I could never have known at the time – after all, she was my first – but looking back, I can say with utmost certainty that I began suffering from anxiety and depression during my first pregnancy.
I can’t say I am terribly surprised. I’ve been prone to anxiety my entire life. As a child, I worried constantly about all the things I couldn’t control; as I grew older, worry turned to panic, which turned to general anxiety about … everything.
Even though I so badly wanted to be pregnant and have children, I couldn’t stop the worrisome thoughts from incessantly invading: What if I’m not a good mom? What if having a child wreaks havoc on my marriage? Will I ever have time to myself again? What will become of my career? How will I multitask my life?
And so on.
As my due date approached, I didn’t feel ready. I wanted to keep her in longer because I knew this baby would be way easier to protect and take care of inside as opposed to out.
When I asked my doctor if this was a possibility, he laughed.
Except, I wasn’t joking.
At 42 weeks when she still hadn’t arrived, my OB said the words I really didn’t want to hear: “It’s time to induce, Marissa. She needs to come out.”
And so, on October 23, 2012, we went to the hospital early in the morning to begin the induction. For some reason (read: naivete), I assumed the process would move quickly – that the doctor would break my water, the Pitocin would bring on contractions, and within no time we’d be snuggling our little peanut.
Except that’s not what happened at all.
The entire process, beginning to end, took 16 or so hours. Somewhere around hour 14, my OB explained that my labor process had stalled—I couldn’t seem to dilate past 7 centimeters—and since my baby was “sunny side up” (an expression that essentially means she was facing the wrong direction to birth vaginally), it was highly unlikely she was going to come out the way I’d hoped.
“Prepare for a C-section,” he said.
I started to cry.
This wasn’t what I’d envisioned at all. In fact, I had skipped right over the entire C-section chapter in my pregnancy book because I was so certain I wouldn’t need one.
When they finally wheeled me into the OR, I’d been in labor for several hours and had been battling a migraine and severe nausea for the past three. As they prepped me for surgery, I began vomiting, turning my head left and right so I wouldn’t choke. I was miserable.
The nurses and anesthesiologist were incredible and helped me survive the ordeal, but it wasn’t the beautiful birthing scene I’d so desperately hoped for. It was scary and a bit traumatic.
The whole time all I could think of was that when it was all over, I’d have a tiny human to take care of … and keep alive.
** Cue the terror **
When the OB pulled my daughter out, I feigned elation. As he held her up in front of me and introduced her to me for the first time, I was angry at myself that I wasn’t crying tears of joy, or that I didn’t feel anything … except disconnection (from her, motherhood, and the entire birthing experience).
As the days wore on in the hospital – I wound up there almost an entire week – my fears turned to full-blown anxiety and panic, and my sadness transformed into hopelessness. Each morning when my doctor came in for rounds, I would burst into tears and ask, “Is this normal? Shouldn’t I be happy? Why am I so terrified? Why am I so depressed?”
“It’s normal,” they assured me. “You just had a baby and your hormones have plummeted. Plus, you’re recovering from a major abdominal surgery. It’s probably just the Baby Blues. In a few weeks, you’ll feel better.”
And so I waited.
I waited and waited and waited to feel better.
But I didn’t.
Weeks passed. Then months. Then an entire year.
And I didn’t feel better.
Some days I was able to fake it—to pretend that I was doing well and that I was really getting the hang of this whole motherhood thing—but anyone who knew me well knew it was a façade. I was falling apart inside and out. I was frazzled, not sleeping more than an hour or two at night (even after the baby started sleeping through the night). I feared leaving the house, because “we may get into a car accident,” or “I might slip and fall while holding her and she’ll get hurt, or worse…,” or “someone may try to kidnap her,” and so on and so on.
Type-A by nature, my obsession with schedules and my inflexible rigidity grew much worse. We absolutely could not, under any circumstance, bend my daughter’s schedule even by a minute. She had to have her bottle every three hours, on the dot, and she needed to nap at exactly 9 a.m. and exactly 1 p.m. every single day. And of course, she had to be in bed no later than 7 p.m. every evening—and if this got pushed late, even by five minutes, I was a panic-stricken mess.
Surely going to sleep late would throw everything off for days, maybe even a week, and then she’d certainly develop poor sleep habits, which would eventually turn her into a terrible student (because— hello!— she wouldn’t be able to stay awake during school), and, a sleep deprived disaster, she would likely drop out of school and wind up on the streets.
It sounds crazy, I know, but this is how my mind was operating at the time (and, left to its own devices, still does…).
I call this “The Tumbleweed.”
