It seems faux pas to discuss let alone admit to the possibility of having a perinatal mood disorder, most commonly postpartum depression. Let me be the first to proclaim it SHOULDN’T be. Many many many of us out there have been through it to varying degree.

70-80% of women experience SOME form of negative feelings following birth
1 in 7 women develops postpartum depression. You are not crazy or a horrible mom for feeling this way.
PPD and perinatal mood disorders can also affect new FATHERS.
Feelings don’t have to appear right after birth, they can show up a YEAR later.
It is also the most under-diagnosed OB complication.

Do NOT suffer in silence, there is help for you. A great resource for information is here.

If you need help right now call to chat with someone
1-800-273-TALK (8255)

My own bout with PPD & PPA

I have bolded several words and phrases below as RED FLAGS. If any of these resonate with you please reach out!!

The Thanksgiving holiday was supposed to be a time of joy and getting together with family, everyone excited to have a new addition to celebrate with. What it turned into was a complete living hell that was upon me before I could even form the words to describe what I was going through. Long story short, we were surrounded by the usual holiday craziness with a baby who was suffering from relentless colic. We were new parents, sleep deprived, with a screaming baby most hours of the day and were trying our best to carry on with the normal festivities as if these things didn’t matter. We ended up in the mountains as we usually do for the holidays, we had all of the baby gear jammed in the car, all of the dogs, we were ready to set up shop. Unfortunately, as hard as we tried to replicate our “home” environment it just wasn’t the same being away from our home, our nest, and familiarity.

The night ended up just as the past several had been, with a screaming baby who would drift off for 10 minute stretches and wake up screaming. Colic is a beast. Hubby and I were trying everything we could to comfort him. Top that with a dog that decided to start puking and having bloody diarrhea as soon as we arrived at our destination and it was a recipe for disaster.

Despite the extra chaos I had felt uneasy the entire time for different reasons that I couldn’t really vocalize. I felt extremely uncomfortable like I was crawling out of my skin. Everyone around was happily carrying on, laughing, and enjoying themselves and I was in a very different place. I was watching it all go on around me as if I wasn’t there. People were wanting to hold the baby and give us a break but I resented the nice gesture for some reason and was getting increasingly agitated about this. I couldn’t put into words how awkward everything felt, we’d been at this house many many times before and done the exact same holiday festivities but I absolutely couldn’t stand it this time. The noise and laughter, dishes clinking, tv playing all seemed over the top, I was hypersensitive to ALL outside stimulation and somehow convinced myself that our baby was too. In the end I felt an overwhelming need to escape the current environment, I had to get out of there.

I was pleading with my husband to go home at 2:00 in the morning in a snowstorm to which he looked at me like I was nuts. He convinced me to stick it out through the night while he took the baby by himself downstairs all evening so I could sleep and we agreed to pack up and leave around lunch time.

I felt a sense of relief knowing that soon we’d be back in our home, with our routine, much more at peace. I bawled the entire car ride home about how I felt like I was a failure, I couldn’t even handle a weekend trip with a 3 week old baby, I must be the worst mom in the world. I had been having these feelings over the past several days but they had intensified so much I didn’t even know what to think. A week prior we were at dinner and I had the same uneasiness which obviously my husband could sense when he asked “are you ok?” and I responded “aren’t you worried about the baby?” and I was again met with a look of pure confusion. He said, “he’s sound asleep in the carrier right here, what are you worried about??!” I was worried that he was going to wake up crying and I just felt like we shouldn’t have been out at dinner, we should’ve been at home. When I was at home I would watch the sun starting to go down in the afternoon and immediately start feeling that uneasiness, I dreaded night time because I knew he would be crying all night. These scenarios kept coming… I was sure that “hormones” were playing a part in my misery but that’s as far as I took it.

When we got back home from the mountains and back to our routine, I definitely felt more at ease with the anxiety but the problem was far from fixed. Over the next couple of days I spiraled downward very quickly. I became increasingly agitated and restless, I couldn’t sit still and felt like my skin was crawling but yet I had no motivation to even pick myself up off of the couch. Going out anywhere was laughable so I continued to pace around the house, sit down, get up, fix a drink, get a snack, sit down, get up, it continued for hours. I finally took 3 Advil PM at 5:00 in the evening to knock myself out, I literally had no idea what else to do with myself.

