With the holiday season upon us, I have been reflecting on this past year. It has been a whirlwind to say the least. We moved to a new city, Nashville, where we have fallen in love, made amazing new friendships and have finally put down some roots (yay!). Then in March, we welcomed our second son, V, have spent the past nine months ingratiating him into our family and getting to know this sweet little guy. And last but not least, we have witnessed our "baby"/first-born, grow into a little boy and started him at a wonderful pre-school for the first time. With all of these emotional highs, I feel happy and so full looking back on this past year. So full that it almost seems unreal that I experienced one of the darkest periods of my life.
Today, I am going to talk about this dark spot, also known as postpartum depression and postpartum anxiety, that I experienced this past year. It is a difficult topic in general and for me personally, however, I believe in sharing my story that I may be able to find further release from it and that I can also help relate to other women who have encountered the same. It is interesting because as a mother of two I had heard of women battling postpartum depression/anxiety, but never fully grasped what it looked like or meant until I endured it myself.
The days that I endured the worst of my postpartum depression and the trauma that followed were some of the worst in my life. In the midst of such a beautiful time with two beautiful baby boys and a wonderful husband, I was experiencing an unexpected and complete disaster both mentally and physically. And with two little babies relying on me for everything, it seemed to exacerbate the problem. Before I could grasp the issue or understand what was happening, my postpartum anxiety soon manifested itself physically through migraines and nausea, and I ended up in the ER. It is crazy what postpartum depression and anxiety can do to the body.
Thankfully, yet sadly I am not alone. According to the CDC, 11% to 20% of women in the United States face some version of PPD. With 4 million live births in the US annually, this would mean that approximately 600,000 women experience postpartum depression. Keep in mind that this number represents only what has been "reported", so the actual number is likely a lot higher if you consider all of the women who don't report their specific cases. Not to mention, other cases of maternal depression, such as prenatal depression/anxiety, which often is not talked about.
Before I get into the start of my story, I want to preface this post a disclaimer, if you will, because postpartum depression and anxiety (or PPDA as I will refer to it) is something that is to be taken very seriously and should be under the care of a medical professional. First point, I am in no way an expert on the topic of PPDA. Before it happened to me, my understanding of the topic was somewhat far off. Now that I have gone through what I think was PPDA and have a baseline understanding for what my personal experience of it was, I will say that in my research and in talking to some professionals, each person's experience of PPDA can be quite unique. It is not a one-size fits all disease, and therefore certain symptoms and also cures may very much be entirely different. Therefore, please do not take my words as truth if they do not resonate with you and your story. Your experience may be different than mine and may also require an entirely different regimen of care and healing. Do that. Again, I recommend that you use this blog post only as an anecdotal experience rather than a form of treatment.
Last point, I drafted an entire story of my PPD experience; downfall and recovery. I am not going to share that today, as it a very long, meticulous and deep. Some of it was documented when I was actually going through PPDA - and is a little too heavy and a little too much, especially over the holidays! So, I decided that I will share that at a later time (or for those who need it). Instead, I figured this Q+A would be a good start to give an overall picture of my experience with PPDA (postpartum depression + anxiety) that will hopefully be more helpful and to-the-point.
When did your postpartum depression/anxiety (PPDA) start?
My PPDA started around six months postpartum. Now looking back, I'll say that I did start having some symptoms a few weeks before the six month postpartum mark, but the full-blown PPDA didn't start until six months postpartum (literally on the dot).
I thought that PPDA started right after you give birth, how could it have happened at six months postpartum?
All of my answers here are anecdotal, again, so please don't take this as fact, but my PPDA counselor told me that PPDA can happen at any time within the first year postpartum. So it doesn't have to be right after you deliver your baby. My counselor also told me (anecdotally) that PPDA often comes on in three month increments postpartum. So often times you will see women have onsets of PPDA symptoms at three months, six months, nine months, and twelve months postpartum. It can, however, happen at any time.
I have also heard many stories of women having prenatal depression/anxiety. So before giving birth, it can be common to have symptoms, as well.
What were some of the early symptoms of your PPDA?
Before the six-month postpartum mark, I started noticing that caffeine was effecting me differently. Instead of giving me a boost, it started giving me headaches, making me more lethargic and noticeably contributed to my anxiety. I am already somewhat of an anxious personality, but I have very manageable anxiety (or at least I think that I do). Again, I was noticeably more anxious; so anxious, in fact, that my sleep patterns became irregular. I also had a faster heartbeat (uncontrollably) and suffered from one panic attack (before any of the full-blown PPD kicked in).
