ABC-PPD

If you didn’t sing this title to the tune of Motown Philly, please stop reading now and lose the link to this website.

Just kidding, please keep reading because I need readers and followers. ❤ But also get up on your Boyz II Men lyrics. Thanks.

Motown

I actually don’t have as many straight facts for this post as I was hoping, but I am going to share a little bit about how I “self-diagnosed” post-partum depression, how I worked up the nerve to go to my OBGYN and ask for a referral, how I got a TRASH therapist at first and just got referred to another, and some of the things I realized not thanks to the trash therapist but just through my own reflection.

I really struggled in the first several weeks after Liam was born.  There are “baby blues” brought on by the enormous change in hormones post-birth (and after delivering the placenta which is chock full of all the ‘mones).  It’s a BUNCH of crying, but that usually only lasts a few days though.  Then there is post-partum depression (PPD).  There is also post-partum anxiety, which to be honest I never heard of until I started looking up PPD, but it makes sense that it would exist.

PPD is like gestational diabetes or preeclampsia. It is something that some women just get related to pregnancy and childbirth.  There may be risk factors, some may be more prone.  Just like any other health condition, it is a diagnosis that is not something you brought on yourself. Unfortunately mental health conditions are not looked at the same way other health conditions are.  To me, this was the hardest part to swallow.  The same way I felt about recurrent pregnancy loss and infertility, I felt about wondering if I had PPD: How did I do this, cause this, create this.  According to the Mayo Clinic “Postpartum depression isn’t a character flaw or a weakness. Sometimes it’s simply a complication of giving birth.”

I referenced the symptoms of PPD before, but just to refresh people’s memories:

  • Depressed mood or severe mood swings
  • Excessive crying
  • Difficulty bonding with your baby
  • Withdrawing from family and friends
  • Loss of appetite or eating much more than usual
  • Inability to sleep (insomnia) or sleeping too much
  • Overwhelming fatigue or loss of energy
  • Reduced interest and pleasure in activities you used to enjoy
  • Intense irritability and anger
  • Fear that you’re not a good mother
  • Hopelessness
  • Feelings of worthlessness, shame, guilt or inadequacy (!!!!!!!!!!!!)
  • Diminished ability to think clearly, concentrate or make decisions
  • Restlessness
  • Severe anxiety and panic attacks
  • Thoughts of harming yourself or your baby
  • Recurrent thoughts of death or suicide

I have a pretty good gut/intuition and I felt like I might be dealing with PPD from very early on.  But it is hard to tell when you gave birth 6 hours away from home, 6 weeks early and spent the first 10 days of your baby’s life in the NICU for 12 hours a day and covered in a full body rash (look up PUPP if you don’t know it, or forgot.  Or don’t because it’s gross).  Who wouldn’t feel tired, stressed, guilty, irritable, have mood swings or cry if that was the first couple weeks of motherhood? But a lot of those feelings persisted, and were often tied directly into my inability to breastfeed.

I thought I had a pretty good head on my shoulders about breastfeeding and was not putting undue pressure on myself; I wanted to breastfeed if I could, but I also knew there were many reasonable alternatives and lots of healthy babies and adults from both of them. The labor and delivery floor tried to help us, the NICU tried to help, 4 lactation appointments at home. But, when it actually came down to it, and it was just the two of us at home-it just wasn’t working.  I felt like, yet again, my body failed at doing the thing it was meant to do. It honestly felt like another loss.  And even though, via pumping 8-10 times a day for months, and eating a million things with oats-barley-and whatever other milk generating nonsense, and just luck I guess, I was able to create enough milk to sustain him thus far (8.5 months) I still felt like I failed.  To me, failure is a big part of the root of a lot of feelings that I believe, in my farthest from an expert view, led to PPD.

Most of what we hear about PPD has to do with the last two bullet points on that list of symptoms.  They are often sensationalized stories of mothers “pushed to the brink” and harming themselves and/or their children.  So, naturally, that is what I originally thought of and brushed it off.  But when I was honest with myself and looked deeper into the symptons, I realized I connected with a lot more of them than I thought.  The ones in bold are the ones I related to.  Especially: Feelings of worthlessness, shame, guilt or inadequacy.

Once I was honest with myself I knew I needed to talk to my doctor.  I also knew I really enjoyed therapy before.  I had a therapist when I lived in Rhode Island, not for anything specific but to just talk through life happenings.  I highly recommend that btw.  I also, luckily, had one that was housed within my fertility specialist’s office who was very helpful throughout my fertility treatment cycles.  Of course, as it happens, my OBGYN left the practice right before I wanted to be seen so I had a brand new doctor.  My biggest fear was that I would be judged, by her and others, and that she might think I was “crazy” or unfit.  Especially since she had never met me before. I think it was scary for me to admit I was struggling with motherhood in some capacity while worrying the doctor would just go through the checklist and say yup PPD, concerned for safety, here’s some medication and DCF.  This isn’t funny, but it was a real fear.  The medical industry-and the thing is it is definitely an industry ($$$$$$$$)-there are checklists, and diagnosis codes, it often feels very cold and not human. Luckily, this doctor was very good, listened and thought I could benefit from therapy but didn’t think I needed medication at this point.  I was glad she was honest about medication; didn’t want to jump to that right away but also set the expectation that it might be useful or necessary eventually.

