Sunday, October 16, 2011

At The Risk of Boring You [or perhaps bumming you out]

I've got some more to say on being crazy, and specifically on postpartum issues.  Through the blog party I participated in and the Strong Start Day blog posts I read, I discovered this website called Postpartum Progress.  It is THE website on PPD/A and has won many awards for the blog itself and for individual articles.  It is EXCELLENT.  I wish I had found it EIGHT YEARS AGO, and especially six years ago, it would have changed my life.  Much quicker than it actually changed.  It would have accelerated my healing and my ability to feel connected to others experiencing the same things.

At any rate, I read through a bunch of the resources on that site and I have to say I was blown away by this particular list of postpartum depression and anxiety symptoms translated into plain english.  Even after years of education and treatment and researching and becoming stable, I still learned some fundamental things from this list.  If you are a postpartum mother, know one, or might someday become one, this resource is really important.  PPD is something that none of us think we're going to need to know about or deal with [yet of course some of us will], and it's something it is helpful to have tools for recognizing and reaching out before it ever happens to us.  Not in a self fulfilling prophecy kind of way, but in an arm thyself just so you could help someone else [or maybe even perhaps yourself] kind of way.  JUST in case.

Here's the list.  I put in bold the symptoms I experienced in an overwhelming capacity after we adopted Matthew, which is when my PPD/A was the most out of control.  I write a lot about my PPA after Riley was born because (a) it is more recent, (b) it was when I got helpful treatment, and (c) it is less painful for me to talk about, but in actual fact my disorder was far more out of control after we brought Matthew home.  Here goes:

