Tag: postpartum anxiety

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.

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.

 

the bloom foundation postpartum depression and anxiety

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.

 

 

Notice Me. This is PPD

[vc_row 0=””][vc_column][vc_column_text 0=””]David Zinell, writes in his science fiction novel, The Broken God, “Before, you are wise; after, you are wise. In between you are otherwise.”

We have all been there, been in the thick of it.  We struggle to stay afloat in the proverbial swamp and only later when we emerge and dry ourselves off do we see the paths we could have taken to avoid the swamp completely; and while hindsight can be frustrating the power it provides is immeasurable. The power to help others.

A couple of blocks east of Downtown Scottsdale in a newly renovated 3 bedroom townhouse that would make Joanna Gaines proud, Lisa and I sat at a kitchen table that had become our impromptu office space and talked lived experience, hindsight, PPD, and the triangle of power they form.  We talked about moms in the swamp, when they are “otherwise”, and wondered how to get their husbands, their partners, their families –their people– to notice them. To see their PPD. We talked about how PPD manifests itself differently in its’ sufferers, and as the Arizona sun shone through the windows and the kitchen table grew heavy with empty coffee cups and discarded post it notes, we realized we needed help from those with the power.

100+ moms who have been swam in the PPD swamp told us how to help people see. They told us what they wished “their people” had noticed. This is their hindsight.

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Words Matter

[vc_row 0=””][vc_column][vc_column_text 0=””]***TRIGGER WARNING***

Missouri mom believed to have killed husband, baby, herself; postpartum depression eyed” This headline and accompanying article filled my news feed this week, and it probably did yours as well. Or perhaps you saw the articles that replaced the word “depression” with “psychosis.” I saw those as well.

When I saw this story, I quickly reached out to the women of the Bloom Foundation. These are the women in the thick of it, deep in the trenches. They are clinicians and support group leaders, they are survivors and advocates, and they are the women who everyday work with new moms struggling with postpartum anxiety and depression. I needed to hear what they had to say.

 

Lisa Tremayne

“This is heartbreaking on every level. My prayers are with the family and friends of the Trokey’s. I am saddened, but I am also frustrated. There is such an enormous amount of power in the words we use every day and a responsibility that comes with the terms we attach to illnesses. Depression and psychosis are very different conditions, and the tendency to use them interchangeably when pairing them with “postpartum” frustrates and scares me. We wage a daily battle to erase the stigma associated with postpartum mood and anxiety disorders so women no longer have to suffer in silence. When terms are misused or used ignorantly, in order to sensationalize a story, I fear the effects. I fear for every new mom suffering from postpartum anxiety who today will decide to not speak up, to not seek help. I fear for every mom next week who Googles postpartum depression and is presented with Jessica Porten’s story and what she encountered when she did speak up. I fear for every mom next month who will find the strength to make that first call finally asking for help, and then the second, and third, and then finding nowhere to go. These are not bad moms. They have a real illness, and it is treatable and with help they will get better. Yes, there are moms who experience psychosis, and yes, tragedies happen. I feel it is the biggest part of our job to be the voice of the women silenced by the stigma, the shame, and the secrecy. To educate the public, the providers, the families about the realities of postpartum anxiety and depression. It is treatable, it is temporary,  and it affects 1 in 5 new moms.  We must erase the shame.”

Lesley Neadel

“As soon as I heard there had been another maternal mental health tragedy, my heart sank as my tears welled up. These stories shake me to my core. But this time, for the most brief of moments, I realized with satisfaction that the article I saw labeled what happened as a potential case of postpartum psychosis. Bravo to the St. Louis Post Dispatch, I thought fleetingly. Because when the media reports that this tragedy happens because of a battle with postpartum depression, and not the more accurate psychosis, they spread misinformation that keeps women who DO suffer from postpartum depression and anxiety from coming forward to seek treatment. They suffer in silence because they think, “we’ll, I’m not that bad.” “I don’t want anyone to think I’d do THAT.” What people need to know is, there is a spectrum to perinatal mood and anxiety disorders (PMADs) such as postpartum depression, postpartum anxiety and postpartum OCD. The symptoms and severities can appear differently in each person, but all are temporary and treatable, if we know what to look for, are open and honest about our feelings, and seek the help that we need to get better. Yes, postpartum psychosis is on the far end of that spectrum. But it is not postpartum depression.”

