Wednesday, June 26, 2013

The Truth about Postpartum Depression

One year ago today I was in the darkest place I could imagine.

I had given birth to Titus two months earlier and Garland had to work a summer camp in Colorado all week. The morning Garland left I held it together for about 2 hours before putting Titus to sleep in his nursery and collapsing on my bed, unable to do anything but cry. Cry isn't the right word, this was more like body-shaking-can't-catch-my-breath-wailing-like-a-feral-animal absolute sobbing. I didn't know what to do. I alternated between rocking back and forth like a lunatic and feeling unable to move,  as though I weighed 900 pounds. I kept pressing my hands to my face, like maybe if I pushed against my eyes hard enough it would force the tears back inside. Or maybe it would even pop my head like you would pop a bubble floating by, at least then I wouldn't be able to cry anymore. I was praying that Titus wouldn't wake up because I was afraid I would just pull the cover over my head even tighter and ignore the little baby in the next room. I sent a text to my friend Katelyn that said simply, "I need you." She immediately responded with, "coming right now." I laid back down, completely exhausted, and just stared at the ceiling fan as the numbness settled over me like ancient dust once again.

This, my friend, is what Postpartum Depression looks like. 

Luckily for me, we recognized the signs and symptoms quick enough that I was feeling completely back to normal within 5 months of delivery. While I had a relatively short bout with depression, I make no bones about the fact that it was by far the most difficult thing I've ever gone through in my whole life. I can tell you that one of the things that helped me immensely when this all started was hearing stories from other women who struggled with the same thing. The idea that I was not going crazy or alone in this struggle made me feel like it was possible to overcome. So because of that, I've chosen to use my blog to answer some of the most common questions I get asked about my battle with Postpartum Depression (PPD). My hope is that maybe another new mom would happen across this link and realize that there is hope and life after PPD.

When did you know something was wrong?
Nothing was wrong for the first few days. Then I started to not be able to sleep in the same room as Titus because every little noise he made gave me an adrenaline rush and a million questions rushed through my head (is he waking up? is he hungry? is he cold? is he stil breathing?). During the day when he was napping I would try to lay down in a different room and nap, but as each minute ticked by all I could think was, "I'm one minute closer to him needing me," and just could not fall asleep. After a few days of this cycle my ravenous appetite that I had gained from breast feeding dropped off drastically. I started throwing up and having diarrhea all day and could not keep any food down, I could barely even drink Gatorade. I just assumed I had a bug, but this continued for over 10 days. I would have times where I had to practically throw Titus to someone else while I was breast feeding so I could run to the bathroom and throw up. I had tons of tests done, a trip to the ER for fluids, a false guess by a doctor that it could be mastitis which resulted in a horrible pumping regiment (which only caused engorgement and leaking from too much milk), but still no solution. After all my medical tests came back negative, my trusted OB gently suggested that we should look into the possibility of PPD, which seemed absolutely absurd to me. I didn't FEEL depressed, my main problems were physical (I would even run a low-grade fever some days). How could this possibly be related to a hormone-induced depression? Not to mention it took us over a year to get pregnant, so I felt like having PPD meant that I was not grateful for the gift we had waited so long to receive. But in the end, he was absolutely right.

How did you know it was PPD and not Baby Blues?
This was the same question I kept asking myself over and over and over for the first few weeks after delivery. Baby Blues are usually classified as general emotional highs and lows that a new mom experiences within the first couple of weeks after delivery. This is a natural reaction to your body's hormones trying to adjust to no longer growing a human being inside of you! Before my PPD kicked in I had the Baby Blues, which manifested for me by having an emotional meltdown every night at 8pm. No joke, every night at 8:00 I would cry for absolutely no reason, I wasn't even sad! I talked to a lot of other moms who said they experienced the same thing at different times during the day.

I knew I had something greater than Baby Blues when I was having trouble getting "mushy gushy" over Titus. I had this desperate need to take care of and protect him, but I didn't really have that, "Oh my gosh, my heart could burst from love!" feeling that so many moms described. I tried to casually mention this to other moms without giving myself away completely, but it seemed like no one quite understood what I was trying to describe, so I stopped telling anyone how I really felt. This coupled with the physical symptoms made me realize that something extraordinary was happening to me.

What's the difference between Postpartum Anxiety (PPA) and PPD? Did you have both?

