VitalChild - Postpartum Depression (PPD) and Post Traumatic Stress Disorder (PTSD)

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Postpartum Depression (PPD) and Post Traumatic Stress Disorder (PTSD)-one woman's moving emotional journey

Source: Bostonhealthcoach Date: 10/5/07

My Toughest Newsletter Yet

For the last 19 months, I’ve been trying to decide when and how to write this
newsletter. This is the most vulnerable I’ve ever been in my newsletter… and this

is by far the toughest, most complex topic I’ve addressed. I’ve been fine-tuning it all month,
but it’s time to take a deep breath and hit “Send.”

One of the reasons I decided to share this intimate story with you is because of a
recent email that I received from a Nourishing Nuggets reader. She wrote:

“I am in awe that you can do all of that while being a new Mom. It looks easy in
your pictures - you and Evan laughing and bonding, him eating kale without a
fuss and you looking radiant… and anyone would be envious of how great you look!
I see the incredible accomplishments you are pulling off while being a full-time Mom.
You seem to be taking it in stride.”

I started laughing hysterically when I read her email, because this image couldn’t
be farther from the truth. Is that what my readers think about me and my life?

If it is, then I owe all of you the truth. So, here it is.

May 2005 - I’m pregnant for the first time.

September 2005 - Ben and I get married.

October 2005 - We start planning a natural homebirth with midwives.

January 2006 - We learn the baby is breech (feet down), and our homebirth dreams are dead.

February 15, 2006 - My son is pulled out of me by C-section and my world comes crashing down

You might be wondering:
What’s the big deal about a C-section?

I can only speak for myself and my birth experience,
but I can tell you:

Although I’ve never been raped before,
the only way I can describe
the physical and emotional trauma of my C-section
is to compare it to a rape.

It was the most heartbreaking, violating, painful experience of my life.

You see, my body was not the only thing
sliced into during that surgery. A large chunk
of my soul disappeared that day, too.

I became a broken woman that day…
and I’ve been picking up the pieces ever since.
If you keep reading, I’ll explain what it’s been like.

For me, the C-section caused a double whammy case of
Postpartum Depression (PPD) and Post Traumatic Stress Disorder (PTSD).
I suffered from both of these for the first 15 months of my son’s life.

I’m sure you’ve heard of Postpartum Depression before (I knew about it, but of
course I paid no attention to it before Evan was born, since I assumed I would
never experience depression). After all, I was healthy, strong, well-connected…
and I had no history of prior depression.

PTSD is the same thing that war veterans get from traumatic war experiences.
As it turns out, you can get PTSD from a traumatic birth experience. It may be
helpful to know that any kind of birth (C-section, vaginal, drugs, no drugs) can
cause PTSD - the main factor is how the mom feels about the birth. One mom’s
glorious birth could be another mom’s traumatic birth. This is rarely acknowledged
in our culture, however, because most people assume a baby’s birthday is
automatically the happiest moment of a mother’s life. This is not necessarily the
case - it certainly wasn’t for me.

To be honest, I can’t remember much about the first 12 months of my son’s life.
When I look back at videos and pictures from that time, I notice that I looked happy.

Maybe I should take up acting…

Because inside…
I wasn’t happy.

Inside, I was raging.
I was screaming.
I was sobbing.
I was aching and hurting.
I was angry and bitter.
I felt violated, and I was grieving in a big way.

Here’s what a year of PPD and PTSD looked like for me:

- Contrary to popular belief, I was NOT hanging out with Ev in the kitchen, munching on
kale and tofu. I do, however, remember sneaking into the kitchen quite often so I could
take a swig of wine. I didn’t even bother pouring it into a glass - I just drank it straight
from the bottle. It helped me forget about my life for a little while.

- I had flashbacks to my surgery 5-20 times a day. Nighttime C-section flashbacks caused insomnia. Daytime C-section flashbacks caused sobbing, rage, and zombie-like apathy.

- I experienced feelings of gloom, grief, and anger almost constantly, these feelings, like an annoying cloud over my head, rarely went away for a year.

- I had trouble bonding with my son, because he reminded me of the C-section.

I didn’t keep a baby journal or decorate his nursery. I didn’t feel like his mom, and I certainly didn’t have any confidence in my mothering skills. It took me three months to muster up the courage to take him to the grocery store. For the first few months, I avoided anything that made him cry (giving him a bath, putting shirts over his head, putting him in the carseat). I know that we smiled and laughed and played peek-a-boo. I know that he’s always eaten great food, and that I’m still breastfeeding him 19 months later. We’ve gone on adventures together, and he’s gotten lots of cuddling and love. But there was a fog between us for the first year of his life. I simply wasn’t “there.”

