Today, a mother (and friend) shared, with me, a little about her experience with postpartum depression. About the isolation. The overwhelming sadness. Nervousness around having another child. We talked about medication. About what we would have done differently if we could go back.
It reminded me that it's been almost one year since we started our #PMAD Awareness Blog Series. And, in honor of my friend, I wanted to share a new story on the blog today.
Friends, this is our purpose. For parents who have or are experiencing #PMADs, we want you to know that you. are. not. alone. We have walked the paths you are on. And we will walk them again with you.
JoEllen Noble is one of the strongest humans I know. I don't have many memories from the time that she and I met, but I do remember how inspired I felt when she told me about her struggles with perinatal mood and anxiety disorders. I remember thinking: She experienced something I'm experiencing and she made it out alive. And it was in that moment that I knew I could, too.
It was grief, they said. I was obsessive and fearful.
“What you are experiencing is normal after your baby dies. You don't need to medicate a natural process.”
Then I immediately fell pregnant with my next son.
"Medication isn't safe during pregnancy. You've already lost one child to a critical congenital heart defect; why would you do something that could increase the risk of it happening again?"
Grief counseling helped. But it didn't delve deep into the hard work I needed. I should have pursued more help, but I was so tired. So very tired. I had been clinically diagnosed with PTSD after months of a very unexpected NICU/CICU stay for my second son, Lincoln. Months full of the highest of highs, to immediately turn to the lowest of lows. It ultimately climaxed in him being removed from the transplant list, from the ECMO machine keeping him alive, and his inevitable death.
Oddly, I have had tremendous peace around Lincoln's death. I worked my emotions and questions out with God and found acceptance. What hung around were reactions and thoughts I could not control, much less stop, no matter how hard I prayed. I was tormented by desperation and fear...and no one knew. I was always being told that I was so strong, but I was simply surviving. I didn't have any other choice.
My pregnancy with my third son, Leo, was physically manageable until we reached the third trimester. As soon as we reached 27 weeks, I remarked that each week became increasingly more difficult. At the very end (41 weeks) I was truly enormous and finally diagnosed with polyhydramnios (basically, an enormous of amniotic fluid). Those last few months felt never-ending; I was huge, it was an unbearably hot summer, and I grew more anxious of something- anything- going wrong.
I also felt guilty.
"Why do you borrow worry, JoEllen? Why don't you just go find something else to freak out about?"
I felt guilty that I couldn't fully connect with Leo in utero. I felt guilty for being so fearful. Lincoln had been my rainbow baby- we had a beautiful waterbirth at home after years of trying and miscarrying numerous pregnancies. We had co-care from our OBs and he'd seen the pediatrician right away. We did everything right. And he was taken from me, too. Leo would be the ultimate rainbow, conceived after years of loss. I felt guilty for that too, though. For projecting such a heady role onto this yet-unborn son.
My water broke in such an enormous wave that nurses rushed towels around me and laughed that they hadn't seen anything like it in a long time. Leo came out red and screaming not long after. I loved my hospital birth and epidural, but felt the need to downplay those parts of his birth story because I'd already been questioned by some in my local natural birthing community.
"What could change your mind so you stay home to birth again?"
As though my choices made some kind of statement. In reality, I was terrified of being triggered by being home again, as Lincoln's birth was the only time of pure joy we had with him. I was exhausted by having to explain myself and though I'd felt confident in my choices, being presented with passive-aggressive links about the ways to prevent complications (links about a certain prenatal diet to prevent birth defects; chiropractic care and weird stretches to turn my OP baby so I would not have exposed him to an epidural; risks of birthing in the hospital) made me doubt myself.
My intuition was wrecked during those months with Lincoln. It had always been so strong and reliable. Then it was violently torn from me, too. So I questioned everything.
Countless nights I cried myself to sleep as I prayed and begged God to protect Leo. I obsessed over SIDS and was convinced he would die too if I fell asleep or took my eyes off of him for more than a moment.
Why is he crying?
Is there something wrong with him too?
Was I bonding with him?
I didn’t feel like I had connected with him that way I had with Lincoln. I wound up removing myself from a regional homebirth group after it was said to me, “If there is something wrong with your baby, your intuition will sense it. If you didn’t pick up on your son’s heart problem even during pregnancy, you must not have been in-tune with him or your body enough.” The utter rage I felt the moment I read that comment, and in the minutes after as the “likes” piled up, was something primal. Anger aside, I’d later cried again and secretly believed the commenter was right. After all, what mother doesn’t know when something is wrong with her child?
Rage is how my anxiety/depression likes to manifest itself. The rage couples itself with obsessive behaviors and hypervigilance. The more I’d desperately try to cling to control as I felt it slipping wildly away, the angrier I’d become.