I kept thinking that maybe we’d made a mistake that we never should’ve had a baby. I would be out in public staring blankly at everyone with children from infants up to teenagers and I would think “How in the world did they do this? How does ANYONE have children? This is sooooo hard!” All I could think about was how hard this was. I felt like a complete failure as a mother. My husband would continue to reassure me every day that I was doing a good job, the baby was fine, that this isn’t hard, but I couldn’t wrap my head around that… to me this was NOT easy… I felt like I was on a different planet.

Every moment of the day I was anxious, I was worried. I was worried that he would wake up fussing, worried that he’d be up all night, worried about the next feeding, and changing, worried that he’d have gas, worried that we’d bother people if he cried. It was awful, I literally hadn’t eaten anything in close to a week, NOTHING. I had no appetite. I was dropping 2-3 pounds every other day when I’d get on the scale and this was weight that I didn’t have to lose, I was already at my pre-pregnancy weight.

I felt a huge sense of failure as a mother since I wasn’t handling it as expected. I mean here I was living the dream that I’d always had, I had everything that I’d ever wanted in life and yet I still wasn’t happy. Talk about guilt…. I would tell myself “You’re still not happy, what’s it going to take to be happy then?!!” I felt like I was letting my son down, my husband down, myself down, the dogs down. I mean I couldn’t even breastfeed my baby, that’s the ultimate sense of failure, I couldn’t even provide nourishment for my baby! What was WRONG with me??!

The guilt was overwhelming.

I remember distinctly one car ride that I stared out the window and thought my husband and baby would be SO much better off without me here.

Obviously my husband was handling the baby thing just fine, I was the one in la-la land, so if I weren’t around they’d be much better off. This was my breaking point, the moment those thoughts crossed my mind I knew things had gone too far and was thankfully rational enough to know this was not normal. I never wanted to hurt my child and I never thought about suicide but I was very convinced they’d be better off without me. Those dots aren’t too hard to connect and luckily my brain was still sound enough to throw up a thousand red flags in that moment and get me to reach out.

I finally decided to start looking up Postpartum Depression online when my husband and I were discussing it. I was open to admitting it simply because I knew there was treatment and that I could stop feeling so awful, that was my only saving grace to admit it. I had heard the term Postpartum Anxiety mentioned in a chat forum and I thought that the anxiety aspect more described what I was feeling. So I started researching PPA. I found the most amazing website that broke down the symptoms of PPD and PPA and actually a whole series of postnatal mood disorders that I never even knew existed. After looking over the symptoms I realized that I definitely had a handful of them on each list, and so I set out to get in with my doctor.

I was bawling as I read the list of symptoms to my husband, every one of them hit a chord in me and made me feel even worse. Just admitting that I had PPD/PPA was like a failure in itself, “why can’t I just handle this like everyone else does?” Again WHAT is wrong with me.

I was talking with the nurse practitioner about my symptoms, she agreed that I should go on an anti-depressant to help stabilize my mood, and right before our conversation ended the nurse in me decided to ask her if the new medication would have any interactions with the Reglan (metoclopromide) I was taking to increase my milk supply. She promptly said “OH? You’re taking Reglan?” and proceeded to inform me that Reglan itself can cause depression! It was like a lightbulb went off, as I had been increasing my dosage of Reglan for my broken boobs I had started going downhill right into the holiday.

Needless to say I immediately discontinued using the Reglan and at the same time started taking Zoloft. Within just a day or two I noticed an improvement and after a month or so I started feeling back to my normal self. There were good parts of the day and still bad parts of the day but all in all I felt so much better. I was back to enjoying my baby and stopped flipping out about him crying or having gas every waking moment of the day. It seems silly to me now how I was feeling, how anxious I was, but it was very real at the time. My appetite started getting back to normal and I started regaining motivation to get out and do things. I was so incredibly thankful that I reached out to get help because I was in a bad place and I wasn’t sure that things would ever go back to normal.