But, here is the thing about therapy/counselors…there aren’t enough and they triage.  So, I was referred to the Behavioral Department within my overarching practice.  My OBGYN, Fertility, PCP and Pediatrician are all under the same umbrella which is cool.  They also have a lab, radiology and pharmacy in-house which I love.  Anyway, in January the Behavioral Health department was booking out until SUMMER.  All I thought was what if I was having an actual mental health emergency? But, maybe they would have found time for that? Anyway, they referred me out to a “partner” office.  Then they called me, and asked a few questions about what I was dealing with and looking for.  And then I heard from, we’ll call her Dr. B.

She called while I was in Vegas, and if I LISTENED TO MYSELF, I would have known she was not the right fit from the very first call.  I could just tell.  TBH, I didn’t like the way she talked-I knew it would bother me and I would be distracted.  Maybe that is mean, I don’t know, but even though it is true and I was right it was far from the biggest problem.  I was away when she called so we played phone tag for a while and finally got an appointment.

The first one wasn’t bad, but wasn’t great.  Even though it SEEMS obvious, she did point out that my feelings are probably pretty closely tied to the grief from my dad’s sudden passing as well.  I was aware of this dichotomy of feelings when I was pregnant, since I found out about the pregnancy the day after my dad died.  So, the entire thing was a whirlwind of sadness, terror, excitement, hope, fear and worry.  I never really, truly got to process and grieve.  I felt like I shouldn’t be sad when I was so excited about this *seemingly healthy*, surprise pregnancy.  Even though I am not a religious person, I felt like the timing was wild and it was hard to believe the two happenings weren’t connected in some strange “bigger than us” way.  I am also the planner and caretaker in my immediate and extended family, so I was doing a lot of the management of plans, paperwork, other people’s emotions, etc.  While it was a good that thing was a distraction from the other in a way, it definitely prevented me from sitting with the grief of the loss of my father which I still don’t think I have fully processed.  This realization is probably the only good or helpful thing that came from this therapist.

I went to see her two more times. Somewhat out of hope that maybe it would work out. Partially out of exhaustion and not wanting to go through the doctor-referral-scheduling thing again.  And partially out of guilt because she was an older, arguably pitiful woman, and I basically felt bad telling her it wasn’t going to work out. LORDY COLLEEN what in the hell.  I didn’t want to be judgy and dismiss her right away.  But the phrase used most often in my first appointment was “that’s cool”. I don’t know why it bothered me so much, mostly I think it was unintelligent and unhelpful. When I am talking about how difficult it has been for me to go back to work and feel like I am failing both in work and at home, and your response is your job sounds cool??  I meeeeeeeeeaaaannnn…

The second appointment was more of the same.  I left there feeling more stressed, annoyed, and like I wasted PRECIOUS time driving there and back.  I decided to give it one more appointment (which was a mistake). In appointment #3 I got a lot more of that’s cool-WHAT IS THIS COMMENT?  I also felt like I was counseling her at some points.  Some of you who follow me on Instagram recall me sharing on my story some of the comments she made like asking if someone I was referencing was African because she had a boss once who was African and who looked down upon women…I am sorry WHAT. And that she is a massage therapist and worked for a bunch of super rich people from India (she guessed because “they’re all rich”) who paid her double her rate just because they could.  This was in reference to her asking me if the “college admissions scandal” was all the talk at work since I work at a college.  And then said she felt bad for Robert Kraft and that they should “let that poor man just be” and that he probably didn’t do what they said because why would he.

Besides that so much of this is so problematic in so many ways…WHY ARE YOU TALKING ABOUT ANY OF THIS IN MY COUNSELING APPOINTMENT? Anyway, when she asked when I wanted to meet again I gave her the let me check my schedule because April is really busy and then ghosted her harder than anyone else in my life.  Such a waste of time, money, energy and actually left me more frustrated and exhausted emotionally.

But…I did not give up!  I reached back out to my OB, asked for another referral, did a phone triage with the office in that practice and then was referred out to the same company as useless Dr B again. Ugh.  BUT I got connected with a different person who I saw tonight.  She was kind of a spaz, but gave me a book and an app recommendation so I already got more out of one appointment than 3 with B.  So, we’ll see, but progress.