We don’t know Mary Jo Trokey’s suffering. We do know that postpartum psychosis only affects 1 to 2 in 1000 out of every 1,000 deliveries, or approximately .1-.2% of births and .00005% suicides and/or infanticides. We have a responsibility to use our words wisely, with thought, compassion, and a real understanding of their impact and meaning on others.

The Bloom Foundation sends its deepest condolences to the extended Trokey family. Our hearts ache for their loss, one that we feel so acutely. We are committed to doing the work and informing and educating pregnant women and new mothers about the signs, symptoms and risk factors for PMADs. We are committed to reducing the shame and stigma associated with these illnesses, the most common complication of childbirth.

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The Many Faces of Postpartum Depression

The image of a woman sitting alone in a dark corner, usually on the floor, shoeless, head down, hair a mess. 

It is the picture we attach to postpartum depression. We use this picture – I’ve done it – and then add a quote to it or include it in a blog post as a visual representation – an offering of understanding.

She is the face of postpartum depression… and she is lying to you.

I understand this woman is only here to help. She is a placeholder, a conduit, a way to connect and say “you are not alone,” and perhaps calling her a liar is a bit harsh, but in her desire to help she may be hurting as well.

Postpartum mood and anxiety disorders are real…and this nameless, sitting in the corner, shoeless woman represents the depression many new moms experience after the birth of a child.  Depression is this woman, the face of PPD, but depression rarely arrives alone.

Postpartum Anxiety is a strong companion and usually much more formidable.

Recently, in one of our closed PPD/A online support groups a member asked this question…

“What does your PPD look like?”  

As you read how members responded you can see that while depression peppers the conversation, the face of anxiety is a constant and powerful force… and this is what I mean when I say the woman in the picture may be a problem.  She connects, but she also alienates, because PPD has another face and it is NOT staring at the floor or out the window or hiding under the bed covers.

[su_pullquote]Mine was white hot rage. Obsession over sleep schedules-mostly naps. Insotmnia which fueled racing, intrusive thoughts. Hopelessness. But for months I spent my energy making it look good for anyone and everyone around me. Only my husband knew something wasn’t Pinterest perfect. And I felt like I was a monster for months before seeking help.[/su_pullquote]

[su_pullquote]So much rage, insomnia, intrusive and racing thoughts, feelings of failure and hopelessness. So much anger followed by deep sadness.[/su_pullquote]

[su_pullquote]Mine was mania with a side of OCD. Doing it all like a baby hadn’t changed me. Putting on a good face. Obsessed with order both in my home and for my kids. Rigid schedules. I’d crack behind closed doors.[/su_pullquote]

[su_pullquote]My PPA is like a musical crescendo. Slowly building up and my heart is racing and sometimes a cannot catch my breath. It causes me to snap at my kids. Then I feel awful.[/su_pullquote]

[su_pullquote]Feeling completely overwhelmed, intrusive thoughts, feeling like a failure, crying uncontrollably for no reason, rageful moments[/su_pullquote]

[su_pullquote]Panicking awake in my sleep every half hour until I started medication-Terror at the idea that my colicky baby was going to wake up any second and cry-The obsessive thought I should give him up for adoption because I clearly wasn’t meant to be a mom.[/su_pullquote]

[su_pullquote]Insomnia, racing thoughts, failure for everything I did or didn’t do, crying uncontrollably for no reason, feeling completely overwhelmed, and being scared of my baby at times.[/su_pullquote]

[su_pullquote]Feeling like a failure, feeling like I had made a huge mistake having kids because I obviously was no good at it, constantly feeling overwhelmed by the simplest of tasks. Severe anxiety around the safety of my kids.[/su_pullquote]