I also started noticing that little things, like leaving the house, became overwhelming. I understand that with two kids it is now harder to leave the house than it was without kids or even with one kid, but I noticed that mundane activities that I used to be able to do became very overwhelming for me. So overwhelming that it became somewhat paralyzing.
In addition to the caffeine impact and feelings of being overwhelmed, my brain and vision felt foggy. I will talk about this fogginess more in the next point. I felt this symptom sooner than all of the other symptoms. I probably felt this around three months postpartum, especially in the later afternoons. I didn't do much about it because I had heard about mommy fog and thought it would go away on it's own. It didn't; instead, it got worse. Again, it felt like blurriness; like I couldn't see or think clearly.
How did you feel (what were some of the ongoing symptoms) when you had PPDA?
The biggest physical symptoms: headaches, constant nausea, loss of appetite, fatigue.
The biggest mental symptoms: fogginess, depression, anxiety, feelings of being overwhelmed.
I will start with physical symptoms. I started having headaches for a few weeks on and off. They came on gradually. Again, at first I thought it was my caffeine (my daily espresso) intake that was causing the headaches. I tried cutting out caffeine, but I wasn't successful. Ultimately, my headaches became debilitating. At the six-month mark postpartum, I started having extremely painful headaches, like migraines, that felt like an enormous pressure on top of my head. They were so bad that I couldn't see straight and felt unsafe caring for my kids. The headaches became so debilitating that one day I drove myself to urgent care. Urgent care then instructed me to drive myself to the ER, which I did. At the ER I had an MRI and was checked out by doctors who diagnosed my headaches as "tension headaches". While they might have been tension headaches, they were most definitely symptoms of postpartum depression/anxiety. None of the doctors I saw at this point told me that headaches were associated with PPD. It wasn't until a google search and adding up all of my symptoms that I realized PPD was the cause.
I also had constant nausea and no appetite whatsoever. I'm not sure if the nausea was causing the loss of appetite or visa versa; or maybe even the pain of the headaches causing the nausea. I have no clue. All I know is that I was constantly nauseous. I was so nauseous that I was convinced that I was pregnant again because it felt like severe morning sickness. I took several pregnancy tests, but obviously was not pregnant. When I went to the ER, they also gave me a pregnancy test, I believe via blood, and it was also negative.
As for mental symptoms, the biggest symptom I had was mental fogginess. The mental fogginess started (now looking back) maybe around three months postpartum. I had difficulty, especially in the later afternoon and evenings with mental fogginess. Essentially, I felt as if my brain wasn't processing on all cylinders and that mentally I was in a fog. I wasn't sharp, had difficulty concentrating, and also had difficulty seeing clearly. Sometimes I felt like I had to squint to see clearly. Once I hit the six-month point, my fogginess became unbearable. I'm not sure if the fogginess caused me to be depressed or it was the postpartum depression that caused the fogginess, either way I became very sad that I felt this way.
I also felt feelings of depression and anxiety. The feelings of depression were kind of bi-polar. It's not like I was in a constant state of depression, however, the symptoms I was having (the headaches, nausea, fogginess, etc.) all made me feel very depressed. I didn't feel like my happy, bubbly self. Generally, I can fight off feelings of sadness because that is my personality, but this time I couldn't fight my way out of it.
In addition to feelings of depression, I also felt very anxious. There were countless situations that I faced while enduring PPD that I had to remove myself from because of how overwhelming anxious I felt. For instance, on my thirtieth birthday my husband took me out to eat. We sat down and anxiety/fogginess overtook me. I told him that we had to leave and that I couldn't finish the dinner. I begged him to help me feel better.
I also remember (several times) nursing V to sleep in his dim-lit nursery and felt as if I couldn't do it; I was in a panic and couldn't sit there and nurse him. I literally had to physically set him in his crib, walk out of the room and compose myself. It was a horrible heart-racing feeling that I'd wish upon no one. While I had anxiety during the day, I also had it at night. I'd go to sleep with a racing heart and couldn't fall asleep; almost as if I had insomnia or something. On a few occasions I had to take Benadryl to calm myself down to sleep. I hated that because I felt groggy the next day. And with mommy fog, any additional grogginess was bad.
How did you know that you had PPDA?
Initially, I was in-denial that I had PPD. The thought of being (and staying) depressed scared me. I've definitely encountered feelings of sadness sporadically in my life, but nothing that compared to how I felt when this all hit me at six months postpartum. It felt like my sanity had been overtaken. Psychologically, I was not okay. Again, I was used to being able to exercise and feel better or drink some caffeine and feel better, but this dark cloud over me along with the mental and physical symptoms all made me feel depressed and highly anxious.
