This Is What We Know…The Latest On The New PPD Drug, Zulresso.

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For many women, having a baby is all they ever wanted. Pregnancy, and the promise of motherhood, will make you the happiest woman on earth. However, the reality for 1 in 5 women is a far cry from the what they always dreamed of.  Postpartum depression, anxiety, OCD, and other perinatal mood and anxiety disorders become the new reality, and for these women options are scarce.  Women suffer in silence. Mom guilt descends, screening is spotty, providers are untrained, treatment is sparse, and it’s one of the greatest causes of maternal mortality. So on March 19th when the FDA approved Zulresso, the first drug ever for postpartum depression, the game changed. But, initial reports of lengthy hospital stays and costs over 30K created a huge backlash from skeptics and hopefuls alike.

Lisa Tremayne is the Director Center of the Perinatal Mood and Anxiety Disorders in Long Branch, NJ. This center is one of only a handful across that country that is hospital based and provides support and treatment for women suffering from PMADs. Lisa has also been part of Sage Therapeutic’s (maker of Zulresso) advisory council and returns to the Bloom Foundation (she is also President) after meeting with the Sage team and other leaders in the PMAD field in Washington DC to discuss the next steps for Zulresso with COO, Shannon Hayes.

Shannon Hayes: When the announcement came that the FDA approved Zulresso, we were thrilled here at Bloom. I don’t think our phones stopped ringing for days. It was exciting, but then we started to see a backlash.

Lisa Tremayne: Yes, the pushback came pretty quickly.

SH: Because you are on the front lines, you see and treat women suffering from PMADs every day which is an unusual situation due to the limited number of resources around the country, you have a unique perspective on this issue. There are very few people like you and your team. You know what works and what doesn’t work…

LT: …and we see the collateral damages of waiting to get help. That is my number 1 frustration. So, here we have a breakthrough drug, the first drug ever for PPD and I wonder why anyone would feel anything other than – WOOHOO! Why, without the full answers, would one be against something so groundbreaking. I also assume this approval will open up a full new class of drugs. Every time there is a new allergy drug it is like, yay this is the best one! Why wouldn’t this be received the same way.

SH: I think you said it when you said “without full answers.” So let’s address that because we don’t have all the answers but let’s talk about what we do know. It has been reported that the treatment doesn’t come cheap—the average cost per patient is $34,000. Do you know anything more about that, how is that going to be addressed?

LT: The FDA approved this drug on March 19th, and now the process begins. The manufacturing, release, and launch looks to be about June. Again, I am not an FDA person, I am just telling you what I heard. Once the FDA approved it, Sage went to their insurance board and said –  here is what we have, here is what it treats and what will be the reimbursement for this or what information do you need from this. As of day 8 from FDA approval, they have had no negative feedback from insurance companies. There is an out of pocket and deductible expense, as there is with any hospital treatment. Everyone reacted to the wholesale price that was reported, but that is not the price that will be passed on to the consumer.

SH: Another pushback that has garnered lots of discussion relates to the 60 hours of IV infusion needed. One of the first texts I received after the announcement was  “What mom who has just had a baby is going to take the time away from their newborn to spend 60 hours in a hospital hooked up to an IV?”Do you feel this a valid push back?

LH: I feel this is an uneducated response. Zulresso is a tool in the breadth of drugs available, if needed, for a woman and for a family unit that is suffering the impacts of perinatal mood disorders. Say a mom scores off the charts for PMADs, hypothetically a 10 out of 10. Medication will work, but it will be 4-6 weeks before any real effects are seen, and that is if the correct med and dosage is given the first time. Can we help her with that now; absolutely? But, If you told me I could feel better from my allergies tomorrow instead of June, I choose tomorrow. Zulresso is the tomorrow choice. A woman who is going to be considered for this drug, or more likely will be suggested to receive this 3 day treatment after evaluation, is despondent. She is not intact in her family. She is not showering. She is probably not breastfeeding.

SH: Breastfeeding is another question that has been raised.

LT: If breastfeeding is a way mom is feeling attached to her baby, then she can pump and dump for 3 days. We do this when babies go into NICU, we do this if a mom gets into an accident and needs general anesthesia. This is not a bizarre request.

SH: So this is for the woman that is suffering so much that 3 days won’t matter because she is not engaged, she is not involved, because mom is sick.

LT: Exactly, mom is sick. I also did hear some questioning about the single mom. This is a valid question, and I think this is a wonderful opportunity for nonprofits and advocacy groups to step in and offer help. Help with child care, or financing so dad can take time off or for a nearby hotel for the family to stay… there are may ways to address this.

SH: Who exactly is this drug for?