The endless catastrophic thoughts just roll, and roll, and roll. The Tumbleweed grows bigger and bigger and gains more and more force, and before I know it, I can’t stop it. And so I follow along, and my heart races faster, my breath becomes shallow, my appetite diminishes, and sleep—oh, sweet sleep—becomes a distant memory.
This is how I lived for a year-and-a-half.
I’ll never forget the evening my husband came home from work to find me curled into a ball, weeping on the floor. This was, perhaps, my lowest moment. I had alienated everyone—family, friends, caregivers, all the helpers—because I didn’t trust anyone else to take care of my child (read: follow all my obsessive rules and scheduling guidelines to an absolute T). Yet at the same time, I didn’t even trust myself to take care of her. I felt lonely, exhausted, and isolated, but I refused to ask anyone to come over and help so I could take a break.
I was a fragile shell of the dynamic woman I once was.
Everyone knew they had to walk on eggshells around me for fear of setting me off into a state of panic and tears. It was incredibly ironic that even though I was studying mental health (I was a marriage and family therapy graduate student at the time), and was particularly drawn to working with couples and new parents, I didn’t recognize the symptoms within myself or understand that what I really needed was professional help.
I honestly assumed this was just what new parenthood was supposed to be like – a terrible initiation, of sorts – and that I had to suffer through it to find my groove. I would even get angry with my husband when he suggested we get a sitter and take some time just for us; in my mind, this was a selfish notion because, as parents, we needed to take care of our baby—not a babysitter.
And yet the signs were all there.
I was in the throes of postpartum depression and anxiety. This perinatal mood disorder was clearly taking over my life and stealing all the joys of new motherhood from me. I finally realized this when I saw friends doing fun things with their spouses and children—things I would never have dreamed of doing, like going on vacations or taking day trips to the zoo—because it would have disrupted my daughter’s nap schedule or possibly made her (or rather, me) uncomfortable or nervous.
With support from friends, family, and most importantly, my husband, I found an amazing perinatal psychiatrist and a therapist who helped me work through the heavy torrent of fears, anxieties, and emotions. My husband was very encouraging, and he even came to several therapy sessions with me so he could learn how to best support me, us, and our family.
This made a huge difference for me – it showed me how much he cared, and that I wasn’t in this alone. Perinatal mood and anxiety disorders truly are family diseases—they affect and afflict the entire family system: mom, dad (or partner), and child(ren).
I remember feeling guilty for taking time away from the baby to finish my graduate program, to go to the gym, and even to go to therapy. I don’t know why it is that moms always feel they must put everyone else first, casting themselves to the back of their own priority lists. When I voiced this guilt to my therapist one day, she said, “You need to put your own oxygen mask on before assisting others, Marissa. If you’re not alive and healthy, you will be no good to anyone else. So take care of you first, and then you’ll be better able to take care of others.”
I don’t know why I’d never thought about it this way before, but her words struck a serious chord. In that moment, I switched my mind-frame and stopped looking at “me-time” as something to be ashamed of, or feel guilty about, but instead as my survival mechanism and the thing that would make me a far better parent, wife, and overall human being.
To this day, I preach self-care above all else—it is the most important thing a person can do for him/herself. People who don’t take care of themselves are usually unhappy and eventually always burn out.
I see that now.
After I sought help, my life improved dramatically. I grew much more connected to my daughter—she was no longer just a being to keep alive, but rather a beautiful, intelligent little person with a sassy and sweet personality.
My relationship with my husband grew stronger. The passion I once possessed, and that had completely dissipated, finally returned (I started writing again, working out, seeing friends, etc.).
In short, everything got better.
And then, when my daughter was two and a half, I became pregnant with twins.
I knew there was a slight chance I could get pregnant with twins because I was taking Clomid, an infertility medication that helps with ovulation. My OB had warned my husband and I that there was a 10 percent chance of conceiving multiples … but I really didn’t believe him (and my husband claims he never even heard the doc say this). Oops.
I’ll never forget the ultrasound tech’s words at our first doctor’s appointment: “Oh look…There’s two of them! You’re having twins! I love when it’s twins!”
Let’s just say I was glad someone was excited in that moment. I looked over at my husband, and his jaw was open so wide, I could have stuffed a softball in there. And then there was me. I literally felt like I had been hit by a truck. I sat there, unable to breathe, salty tears streaming down my cheeks. All I could think was, “I can’t do this…I really can’t do this.”
The first thing I did when we got home that day was Google “how to come to terms with having twins,” because I knew that this was reality—there were two babies growing inside of me—and I had no choice but to get on board. Whether I thought I could do it or not, I was going to be a mom to a toddler … and twin babies.