- I didn’t want to go out and meet new people - it was too hard to pretend I was doing OK. Besides, I got really jealous, sad, and mad when I heard other moms raving about motherhood, or sharing their positive birth stories. Those positive feelings felt so foreign to me, and I thought… surely, they must be lying. Because motherhood wasn’t fun for me until Evan was more than a year old.

- I had intense fear, grief and anxiety in the weeks leading up to Evan’s first birthday. I didn’t plan a party for him that day because all I think about was the memory of my C-section. I didn’t want to celebrate the worst experience of my life.

- I disconnected from many people in my inner circle except people with whom I could discuss the C-section and my true feelings. Most people didn’t understand why I was unhappy, and they downplayed my feelings. They told me I should be healthy because - after all - “you have a healthy baby.” They told me I was stewing over something that was over and done with, and that my expectations for Evan’s birth were too high. They told me I was wasting precious time with my baby. Didn’t people see that everytime they said something well-intentioned like this, they just made me feel guilty and horrible? Comments like these only added to my depression. So I eventually stopped bringing my anger and sadness up, except to the few people who didn’t judge me for how I felt.

- I often wondered if my new marriage could survive this storm, and if I would ever like motherhood.

- I researched the heck out of PPD and PTSD, and I knew there were lots of treatment options. But I had so little energy that it was hard for me to take the first step. I had to ask a friend to come over, sit down at my dining room table, listen to me dump out all of my options, and help me put a recovery plan in place. How bizarre is that? I create health plans for my clients all the time, but I didn’t have the energy to do it for myself. That showed me how “off” I really was. The simplest tasks were extremely difficult.

My Recovery

I had a rough time - emotionally - during the last month of my pregnancy, as well as the first few months of motherhood… but I simply attributed it to the C-section.

It wasn’t until Evan was 7 months old that I figured out I had PPD. I had taken the PPD screening test when Evan was only a few weeks old, and scored very high… but I thought I’d get better in a matter of weeks… once I started sleeping more. When Evan was 7 months old, I revisited the PPD screening test again when I was up late with insomnia. Once again, I saw that I still met almost every single PPD criteria. The next day, I asked my husband if he thought I might have PPD. He didn’t even hesitate for a nano-second. He simply replied, “Yes, I think you do.”

I realized I needed to pull myself out of the depression, and fast. And to heal myself, I’ve had to pull every single gosh darn ounce of Guilt-Free Self-Care that I possess and put it into action to save myself.

I had a really, really, really, REALLY hard time getting help at first, particularly from the traditional medical community. I tried to follow the traditonal PPD treatment avenues, but I fell through the cracks, it seems.

My OB-Gyn never called me back to give me a referral. And because I haven’t seen a doctor in 5 years (I don’t have a Primary Care Physician), I had to wait more than four months to get in to see a nurse practitioner who could do bloodwork to rule out anemia or thyroid problem. Four months is a LIFETIME when you’re not feeling well, as you know. Once I did get to my appointment, the nurse never even addressed my PPD. When I tried to bring it up, she told me, “Well, at least you have a healthy baby… that’s what’s important, right?”

** Please know: A mom can love her baby tremendously, and be glad her baby is healthy… yet she can still despise her birth experience… and still feel depressed. A healthy baby doesn’t cancel out birth trauma and depression. Besides, a mom is not merely an extension of her baby.

And you should also know that my C-section was “picture perfect” according to the medical doctors. I can only imagine how C-section complications affect a new mom’s postpartum period.**

The traditional psychologist I saw didn’t help much either. She basically ignored my PPD and and never even asked about my birth experience. I went to her a few times because she took my insurance, but in the end, I decided that I’d rather invest money in people who can really help me… even if they don’t take my insurance.

I applied to have a “Visiting Mom” to come to my home and check in on me once a week, but they said that I didn’t qualify, for some reason.

Medication wasn’t an appealing option for me, personally, so…

*******************

In the end, I found myself turning, as usual, to the alternative health world for support. This is what really helped. Here are some of the paths that were most helpful:

- I did lots of counseling with holistic health counselors, baby trauma specialists, birth trauma specialists, my spiritual mentor, and a clinical nutritionist.

- I attended a new moms postpartum support group sponsored by Jewish Children & Family Services (even though I’m not Jewish, they still welcomed me with open arms).

I joined ICAN (International Cesarean Awareness Network) and became a part of their email support group, where I could talk openly and honestly about my C-section without being judged.

I had massages, some shiatsu sessions, and bartered with a personal trainer who came to my house and created workouts that I could do with Evan (this was a godsend).

I journaled, read books, talked with family and friends, devoured websites and blogs, hired a babysitter, cooked and consumed my placenta (which I wish I’d done sooner after Evan was born), posted my birth stories on my blog, and found a few new mom friends with whom I could speak openly and honestly about what I was experiencing.