LT: This is for the mom who is experiencing moderate to severe PMADs. A valid screening tool has been used and a team has made an evaluation and assessment of the mom. This is not a one size fits all. This is not a treat and street situation. This is not, okay you had your IV now off you go!  There is a responsibility to say- Hey, we think this IV treatment is your best option right now and when mom is discharged, here is her follow up treatment plan. She can’t go home and start thinking – I can’t believe I left for 3 days, I stopped breastfeeding, what mother does that? So she has to be in a PMAD specific treatment plan.

Remember, they are coming in for treatment at a time when they feel despondent, lost, are experiencing intrusive thoughts, are not connected. Wouldn’t it be great to take that time mom is hooked up to IV and get her started on some nice self care as well. Have a therapist visit and maybe a survivor who can let her know she is not alone, how about a little aromatherapy and lots of sleep. The goal is to get the mom back to feeling like a human being, not a monster, not a failure, not disconnected.

SH: A lot of blog posts and comments addressed sleep. Many suggested that any new mom who got 60 hours of sleep and rest would feel better no matter what.

LT: Of course, if you put any mom with estrogen and progesterone anywhere for 3 days with protected sleep they would feel better just to get the mental load taken off their hands. My questions is would be how would they feel 3 days or a week later.

SH: So with this drug they still feel better 3 days later? A week? A month?

LT: Yes, but it is not 100%, it is around 70%.  70 works for me. I would a take 70% chance. If it doesn’t work, there are still other options such as medications and therapy.

SH: So hospitals that will be given the opportunity to provide this drug will also need to have in place a comprehensive PMAD therapy plan.  Do you know if there are any physical side effects.

LT:  The only one I know of is somnolence, which means sleepy. I think this is a really good side effect.

SH: I was going to wrap it up by asking what your feelings were on this drug, but I think that it is pretty apparent.

LT: I think it is amazing in my lifetime to see a first drug for something, that part of it blows me away. I can’t remember a first drug for anything.

SH: Viagra?

LT: Viagra was a very good invention….for some people.  Maybe not women, hahaha just kidding.

SH: LOL, and Viagra is covered by insurance.

LT: So if erectile dysfunction pills are covered… this better be covered.

The bottom line is that postpartum depression and anxiety and OCD and psychosis and rage and all PMADs affect the health and welfare of the mom, their children, the family and society as a whole; and suicide is one of the leading causes of women after their first year postpartum. Our nationwide resources are abysmal and while there is no magic pill, Zulresso is one step closer to saving lives and THAT is worth celebrating.

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2019 goals

My 5 Goals (Not Resolutions!) For 2019

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I am ready to kick 2018 out the door. Sayonara, year.

The best thing you gave me was my beautiful daughter. The worst was piles of medical bills from a high risk and awful pregnancy, a traumatizing c-section recovery, and last but very not least.. postpartum anxiety and OCD.

But oh, January 1, how I loathe you.

Not because it’s a new year, I like clean slates, but because everyone everywhere is searching through their cheap champagne hungover brains for a list of resolutions.

The definition of “resolution” is a firm decision to do something.

Firm. Yeah, right.

Exhibit A:  I signed up for a weight loss program a few days ago. The holidays are over, we are a mere five months away from bathing suit season, and I am only six months from my daughters first birthday. I’d be lying if I didn’t tell you, “NEW YEAR NEW ME” was flashing in neon lights in my head when I began this dieting endeavor. Two days later I was in my kitchen eating left over Christmas cookies. Far from a firm decision.

We spend January proclaiming our resolutions, and February full of chocolate and regret for abandoning them.

As someone with postpartum anxiety and OCD the last thing I need is something else to stress and obsess over. The mere thought of creating a list of resolutions to focus on gives me hives.

Instead, I am going to set goals this year.

Rather than resolutions, goals take on more of a destination, and most destinations have bumps in the road. Sometimes the car breaks down, or the bus gets a flat, but everyone gets there in time. It may take longer than anticipated, but you reach your destination in the end.

Here are five goals that I have come up with for myself throughout 2019.

1. Be kind to yourself.

We are all fighting a tough battle. Having postpartum anxiety and OCD caused a whirlwind in my life the last few months of 2018, but I’m entering 2019 on a high. If that high plateaus, or my healing plummets for a moment in time, I will be gentle with myself. I now know healing is a process. Belittling myself for the bad days or bad moments won’t get me anywhere.

2. Set boundaries.
I talk a big game about keeping the negative out, but I never really do it. I set boundaries and allow them to be broken immediately. My goal for this year is to stick to my guns when it comes to boundaries. I know it is so important to ensure the people surrounding me reflect love and light while I journey through the PMAD world. I will work hard on protecting my peace in 2019.

3. Self care.

Instead of saying, “I need to lose X amount of pounds” I am going to incorporate more self care into my life. It can be as simple as applying a fun facial mask a few nights a week, making time for a mani/pedi, attending a yoga class once a week, or even making sure I get back to my nightly chamomile tea while watching my favorite show. If along the way I am able to begin a diet and shed some pounds, great, but that isn’t my goal. The goal here is to nurture myself as well as I do others.