You may have postpartum depression if you have had a baby within the last 12 months and are experiencing some of these symptoms:
  • > You feel overwhelmed.  Not like “hey, this new mom thing is hard.”  More like “I can’t do this and I’m never going to be able to do this.”  You feel like you just can’t handle being a mother.  In fact, you may be wondering whether you should have become a mother in the first place.
  • > You feel guilty because you believe you should be handling new motherhood better than this.  You feel like your baby deserves better.  You worry whether your baby can tell that you feel so bad, or that you are crying so much, or that you don’t feel the happiness or connection that you thought you would.  You may wonder whether your baby would be better off without you.
  • > You don’t feel bonded to your baby.  You’re not having that mythical mommy bliss that you see on TV or read about in magazines.
  • > You can’t understand why this is happening.  You are very confused and scared.
  • > You feel irritated or angry.  You have no patience.  Everything annoys you.  You feel resentment toward your baby, or your partner, or your friends who don’t have babies.  You feel out-of-control rage.
  • > You feel nothing.  Emptiness and numbness.  You are just going through the motions.
  • > You feel sadness to the depths of your soul.  You can’t stop crying, even when there’s no real reason to be crying.
  • > You feel hopeless, like this situation will never ever get better.  You feel weak and defective.  You feel like a failure.
  • > You can’t bring yourself to eat, or perhaps the only thing that makes you feel better is eating.
  • > You can’t sleep when the baby sleeps, nor can you sleep at any other time.  Or maybe you can fall asleep, but you wake up in the middle of the night and can’t go back to sleep no matter how tired you are.  Or maybe all you can do is sleep and you can’t seem to stay awake to get the most basic things done.  Whichever it is, your sleeping is completely screwed up and it’s not just because you have a newborn.
  • > You can’t concentrate.  You can’t focus.  You can’t think of the words you want to say.  You can’t remember what you were supposed to do.  You can’t make a decision.  You feel like you’re in a fog.
  • > You feel disconnected.  You feel strangely apart from everyone for some reason, like there’s an invisible wall between you and the rest of the world.
  • > Maybe you’re doing everything right.  You are exercising.  You are taking your vitamins.  You have a healthy spirituality.  You do yoga.  You’re thinking “Why can’t I just get over this?”   You feel like you should be able to snap out of it, but you can’t.
  • > You might be having thoughts of running away and leaving your family behind.  Or you’ve thought of driving off the road, or taking too many pills, or finding some other way to end this misery.
  • > You know something is wrong.  You may not know you have a perinatal mood or anxiety disorder, but you know the way you are feeling is NOT right.  You think you’ve “gone crazy”.
  • > You are afraid that this is your new reality and that you’ve lost the “old you” forever.
  • > You are afraid that if you reach out for help people will judge you.  Or that your baby will be taken away.
You may have postpartum anxiety or postpartum OCD if you have had a baby within the last 12 months and are experiencing some of these symptoms:
  • > Your thoughts are racing.  You can’t quiet your mind.  You can’t settle down.  You can’t relax.
  • > You feel like you have to be doing something at all times.  Cleaning bottles.  Cleaning baby clothes.  Cleaning the house.  Doing work.  Entertaining the baby.  Checking on the baby.
  • > You are worried.  Really worried.  All. The. Time.  Am I doing this right?  Will my husband come home from his trip?  Will the baby wake up?  Is the baby eating enough?  Is there something wrong with the baby that I’m missing?  No matter what anyone says to reassure you it doesn’t help.
  • > You may be having disturbing thoughts.  Thoughts that you’ve never had before.  Scary thoughts that make you wonder whether you aren’t the person you thought you were.  They fly into your head unwanted and you know they aren’t right, that this isn’t the real you, but they terrify you and they won’t go away.  These thoughts may start with the words “What if …”
  • > You are afraid to be alone with your baby because of the thoughts.  You are also afraid of things in your house that could potentially cause harm, like kitchen knives or stairs, and you avoid them like the plague.
  • > You have to check things constantly.  Did I lock the door?  Did I lock the car?  Did I turn off the oven?  Is the baby breathing?
  • > You may be having physical symptoms like stomach cramps or headaches, shakiness or nausea.  You might even have panic attacks.
  • > You feel like a captive animal, pacing back and forth in a cage.  Restless.  On edge.
  • > You can’t eat.  You have no appetite.
  • > You can’t sleep.  You are so, so tired, but you can’t sleep.
  • > You feel a sense of dread all the time, like something terrible is going to happen.
  • > You know something is wrong.  You may not know you have a perinatal mood or anxiety disorder, but you know the way you are feeling is NOT right.  You think you’ve “gone crazy”.
  • > You are afraid that this is your new reality and that you’ve lost the “old you” forever.
  • > You are afraid that if you reach out for help people will judge you.  Or that your baby will be taken away.
Now that you’ve gone through these lists are you thinking “How the heck does this lady know me? Is there a hidden camera in here?”  Nope.  What this should tell you is that you are NOT alone and you are NOT a freak and you are NOT highly unusual.  If you are having these feelings and symptoms then it is possible you are experiencing common illnesses that 15 to 20% of new mothers have, and they are completely treatable.  Just reach out for help
