted to give my hormones a chance to finally balance out.  I have been having mostly good days with a bad day sprinkled in now and then. I am blessed with three beautiful children and have decided that it would not be healthy for me to have any more. I strongly believe that it is important to regard our mental health as we would any physical ailment.

For anyone who this may resonate with, you are not alone. There would be days where a momma who walked in my shoes would tell me “tomorrow is a new day”, and the clouds would lift, if just a little bit.  I will look you in the eyes and promise you that it will not always be this way. You WILL look back and see your strength. You.are.fierce. At your weakest and most vulnerable, I promise that you are being so, so, brave for fighting this fight. I won’t promise that tomorrow will be better.  I won’t promise that next week will be better. I do promise that one day will be better. I won’t promise that your mental illness will go away and never come back. I continue to fight this fight every day. I do promise that health is waiting for you, and you WILL find it.I see you, momma. 

I see you pushing the shopping cart at Target with two little ones, putting on a happy face for them, but going home and crying because you don’t feel like a good mom.  I see you look at your babies with so much love, but go home and have nothing left to love yourself. I see you look at other mommas, thinking, “If only I was happy” and quietly panic inside because you don’t think it is possible for you. I am here to let you know that you are loved. You are honored.  You are appreciated. You are me. WE are women. WE are moms. WE are the face of strength.

–Written by Kiah Allen

Dads and Perinatal Mood and Anxiety Disorders

Posted on by Alexis Bruce

“We’re pregnant!” As a Dad of now four kiddos, I remember the mix of excitement and terror that came with our first positive pregnancy test. I also remember feeling for the first time (and truthfully still live with) a unique brand of anxiety that goes along with being a parent.

It is very normal to experience symptoms of anxiety and depression while expecting and after the arrival of a newborn. Symptoms of anxiety can include restlessness, feeling keyed up or on edge, being easily fatigued, difficulty concentrating, muscle tension, and sleep disturbances such as troubling falling or staying asleep. Symptoms of depression can include depressed mood, loss of interest in previously pleasurable activities, sleep disturbance, fatigue, feelings of worthlessness, indecisiveness, and thoughts of death or suicide. If you are noticing that these symptoms are persisting or increasing in yourself or your partner, you may be experiencing what is known as a perinatal mood and anxiety disorder (PMAD). Did you know that 1 in 7 women and 1 in 10 men experience a PMAD? To put that in context, that’s a minimum of 3 to 5 parents of students in a class size of 30.

What to know and expect about a PMAD? To begin, it is not the fault of the Mom or Dad and no one did anything wrong to bring the symptoms on. In my work as a clinical therapist, I know that people can under-report the intensity, frequency and duration of their depressive and anxious symptoms. There are a variety of reasons for this, including not wanting to feel like a burden in general or to their spouse in specific, not knowing how to talk about feelings that are persistent and even scary at times, feeling guilt or shame, as well as just being overwhelmed and too exhausted to take note of what is being experienced. The reason for sharing this is that if you are noticing that you or your partner are exhibiting symptoms of anxiety and/or depression, those symptoms could be more intense than you are observing and are likely going to be under-reported by your partner.

What can you do? As a Dad, you are going to feel tired and overwhelmed at times too. Have you felt as a Dad that more is being expected of you? That’s probably because it is! In his book, The New Rules of Marriage, Terry Real talks about 21st century expectations for marriage and how they have shifted. He extends this to indicating that expectations for us as Dads have increased and rightfully so. Taking a hard look at ourselves and how we can share in the hard work of managing the household (e.g., cooking, laundry and cleaning) and talking about this with your partner would be helpful.  

You can be empathetic and show understanding by asking open-ended questions. For example, two great questions are: “What can I do to help?” and “What do you need from me?” Additionally, be prepared for your partner have different answers to those questions depending on the day or that your partner may not be able to speak what they need in the moment. That is totally okay.  On this note, another way to be helpful is to take initiative without being asked. A key point here is communicating with your partner to see if they want to be asked, prefer you take initiative, or a combination of both.

You can encourage self-care for your partner and for you. You can encourage rest, exercise, socializing with friends and prepare healthy meals. You can go with your partner to see the doctor and/or to see a therapist. One avenue to consider when seeking therapy is that many companies and plans have what is called an Employee Assistance Program (EAP). EAPs typically authorize a certain number of sessions (often 3 to 4) that are no cost to the employee or spouse.

Finally, you can get informed and seek out support from people who have been there or who are currently going through what you are…you are not alone! You can communicate with your partner and loved ones in a caring yet direct way that you are concerned about them. The links below are two great places for Dads to start…

Resources for Fathers

http://postpartumdads.org/

You got this and will get through it! There is hope!