4. Read, real books, not your phone.
Social media is the bane of my PMAD world. Unfortunately, not many will show the negative aspects of being a Mom and wife across their social media accounts. My goal is to put down my phone more when I am about to mindlessly scroll on social media, and pick up a book. I have 2 books on my nightstand with a small book light. I’ll replace scrolling through Facebook for way too long with a chapter of a book. Gone are the days where I would fall asleep with a book wide open on my belly, and now I instead fall asleep with my phone smacking me in my face.

5. Help others.
I have always been proactive in areas I feel passionate about, and being thrown for a loop into the world of PMAD has opened new territory for me that I never knew existed. The stigma, shame, and secrecy surrounding PMAD has created an environment and culture that has prevented Moms from getting the help they need at the most vulnerable time in a family’s life. If in 2019 speaking out about my PMAD experience can help even one single Mom, then it is worth it.

When the clock strikes 12:00 AM on January 1st, take a deep breath, and remember it is just another day. There are no mandatory resolutions to be made, only goals to journey through 2019 with.

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Allison Sharkey

My Anxious Christmas

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It’s Sunday. I’m sitting on the couch nursing the baby when our 5 year old sits next to me. She pauses, drops her head and frowns. I roll my eyes without her seeing. I can only imagine what she’s about to say.

Today has been a good day so far. Granted, it’s 9:12am but waking up feeling genuinely good these days is a celebration in itself.

We’ve already made pancakes, not box mix but from scratch (only because we ran out of the boxed one), and watched the movie “Elf” while eating them.

“I’m sad because we didn’t put up more decorations for Christmas..” she says, still frowning and about to cry.

Big thanks to Will Ferrell and postpartum anxiety for this moment.

I look at her and answer the only way I know how to lately, through half sincerities, “baby we’re going to put more decorations up just not today.” Total lie. I have no plans on putting up more.

“I want to right now,” she says.

“We can’t right now. I’m feeding your sister,” I answer.

The baby has recently foregone napping anywhere except my arms, usually 10 min after nursing, leaving me paralyzed.

As my daughter was yelling at me about decorating, my bladder was also screaming. I had to pee for the past 20 minutes yet was also unbelievably thirsty since I forgot to grab a water before sitting.

For the 500th time this week I think to myself, “I really need to get her to nap in her crib already…”

There’s a container of Christmas decorations sitting next to the tree yet to adorn the house. The tree that’s been up since 2 days after Thanksgiving.

It’s December 2nd and I know very well having the amount of Christmas decorations up right now makes us ahead of the game. After all, I grew up with our tree and home being decorated one week before Christmas. So prior to this year I make sure to go full on Clark Griswold and decorate on Black Friday.

I blast Christmas music, we make hot chocolate, and we dance around the living room while decorating our lives away.

My five year old is obviously aware of her Christmas crazy Mom taking a back seat this year.

She gets louder now.

“Can’t we turn on Christmas music, Mom!” She begs. 
“Make hot chocolate for me PLEASEEE!” She pleads. 

“Alexa, play Frosty the Snowman!” She yells.

Frosty starts blaring from the speaker. The baby wakes up screaming. I knock over three ounces of milk collected in the device suctioned to the non nursing boob catching every drop of milk. My daughter sees the milk spilling and rage building. She immediately apologizes.

The rage that comes along with postpartum anxiety arrives. 

I scream my head off.

I want so badly to yell back at her:

“I’ve done enough decorating already!”

“I could care less about Christmas this year!”

Sending cards. Decorating. The movies. The cheerful songs. The lights and sparkles. Words like joy, merry and bright showing everywhere none of which depict the way I feel.

The holidays can be a lot for any Mom, but in the midst of postpartum anxiety I am so overwhelmed that Christmas has me underwhelmed.

I feel guilty. Guilt I’m not my holly jolly self for my five year old, and I’m not over the moon for my baby’s first Christmas. This is supposed to be the most wonderful time of the year but right now the pressure of the holidays is making it feel like the worst.

I don’t want family members passing the baby around like a hot potato.
I’m worried about whether or not everyone got a flu shot.

Questions about her not taking a bottle yet.
Comments about her tiny size.
And I really don’t want to bake cookies.
Or send the cards I’ve had on my kitchen table for the past 3 weeks.
I don’t feel like decorating more.
Or singing Christmas carols.
Or watching Christmas movies.

I am telling myself it’s just fine to take it easy, to tone everything down this one Christmas and focus on myself. Every year won’t be like this. It’s fine because our 5 month old surely won’t remember it, and 5 year old will still run down the steps with her eyes wide on Christmas morning.

And it’s especially okay because the way I feel right now is just a season.

A cold, dark, and at times stormy season that’ll pass in time. Right now the only thing I can equate with Christmas is the intense chill in the air. I know it’ll get warmer soon enough. The sun will melt the darkness away, and everything will Bloom again.