Yet I couldn’t really stop the familiar fears from returning. The depression crept back in. The panic took hold. I worked through it fairly well on my own during pregnancy, but about six months after they arrived (postpartum depression and anxiety can occur any time during the first year postpartum), I fell into a deep state of sadness and despair.
But this time it was a little different. I was less anxious, but much more depressed.
There were days I simply didn’t want to get out of bed (but I did, because I had to), and felt that my family would probably be better off without me (I obviously wasn’t capable of taking care of three kids, and I certainly didn’t want my kids to see their mother this way).
It was around the winter holidays when the hopelessness reached its peak. One icy afternoon when I was driving alone in my car, I vividly remember thinking that if I “accidentally” swerved and drove off a bridge, it wouldn’t be so bad.
The thought jolted me, and in that moment I realized just how far gone I was; I had never thought or hoped for something so morbid before. The postpartum depression had reached its peak, and I knew it was time to get help.
Because I was too overwhelmed with, well, life, my husband called my psychiatrist and therapist and got me appointments immediately. He took me to all my appointments, where I was put back on medication (I took—and still take—Lexapro. This may not be helpful for everyone, and that’s okay! But it has been exceptionally helpful for me), and able to start working through the feelings of futility and sorrow.
Within weeks, I began to feel better. But though relief did come much faster the second time around, each day of being “in it” felt excruciatingly long and painful. I remember waking up each morning thinking, “How will I ever manage to get through this day? How many hours until I can go back to sleep?”
During that time I lived on auto-pilot, doing what I had to to take care of three kids. I backed out of all social plans—my energy levels and desire to socialize were at an all-time low—and I would go to bed as soon as the kids were all asleep.
Today I am almost 20 months into life with three kids, and I am doing so much better. The smile has returned to my face—and it’s a genuine one. I am finding ways to carve out time for myself again, and I’m doing things I truly enjoy, like working, writing, exercising and simply breathing.
I will not lie and say that either recovery has been a cinch—both recoveries have been (and continue to be) a challenging process in which I still battle negative and worrisome thoughts—but I can say with confidence that I am truly healthy, happy, joyful and full of hope again.
And so to any others out there (moms or dads!) who may be suffering from a perinatal mood and anxiety disorder, let me just say: You are not alone. One in seven women suffer from postpartum depression. This disease can take so much from you, but it does not have to defeat you. You can fight back, and you can win.
After I finished my graduate program, I decided that the population I wanted to work with was new parents—and particularly those suffering from perinatal mood disorders. After going through what I did, I felt incredibly passionate about helping others in similar situations.
When I was deep into my PPD/PPA, I felt so ashamed. I didn’t want to tell anyone about my thoughts or feelings because I was terrified they would see me as an unfit mother (something I already felt about myself…). I was also afraid that if I shared my feelings, someone might think I would harm my child and take her away.
As I learned during my professional perinatal mood and anxiety disorder training, all of these fears are extremely common and are also what prevent a lot of parents from seeking help when they need it most. There is such stigma around perinatal mood and anxiety disorders—namely that if you are suffering from postpartum depression, you are probably going to harm or kill yourself and your child(ren).
This couldn’t be farther from the truth.
In fact, Postpartum Psychosis is incredibly rare. According to Postpartum Support International, it occurs only in about “1 to 2 out of every 1,000 deliveries.”
Women suffering from Postpartum Psychosis experience a severe break from reality, and in their psychotic state, believe the voices and delusions telling them to do things (such as: the world is a terrible place, and if you were a good mother, you would free your children from this world so they don’t have to suffer) are very real and compelling. We’ve all heard the horror stories about those like Andrea Yates, the Texas mom who killed her five children while suffering from severe postpartum psychosis (among other things). These tragedies (obviously) make a lot of headlines, but are quite rare.
In addition to Postpartum Psychosis, there are a few other perinatal mood and anxiety disorders which all tend to get lumped under the umbrella diagnosis of “postpartum depression.” These include: Pregnancy and Postpartum Depression, Pregnancy and Postpartum Anxiety, Pregnancy or Postpartum OCD, Postpartum Post-Traumatic Stress Disorder and Bipolar Mood Disorders.
For more information on all of these perinatal mood disorders, and to learn more about the symptoms and risk factors for each, please visit Postpartum Support International.
For every person who comes forwards and talks about her/his PPD and/or PPA and seeks treatment, there are several others who don’t. Let’s work together to eradicate the stigma around these diseases. There is help for PPD, and there is a cure! Please don’t suffer alone, or in silence. If you are struggling, please reach out for help. You are worth it!
For more information and to find resources in your area, check out Postpartum Support International.
How has a perinatal mood disorder affected your life? Please leave us a comment below.