-Written by Joe Halaiko, LPC-IT, SAC-IT

Joe Halaiko, LPC-IT, SAC-IT specializes in relationship concerns, trauma, grief/loss, managing chronic illness, depression, substance abuse and anxiety. He has prior experience in human resources and can help people strategize on work issues or navigate career transitions. He works with adolescents, adults, couples and families to develop goals tailored to each of their individual needs. He uses an integrated approach, drawing on Person-centered, Existential/Humanistic and Narrative models, as well as using Cognitive Behavioral and Motivational Interviewing strategies. He plays guitar, and believes in the power of creativity, possibility and compassion.

The Light Went Out–My Postpartum Journey

Posted on by Alexis Bruce
Trigger Warning: suicidal thoughts

The Light went out.

“You’re glowing!” – I heard it so many times during my pregnancy. I felt the glow; I really did. I could feel the abundance of love and happiness that beamed from my face; the happiness that embraced me. That same glow followed me through childbirth, through the long, sleepless nights of nursing a tiny human and the dreaded witching hour that came in the evening. That glow got me through, but that glow dissolved. My light went out and this is the story of my recovery. I promise, if you keep going, you will also recover from your time of darkness. The light will return.

While growing up, I suffered from a mild form of OCD and some anxiety, though those things never inhibited my ability to live.  I loved to live, to smile, to laugh, to joke—but that all changed. After my third baby, I felt the shift. If you have ever gone through a perinatal mood or anxiety disorder (PMAD), you know that feeling and the very words you’re reading are likely filling your soul with the feelings you once felt. The dark, all-encompassing hole of spiraling thoughts, that you were sure had no end. The hole that completely swallowed you and and made you feel as thought there was no way out. I can look at pictures that I forced myself to take with my sweet newborn and remember the thoughts going through my mind—not feelings of harm, but of hopelessness. PPD/PPA stole my shine at one point; it took the light from within me. The light that once was illuminating my every move—it went out and with little warning.

I remember waking up one day and everything within me was off.  It was as though I had left my physical body and I was walking in a dream, but that dream was my reality. Every second felt like a mini-panic attack.  My brain was in a constant battle of fight and flight, circling itself with thoughts that nothing was real, but it was, it was so real. There was a disconnect from my life and family and it consumed me with feelings of hopelessness and defeat. Who were these children? Surely, they were not mine. This house wasn’t home. My husband, well, I was light years away from a connection I had felt with him just the day before. I would sit in the bathroom and have a raging fight within my head over the very real life that was happening outside of those doors—a life I very much did not feel a part of. I couldn’t drive. I couldn’t leave my house; I could barely leave my chair.  I nursed my baby and handed him back over to dad because it was too much.

I didn’t know then that I was suffering from a PMAD. It seems so obvious, I know. I remember exploring options like brain tumors and prayed that doctors would find one and be able to physically remove the mental anguish I was feeling. I didn’t know this wasn’t a job for my primary doctor.  I surely didn’t think I needed a psychiatrist because something was physically wrong with me, not mentally, right? Me—a student that had been studying mental illness for years and who had devoted hours and hours of learning the signs—I didn’t recognize the type of help I needed. I didn’t recognize that I needed medication to reroute the wiring in my brain or that I needed to surround myself with support. I just didn’t know, and it took me almost too long to figure it out. I was almost too late.

Did you know 20% of postpartum deaths are due to suicide and most women suffering from perinatal mood or disorders do not seek treatment (Wisner, 2013)?  Women like me. They don’t know the signs or think they are at risk. Maybe they are ashamed; too ashamed to seek the help they desperately need. What some new moms may not know is there are people out there longing to help them—begging to give them the ladder they need to climb out of the darkness.  People who won’t guilt or shame them but who will encourage and love them. The signs were there. THEY WERE EVERYWHERE, yet I still felt shame and was filled to the brim with denial.

So there I was, longing for help, for someone to pull me out of the water that was filling my lungs, depleting my oxygen, and stealing my life. I needed someone to tell me it would get better; a blog, a friend…anything. Not medicine though—I didn’t need that. I’m not “that” person. I was going to school to help those people, not be one. I just needed a shred of hope. Surely, I could continue hanging from the fraying string of life without the medicine my doctor assured me I needed.

The darker thoughts soon started flooding my mind. I didn’t want to kill myself, but I didn’t want to live. How could I? Nobody could live the rest of their life feeling this way; it wasn’t life, it wasn’t living. For the first time in my life, I understood suicide and the desire to leave the darkness behind. It sounded like a relief. I wasn’t really living anyways. I was simply a beating heart in a lifeless body; a shell that everyone would be better off without. The wall between me and the world was rapidly growing thicker and I didn’t want to be a part of it anymore.

Enter Zoloft.