I knew it had to be some sort of PPD because it hit me all at once, but also wasn't sure because of the delayed onset at six months postpartum. At first, the physical symptoms started (the headaches and nausea), which lead me to the ER, where I picked up more clues from the doctors that it might be PPD, although none of the doctors mentioned anything about PPD. All they said is that it was "stress-induced" symptoms. A few days later, I felt the anxiety and depression worsen, so bad that I desperately called doctors in a fiery: PPD counselors and psychiatrists. At this point I was desperate to figure out what had overtaken me. I felt like I was going crazy.
I was able to get into a PPD counselor and also a holistic doctor. It was the PPD counselor who informed me about the onset and about the symptoms. As I continued to endure the PPD symptoms, I still wasn't confident that it was PPD, although I couldn't imagine it being anything else. I was scared in those moments that the PPD wouldn't go away, especially after having googled "how long PPD lasts" to find that the most popular answer said "1 to 3 years." Now that I am looking back and out of the PPD, I can 1) confidently say that it was some form of PPD/PPA and 2) confidently say that it took me 2 months (of hardcore symptoms) to get out of it. More on this later..
What did you do when you found out that you had PPDA?
So again, at first I had physical symptoms (the headaches and nausea) that forced me to go to urgent care and then to the ER. At this point, I still wasn't sure I knew what was happening to me, but I KNEW that something was wrong. Knowing that I was desperate for help, the first thing I did was tell my husband and close family about the PPD. I also told my nanny.
Let me also say that I didn't tell my husband/family in a way that was like, "Hey guys, I am going through PPD. I need help." It was more like, "I have no idea what is going on with me. I have headaches and crazy bad nausea. I don't feel like myself, my vision is blurry. Something is wrong. I have no clue what it is, but I am desperate for help. Please help me get better." It was more a cry of desperation rather than a calm explanation that I was enduring postpartum depression.
As a result, my sister ended up flying out from California to Nashville to be with me. It was extremely helpful to have her to lean on while I endured the symptoms. While my sister was here, I was able to organize some doctors appointments. And it's funny I say "organize", it was more of frantic desperation to get into see anyone that could help me.
By the grace of God, I got in to see a holistic doctor. I also scheduled an appointment with a postpartum depression and anxiety specialist. I will talk more about the doctors I saw in later points.
After my sister left, my parents flew in to help. They helped BIG time, whoa. I will talk about this in later points, as well. I honestly don't think I could have gotten out of this depression without them. Fact. Then, after my parents left my mother-in-law came in to help.
I also started talking to other women (especially mothers) about my symptoms. In doing this, I was comforted that I wasn't alone. Friends shared multiple stories, personally or about someone they knew, who had encountered postpartum depression. This was empowering and encouraging. First, it made me feel comforted that I wasn't alone. Second, it gave me information about the disease that I could use for healing.
What kind of doctors did you see when you found out you had PPDA?
I saw an urgent care doctor for the headaches/nausea. He wanted to rule out anything wrong with my brain, such as a brain tumor, so he sent me to the ER.
I then saw the ER doctors. After a clear MRI and clean bill of health, they diagnosed the headaches/nausea as "stress-induced" tension headaches. They prescribed me Moloxicam for the headaches (which may or may not be safe while nursing) and Zofran for the nausea. Sorry if I'm misspelling any of these. I didn't take the Moloxicam ever because I was worried that it wasn't proven safe for a nursing mother. #stubborn . I did take the Zofran a few times when my nausea was painful, and honestly should have taken it a lot more. I am super weird about taking prescription drugs while nursing even when doctors tell me they are safe, as in the instance of Zofran. It wasn't until my holistic doctor told me that Zofran was safe that I felt more comfortable taking it. Ha!
Next, I saw a holistic doctor, which I highly recommend. Friends/people recommended I see a holistic doctor and at first I scoffed at the idea. Now having gone through all of this, he was probably one of the most helpful doctors. He listened to all of my symptoms, even my mental symptoms, and gave me some natural techniques to reduce stress and tension. The techniques were life-saving during those dark times.
Simultaneously, I saw a PPD/PPA counselor and specialist. If you are going through PPD, I highly highly recommend that you see a specialist. These people see cases of PPD regularly and they will be able to tell you if your symptoms are that of PPD. None of the MD doctors I saw concluded that what I was going through was PPD/PPA. Crazy. The specialist was the only one to pinpoint the symptoms and give me information about what to do regarding PPD, and specifically relating to PPD.