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Allison is a wife, mom to two beautiful girls,
and freelance writer living at the Jersey shore. She loves writing, cooking, Pinot Noir, Bruce Springsteen, and combing the shoreline for seaglass. After having her second daughter in the summer of 2018 she’s slowly navigating the world of postpartum anxiety.
You can follow her on
Instagram (Instagram.com/alli_shark) and

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a poem about ppd

It’s Scary What a Smile Can Hide

After working up the courage, I shared this poem on Facebook a few months ago. It was a scary thing to do.

It was received with a lot of love publicly and privately, and one friend reached out and said she thought she was the only one who felt this way. With the help of Tiffany of the Bloom Foundation we were able to get her the help she needed.

If you are reading this and feel the same, know that you are not alone. You don’t need to hide behind a smile. There is help.

I lied and said I was busy. 

I was busy; but not in a way most people understand. 
I was living in a body fighting to survive. 
I was fighting a war inside my head.
EVERY.
SINGLE.
DAY.
It’s scary what a smile can hide. 
My illness does not define me. My strength and courage does. 
Although I am still Blooming, I made it to 2018 as a survivor
and…
my story is not over.

An Open Letter to My Loved Ones

Dear loved ones,

It isn’t anyone’s fault I ended up having Perinatal Mood and Anxiety Disorders after my son’s birth, nor have I done anything wrong while suffering from this illness. I know surviving this has affected me in a number of ways and I imagine it has affected you in a variety of ways.

For that, I am sorry.

I’m sorry I wasn’t honest with you.

I’m sorry I kept you out.

I’m sorry if I hurt you.

I wasn’t well and wasn’t able to do more than I did at the time. Denial was present before I had any clue what was happening to me followed by intense confusion and all consuming fear. I wanted so badly to believe I was ok, I could do this mom thing, and the hard times would pass. I wanted it so badly I tried to fake it till I made it. I only started to make it when I stopped faking it.

I was lost within myself. My thoughts and feelings terrified me to the point where I couldn’t believe anyone else could handle them. I kept you at a distance because the thought of horrifying you with how I felt or losing your love as a result of my feelings was far too much to bear.

None of what happened is a reflection on you or the love you have shown me. It speaks to what mental illness and trauma can do to a person. My postpartum anxiety,depression, and PTSD altered my perception of everything including what I know to be true about myself and all of you.

You’d give me the world if you could and do anything to make sure I was ok. These facts weren’t in my mind for a while but were always in my heart. When I started to put myself back together again, I began to remember the truth.

The truth is you were with me through the darkest and scariest hours, the smiles I faked, the lies I told, the times of real joy and fun, and the moment I accepted what was happening to me. My being able to come to acceptance of my illness, receive treatment, and share it with you speaks to who you are in my life and the love you’ve shown me.

Please understand that PMADs are a complex beast to war with and it takes a strength, determination, and resilience you don’t know you have until you start digging for it. It wasn’t that I wanted to be how I was or treat you as I did; I was in deep pain and survival mode. What I thought I needed the least I needed the most – a tribe of other mothers who shared my experience. I needed to be in this community to begin my healing then carry it out into my life with you. It couldn’t work the other way around.

Please know my struggle wasn’t your fault. None of us were properly educated in PMADs and, even if we had been, it may have all played out the same way. I was so panicked from the depths of my being that I strapped on a mask and held it in place as tightly as I could. If you saw past my mask and have any regrets about how you handled that moment, please try to let it go.

It is unknown to me whether or not you having said something or done differently if I could’ve received it. I do know now it is worth it to ask questions of a mom and say you’re concerned when you are even if it appears to fall on deaf ears. We can never know what might stick in a person’s mind and how they may use it later on.

Please hold onto the fact that your love and acceptance of me is what helped me climb out of the darkness and re-emerge back into our life.

Thank you for never giving up on me.

I love you.

3 smiles pmad

Three Smiles

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These three pictures were taken at very different times.

[/vc_column_text][vc_empty_space][/vc_column][/vc_row][vc_row][vc_column width=”1/3″][vc_single_image image=”1219″ img_size=”medium” alignment=”center” style=”vc_box_shadow_3d” css_animation=”slideInLeft”][/vc_column][vc_column width=”1/3″][vc_single_image image=”1214″ img_size=”medium” alignment=”center” style=”vc_box_shadow_3d” css_animation=”slideInDown”][/vc_column][vc_column width=”1/3″][vc_single_image image=”1218″ img_size=”medium” alignment=”center” style=”vc_box_shadow_3d” css_animation=”slideInRight”][/vc_column][/vc_row][vc_row][vc_column][vc_empty_space][vc_column_text]True, they are only a few years apart, but the person in them is different. The first was taken in December  2012, the second in May 2017, and the last in April 2018. It’s the same person on the outside, but a very different person on the inside.

