Hello again, long time no see! I’m finally, finally coming back to this space.
It has taken me a long time to get my head around this blog post, because the topic is postnatal depression. There’s a lot of fear to overcome when admitting to having suffered from such an experience: the question of whether publicly discussing my illness will de-legitimize my abilities as a doula was a huge one. In the end I’ve decided that if it does stop a few prospective mothers from hiring me, that’s not too high a price to pay in order to reach those that are struggling and really do need help. So, if you’ve googled this topic because you or a loved one of yours is suffering and you’re trying to understand why and how to help, this post is for you. And from the bottom of my heart I am cheering you on, having walked through the fire and come out stronger.
I suffered from severe clinical postnatal depression after the birth of my second child. Therefore for this third birth we planned meticulously. One of the steps I took was to dedicate the entire first year of my son’s life to lying low, and I planned a whole year of maternity leave (ha, being self employed of course, the pay is symbolic!) and focus on my health and stability. I am happy to say that this time things have gone well and I’m very thankful that there was no repeat experience of last time, even though my psychiatrist said that I had a 98% chance of the illness coming back as bad, or worse. And here I am standing in the 2%! There were some tricky times a few months in ,where I was close to sliding into that hole, but thankfully we pulled through and I’ve grown stronger and stronger, and in the end I’ve returned to the birthing world earlier than I had planned, and I’m well. Thank God, I’m well!
A list of self-care steps we took when facing this third pregnancy and birth will be published shortly.
Here’s a myth about PND* that I’d like to bust: Post Natal Depression doesn’t necessarily go hand in hand with sadness.
Before it happened to me, after my second birth, I have to be honest, I didn’t really believe in depression, full stop. I was in that snap-out-it, pull-yourself-up-by-your-own-bootstraps, just-pray-harder category. PND sneaked up on me when I was in a time of my life when I thought I had no reason to be struggling! I was (am) married to a handsome, talented man, my children are healthy and cute, I loved my home, and my work as a doula is so satisfying. I’ve had a safe childhood and never self harmed or suffered from mental illness or trauma in my past. Just because circumstantial and historical issues place you in the risk category for PND, doesn’t mean that you must be already off your rocker to have intrusive thoughts. I didn’t have all the classic signs one thinks of with depression: I wasn’t crying all the time, my house was spotless (too tidy) my children and myself were well dressed, and I smiled. A lot. What I didn’t realize is that there are a host of other risk factors and symptoms. PND is sneaky. I got blindsided.
By the time it was diagnosed in 2006, my daughter was seven months old. I was unable to leave the house to attend functions, because of panic attacks that would start three hours before an event and last for three more after we returned home – not worth the effort. I couldn’t drive our car, because I couldn’t concentrate on all the visual input and decision proccesses it takes to drive (too fast, dangerous corners, urges to crash into walls.) I often couldn’t make dinner for my children, because I couldn’t decide what to make, or focus long enough to make anything. I couldn’t concentrate to watch a movie or read a book . I was terrified of taking a shower (have you ever thought of how many steps it takes to complete that task?) and at one point went three weeks without washing my hair. Speaking of hair, one night at 2am I used the kitchen scissors to cut it all off. A few years later when Brittany Spears did the same thing just after the birth of her second child, I was like, hey! She’s copying me!
Sleep. Disturbed sleep patterns always accompany PND. While I mastered the motherly art of falling asleep in the instant after finishing a breastfeeding session, I would awaken 20 times a night to check the kids blankets/windows/oven/I have no idea what else. I was obsessive compulsive about the cleanliness of my own home, and could not sit still and chat to a guest (my health visitor) if there was a piece of lint on the carpet across the room, I would have to pick it up immediately. If I couldn’t feed my family, at least the home would be clean.