I realize now that it is a terrible idea to believe that you can think your way out of these feelings or somehow rationalize them in your brain. I certainly tried to and all I did was make myself miserable when I could’ve reached out for help much earlier. PPD/PPA and the like are the result of a CHEMICAL imbalance in your brain and nothing that is in your control! Without medication to regulate your neurotransmitters it will not “fix” itself no matter how much effort you put into it.

When people hear “Postpartum Depression” they automatically think that you want to hurt your baby or commit suicide. There’s much more to it than that! There is an entire spectrum of feelings related to PPD and many women never reach the end of this spectrum. I never wanted to hurt my baby or myself, never even crossed my mind, but I knew that something was definitely “off” and it wasn’t getting better. My goal in all of this is to educate people so that more women feel confident in getting the help that they need, so they aren’t ashamed to reach out.

PPD and similar disorders affect 20% of women and this only represents the women that actually report it, the true number is likely higher. We aren’t alone here and there is no shame in getting help, I am proof that it does work and that you don’t have to “suffer it out.”

Postpartum Issues with Subsequent Pregnancies

After a few more pregnancies under my belt, these same similar feelings have appeared after each birth. I have not had the anxiety component but have definitely had a feeling of being uneasy and “off” following each of my kiddos. The third time it wasn’t until about 5 months postpartum which I attribute to the decrease in my ability to breastfeed that obviously triggered some hormonal imbalances. Each time I experience sadness and depression to varying degree, a feeling of almost being trapped or that every day is Groundhog Day. I have a clear awareness that I don’t feel like I used to, almost like I’m in an out of body experience watching myself go through life.

I anticipate the same thing happening after baby 4 arrives and luckily I’ve experienced it enough to know what to look for and I’ve found a solution that appears to work for me. Each time it takes me about 2 weeks of feeling pretty miserable to keep pushing through before the fog starts to lift.

Things that helped me

Despite having a super supportive husband I find myself wanting to be very secretive about my feelings when this happens, I try to hide it which I’ve obviously learned is a HORRIBLE idea. Just getting the words out that “I’m not feeling right” feels like a weight lifted off of my shoulders and he immediately jumps into action mode. What we’ve found together that helps is to keep busy, to have something (at least one thing) every single day to get OUT OF THE HOUSE to go do. It’s very easy to retreat and stay in the house avoiding the issue, it truly takes a tremendous effort to get out and do something. Many times my husband has almost had to drag me out of the house yet every time I feel SO MUCH BETTER after I force myself to do it. It doesn’t need to be anything fancy, just get dressed and get out of the house. Go on a walk, go to the grocery store, drive around, go to a restaurant for lunch, even doctor appointments were a welcome excuse to get out in the world and stop isolating. This is what has helped me.

It isn’t an overnight thing and requires effort. Thankfully I have had the willpower each time to put in this effort, not everyone can and that’s OK!! Lean on your support system, call a friend, call your OB, write ME a message, there is always somewhere to turn.

Some triggers I’ve noticed

Pain meds from birth, this may be an obvious one, but don’t underestimate the effect of these on your brain chemistry. This can be something to tackle in and of itself. For me, following birth, I try to use them as sparingly as possible and move right to over the counter meds. I ended up having baby 3 naturally and I actually did notice a difference here.
Breastfeeding, the hormones your body is pumping out and adjusting from pregnancy- to feeding- to not feeding and everything in between are NO JOKE. As I said, I didn’t notice any postpartum symptoms with baby 3 until after I was pretty much done nursing.
MEDICATIONS, I emphasize this one because you MUST be an advocate for yourself and be careful of meds that can affect your mood. Even as a nurse it didn’t dawn on me with baby 1 that the breastfeeding medication Reglan could precipitate depression. With my struggles to breastfeed baby 3 I stupidly and knowingly opted (as my final resort) to get a Rx for Reglan again hoping it would help and thinking there may be a tiny chance it would be fine this time. 2 doses in and I IMMEDIATELY felt that weird depressed “off” feeling creeping in and dumped those pills down the toilet. I strongly urge everyone out there to avoid these meds like the plague!!! That includes Domperidone and other off label prescription meds that have been traditionally used to stimulate milk supply. There are natural and herbal products out there that I would go to first, however, ONLY AFTER researching them extensively.