Even though Dr. B was a trash therapist, and perhaps a trash human, here are a few of the things I learned through my own self-reflection:

  1. I cannot separate myself as a mother from myself as a person trying to have a baby.  These people are not separate.  Having a baby does not erase the trauma I went through trying to conceive, having 5 miscarriages and two failed IVF cycles and thinking having a baby may not be possible.  I carry all of those things with me everyday as a mom now.  And even though I am more grateful and feel luckier than I could imagine that something I thought was not possible did happen, the trauma and grief does not disappear and does infultrate my thoughts, actions and mental health now. Being grateful for what I have doesn’t make the pain disappear.  “Getting what I wanted” doesn’t mean that there are no challenges or that sleep deprivation isn’t real.  I can both relish in the fact that his human exists and that I have this title I thought I may never have annnnnnnnnnnd be scared and on edge and question myself at the same time.  I remember not being able to understand people who struggled or had PPD after going through fertility treatments. How could you be having a hard time when you FINALLY got what you wanted? Welp, now I get it.
  2. We can’t pretend that the pressure (and judgment) put on moms about working…and not going to work…isn’t a factor in PPD and PPA.  While I struggled in the first several weeks, especially with breastfeeding, I really struggled once I was back to work.  This unrealistic set of expectations explained in this quote that is published often and widely “we expect working mothers to work as if they don’t have kids and parent as if they don’t work” resonates with me on a spiritual level.  The attempts I have made to accomplish that feat have left me completely depleted physically and mentally.  If you’ve ever taken anything like StrengthsQuest (shout out to my higher ed peeps) I score highly on Achiever.  I rely on my ability to succeed as validation of my worth. And being an achiever is part of my identity at work and in my personal life. Who am I if I am not achieving at a high level? I actually don’t know.  This applied during my fertility struggle as well, in not “achieving” a healthy pregnancy, and applies now even more so.  Who am I letting down if I can’t achieve the unachievable BALANCE (vom) between work and life (as if they are separate when most people spend more of their time at work than at home)? In essence, everyone.  Please read this BOMB ASS ACCURATE AF post by Sarah Buckley Friedberg that went viral recently for a better description of what women are essentially told to do after having a baby. I was yelling AMEN while reading it, and I am sure many can relate.

Society to working moms:

-Go back to work 6-8 weeks after having the baby. The baby that you spent 9-10 months growing inside of your body. Go back to work before you have finished healing or have had time to bond with your baby. Keep your mind on work, and not your tiny helpless baby that is being watched and cared for by someone other than you. Make sure to break the glass ceiling and excel at your job- you can do anything a man can do! It is your job to show society this! Show the world that women can do it all. Rise to the top of your career.
-Also breastfeed for at least a year. So take 2-3 pumping breaks a day at work, but don’t let it throw you off your game or let you lose your focus.
-Also, lose that baby weight and get back in shape, as quickly and as gracefully as possible. Make sure to get 8 hours of sleep a night so you can work out, work, and care for your family. But also get up at 5 am to workout, unless you want to do it after your kids go to bed when you also need to clean the house and get life ready for the next day and you know, sleep.
-Maintain a clean, pinterest worthy house. Take the Christmas lights down. Recycle. Be Santa Claus, the Easter Bunny, the Tooth Fairy, the birthday planner, the poop doula (seriously when will this end), the finder of lost things, the moderator of fights. Be fun. Be firm. Read books. Have dance parties.
-Maintain the schedule for the entire family. Birthday parties coming up? Make sure to have presents! Ensure the kids are learning to swim, play an instrument, read, ride a bike, be a good human being, eat vegetables, wear sunscreen, drink enough water, say please and thank you. Don’t forget they need to dress as their favorite book character on Monday, and wear something yellow on Thursday. Oh it’s totally your call but most parents come in on their birthday and read to the entire class. In case nobody told you, if you have more than one kid you will need to buy new shoes approximately every other day. See also: winter coats, shorts, pants that aren’t 4 inches too short. There will never be matching socks or gloves for any member of the family, ever again.
-Remember the dog you got before you had kids? Shes getting old now and needs expensive surgery. She also need walking, a new bed, and she smells pretty bad.
-Hey! Kids need lots of doctor appointments. Monthly as babies. Every time they are sick. Specialist appointments, especially if any of them have extra needs. At least two school conferences a year. IEP meetings, if applicable. Parents night. Back to school night. Get to know your school night (what IS this). Most parents are volunteering at least once during the year, would you like to come make a craft with the kids? It will only be an hour or two of your time.
-Sorry, you are now out of vacation time because you used it all for time taking your kids to appointments or when your childcare is unavailable. You should go on vacations though. It’s good to relax and unwind from work. Makes you a better employee.
-Don’t forget the kids need healthy meals (and so do you! you are trying to lose that last 20 lbs before swim season right). That requires meal planning, grocery shopping, and meal prep on the weekend. But also hang out with your kids on the weekend since during the week you only get to hang out with them when they are exhausted and angry that you made the wrong kind of spaghetti for dinner.
-Date your spouse! It’s important to keep your relationship alive and fresh. Try to go out 1-2 times a month. Good, kid free time. Hire a babysitter, they charge 22+ dollars an hour in your area so make sure to take out an extra mortgage and/or work another job to be able to afford this.
-Oh hey you should have a hobby too. It’s important to have “you time”. Also be well read, keep up with the latest pop culture and tv shows, and keep an eye on politics and be able to discuss at least one of the above on the small chance you are out in public and encounter another adult necessitating small talk.
-Make sure to have friends. Social time is SO important. Surely there is an hour or two left in the week after all of the working, appointments, exercising, cooking, scheduling, cleaning, imparting lifelong morals and learning on the kids, the usual. Maybe go out after the kids are down for a glass of wine and a bite to eat. Make it a healthy bite though. And you may regret that wine at your 530 am spin class.
-Self care though. SO important. See also: getting in shape. See the general doctor, the dentist (TWICE), the lady doctor. Prob need to get your eyes checked. Full body skin checks 2+ times a year (just me? okay well). Mental health too. Postpartum anxiety? But you look fine and your kids are so cute. Everyone should have a therapist. Good luck finding one that takes your insurance and has hours outside of your normal working time (out of vacation time, remember?). That leaves evening time when you want to hang out with your kids. But it’s important, so make time for it.
-Don’t wear yoga pants and a mom bun or society is going to mock you in numerous witty blog posts. Never mind that nothing fits. Going to have to get up even earlier so you have time to style your hair, wing your eye liner and search for a pair of pants that fits your new post baby (or multiple baby) shape.
-Get off your phone, turn off the TV, and enjoy your life. Enjoy your kids. THESE ARE THE GOOD TIMES make sure to love every minute of life because before you know it all of this will be in the past.