I thought I would recover within a few weeks… but it hasn’t been a fast recovery. It ebbs and flows… just when I think it’s gone, it resurfaces and I get frustrated. Evan is 19 months old, and I can honestly say that my PTSD is gone, but some PPD remnants still linger. They’re reminders of my past, and motivators for my future. My mission is to ensure that no other mom EVER has to endure what I’ve endured since my son was born.

*******************

When I look back on the way I feel now… compared to last year… it’s like I’ve come back from the dead. I only had the energy to take care of my son and myself… and beyond that, I have let other things slip… and let relationships slide. It was what I had to do to survive.

Obviously, I spent a ton of time, money, and energy on my recovery. It hasn’t been easy. I had to really want to get better. I know that my husband, friends, and family wanted me to feel better… but in the end, no one else cared as much about my recovery as I did. No one else could do the work for me.

Why have I been working so hard to pull myself out of my depression? While I love my husband and my son, I didn’t do it for them. And I didn’t do it for my business.

I worked so hard to pull myself out of my depression because I believe that I deserve it. Me. Myself.

I deserve it.
I deserve to feel good.
I deserve to stop crying, to stop hating myself, to feel like a marvelous, powerful, passionate, strong woman again.

Some may call me selfish for saying that. In fact, much of the PPD literature says that mothers with PPD should be treated so that their babies don’t suffer from developmental problems… and so their families won’t suffer from being around a depressed mom.

Well, I certainly believe our health affects those around us. However, I also believe our #1 reason for healing ourselves should be because… WE deserve it.

WE. DESERVE. TO. HEAL.

Those who were on my New Mom teleclasses lately know that my personal mantra is,
“Who’s taking care of the mommies?”

Once a baby pops out, the focus gets shifted to the baby, and many new moms are ignored.
I believe we need to take care of the mommies… not because mommies take care of
everyone else, but because mommies deserve to be taken care of for their OWN sake.

The same can be said of you. Whether you’re a mommy, a daddy, a son, a daughter,
a woman, a man, a teacher, an accountant. Whatever you are, whoever you are…

You deserve to be healthy.

To feel strong.
To be happy.
To love your life.
To love yourself.
To practice guilt-free self-care.

I really hope that this newsletter will inspire you to do just that. Sometimes it takes
multiple false starts before you find a health practitioner that you like. Sometimes
you have to ask people - over and over again - for help so that you can heal.
Sometimes you have to simply muster up all of your courage and self-love and
take that first step. Because no one else can do it for you. Believe me, I know how
challenging it is.

I shared this incredibly intimate story with you because we are in this health journey
together - you and me. I want you to know that I am not a superhero just because
I’m a holistic health counselor. Just because I support people in their own health
struggles doesn’t mean that I don’t have health struggles of my own.

However, I firmly believe this whole postpartum journey - as tough and painful as
it’s been - has made me better able to do my work in the world.

Postpartum Depression - A Serious Problem

More than 400,000 new moms get PPD each year (that’s more than the number of
people who are diagnosed with Alzheimer’s, Parkinsons, or Multiple Sclerosis).

If you know anyone who’s a new mom, it’s important for you to familiarize yourself
with the signs of PPD. There is a stigma around depression (especially for new moms),
so most new moms won’t show obvious signs of depression… but if you listen to her
words and watch her facial expressions, you’ll often see it.

Here are some ways to gauge a new mom’s emotional health (keep in mind not
only the words they say, but the emotion behind the words):

Ask a new mom about her birth experience - was it what she hoped for?

Ask a new mom what she’s eaten that day… and what she’s done to take care of herself?

Ask her how motherhood compares to what she expected?

Ask her when she last had 2 hours to herself without her baby around?

PPD can surface anytime in the first year, so please continue to support moms,
even after the initial newborn phase. If you know any moms who need support,
but aren’t sure where to turn, please send them to my website. I’m compiling a
list of PPD resources for my Recommended Reading page. If they need/want
immediate support - and someone to talk to - please encourage them to call me
at 978-474-0144 or email me. I will do my best to help them find support.

I don’t know where this new piece of PPD and motherhood will fit into my
Boston Health Coach business in the future. And I don’t have any of my usual
tips or words of wisdom at the end of this Commentary.

I do, however, want to thank you for allowing me to share my story with you.
Please take any pieces that resonated with you, and if you think this would
help another new mom, please pass it along.

If this piece offended you in any way, I'm sorry. It wasn't meant to offend.
It was simply an honest portrayal of one woman's experience, and if it pains
you to read that birth can have this kind of negative effect on a new mom,
please know that it happens more often than TV shows and the media lead
us to believe. Birth and motherhood aren't always pretty... and I believe it's
important to give all mothers the space to talk about what it was truly like for
them... without feeling judged or crazy. Thank you for allowing me this
opportunity.