I also saw my OB, but it was for my 6 month checkup. I wasn't able to get into her to discuss the PPD issue because she was booked solid. When I saw her, I talked with her about PPD and she informed me that she could write me a prescription for Zoloft if I needed it. I haven't called her to fill it because it was at that point that I started to come out of the PPD. That said, I am not opposed to medication and encourage it depending on the severity/type of PPDA you are going through.
Last, I tried to get into a psychiatrist. I made an appointment, but ended up canceling the appointment because I started feeling better. Out of pocket, she cost something like $450, so if you are worried about money (which you shouldn't be when you are going through PPD!), I suggest going to see your OB instead, which should be covered by insurance. He/she can prescribe any medication in regards to your PPD and he/she should be familiar with symptoms. Again, I am not a doctor, this is just what I will do next time (if there is a next time).
What kind of doctors did you find the most helpful?
Again, I'm glad I went through the route that I did, seeing all of these doctors. Each doctor helped me along to the next doctor. However, if I were to do it all over again (and hopefully I don't have to!) I would definitely start with a PPD/PPA specialist and counselor. Having someone who is familiar with cases of PPD and PPA to quickly recognize the symptoms and point you in the right direction of recovery is my best advice.
I'm also glad I saw the holistic doctor, who is also an MD by the way. If you are going to see a holistic doctor, I recommend seeing someone who is credentialed; not a quack; there are a lot of holistic whackos out there. My doctor, Dr. Joseph Forbes in Nashville is not. He is a highly respected MD with years of experience in holistic medicine. What I liked about him is that he worked from the inside out, and really took a personal interest in my healing.
While I love mainstream doctors, what I didn't understand about the ER doctor and Ugent Care doctor is that neither of them recognized that I was going through postpartum depression or anxiety, which was a little confusing. Instead, they diagnosed my symptoms as stress-induced.
If you are a mom struggling with PPD, you begin to feel helpless when countless doctors tell you that your symptoms are stress-induced. I felt helpless because I didn't know what I was doing differently to contribute to the onset of the symptoms at this point than I had done any other day of my life when I didn't have the symptoms. Therefore I didn't know how to stop the symptoms because I didn't know what I was doing wrong. I essentially felt responsible for the symptoms and the state that I was in when MD's told me that the symptoms were stress-induced.
When you KNOW that it is PPD that is causing your symptoms and that the causation/effects is outside of your control, it tends to make you feel better. Because and when I knew it was PPD/PPA, it was more empowering. I knew what I was dealing with (to a certain level) and could seek care as such. I also knew that there would hopefully be a terminal point to the symptoms and my life would resume back to normal. If it didn't go back to normal, I could then proceed and get on anti-depressant and anti-anxiety medication. Again, the most comforting thing to hear from someone, namely a doctor, is that the symptoms are common and particular to postpartum depression and anxiety. AND that the symptoms will go away or become manageable with the proper care and treatment.
All in all, I got the most out of the PPD specialist and the holistic MD. The PPD specialist because she knew (in my case) the most about the disease and the holistic MD because he worked from the inside out. I also thought my OB was helpful because she could prescribe medication, if needed. However, I'm not sure if she and the nurse knew that it was PPD/PPA that I was suffering from when I called in and talked to the nurse about my severe headaches and nausea when it all started. In all fairness to them, I didn't tell them I was feeling depressed - maybe because I was in denial or maybe because the depression came as an effect of the headaches/nausea. Either way, if I start having crazy physical symptoms next time, I will know to see a specialist, my OB or a holistic doctor!
Last point, if you see an MD, which you probably should in all of this mess, make sure you get your blood work done! This can throw off your physical and mental state, as well. My holistic doctor checked mine; everything came back normal, except for my vitamin D levels were slightly low (although not out of range).
Who did you talk to about your PPDA?
Again, I talked to my husband, my parents and my sister. They helped me out of the trough of PPD. In addition to family, I talked to mom friends. Again, this helped TENFOLD. One of the hardest parts of PPD is feeling like you are alone and that you will never heal. In talking to women who have gone through the same or know someone who has gone through PPD, you will feel comforted in hearing how common it is and how quickly you may recover.
What remedies helped your PPDA?
Having family come in to help me was life-saving. My sister dropped everything and flew in to be there with me. The mere act of having someone by your side as you go through depression is necessary. After my sister left, I asked my parents to fly out. They helped SO much. From the bottom of my heart, I cannot thank them enough.
What my parents helped most with was implementing a plan. The plan was aimed at getting me out of PPD/PPA! We went to a coffee shop and wrote down any and all stressors in my life. We then went through each stressor, addressed it and figured out a way to solve it. Things that came up were: not having enough personal time - aka: getting a nanny, not exercising enough, not having a regular date night with my husband, not talking about my problems, not getting one-on-one time with Lincoln, etc. It is crazy how powerful writing down your problems is.
