Wednesday, August 12, 2009

Post-Partum Depression

originally posted at Reepicheep's Coracle

I've wanted to write this post for a while, but I have been putting it off. It's hard to talk about such an emotional topic. It took me several years after my bout with post-partum depression (PPD) to even talk about it with my close friends. But, I think it is very important for people who are having babies to be aware of the possibility of PPD, and particularly important for Objectivists. In my experience, Objectivists don't talk much about mental illness. So here is my story.

According to the Mayo Clinic, the risk factor for PPD are the following:
  • You have a history of depression, either during pregnancy or at other times
  • You had postpartum depression after a previous pregnancy
  • You've experienced stressful events during the past year, including illness, job loss or pregnancy complications
  • You're experiencing marital conflict
  • You have a weak support system
  • The pregnancy is unplanned or unwanted
Several of the above applied to me. I had definitely had intense mood swings, including depression, during my teenage years, though I had never been truly diagnosed. My marriage, though not too bad at that time, had been a bit rocky. I did not have a strong support system. And Livy's birth was very stressful and her infancy even harder.

We had planned a homebirth that ended in a transfer to the hospital. Livy's birth was fairly normal for a hospital birth, but to me, apprenticed to a homebirth midwife, it was incredibly traumatic (epidural, pitocin, short separation from the baby). I believe that the transfer was not medically necessary, and I blamed myself for not making better decisions. We had a horrible time breastfeeding. Though my husband was helpful with the baby, I did not have family in the area and didn't have friends close enough to help much with the baby. Honestly, I didn't know how bad I was and didn't ask for help. I didn't realize until it was too late how much I needed it. Livy didn't sleep for more than an hour at a time; she nursed round the clock; she was incredibly fussy much of the time; and I was a zombie.

That may all sound like normal parenthood, and it might have been if it wasn't for the PPD. I didn't have any energy. I didn't want to do any of the things I liked. I didn't even love my baby. That sounds horrible, but it was true. I felt protective of her, and I felt bound to take care of her, but I didn't feel any of the happy feelings about her that make so much work worth it. I remember the day when she was 14 months old when I looked at her and thought, "Oh my God, I love her. This is how mothers feel about their children." During the worst of the depression, I had violent daydreams about doing terrible things to Livy; I find that even now I can't write them down. I didn't do anything horrible to her, but I thought about it. And then I felt guilty and somehow wrong as a person, like I wasn't capable of loving a child like ordinary women could. Once, I yelled at her because she wouldn't stop crying. She was about 8 weeks old maybe, and I couldn't believe I had yelled at that tiny infant. But I was completely unable to emotionally handle her care.

I did all the right things, and I am still proud of not letting my emotional state affect the things I wanted to do for her. We pushed through the breastfeeding, though my nipples bled nearly every time she nursed. We did not nurse without pain for nearly a year. I thought about quitting. Looking back, I wouldn't have blamed me for switching to formula then. But, I wanted to do something right. If I couldn't give her (and me) a normal birth and the emotions I knew I ought to be feeling, I would at least succeed at the breastfeeding. And it did give me a kind of productive lifeline, a way to be successful and hang on to a little of myself. I managed to present a fairly normal front; my friends didn't know that I was not okay. My husband knew that I wasn't okay, but I don't think he knew what to do. He was just afraid and angry. Why wasn't this like it was supposed to be?

I don't really know what caused the PPD (some mix of hormones and psychological problems I suspect), and I don't really know what ended it either. At about 14 months, a lot of things changed. Nursing became easier; Livy started to sleep more; and I felt a kind of hormonal shift (no cycles yet, but something about my body felt different). I was myself again. Now I was tired and overworked and sometimes frustrated, but I loved my baby and felt awake. I don't remember a lot about the time before that; I think I was living in a kind of fog. In a way, I missed Livy's infancy. I don't remember her first step or word or any of that kind of stuff. It makes me sad to know that I will probably never get a chance to have another child and experience infancy as it should be experienced.

Part of the reason I wanted to share this is to help Objectivist moms who might experience PPD. I had trouble asking for help, partly because I was too "sick" to know that I needed it, and partly because I thought I should just be able to think my way out of it. If I was just rational enough, if I just worked hard enough, if I just did the virtues to the best of my ability, I would be well. How could this have happened to me, I asked myself, when I am supposed to be all rational and productive and happy? I wish that my ex-husband had been able to get me help. I wish that he had just made me an appointment with a cognitive therapist and driven me there. I was too weak to do that myself. I want partners of pregnant women to read this and have some ideas for how to help. Lots of the advice people give new moms is great, but it wasn't enough for me. Sleeping when the baby slept, take some time for yourself, use the sling to be more mobile with the baby - those are good advice, but I needed real professional help. I was afraid to go to a psychologist because I was afraid of the drugs. But, they might have helped me, and I needed my partner to let me know that he would support me if I decided I needed that. (And yes, there are drugs that are safe for breastfeeding babies.)

The other reason I wanted to share this was because of how alone I felt when I was so depressed. I looked around me, and all the moms seemed so happy, so in love with their babies. I couldn't admit that I was the only one who didn't feel that way. I thought I was the only one who wondered if I had made the wrong decision, if I should not have had children, if I was some kind of genetic freak with no maternal instincts. I want people who might be experiencing PPD to know that they are not alone. Since I have started talking to people about my experience, lots of moms have told me stories about their own struggles, from baby blues to true post-partum psychosis (a much more severe form of PPD). I think our society has a tendency to whitewash parenthood, to tell only the lovely things about it. Since I have shared my experience, I hear others talking about the not-fun parts of parenting, the PPD, the regrets, the doubts, the weariness, the loss of self. Not everyone has a bad experience and some people recover to go on into happy parenthood (like I did), but it is important for us to tell the truth about what happens so that parents can be prepared.

It was really cathartic to write all of this, and if you made it this far, I thank you for listening. I am including some resources in this post so that anyone with friends or family or a partner who might experience PPD can know where to find help.

The American College of Obstetricians and Gynecologists pamphlet on PPD

The Resource page of The Postpartum Stress Center (includes resources from specific states)

Article from La Leche League

FAQ from the Royal College of Psychiatrists

And if you have questions or comments that you don't want to share in the open comments section, feel free to email me.

No comments:

Post a Comment

We'd love to hear your thoughts, so let's hear 'em! We're exploring serious ideas here, and think that a good intellectual discussion is a great way to fine-tune one's thoughts. Especially welcome are concrete examples from YOUR life, questions, and thoughtful challenges.

Personal attacks, spam, etc. is not welcome and will probably be deleted, unless we choose to keep them for our own amusement.