I would say that I mostly had Postpartum Anxiety with some PPD, but they generally go hand in hand. Since I was so anxious about Titus eating enough, and breastfeeding not going well, I wasn't sleeping hardly at all. The thing about sleep is that you need it not just to keep from being exhausted, but to give your body time to regenerate the things it has used up during wake times. One of these things is Serotonin, which is the chemical that creates the calming and happy feeling in your brain and is made while you sleep. If you don't sleep, you don't make Serotonin, and you can't feel at ease and happy. When the PPA would kick in, my heart would race without explanation throughout the day. No matter how exhausted I was, I would lay down and try to nap and feel like I had drank 6 cups of coffee. The best way to describe it is to say it was like I had no "off switch," I could not figure out how to make my brain power down and relax. The less I slept -> the less Serotonin I made -> the less relaxed I was -> the less I was able to sleep... and so the cycle continued. Eventually that lack of Serotonin also caused the crash in my emotional state, resulting in the depression on top of the anxiety.

Does PPD look the same for everyone?
No, it does not. For me, it was mostly numbness. I couldn't make myself feel anything toward Titus to the degree that I longed for. I just wanted to curl up in bed and not exist. I never had suicidal thoughts, I just didn't want to be where I was. The funny thing was, I also didn't want to be anywhere else. Thinking about leaving the house made my anxiety just as bad as thinking about staying in it. I was stuck. I just didn't want to BE anymore.
I have talked to women who did feel suicidal though, and others have even had thoughts of harming their baby. One friend of mine told me she would stare at a painting of bubbles in her bedroom and wish she could just disappear into it. Another mentioned she never consciously wanted to hurt herself but when she would go to sleep she would dream of ways to commit suicide and wake up panicking because she didn't want to do that. Yet another friend told me she would have horrible panic attacks whenever her husband left the house. She thought she might be having a heart attack and had to go to the ER because she would black out.
These things are all out of your control, it's a hormone-based brain response that is happening whether you want it to or not. However, if you are experiencing ANY thoughts of hurting yourself or your baby (even subconsciously you need to see your doctor right away.

When did it start getting better?

Once I accepted and acknowledged that I had PPD it was much easier to work on getting better. 

  • My mom came down from Missouri whenever she could and I had her read the bible to me, or write down and post scripture in different places. A lot of people don't understand that if you are depressed and feel unable to connect with God, it's not necessarily from lack of trying. As much as I wanted to feel connected to Christ, I was numb in that area too. But when I would hear God's words spoken aloud I just cried, it was the only thing that could create a true emotional reaction in me.
  • I started forcing myself to only think one hour at a time instead of focusing on the overwhelmingness of making it through a whole day or week. I would tell myself, "just make it through this nap time" or "Garland gets home in an hour, you can make it til then."
  • I made myself get out of the house even if it was just going on a walk or to the mall. Even though I got extremely anxious about things going wrong when I left the house, it was a good reminder that the world had not ended and one day I would be a part of "normal life" again.
  • Garland made me run to Sonic or get a pedicure or just go read at the park 3-4 times a week. The time away from Titus was stressful but also helped me to realize he would be fine if I wasn't there every second of the day.
  • I tried to have someone with me at all times. Even though I was capable of taking care of Titus myself, I felt a huge burden lifted when someone was there. Katelyn Graves was my lifeline. She stopped whatever she was doing as soon as she got my call and would bring her laptop over and work from my house for entire days. She didn't even have to do anything, she just sat there beside me while I held a sleeping baby and watched tv and I had this overwhelmingly joyous urge to yell, I AM NOT ALONE. I will never in my whole life be able to explain to her the amount of gratefulness I have for how selfless she was during that time.
  • Lastly, I talked with my doctor and decided to start taking the lowest dose possible of an anxiety medicine. This is a personal choice and I would never tell anyone to start medicine if they don't feel comfortable with it, but I know that for me it helped immensely. It took about 4 weeks to fully kick in, but I could notice things changes in about 2 weeks (read about that moment here). I stayed on it for 3 months and then just forgot to take the pill for a few days and that was that.
Are you worried about having it with your next baby?
Sometimes I do wonder about what will happen with our next child. Women who have suffered from PPD have a 50% chance of having it again (the average woman has only a 15-20% chance). I pray about it anytime we discuss having another child. It is definitely not a situation that I am in a hurry to revisit, but I know that I can't let the fear of a possibility rule my world. My God is bigger than any darkness and prepared a way out of the pit for me once, so I have no reason to think he could not do that again. I praise Him for the doctors, friends, and family that he sent me as individual ropes to tie around my waist and lift me when I was too weak to climb out myself.

So if you or someone you know is suffering from depression, please remember that it is a real thing but it doesn't have to be EVERYthing.

I waited patiently for God to help me; then He listened and heard my cry. He lifted me out of the pit of despair, out from the bog and the mire, and set my feet on a hard, firm path and steadied me as I walked along. He has given me a new song to sing, of praises to our God. Now many will hear of the glorious things He did for me, and stand in awe before the Lord, and put their trust in Him. 

Psalms 40:1-3