Now, I know, “prescription medications are the devil.”  I’ve heard it. I’ve seen you write it and share it and rant about big pharma. You’ve listed and rambled on about the long list of side-effects that come with taking SSRI’s and mood enhancers. I’ve scrolled over the posts on social media encouraging people that “nature is medicine, not a pill.” I see you (it’s even possible that at one point I “liked” your post!) but I’m here to tell you that you are the problem. You are an ingredient to a disastrous recipe of misunderstanding mental illness. You are a driving force behind people—moms—feeling shame for taking medicine they desperately need. A huge part of the reason why moms are literally killing themselves and leaving their children and families behind. But a “good” mom wouldn’t need a pill to help her feel love, right? Don’t these moms know the side-effects? Or, that their doctors are at the hands of big pharmaceutical companies and are just pushing prescriptions to fill their pockets? They must not have tried essential oils or used St. John’s Wort, or valerian root, or B12 or D3 or a dose of sunshine. If they had they’d feel better, right? They should try a walk through nature; that would be a cure-all…nevermind that they aren’t showering or picking themselves up off of the couch for days or weeks at a time.

Or, maybe it’s just that you have never felt the overwhelming embrace of a world full of darkness. You’ve been lucky enough to never have to navigate life through a dark tunnel that seems to have no end. We’re taking these medications because we are trying…we are trying so hard! We are desperate to NOT DIE—we do not need your judgement and misguided shame. We need life. We don’t care about side effects of nausea when we don’t even care about living. We don’t care about the profuse sweating we go through, just to feel an ounce of happiness. We don’t care, because we have life—a life we once lost.

The tears literally streamed down my face uncontrollably as I took my first pill of Zoloft. I felt guilt. I felt shame.  I felt like throwing up because I was so confused, but I also felt hope. For the first time in three-long, agonizing months, I felt a tinge of hopefulness, a feeling that things had a chance of getting better. I felt like living was a possible option. I also knew that often medicine can take weeks to kick in, so I scrounged up every last bit of strength in my body and told myself I could hold on for twenty-one more days. I could do this. I looked into the eyes of my children, after explaining my need for medicine and dug as deep as I could to find the energy I needed to live. And I found it. I wove that frayed string of life back together. I built it up, climbed it and threw it out as a lifeline to the others spiraling into a world of darkness.

If you look into your baby’s face and feel nothing, that is not you…that is depression. If you feel like you are nothing, worthless or that life would be better if you were gone—that is not you…that is the depression. If you can’t find the energy to shower or get dressed or move out of your chair, that is not you…that is depression and you are not alone. There is light at the end if you keep going. You are loved. You are more than depression and perinatal mood and anxiety disorders and you will find the spark of life again. One day, you will smile again.  You will half-heartedly laugh again and remember the joy it brings you. You will feel love and you will heal. You will walk outside in the sunshine and take a deep breath of relief—because you’re alive and you beat it. You will look back at your time of darkness and feel like a warrior, because you are. You will look into the mirror and the reflection will be someone you recognize. Do not stop fighting. Do not stop trying to find that light. My light turned back on and if you keep going, yours will too.

Sending love and light.

–Written by Jarrika Falls Stephens

References: Wisner KL, Sit DKY, McShea MC, et al. Onset Timing, Thoughts of Self-harm, and Diagnoses in Postpartum Women With Screen-Positive Depression Findings. JAMA Psychiatry. 2013;70(5):490–498. doi:10.1001/jamapsychiatry.2013.87

Dear Postpartum-OCD

Posted on by Alexis Bruce

Dear postpartum-OCD,

I hate you. I hate you for SO many reasons. I hate you for creeping up on me at a time in my life that was supposed to be filled with joy. I hate the what-ifs and the images you played, re-played and then played again in my mind. I hate how you tried to convince me that I was capable of horrific, gut-wrenching things. I hate that you made me feel that it was best to avoid my children. I hate the way you berated me with intrusive thoughts each one more graphic and terrifying than the last. I hate that you made me want to avoid certain activities and places therefore depriving my kids of experiences they deserved to have. I hate that, because of you, I missed out on so much with my babies. But most of all, I hate that you told me that the only way they would be safe was without me.

I hate that no one even told me you existed. This fact made it so easy for you to convince me that there was something wrong with me…that I was some sort of monster that didn’t even deserve to be a mother. I hate the way you made me view myself. How you stripped me of what little self-compassion I had and made me feel worthless and unlovable.

I hate that you made me feel trapped…that you made me feel like a prisoner in my own mind. I hate that some days you made me wonder if I would ever be well. If there was any end to the agony I was in…if there was any other way out…

But that was before. Through treatment, medication and time, I’ve learned to see you less as an enemy and think of your more as a friend. Because, the reality is that, you’ve made it your mission to protect me, and those I love most. Despite the fact that your warning signals may misfire, I have learned to appreciate the motivation behind them. For your own good (and mine), I’ve learned to challenge you and your screams. I have practiced letting your alarm blare incessantly in my head, in an effort to show you that there’s no real need to be afraid. And in some odd way, I need to thank you. I need to thank you for showing me that I had strength I didn’t know I possessed. For allowing me to find courage to speak out and advocate for other moms who might have a friend like you. But please know that you can rest now. I’ve got this.

–Written by Alexis Bruce