 Okay so I also made those symptoms red.  Looking back on what had happened I had figured what I had was postpartum anxiety with Matthew and with Riley but looking at this list it is fairly obvious I had postpartum depression after Matthew came home.
A word on PPD/A and adoption; it happens.  It is not the hormones that cause PPD/A but rather the drastic socio-emotional shift of having a baby.  In fact, women who adopt often have wrestled with depression over infertility for years and past depressive episodes are a risk factor for PPD.  I'd be willing to bet my life on the fact that many, many adoptive moms struggle with this and go completely undiagnosed, totally missed by any health professional, family members, community group, or support people because the child is adopted, there are no hormones at play, and besides doesn't this woman want this baby so much more than your average woman wants a baby?!  I read a good book called Post Adoption Blues a year or two afterwards, and felt it was an important topic that needs more attention.  Anyways.  Rabbit trail.
If I do the same exercise with my experience after Riley was born, most of the bold red would be in the second list.  In fact, all of the points in the second list would be red.  And a few in the first.  I didn't know that anger could be a manifestation of depression, and I remember at the time thinking, I'm not depressed because I don't feel SAD.  I feel ANGRY!  And I don't know WHY!
Angry and guilty.  My guilt feelings would spin around in my head so fast and furious that they would elicit anger, and then I would feel guilty that I felt so angry and didn't feel much love or many soft, warm feelings for this child in my home, my family, my arms... And I felt just as terrible if we had a good day than if we had a bad day.  It was horrific.  I experienced a profound shift in my sense of identity which I still struggle with, because I faced a very dark side of myself that I didn't know existed, and wish emphatically that I had never met.  I had a hard time seeing myself as a good person, and shifted my self concept from a good parent (when I had just Ayden) to a very bad parent within the span of three weeks.  I had the biggest emotional whiplash imaginable, and that guilt morphed into this very big personal demon who controlled me for years afterwards.  I've written at length about my struggles with guilt, and this list shines a light on the beginning of that story.
It turns out that angry and don't know why is a depression symptom.  WHO KNEW?!  Not I, said the crazy fly.  But now I do.
I'm so glad (so glad doesn't even begin to touch on the extent of my relief and joy) that this is over with.  I was thinking today that that first eight months in particular of my experience after bringing home my baby was the worst thing that has ever happened.  Not HIM, but my emotional unbalance.  I wish I could go back and reclaim those months, and experience that little bit of his childhood and baby-ness without the fog, but much of it I cannot remember.  I only remember the worst of my anger and confusion, and some doctor's visits for mundane things.  That's very normal with postpartum depression; women often feel like they missed out on a portion of their child's life even though they were very much physically present for it.  But there is an element of relief in knowing that the worst bit of your life is behind you.  Seriously, nothing that I can conceive of ever happening to me or in me or around me could be worse than that time in my life.  Nothing.
[I'm tempting fate.]  [Another anxious thought that happens to be a particular weakness of mine]
AND it is interesting to note that I believe I had Postpartum Anxiety AND Postpartum OCD after Riley was born.  OCD is simply an extreme manifestation of anxiety, whereby the compulsions are used as coping mechanisms for overwhelming anxiety.  I had compulsions but they were slightly atypical; checking and rechecking, counting, rituals, etc, that were silent and didn't really interfere too much with my ability to function; but they were there.  And once I dealt with my underlying out of control anxiety, they went away.  It is amazing now to think about how strongly I believed that those rituals were keeping my family alive.  Whew.  Totally crazy (in more than one sense of the word).
I could be wrong, of course; doesn't every hypochondriac self diagnose from what they read on the internet?  But my intuition tells me I'm right.  And so does my stability now, and my body's response to treatment.  If the treatment doesn't fit the diagnosis, it won't cure the disease.  Not that I'm cured.  HA!  Not by a long shot.  But I'm stable.  My moods are, for this season of my life, well controlled.  Not perfect: I just had a two week long fight against a sad, weighty depression recently and it freaked me out.  The difference is that I can recognize these early and be proactive about them, so hopefully I will not spiral so far out of control again.
Let me also just say that there are a bajillion women who struggle with this (and other) form of mental illness and treatments for them are as varied as the women themselves.  I'm an advocate of cognitive behavioural therapy, naturopathic remedies, pharmaceuticals, group therapy, hospitalization, light therapy, diet changes: you name it.  If it keeps you alive, healthy, balanced, and functional, IT ROCKS.  The longer I live with this disease, the more I know this to be true, and the more open minded I become regarding treatments.  Also, a treatment may work for a time and then stop working, and need tweaking.
At any rate, Postpartum Progress.  Good resource.  Enough said.