Among the worst things that happened (and the hardest to admit): I was perscribed co-codimal for a breast abcess and recurrent deep tissue pain, and was introduced into the world of abusing prescription drugs. I bought a bottle of vodka and hid it. (All this from a woman who had never been drunk, never smoked a cigarette, never abused anything!) I was self harming on a regular basis. I felt like if I cut myself and drew blood, that would satisfy the terrifyingly painful urge in my chest to harm my children, to kill myself. It was only a little blood. My children never saw, there was no ‘real’ injury. I had to plan how I would get myself and my baby away from my balcony, where the cement walkway below looked so terribly inviting.
Even more terrifying than that, I felt like I’d lost God. My sense of the divine was gone, like heaven became cement, there was no one looking and no one hearing. Right and wrong, good and evil were all mixed up and I didn’t know who to believe anymore. I felt like I was to blame, and at the same time, that it was so unfair that the one time when I needed help most in my entire life, that I was abandoned. Desolate. Afraid of life, afraid of the world I’d brought my kids into.
I was hospitalized in a Mother and Baby Mental Health Unit for nine weeks. I tried seven different antidepressants and other drugs before we found something that finally, finally, helped me feel like ‘me’ again.
Recovery took years. Hence the age gaps: Ana and Noah are 22 months apart – and then there are five and a half years until Asher.
The first glimmer of hope that spoke to me came from a nurse in the Mother and Baby Unit of my local mental health unit. Being a naturally smiley person, people were often surprised that I was one of the patients. Well, I certainly wasn’t going to erase the smile and look glum, just to fit their expectations. I still struck up conversations with staff, just to be polite. Trying to be friendly, I asked her how working on the Mother and Baby Unit was different from the other mental health wards she’d worked on over the years, and why she chose this unit in particular. (I was a very articulate kind of patient.) Her answer has echoed in my mind all this time. She said,
“I like to work in this ward because mothers suffering from PND get better.
They recover, they go home.
Not like the patients in the regular mental health wards.“
And like that, a ray of hope peirced my darkness. We get better. It is a mental illness with a very high recovery rate; I was going to recover.
I did recover.
The following are very painful lessons I’ve learned:
1. Children are scarred for life if their mother didn’t love them enough to stay around and chose to kill herself. No one recovers from that kind of hurt.
2. Children are resilient. They love their mama, they forgive their mama, they need you.
3. “If I confess what I’m feeling then ‘They’ will take my children away from me” – that fear is false. Health professionals want to help you heal and the end goal is to keep the family together. If you have these thoughts, someone needs to know so that they can heal the source of those thoughts.
4. While it does not happen to everyone, it happens to enough women so that you can know that you are not alone! And those thoughts and feelings that make you feel alone have been felt exactly the same way by so many others. This helped me understand that the awful thoughts and urges must not be true or from me; they belong to the illness. Find a support group – there are some excellent online ones, including the mothers at Postpartum Progress. So many of us do get better.
5. It is an illness. It passes. You do emerge again, changed perhaps, but truely you. I am far more me, honestly, after the re-building of my spirit.
6. So many women are scared of taking medication, whether because of the very real stigma surrounding depression (I personally have spent years avoiding writing this post) or because they are worried about taking something that might be addictive. At some point the benifits start outweighing the cons. Getting well is so very worth it.
7. Breastfeeding – is it a benefit or does it cause more hormonal upheaval? There is a lot of debate about this one, in both directions. For me, I finally needed help myself if I were to remain alive for my daughter. Yes, breastmilk is magic juice and I loved giving it to her, but she needed her Mama living, attached, loving her.
8. It is important to keep looking your kids in the eyes, hug them, and tell them you love them. Daily.
9. For a simple, preliminary online test for PND try the Edinburgh Postnatal Depression Scale.
10. There are survivors who are on call daily, and would like to talk to you. If you live in Israel, phone NITZA, the Israel Center for Maternal Health at 02-5332810, or email them at firstname.lastname@example.org
11. Dads and family members need help too! It is totally bewildering to see your wife turn into someone you don’t recognize. My husband has written a post about what he would like to say to any dad whose loved one is suffering, which I will post next week.
I am on the other side, a stronger, more humble woman; more appreciative of life than before.
*otherwise known as PPD. Since I suffered the illness when I lived in the UK, I refer to it as PND in this article.