[su_pullquote]I learned recently that rage is a big indicator of depression. So I’m going through both PPD &PPA. I can’t sleep. I don’t want to do anything. Intrusive thoughts. Crying comes and goes. Not wanting to get out of bed or where ever I’m sleeping. But force myself. I work on putting a show for my 3 year old. [/su_pullquote]

[su_pullquote]Overthinking schedules, being extra type A, obsessing over how many oz Jake was drinking, pretending I was fine all the time.[/su_pullquote]

[su_pullquote]Can’t nap and turn my brain off when baby is sleeping. Anxiety. Nauseous [/su_pullquote]

[su_pullquote]Rage! So much rage. And just obsessing over every little thing, especially things I can’t control. Not living in the moment, depressed about the past- worried about the future.[/su_pullquote]

[su_pullquote]Crying uncontrollably and not being able to explain why, nausea, not eating, racing thoughts, feeling the need to lay still in bed, guilt[/su_pullquote].

[su_pullquote]Feeling “good” one minute and than what feels like a wave of heaviness taken over by instant tears. Insomnia. No appetite. Lack of interest in things that used to bring great joy. Inability to move past the trauma of my labor/delivery.[/su_pullquote]

[su_pullquote]Because I was so hyper, people kept complimenting how I “had it altogether” and I was a “super mom.” I fed off of it and thought I was just destined to be miserable all the time.[/su_pullquote]

[su_pullquote]Intrusive thoughts (so scary) paralyzed by my anxiety. I would hear my baby cry and not be able to move. Not eating, throwing up, constant crying[/su_pullquote]

[su_pullquote]Panic and racing thoughts. Then it was feeling like a failure and complete withdrawal. I remember nothing from the first few months of his life. My second wasn’t as bad but I had rage and anger. I enjoyed her newborn stage but I resented my older children because I felt like i couldn’t split myself into enough pieces.[/su_pullquote]

[su_pullquote]Rage; hopelessness; racing thoughts; sense of impending doom; cognitive impairment; insomnia; inability to make decisions; complete overwhelm and inability to begin or finish tasks; need to escape/flee. My eating disorder returned[/su_pullquote]

[su_pullquote]Extreme rage and extreme sadness. So overwhelmed with extremely simple tasks, like getting new contact solution from the linen closet because mine was empty. I just couldn’t do it. Crying for no reason at all. Some days not being able to get out of bed.[/su_pullquote]

[su_pullquote]Feeling overwhelmed, rage, hopelessness, insomnia, obsessive thoughts , crying over everything, wanting to just be home, extreme guilt, panic attacks , feeling like I’m going to “jump out of my skin “[/su_pullquote]

[su_pullquote]Paralyzed by every minor decision, obsessed over each detail, nervous, to leave the house, anxious, worried, couldn’t sit still, overwhelmed, hopeless, afraid people would know I was losing my mind, no appetite, uncontrollable crying, I wanted to run away & disappear – very intrusive thoughts of driving my car off of bridges…. felt so alone.[/su_pullquote]

[su_pullquote]I also had intrusive thoughts about driving my car off bridges. It was terrible. I couldn’t go near my windows for awhile bc I had thoughts of throwing my son out them when I couldn’t get him to stop crying n it had been hours of non stop crying.[/su_pullquote]

[su_pullquote]I first started with Being almost “manic.” I was like super mom… i was getting everything done, taking care of the house family etc.. i did it only on a couple hours of sleep.. i felt like i was just in go motion.[/su_pullquote]

[su_pullquote]My PPD/PPA is contradicting. Feeling trapped but no motivation to get up. Constant worry but lack of ways to console those worries. Lack of communication but no desire to communicate. Lack of intimacy but anxiety x1000 about my body image and sex in general. In a nutshell my PPD/PPA is a clusterfuck of emotions. Anger, sadness, helplessness, no control..[/su_pullquote]

[su_pullquote]Rage. Anxiety. No desire to eat.[/su_pullquote]

[su_pullquote]Lately I have a fear of leaving the house to do anything. I have paralyzing anxiety. I want to get back to my normal self. I am not happy. I do leave the house, but it isn’t easy.[/su_pullquote]

 

 

 

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