The girl in the first picture is scared, haunted by obsessive thoughts and feeling like a bad mother for wanting nothing to do with the baby she can’t believe is hers. This girl would be put on medication for the short term, but then suffered with crippling anxiety and rage long after. This girl was a one and done with children. This girl thinks she just made the biggest mistake of her life. She hates the baby, her husband, and herself. She overcompensates by keeping her house obsessively clean and working out for hours on end. She cooks months worth of homemade organic meals and keeps herself up at night making homemade graham crackers. She is not me anymore.

The girl in the second picture can’t believe she did this again. She can’t believe she’s feeling this way again. She had it right this time: exercised and ate healthy all through pregnancy, switched from her  OB to a more natural minded midwife, had a natural birth, encapsulated her placenta, took magnesium supplements and had read every book out there. Yet, once again, she’s plagued by sleepless nights, panic attacks, and a crippling depression. She’s heartbroken to see a safe haven sign and learn that she can only drop off a baby 30 days old, and her son is 33 days old. She has visions of dropping her newborn down the stairs. However, she’s  acting as if nothing has changed, and she can totally handle life. She repeats to herself: This is normal. It will pass. She is not me anymore.

Then that girl got the help she needed. That girl started therapy, found the right medication, and met her people. She made it her job to go to every possible event at the Center for Perinatal Mood and Anxiety disorder. She learned she has struggled with anxiety her entire life. She learned that therapy, meditation, mindfulness, writing, exercise in moderation, medication and acupuncture could help her thrive.

The woman in the third picture is not without her battles. The difference now is that smile is genuine. Sure, her kids drive her nuts sometimes and she still struggles with anxiety and not having a constant sense of order. But, she knows how to handle it. She laughs more and stresses less. She’s found a sisterhood of amazing women who accept her for who she is. It’s hard work changing her mindset, but she’s committed. She loves her boys fiercely and knows that she was brought to this place for a reason. This woman is me.

Perinatal Mood and Anxiety Disorders are the most common complication of childbirth, and affect one in five women. There is help out there. It’s work, but it can change your life. At almost thirty-five, I’ve finally found myself. I’m a work in progress and that’s alright. [/vc_column_text][/vc_column][/vc_row]

open letter to my son jenn Mullen

An Open Letter To My Baby On His First Birthday

One year ago today, you came into a family that loved you so much from the moment we found out about you. One year ago today, you taught me that a mother’s heart has no limits. One year ago today, I fell so deep, so hard, and so fast in love with you. Your birthday is a day to celebrate you, but it’s a day to celebrate Mommy, too.

I know babies are supposed to learn from their mommies, but here’s the thing, my little angel, Jake, you taught me so much about myself as a mother, wife, friend, and person.  My love for you was so fierce from the start that I was overcome with extreme obsessive behaviors, worries, anxiety, and fear- but those feelings stemmed from my love for you. All my life, I’ve always wanted to be a mom to a bunch of beautiful babies. I was so extremely blessed to become pregnant with ease. I felt as if my life truly began when I became a mother, so why is this first birthday so hard for me? Why do I feel like my heart is so heavy?

It’s because my PMAD stole my early moments of you.

I was always so worried about you- worried that you weren’t eating enough, worried your belly hurt from reflux, worried about creating the perfect schedule for you… non-stop racing, worrying all day, every day.  The distress and anxiety manifested in this manic version of myself. I was obsessed with making everything perfect for everyone- your dad, your brother, and most importantly you. I held the panic attacks inside, only saying what I was really feeling through my PMAD treatment. Sometimes I don’t think I was even completely honest with myself and my feelings. I cried as I held you, wondering why you were entrusted to a mom would felt fanatical, panicked, and fretful. Suffering with Perinatal Mood and Anxiety Disorder wasn’t something that I wanted to focus on during the first year of your life, but it happened. It was beyond my control. I fought so hard to manage it for many months.

Now at the one year mark, this is what I’ve learned, I can hold onto the guilt, sadness, and shame or I can honor it as a learning experience and release it into the universe because it no longer serves me. I keep asking myself ‘Why did this happen to me?’ I think there was a reason that I can now see. It was to teach me that life with a baby is imperfectly perfect. Even moms make mistakes. It doesn’t mean I’m a bad mom, it means I’m learning and you’re my teacher. I thank my lucky stars that I was blessed with you and please know that besides my mixed emotions, your birthday is one of my favorite days ever. The moment I saw you, it was pure, organic, phenomenal love.  I want you to know how sorry I am that I spent the first part of your life living as a “mind-full” mom, rather than a “mindful” mom living and treasuring the present moment of your beautiful infancy. I know I can’t get those moments back, but I promise you going forward, I will stay in the now.

This was a hard year for mommy, but know baby boy, it was all for you. I just wanted everything to be perfect for YOU. My sweet Jake, you make my heart smile and all I want for you is happiness, health, laughter & love.  I choose to view your birth as my rebirth as your mom.

