When you’re wondering if it’s Postpartum Depression
If you’re like I was, you feel like things shouldn’t be quite like “this” and you are wondering if it’s Postpartum Depression.
After my girls were born (2011 and 2013) I didn’t know what was wrong, or if anything actually was “wrong” but I knew I didn’t feel right. The haze and, let’s face it, torture, of sleep deprivation and the complete world shift of motherhood had me wondering if what was happening was “normal.”
The first time around, when my doctor told me my symptoms sounded like Postpartum Depression, I’d had a feeling she would blame my problems (fatigue and mood swings) on the fact that I’d had a baby in the past year. But what I knew about postpartum depression made me doubt my doctor. I didn’t feel like I fit the characteristic traits of a depressed person.
For a little background, I was diagnosed with Panic and Generalized Anxiety Disorder in 2001. It was cut and dry.
But when I began paying closer attention to my mood after my daughter was born — the sadness or anxiousness that came wasn’t constant. I wasn’t sure what I felt.
Here’s what the Mayo Clinic has to say about PPD symptoms:
- Depressed mood or severe mood swings
- Excessive crying
- Difficulty bonding with your baby
- Withdrawing from family and friends
- Loss of appetite or eating much more than usual
- Inability to sleep (insomnia) or sleeping too much
- Overwhelming fatigue or loss of energy
- Reduced interest and pleasure in activities you used to enjoy
- Intense irritability and anger
- Fear that you’re not a good mother
- Feelings of worthlessness, shame, guilt or inadequacy
- Diminished ability to think clearly, concentrate or make decisions
- Severe anxiety and panic attacks
- Thoughts of harming yourself or your baby
- Recurrent thoughts of death or suicide
Questions before a Postpartum Depression diagnosis
The tricky thing with health, and mental health as well, is that we are individual, with very different bodies, symptoms, chemical balances, sensitivities to chemical fluctuations. Throw in the demands of early motherhood and you have a twisting list of things that “could be.”
You ask yourself:
Is it just sleep deprivation?
Is it just reactions to nursing?
Has my thyroid gone crazy?
Has my low iron never recovered?
Are my periods just totally screwed up after kids and this is wild and crazy PMS?
I was running these questions through my mind, partly to be thorough and partly because I felt the threat of postpartum depression stigma rising.
As I began to look seriously at the possibility that what I was feeling was not what normal moms of infants felt, these nagging thoughts bubbled to the surface:
They’ll think I’m a bad mom. Or weak.
They’ll take away my kids.
Can I trust myself around my kids?
Will my husband trust me with the kids if I’m “diagnosed?”
What if I am sick and I snap?
But it’s all too much. You think, maybe this is just another box to check on the list of what every mom knows but will never tell a pregnant woman — maybe I’m just fooling myself into thinking anything is wrong.
It’s easy to think you don’t have a problem
Let’s take a look at what denial looks like. When you don’t know if anything is wrong, when you feel there might be a problem but part of you isn’t convinced, you can rationalize away your symptoms, especially when you are caring for at least one infant.
Let’s look again at some of the classic postpartum depression symptoms and how my mind worked when I read them:
- can’t get out of bed (that’s not me, I have to get out of bed to care for this little bundle)
- insomnia (how do I know, because I have to get up every 2 hours anyway. Sometimes it’s hard to fall asleep at certain times of night when you’re expecting to hear cries)
- isn’t interested in things (I am interested, I just don’t have time/don’t have the energy/ don’t have a spare moment to myself)
- doesn’t feel happy (I can feel happy, just not all day every day)
- crying spells for no reason (I cry because I’m damned tired, because it hurts to nurse and I’m frustrated, because I don’t know how to shower without my baby freaking out … you get it, the list is infinite)
- weeks or months on end of lack of feeling (my emotions come and go, it’s not constant)
- suicidal thoughts (hmmm, I don’t want to kill myself, but I have wanted to run away, and felt the crushing realization that if pressed, where could I actually go to get away from this, the answer is “nowhere.” — or maybe I have glanced at suicide but can’t even admit it to myself)
See how easy it is to think you don’t really fit with those other women who sit and cry all day and stare bleakly out the gray, rain-splashed windows?
I didn’t cry all the time. I wanted to do the things I loved, like run or write, or read or hike, but my energy was asleep on the floor. I did those things occasionally, even if I had to do an hour’s worth of mental persuasion to get out the door. But much of the time I felt frustration that I couldn’t do more.
There were moments I felt like I was failing miserably and sometimes those moments led me to wonder if my daughter would be better off without me.
In those moments I would sob. I would imagine what people would say if they could see me, 4 a.m. wrestling with a flailing baby, wishing for sleep, wishing for different choices, wishing that I could just leave. And it would crush me.
And then I’d get a nap (because really, you can’t call what most moms do for the first year “sleep”) and I’d feel better.
The truth is, it’s not easy to determine by yourself if what you’re feeling is normal mom of newborn (or infant, or frequent night waker) or if you’ve crossed over into Postpartum Depression or Postpartum Anxiety territory.