I don’t know about you, but I’m ready to lean OUT. Thanks for coming to my Ted talk.

3. Failure.  It is connected to #2 but so many parts of parenthood are listed in terms of failure. Ooooooooh you’re not breastfeeding? Oooooooooh the baby isn’t sleeping through the night? Are they a “good” baby? Your baby isn’t rolling yet? Crawling yet? Standing yet? Eating yet? (First of all, don’t ask the good baby question, that’s a ridiculous question straight up). My friend, and fellow new mom, posted an article from Raisedgood.com the other day that hit me so hard. It is specifically about baby sleep;  people give/receive a lot of judgment about their parenting based on how well or how long their baby sleeps for (and how soon). Listen, I’ve wanted to sleep for more than 90 consecutive minutes as much as the next girl, I wondered if I would ever sleep to a point of feeling rested ever again. And I did feel heaps of inadequacy when friends and acquaintances were sharing (or bragging) about their “great sleeper” and the 7-7 sleep schedule they were enjoying. I bought every sleep device on the market. I felt three things at once: (1) complete and utter exhaustion and wistfully hoping that one day I would ever sleep again, (2) jealousy and inadequacy that these other parents somehow got their babies to sleep for long stretches and (3) deep down I also knew that my baby’s sleep was totally normal and that he was doing just fine.  But this article highlights a lot of the problematic “facts” and “advice” that is passed along-almost always unsolicited-that make moms feel like they’re failing, or question themselves and their instincts. A couple of my favorite excerpts:

SleepQuote1

EVEN AND ESPECIALLY IF YOU HEARD THESE AS A NEW MOTHER.  Break the cycle of spouting off randomness that is not researched, generalized, passed down without investigation and harmful! Please and thank you!

SleepQuote2

Human mothers are among the most needed, hardworking and exhausted mothers on the planet.

In honor of Maternal Health Awareness Month, I felt like I wanted to dive a little deeper into my experience with PPD symptoms, my effort to seek therapy to understand and grow, and some of the pressures and expectations put on new moms in particular that I think contribute to an environment that can lead to those feelings. I say PPD symptoms in particular because I have not received this as a specific diagnosis yet.  My second non-trash therapist actually thought I may have PTSD from my fertility struggles and recurrent pregnancy loss. So, diagnosis TBD but as important as it has been to me to bring awareness to infertility, I feel the same now about Maternal Health Awareness. While the challenges are different and certainly many women deal with PPD and PPA who never had a fertility issue, for me the 2.5 years of trauma and grief related to these struggles are intrinsically connected to my mental state now.

Not Quite Knocked Up turned into Not Quite Knowing What I’m Doing as a Mom. And I think I am becoming more ok with that.

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