I promise to practice mindfulness, patience, and flexibility.

I promise to be your imperfectly perfect mom…the perfect mom for you and your brother, James.

You have my heart always & forever. Happy First Birthday to my beautiful, blue eyed angel.

Love always, Mommy

Jennifer Mullen
Preschool Teacher Room 208
Piner Elementary School

jenn mullen shares her PMAD survivor story

My PMAD Journey Led Me to Mindfulness

Have you ever wondered how you became the person you are? This question haunted me for awhile because I had realized that the person I once was, has left the building—ok, ok, she left the building but it was for perinatal mood and anxiety disorders. Even typing that makes me wonder, “What?! How did I get there?” Thinking back to my pre-baby life, I can remember myself as fun, carefree, and maybe at times a little stubborn and bitchy. But never anxious- never manic- never this distorted version of myself. So this recollection always led me back to, how did I get here because I followed the path I had always envisioned for myself- college, teaching young children, home by the beach, happy marriage, & beautiful, healthy babies. I had literally managed to get everything I’ve ever wanted for myself, so what changed? Well on my road to recovery, I realized- I changed, I evolved, I bloomed. Becoming a mother is beautiful and amazing but oh my stars, it’s mostly terrifying and filled with doubt and worries. The constant anxiety and obsessive behavior over •every. little. thing.• took over my life. I could’ve gone down a dark, slippery slope and just accepted this version as the new, crazy, manic me, but I fought and clawed my way up that hill. Once I reached the top, the view was so clear, so obvious. The new me is an improved version of me. I’m still fun (within limits because, you know, adulting is tiring). I can be carefree in the sense that I’ve accepted to live each moment in the present and stop obsessing over the past and future. I can still be moody at times, but as soon as that mood or emotion enters my mind, I choose to release it as it no longer serves me in a positive way.

Through this crazy journey, I have learned that becoming mindful is my greatest asset because it has allowed me the gift of time- the present. I’ve often asked myself this question, do I want to be a Mindful Mom or a Mind-full Mom? To answer, I want to enjoy the little moments and celebrate the milestones with peace. Life tends to speed by, and it’s easy to fixate on the little shitty things, but that’s when we miss out on those big, beautiful moments. I turned my lemons into a refreshing lemonade- with a splash of vodka on the side…see, i can still be fun.

So here’s the deal…It does get better- I’m living proof and for those days that might seem harder than others, I remind myself- a bad moment doesn’t make a bad day and a bad day doesn’t make a bad life. Stay strong, trust the journey, and lean on your tribe.

Silenced By Fear. A Postpartum Anxiety Story

6 years. 72 months.

72 times I got my period and was so disappointed that my body had failed me again. That’s how the inability to conceive feels and the words that we in the medical field – I am a maternal child health nurse use – the inability to conceive. Just to make sure you know that your body doesn’t even have the ability to get pregnant. This is risk factor number one (infertility).

Struggle with Infertility

When most of your friends are in the same specialty you are – maternal/fetal medicine – you know right where to go to fix the problem. Which is exactly what I did. My story begins in May of 1998. After six years of infertility, being of “advanced maternal age (34), and one round of IVF, I am laying on a gurney having my beautiful, large, round eggs extracted. Twenty two eggs to be exact.

The eggs meet the sperm in a perfectly warm environment and each day we get updates as to how they are “doing”. Three days later, six zygotes are implanted back into my body. Six. The doctor tells me not to get hopeful; one was looking good but the other five were really being placed back inside me to increase my chance of pregnancy. I lay on another gurney for an hour, willing that little strong little group of cells to stick. To find a home inside me and fulfill my dream of becoming a mom. These are risk factors number two (infertility treatment) and three (my age).

Pregnancy – Finally!

Seven days later I’m in the hospital for ovarian hyper stimulation and I find out I am pregnant. I. Am. Pregnant. My body didn’t fail me again. Though I’m alone when I find this out, which is not what I pictured for this momentous occasion, I’m so thankful and happy that it didn’t even matter. This is the first time it’s mentioned to me that there is a real possibility I am pregnant with twins. Twins! I am overjoyed and so proud of my body for finally doing what it’s supposed to. One week later this possibility is confirmed, and we see two tiny little egg sacks. This is what they call them, egg sacks. This is risk factor number four (pregnant with multiples).

Another week later and I’m vomiting each day, all day. At the same time we see another egg sack. Three. There are triplets inside me and I am somewhere between super impressed with my body, and absolute terror. As a nurse in this field I know all the risks that come with “higher order multiples”. We’re 4 weeks from implantation and the doctor looks in utter disbelief at the ultrasound screen – there are now FOUR embryos. FOUR.

I cry. I cry for me. I cry for these babies who are so desperately wanted. I cry because I know too much and because I haven’t stopped vomiting in over a week. I am officially diagnosed with Hyperemesis, vomiting all day, every day, and requiring hospitalization for dehydration. These are risk factors number five (Hyperemesis) and risk factor number six (hospitalization during your pregnancy).

