I have wanted to write about this topic for a long time, but I never really felt led to do so. I have prayed about it often the last six months and finally feel led to share my story.
I would say about half of the moms I know struggle with some sort of postpartum mood disorder. I am one of the ones who struggles with it. It really wasn't a surprise to me that I had PPA/OCD, considering I suffer from generalized anxiety disorder, panic disorder and obsessive compulsive disorder when I don't have massive crazy postpartum hormones to deal with. What was surprising to me, however, was that PPA/OCD is different from my GAD and even panic disorder. What also surprised me was my
reaction to it.
I went to therapy in the past for a long time to get a handle on something that I unknowingly suffered from for most of my life (I have vivid memories of having anxiety/OCD even at the age of five or six). I pretty much graduated from therapy and was doing much better. After Zooey was born, my anxiety really kicked up, but I thought it was due more to my mom getting cancer. I thought that my concerns about my new baby daughter were "normal" and "rational": the way I would go in and lay my hand on her chest at least once during every nap and in the middle of the night, how hyper-vigilant I became about germs or how I worried she was going to die from something that happens to all kids like falling and hitting her head, for example. I wish I knew then what I know now, that PPA is not always seen by the state I was in after I had Tennyson, but that it is often seen as constant worrying and rumination about your baby and/or your baby's health and safety. I started an SSRI around the time my mom had surgery, but it was not a good fit for me and created a manic response in my body. That was the first time I had scary and intrusive thoughts about harming my baby. I stopped the SSRI, and the intrusive thoughts stopped, but my incessant, unhealthy level of worrying about Zooey did not. My experience with that drug left me vary wary about trying anything else, until my mom was about to die and I literally could not take the constant state of panic I was in. I prayed very hard, and so did my Bible study sisters, that I would find a good fit, and thankfully I did. I felt like a new person! I stayed on the med and was in the process of weaning when I got pregnant with Tennyson, which is when I stopped it altogether. An interesting thing about my anxiety is that when I was pregnant with both my children, I felt amazing - I had almost no anxiety! That proves to me how big a role hormones play in my anxiety.
After Tennyson was born, I knew I needed to pray for protection against postpartum anxiety/depression, so I did, and I also asked a lot of people to pray with me. While I had some rough moments in the beginning (as most moms do), things seemed to be going ok. Four months postpartum, at the return of my first period, I had what I not-so-lovingly refer to as my breakdown. Intrusive thoughts started to creep into my mind. I had scary thoughts start to creep in about a week before this. Scary thoughts about both my children; they were just random, "What-if" thoughts that I won't share in detail so as not to trigger anyone who might read this who may be having those thoughts.
Thank God that I had gone back to therapy after the first SSRI didn't work well for me, and I talked to my therapist about the couple ITs I had, because that kept me at least a little sane. I knew from therapy that everyone has intrusive thoughts and that my anxiety about it actually shows I would never hurt my children. Not only did my PPA/OCD hit, I had some major life stressors hit, too. All this combined was just enough to put me over the edge in a case of constant worrying, rumination, obsessive thinking and panic. I am also so thankful that God had earlier in the year prepared me spiritually for this valley season. He let me know through the study of Matthew that He is always by my side and never leaves me when the storms hit. That's for another post, though. :) He did so much! Clinging to Him is honestly what got me through. So, here's where the part that surprised me comes in: my reaction. I began ruminating and worrying about the thoughts and what was wrong with me that I was having these thoughts. I could not stop worrying about the next thought. I obsessed and to top it off, my hormones were sending my body into constant panic attacks and hot flashes. I told Ryan I just wanted to go to the hospital; I thought I was going crazy. When I started having intrusive thoughts about hurting myself (not the URGE to hurt myself or a PLAN, mind you, just scary thoughts, like it would be better if I wasn't here and "what if I ____"), I knew it was definitely time to get help. I had a bottle of my SSRI that was prescribed by my OB after the birth "just in case" that I began taking. Sometimes when you begin an SSRI to treat anxiety, it is normal for your anxiety to worsen for a bit before it gets better, which happened to me. But, I held on and after having my dose adjusted, I finally began to feel better. I also went to a couple of therapy sessions to brush up on some panic attack coping skills.
I still have rough moments, like the last week or so. I have had another stressor hit that got me worked up and kind of started the cycle again. Once again, thank God, because He had me stumble upon a book that I started two days ago and am almost done with, called
Dropping the Baby and Other Scary Thoughts: Breaking the Cycle of Unwanted Thoughts in Motherhood by Karen Kleimen and Amy Wenzel. This book has
really helped me process what is happening and reassured me that I am not going crazy nor am I the only woman who is going through this. In fact, it's estimated that 91% of women postpartum and 88% of new fathers have scary thoughts. It's just that women who have PPA tend to obsess and ruminate on the thoughts, because they are distressed by them. As the book says, "The factor that determines whether a thought is troublesome or not is
not the content, but rather
the individual's level of distress and meaning attached to the thought." (Loc 345 of 3849). It is repeated again and again the same truth I learned in therapy after Zooey was born: "Women who are concerned about the scary thoughts they are having do not hurt their babies." (Loc 596 of 3849). "The anxiety that accompanies scary thoughts speaks volumes. Mothers who worry about the thoughts they are having, no matter how big and bad, are demonstrating anxiety that provides valuable diagnostic treatment." (Loc 597 of 3849). I could go on about the ways this book has helped me - and I'm not even finished yet - but that would take up too much time. The book also lists some unhealthy ways to approach the thoughts, one of which was denial and thought suppression, both of which I was trying to do. It is more healthy (although it sounds counterintuitive!) to face the thought head on and address it and to empower yourself to move on from the thought. As we all know, it's human nature to do the thing or think on the things we're told not to, so this makes sense.
I have started telling myself, "That was a scary thought. I am not my thoughts. Nothing bad is happening." I am returning to therapy and of course continuing my medication (which, as a side note to anyone reading this who may be concerned about breastfeeding and taking a medication, many SSRI's are labeled Lactation Risk 2 out of L1-L5, and Thomas Hale has done much research to prove that most do not cause any infant side effects).
I wanted to share this story, because as I mentioned earlier, about half of the moms I know personally struggle with scary thoughts and either PPA/PPD. These are the women who actually
talk about it. I know some who were too scared to say anything for fear someone might take their kids. I actually thought that with Zooey! However, more and more research is being done in this field and showing physicians how common it is. PPD/PPA/OCD can occur anytime within the first year after childbirth, not just the first month or so. I just want to encourage someone - you - that you do not have to go through this alone. It is scary, yes. But, it is fairly common, and there is help.