***sorry about the stupid formatting/font issues.  i can't fix them.  they are driving me nuts***


Rachel Clear @ Clearly Speaking said...

Melissa, this was an amazing post. I am going to link to it. I think a lot of women can relate on both the PPD and the Adoptive PPD (or whatever that's called...maybe the same thing).

I have one friend in particular who I know is struggling with this and is not getting help and I am WORRIED. Like, really worried. But she insists that she doesn't have PPD, and rather it is just that her baby is such a punk (my words, not hers) and that if her baby were calm and happy, she would be too. Maybe there is some truth to that. I mean, fussy, unhappy babies can make anyone nuts. But I know it's more than that and that she needs treatment. Aaagh! It's so hard.

I am TERRIFIED of having another kid, because of this. I didn't experience one drip-drop of PPD with Bennett (though there were a few hard days where I got nothing done and did feel overwhelmed, and there still are some of those days), so I feel that I totally lucked out. And I know I probably won't again. I see what so many other moms go through and how strong they are, and because I've struggled with depression in the past, I question whether I would be strong enough and able to function with a baby if I ever got PPD. It's a very real and terrifying fear. I know that if I ever DO get it (if I have another baby), I will have YOU and so many other great resources for help that so many others moms didn't use to have.

I am pretty sure that Cam has a male-version of PPA (not the depression part, but the anxiety, combined with some OCD) because after having Bennett he went nutso with weird OCD behaviors and over-the-top cleanliness and worry, to the point of irrational and not-makey-sensey. It was rough. I now know that there are resources (not many, but some) for men as well, but I was too baby blissed (and mad at him) at the time to really figure it all out.

Thank you, friend. I think it's very brave and honest and incredible that you share your story so openly. A lot of women can be helped by this.

melissa said...

Thank you! It's always hard to hang your guts out on the internet; I worried all morning and wanted to delete it all. But I know it's important to get it out there!! I'm trying to stay calm!

Sorry to hear about Cam; I wish there was more recognition of how hard it is to become a dad, hey? Rough.
And its not a foregone conclusion that you will get PPD, not at all! It's not even like MOST women get it, just I think 10-15%? But I think your best bet is what you said here; align resources and do the best you can to recognize and intervene early IF it happens to you. It's a journey. And mine is particularly fraught because I 'have a disorder,' ykwim? I wrestle anyways, even without the babies!!

And yeah, someone needs to write a book on adoption and PPD.


melissa said...

p.s. OH! Also I have read from several sources that a higher needs baby (special needs, downs, ill, or high needs temperament) is a risk factor for PPD. It is part of what happened for me; Matthew is such a high needs personality; sensory seeking, intense, spirited, HIGH energy, persistent, etc, that it was difficult for me to manage, navigate, advocate for him, and manage my SELF as well....

tamie marie said...

I read this and thought, "I think I have postpartum anxiety & depression." The baby I had was Bear Island. But anyway. Sometimes it's hard to remember that you can be depressed or anxious & still be functional.

Don't delete the hang-guts-out posts. I always want to do that too, so I really get it, but it's so important for us to share with each other so we know we're not alone or crazy. You're not alone, and baby, you're the best kind of fucked up.

Actually, I don't think you're fucked up in the slightest.

Rach, I'm really sorry to hear about Cam suffering from depression and/or anxiety. Really sorry to hear that.

Louise Chapman said...

Mel, I love these posts. I'm able to forward them or mention them to others and it's a super helpful resource. Go you:)

melissa said...

It's definitely not boring. I'm thankful for the information. It's need to know, stuff.

I was terrified of PPD and sure I would have it due to my family's history of depression, but I was pleasantly surprised to come out mostly okay. Of course I had sad days and totally incompetent (or so I felt) days, angry days, and exhausted days, but mostly it was and is all good. Still, knowing what to look for, both in myself and others is valuable.

Asheya said...

Thanks, Melissa. Angry as a symptom of depression is a big clue for me, too. That whole PPD list sounds really, really familiar...especially not being able to handle it, wanting to run away, irritated & angry with no patience, disconnected. I can compare how I feel now to how I felt when Elias was one or two years old, and it's totally different. Something changed when I was pregnant with Amadeus--prenatal depression leading to postpartum depression, but of course I am still functioning fine (mostly). One of the midwives here says that you can develop PPD even years after your baby is born--the within 12 months may be related to hormonal changes, but depression can often develop slowly, so you may not notice many of the symptoms at first, becoming worse with time if left untreated. Still trying to figure out how to beat this--hoping Hawaii sun and warmth will help.