Hospitalization and Health Problem

Fast forward to Christmas Day and I am now 30 weeks and 1 day pregnant with triplets. One of the babies was lost somewhere between the 12th and 14th week. I was hospitalized almost my entire 30 weeks of pregnancy, eventually being diagnosed with Pancreatitis. I had been in labor five times by Christmas Day but it had been stopped with medications. I was done. I wanted them out – I had nothing left to give. I was a shell of the person I was just 30 short weeks ago.

Though I wanted to be a mom, I felt like was a host – being kept pregnant to grow these babies as big and strong as possible. I delivered two baby boys and one baby girl later that morning. One of my babies is born not breathing, while the other two are so tiny weighing barely over 2 pounds each and in need of around the clock care. They are wicked away after I catch the briefest of glimpses. These are risk factors number seven (traumatic birth experience) and risk factor number eight (premature delivery of infant).

Time Stops in the NICU and ICU

Time gets really fuzzy after that. I remember them taking me to the NICU on the stretcher to see all my babies. The shear volume of emotions that go through my heart and mind are indescribable. There is one son a ventilator to assist his breathing. The other two of my babies are in incubators – fuzzy, yellow, and heavy with IVs. The day is a blur but I remember thinking, and knowing that something is wrong with me.

I remember looking at the bag holding the urine coming out of the catheter inserted into my bladder, trying desperately to remember what would be a sufficient amount. My heart felt like it was racing all the time. I remember being so cold. That same day I’m transferred to ICU in kidney failure and with too much fluid around my heart. Once again I’m alone and I am praying for my babies’ birthday not to be the day they lose their mommy. I don’t remember the next 5 days in ICU. These are risk factors number nine (NICU stay for your baby/babies) and risk factor number ten ( a significant illness suffered by the mother).

The First “What if” Thought

On New Year’s Eve day I’m brought out of my drug induced haze in the ICU and begin lying to get to my babies. Yes – lying through my teeth. I tell hospital staff I am fine, that I can get in a wheelchair, and I can be moved to the step down unit. Yes, yes, yes. Whatever you need me to say. I’ll say it so I can touch my babies. I get to them. My heart explodes with love. I can feel my body wanting to lose collapse from pushing it too far too fast. But I will it away.

I’ve heard of moms lifting cars off their children and this was my version of that experience. I stay with them the rest of the day. It’s at that time I’m struck by my first “what if” thought. “What if I lose one of these babies? How will I survive that?” My mom tells me not to worry. They are in the best hands, in the best unit, and that I have always been a worrier. This is risk factor number eleven (history of anxiety or depression).

Bringing My Babies Home

The next 6 weeks are rotation of going to the hospital during the day to be with the babies, and going home at night and crying because I had to leave them there. They all come home within five days of each other. I go from no babies to all three babies in five short days. “No problem”, I thought. After all, I have been the nurse in charge of the nursery so often, and at any given time there were 15-20 babies. What I didn’t is remember sleep. I would leave work as a nurse, go home and sleep and then start again at work the next day.

Within 72 hours of all my babies being home with each on a three hour feeding schedule, and each feeding taking about 2 hours – I’m a total mess. My worried thoughts turned to non-stop racing thoughts. I was unable to sleep even if all the babies slept at once. Unable to swallow from anxiety. Unable to control this bubbling rage I felt. I mentioned my racing thoughts to my OB at my post op check – he assured me it was nothing, and that a shoe shopping expedition would bring me back to normal. Based on all my risk factors, I should have been screened for depression and anxiety immediately. But I wasn’t.

Silenced By Fear

My OB’s face and eyes looked worried and alarmed but I knew then to never say another thing. I didn’t want anyone thinking I was unstable and taking my babies from me. That is how it went on for months, and months. I was so broken and ashamed of how I felt and the thoughts I had. When I mentioned it my (then) husband he looked at me in disgust and said, “you got everything you ever wanted”.

I was a monster, and I didn’t deserve these babies. I became obsessed with death, and how many ways they could die. In a house fire (which I solved by buying a ranch style house), driving my car off a bridge (which I solved by no longer going over bridges) and many more. But I could always fix it. I always set up a safety net.

The Long Road Towards Recovery

I would like to tell you it got better sooner, but I didn’t. I had a severe case of untreated postpartum anxiety/OCD and intrusive thoughts. It didn’t get better for years. Years later working as a floor nurse on a postpartum unit, I’d see the face of new mothers who I knew were feeling what I felt. My pain was so deep and life altering I vowed that I never wanted another mother to feel that way, to feel like a bad mom, a monster, again. I started giving out my cell phone number to keep in touch with these women. At the same time I started getting them to the help they needed – therapy and medication. All without owning my own story with anyone but these soul sisters. Women who were feeling what I had felt.