After we addressed each issue, we got to solving the problems. The following entail my solutions: I hired a nanny three days a week. She would come two days during the work week to allow me to exercise, run errands and have personal time. She would additionally come on a weekend night to allow Ryan and I to have a date night. In getting the nanny, the most prominent thing that it solved was allowing me to have personal time away from my kids, which I desperately needed, ESPECIALLY while going through PPD. I went from having no help to having help three times a week. It was life-saving.
One of the other key aspects of having a nanny come during the week was being able to exercise. At this point in the game, I needed something that would save me mentally and exercise was the answer. My dad asked me if they had any good gyms and/or classes in the area. I told him that I had heard great things about Orange Theory Fitness and that it was an amazing, high intensity workout (which is what I needed). We immediately drove over to an OTF (Orange Theory Fitness) studio and scheduled a trial day. I did the trial, loved it and signed up for 8 classes a month (2 classes a week).
I cannot tell you how much this hardcore workout has saved me mentally. It literally gives me life. I feel better mentally and physically, and cannot imagine my life without it.
Aside from the nanny and using exercise to help my PPD, the holistic MD gave me advice on how to reduce stress. He mentioned that I turn my back on negative emotions (which is true). Because I don't address these thoughts, they pile up as emotional baggage in my body and ultimately manifest in the physical form. If you think this is weird, that is fine, but I totally buy into this. Anyways, he gave me pointers on how to address these emotions/stress and it has worker wonders for me.
Equally, the PPD specialist helped in multiple ways.
Last, last point and I can't believe I didn't mention this earlier... prayer helped majorly. I prayed hard and often. Sometimes angry, desperate prayers, and other times grateful, loving prayers. No matter what you believe, relying on a power bigger than yourseld is necessary for healing.
In addition to prayer, I read a healing books. One book that helped me is called An Angels' Guide to Working with the Power of Light by Laura Newbury. This book is written by a mother going through a divorce with two small children. In going through the trauma, she developed painful headaches, anxiety, depression and a bunch of other things. What she found was that angels and the power of light, and namely forgiveness helped heal her. This book is amazing! It was only by coincidence that I picked it up to read one night while I was in the trough of my PPD. It helped my healing majorly and I'm thankful that God put it into my hands.
Last, last, last point.. ultimately what got me out of PPD was time and patience. The worst of my PPD lasted about one month and I did have symptoms on either side of that month for another couple of weeks. Be patient, give yourself time and have faith that you’ll come out of it. You will!
Why do you think exercise helped so much with your PPDA?
Exercise may not help everyone, so I don't want to say that exercise is a cure-all remedy. It may not be for you! But for me, personally, it was my saving grace. When I talk about the benefits of exercise, I believe it was "intense" exercise that helped me most.
I have exercised the majority of my life, but it was only through sports and in some instances of my life did I really exert myself hardcore through intense exercise... I mean the kind that makes you sweat like crazy, pushes your heart rate through the roof, and makes you feel like you're going to throw up or die ha! After I had kids, I exercised, but not in a way like this.
I found that intense cardio and weight-lifting really changed me as a person; mentally and psychically. First, it increased my heart rate. Second, it made me sweat. Third, it allowed me to release stress through the intensity. Fourth, I felt major endorphins. Fifth, it gives me a ton of energy. All of this combined, I felt a release of toxins and a rejuvenation in my body. I feel stronger and more energized because of exercise... AND happier. When going through PPD, this is something that truly saved me for those reasons.
How did you care for your children when you had PPDA?
I had family come in to help. This allowed me to attend doctor's appointments. I also hired a nanny. If I ever go through PPD/PPA again, I will definitely have a nanny on-hand hopefully full-time during the week if we can afford to. Being alone with my kids while I had PPD was horrible. I felt debilitated and certainly not in a state to care for two overly-reliant, young children.
How long did your PPD last?
The symptoms started at six months postpartum around my thirtieth birthday, which was mid-September. The symptoms were pretty gnarly for about six weeks and then started to subside, but not all at once. The headaches and nausea gradually got better. I started sleeping better at night. The depression and anxiety slowly lifted. So maybe like 8 weeks after that. It is difficult to remember clearly, but I believe it was no more than two months. I'll say that I have a friend who said that her specialist said that symptoms generally last for one month, on average. My PPD specialist told me the same ish, and said that once you start to come out of the "trough" that you likely won't go back into the trough; the road may be a little bumpy, but that you should be in the clear (in her experience).