So, you power on. Misery starts to tip the scales on happiness and you might not realize.
What you can do
When you’re googling PPD symptoms more than once, pick up the phone and, instead of burying the question in a search engine, open up to someone. Multiple someones.
If you have a friend who has shared any fraction of her struggles — in passing at a playgroup, in a heart felt revelation — get in touch with her. The contact with another flesh and blood beautiful mom PPD survivor that you already know and like will lift the veil of shame.
And get in to have a chat with your doctor.
They will talk with you about your range of symptoms and whether they think they fit on the spectrum of mood disorders. They can run blood work to rule out imbalances in thyroid, iron, vitamin D, etc.
Where you go with treatment will depend on your specific symptoms and what you’re comfortable with. You and your doctor can build a plan — anything from a trial of medications to nutritional and lifestyle changes and therapy.
In the mean time
Consider keeping a journal to track your emotions, other symptoms and note anything you were doing that possibly triggered moods. Not only is it a good tool for your doctor, how many times have you forgotten a point you wanted to make only to do the face-palm when you got home, but journaling is also a powerful tool for treating or coping with mental health.
Check out something like the PTracker app here for the iTunes and here for Android version. You can log your symptoms and moods, watch for trends and spot if any of it is connected to your periods, perhaps something like PMDD is at play. At the very least, you can show your doctor the level of moods you’ve been experiencing and try to see a correlation. You can even create notes so you can write about anything you’ve noticed.
Take a look at your diet and consider if you’re eating too much sugar. You can read here about how cutting out fructose, the type of sugar added to sweets, helped to improve my sleep and my mood.
Finally doing something about it
My GP referred me to an obstetric psychiatrist who suspected Postpartum Anxiety.
Just a short aside here to comment that you may find different thoughts on whether anxiety and depression are two points on the same scale of disordered moods, or if they are completely different problems. While the symptoms vary, it’s quote common for someone with depression to also have anxiety and vice versa. They are both postpartum issues to address and my recommendations here apply to both.
The psychiatrist gave me a low dose medication to try and I was off of it in a couple of months when we began planning for Baby No. 2. My sleep had improved, I’d begun supplementing with Evening Primrose Oil and I was feeling much better. I wasn’t even sure the medication had affected me at all.
After my second daughter, I knew to watch for my moods. Things went well until, after 9 or 10 months, my energy plummeted. I was diagnosed with low iron. While we worked through three types of supplements my GP again suggested that the moods I was complaining about (again, mood swings that sometimes left me crying, sometimes filled me with dread) sounded like postpartum depression.
I wasn’t convinced. Again, I wasn’t crying all the time. I was still interested in my hobbies, in my family. I just felt absolutely exhausted, frustrated and sure, anxious, but it felt a little different than with my first daughter.
I went looking for better answers. I started supplementing again. I had my hormones tested. I googled. With no changes I tried the same medication again, but this time it felt like a shock to my system and my anxiety skyrocketed. I had to stop.
I learned that some women, when weaning (and we were beginning the slow process) begin feeling big mood swings. These hormone shifts aren’t the same as a disappointment when nursing ends. I never felt it was “a beautiful relationship” so I grabbed onto the notion that, given my propensity to mood issues my mood swings were caused by my crazy weaning hormones.
So I waited. The iron put a stop to dizzy spells and I felt a bit of a pick-me-up energy-wise, but the mood swings were still in effect, and this time I was feeling angry, angry beyond anything I’d ever known existed in me.
I complained to a friend who had been on this roller coaster ride herself, but with prenatal depression, and she put her foot down.
“If you don’t start feeling better in four weeks,” she said, “I will fly to Switzerland and march you to a doctor.”
I relented and found a therapist. We discussed scenarios and she didn’t label me. We just talked, drilled down to take a closer look at the things I wanted to ignore but could no longer.
I “graduated” therapy last year, though I touch base with my therapist from time to time. I still supplement and try to keep the sugar to a minimum. I still have difficult times, but I am no longer afraid to admit to this aspect of me. I can reach out to the network of survivor moms, the tools that helped me get through and I keep walking on. You can, too.
So consider this my way of telling you to stop delaying. Tell yourself that this is nothing to be ashamed of. That you are a strong woman, a good mother and someone who won’t take this laying down (though wouldn’t it be nice to lay down?) Tell yourself, write it down, tell a friend, tell your partner, that you need to see if what you’re feeling could be postpartum depression or postpartum anxiety. There is really no reason to wait. Unless you’re reading this at 4 a.m. with a sleeping infant on your chest.
Aside from the links I’ve provided in this article, here are some amazing places to find information and community.
Please share your experiences in the comments below to help grow this community of women who have been there, women who are walking through this right now, or who have yet to go down this road.
If you’re a postpartum depression or postpartum anxiety survivor, I’d love to hear in the comments section what you’ve done to cope, what advice you would give to your struggling girlfriends.