In 2007, New Jersey became the first state to mandate depression screenings for new moms before they left the hospital. It was thrilling. At the same time I started volunteering for a consortium that was getting PPD resources into the hands of moms. In 2011, I started an official postpartum depression support group at my hospital, and it quickly became the most attended support group in the hospital.

Helping Other Moms

My phone number was passed around and I became something of an urban legend: if you call/text this number, she will help you. In 2013, I presented an idea to my hospital for an actual PPD program. There were none in the state – hell there were only a handful in the whole country. It took 2 years but I got the go ahead, and began building the very program and services I know would have helped me.

The program quickly took off and in less than two years we officially became an interdisciplinary Perinatal Mood and Anxiety Disorders Center. Specialized treatment given by the right team, for any new or pregnant mom. We can easily see 50 new moms a month. We have days we get 10 phone calls – from moms, from husbands/partners, from grandmas. All are asking for help, and we bring them in and we heal them. We validate what they are feeling immediately. I tell each and every new patient that this is the most common complication of childbirth. One in five new moms will experience this. PPD is both temporary and treatable, and we can help you – you will get better.

Peer to Peer Support

Our peer to peer support group is the absolute crux of our center. It’s an honor to have been able to make this happen. Thrilling that I’m part of a hospital system that feels the responsibility to take care of mental health as much as physical health. It’s a blessing to be part of an amazing team of women who are selfless and tireless in helping moms. This job has no clock and we are on all the time. Because in taking care of a new mom, you are taking care of the baby and the family. You are keeping everyone together and intact, which is vital for recovery.

If a new mom isn’t doing well and she is not bonding/attaching with her baby, it can have devastating effects on the whole family unit. Our calling is to keep moms healthy in every way. New Jersey is the first state to mandate postpartum screening and will be the first state to offer pregnant and new moms help – no matter where they are in the state. It’s my dream that one day these same supports will be offered to all moms across the country.

 

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This Was My Trigger Moment… Surviving Postpartum Anxiety

I am the mother, I am in labor, so why do I feel so out of the loop?

I remember waking up from a nap mid-labor (yes I had an amazing nap during the height of my contractions…thank you epidural!) to a darkened room, spa-like music playing from the TV, and some woman I have never met before massaging my feet and staring intently at the readings on the monitor. I remember asking her what was going on in my lethargic stupor, and although I do not remember her exact response, I do remember feeling like something more serious was going on. This is the moment I have identified as the trigger for my postpartum anxiety.

When my husband was allowed to come back into the room, I asked him what was going on and he told me that my contractions were becoming too frequent, and because of the epidural, I was unable to feel a thing. The baby became in distress. The reflexologist was consulted to help slow down the contractions. So why wasn’t this explained to me?

When it was time to begin pushing, I knew something felt off. As a dance/movement therapist, I have a good sense of my body. I know when something does not feel right. My job is centered around kinesthetic awareness and utilizing that in a therapeutic setting, but for some reason, I immediately felt disconnected from my body. I remember after my first round of pushing, I collapsed into the pillow and felt like I was going to faint. Oxygen was placed on me and I was asked to turn on my side and try pushing again. Second round of pushing and that feeling of weakness and defeat fell over my body once again. I looked at the nurse, probably with sheer panic in my eyes, and she stated “I don’t like what I see. I am calling the doctor in.” I looked to my husband for an answer once again, but this time, he was unable to provide me with one. We were both out of the loop.

The doctor came in and told me I was going to go in for an emergency c-section. Baby was in distress. I was whisked away, separated from my husband almost immediately, feeling so anxious and scared. While they began the operation, my husband recalls being asked to wait in a small room by himself and told to put on scrubs. He says that was the worst fifteen minutes of his life. My support, my rock, the one person that knows how to calm me down, was now separated from me at the scariest moment of my life. Am I ok? Is the baby ok? My plan of having a seamless, stress-free vaginal delivery was now crumbling down right before my eyes.

In the end, we had a beautiful, happy, healthy baby girl. She brings such joy into my life it is unfathomable. But after my birthing experience, I was struck with postpartum anxiety almost immediately. I have often wondered whether or not I would’ve been struggling with it if I was informed about what was going on during my labor rather than feeling like an outcast. I had always imagined this experience to be about me, my husband and our new addition to our family. When in reality, I essentially felt invisible.

I read somewhere that the key to happiness is to accept the present moment as if we chose it. While this is a personal struggle for me because when dealing with anxiety, that state of total powerlessness is a scary, scary place. I have come to accept that is it ok to not have all of the answers. I could ask myself “what if I was better informed about what was going on, would that have helped my anxiety? Would that have alleviated my severe anxiety after the birth of my daughter?” Perhaps. Who knows. But I do know after the birth of my daughter, I have learned to advocate for myself more. To not ever feel left in the dark again. In all aspects of my life. And I have this experience to thank for that.

 

 

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