After Leo was born, I returned to work the day he turned 4 weeks old. One night as Leo squalled and refused to sleep, I sobbed to my husband that I couldn’t do it.
It wasn’t fair.
But I had to.
I had no paid time off and no protection by FMLA as I was part time.
We had bills to pay.
I grew resentful. I knew my husband wanted to be empathetic, but bless it, he just didn’t understand that I was drowning.
He didn’t understand and dammit, he didn’t do things right. The best I could do to communicate better was to yell louder and demand more, which made him retreat further. I resented that he could retreat, while I had to hold it all together, as always. Only I wasn’t really holding it together either.
At the same time, our oldest son, Logan, was having a hard time in preschool and had not yet been diagnosed with Autism and ADHD. Deviations from his normal routine set him off. His speech was delayed and he’d get frustrated and eventually tantrum if he couldn’t communicate his desires. The need to constantly anticipate his next three moves and plan accordingly for any and all outcomes, exhausted me.
Things came to a head when Leo was around 9 months old and school was out for the summer. I was overwhelmed. There were numerous meltdowns between the three of us, but one day I can recall clearly.
Something had set me off and Logan’s refusal to follow directions to pick up his toys fueled my anger. The rage spiral started, and though I recognized it, was powerless to stop it. I screamed at him and remember throwing toys across the room. I slammed the door and closed myself into the playroom alone, where I continued to scream and throw things. Then I collapsed in the floor and sobbed heavily. The dark thoughts pooled in my mind like a flood.
I’m breaking my kid.
I’m fucking him up while I’m worried about someone else doing it.
He doesn’t deserve it.
He doesn’t deserve me.
Neither does Leo.
What kind of mother am I?
I’m not worthy of my own children.
I don’t deserve them.
I don’t deserve any of them.
That’s why they were taken away.
That’s why I miscarried the others and Lincoln died.
I’m not worthy.
I’m a monster.
I finally met with my PCP and told her I was overwhelmed, angry, and depressed, but continued to balk at utilizing medication. I reasoned that things would improve once Logan started kindergarten and Leo turned a year old. By then I was able to make time for appropriate self-care, could stop pumping, and enjoyed the added supports the school offered to Logan. Things did improve somewhat for a time, however I was still a long way from good mental health.
I became pregnant with our fourth son, Luke. His pregnancy went smoothly. One Sunday afternoon during the third trimester I had one of those old meltdowns which started with anger and dissolved into sobs. It was the first I’d had of one of those in many, many months. But the desire to self-harm was a first for me. It shocked me for such a thought to even enter my mind and I was so ashamed I didn’t tell anyone but a tiny group of trusted friends who had themselves experienced mental illness. I made up my mind then to be proactive with my mental health.
Luke was only a few weeks old when I admitted to our tiny group that I had lost track of time one evening while nursing on the couch, phone in hand, researching SIDS. It had been a few hours. “Tell your doctor, JoEllen. Call in the morning.” They held me to it too. Despite living on opposite sides of the country, in the morning I received private messages asking if I’d made the call yet. It was so much easier with their help. They also suggested a make a little list of questions and concerns to share with my OB at my visit, so I wouldn’t get flustered and forget. My OB was receptive and started me on Zoloft, with a referral for counseling. I hated the way Zoloft made me feel that first week especially, but my friends kept me on track and encouraged me to stick it out.
Then the fog lifted and I was finally free. I could breathe. I could get through my days without anxious, intrusive thoughts. I didn’t emotionally react as swiftly and aggressively because as one RN friend put it, “You’ve been given a sort of pause button.” She was so right.
I know people who feel ashamed to admit they take medication for their mental health. Obnoxious memes abound on social media, proclaiming time spent outdoors, or pursuing “natural” treatment methods are the only way to go, as prescription medication just keeps a person sick. That’s bullshit, plain and simple. Medication makes it so some of us can take better care of ourselves, through hygiene, nutrition, exercise, and the good, hard work of therapy. There is nothing wrong with incorporating holistic treatments, just as there is nothing wrong with taking medication to help yourself heal and live a healthy life. You don’t have to choose between them if you don’t want to.
I eventually switched to a different medication that has made an entire world of difference for me. I have energy, can stop and redirect intrusive thoughts (which come FAR less often than before), and most of all, I feel like myself. The best part is in trusting myself again. Trusting to recognize my needs and having the confidence to voice them and create a plan of action. While this experience has been incredibly difficult at times, I am grateful to use it for the good to provide supportive, non-judgmental care to my clients.
Written by: JoEllen Noble, IBCLC, PD CD Labor, PD CD P&ICD, PD CPPS, and General Bad Ass.