Beyond Postpartum Depression
My story with postpartum depression begins with the birth of my daughter in February 2020. My husband and I knew our world was about to get turned upside down, that there would be little sleep, a few tears (from her and from us!), and some general bumps in the road as we transitioned from just the two of us to a family of three. We truly had no idea just how much our world was about to change, because what we never expected was a global pandemic that changed everything just three weeks after our daughter’s birth.
The Early Days
It was early March 2020, our daughter was a few days old, and we were headed back home from a weight check-up at the pediatrician. I was feeling guilty that I found breastfeeding uncomfortable and painful, even though I knew fed is best and that there was nothing wrong with formula. My husband begged me to text my therapist, but I blamed my emotions on my crashing hormones, claimed I’d be fine, and I didn’t text her.
My husband went back to work a week after our daughter was born, and I was terrified to be alone with her. I didn’t think I could do everything I needed to do to keep her fed and happy and also take care of myself. She has always been a snuggler and has always wanted to be close to us, and when she was a newborn, that meant that she wanted to be held constantly. There were many times that first week where I skipped lunch or barely ate, because she was sleeping and I couldn’t get up to fix anything to eat.
I was sleep-deprived, but any time I tried to put my daughter down, she woke up and cried (“sleep when the baby sleeps” only works when your baby actually lets you put them in a safe place). I was so afraid of dropping her or smothering her in my sleep that I gave up trying to put her down and just held her. My eyes were so tired and strained that I couldn’t wear my contacts.
We had about three weeks of normal parenthood, where we were able to have friends and family over and show off our precious girl. One night as we were eating dinner with my parents, my phone started to ping with multiple text messages – the first positive COVID-19 case had been reported in central Indiana, and it happened to be at the same hospital I had delivered at. Several people wanted to know if we were safe and if our daughter was okay. I had to remind them that we had been discharged before that patient had even come in, and the maternity unit was nowhere near where they had been assigned. This was our first indication that things were about to change beyond what we had ever imagined.
A week after he went back to work, my husband texted me that he was packing up his office; he was being sent home to work remotely until we flattened the COVID-19 curve. I cried with relief, thrilled that he would be home with me and I wouldn’t be by myself with just our baby and my thoughts.
We watched press conferences from the governor and the White House, learned about staying home to flatten the curve, started wiping down groceries with disinfectant wipes, and tried to find toilet paper (many times, the only available option was lavender-scented). Our daughter was beginning to cry in the evenings, and arch her back and wail in pain after her bottles. We no longer had access to our village; our family were all essential workers, interacting with the public day in and day out, and we didn’t know what an acceptable level of risk was. We were all alone, just the three of us, unable to leave the house except for pediatrician appointments.
And I still didn’t text my therapist.
Even with my husband home with me, I still felt like I was drowning, unable to keep my head above water. His department had never had a remote work policy before, so he had to work and get tasks done to prove it was possible, and I had to pretend that he wasn’t home, even though he was just in our upstairs loft. If she was awake, our daughter was crying, and we were beginning to suspect that she had some kind of intolerance or reflux, because even though she was hungry, she would scrunch up her little face, arch her back, and scream in pain after her bottles.
On one particularly bad night, she screeched in pain from 7:00 in the evening until 10:00 that night. We were texting my parents, asking what we could do to soothe her, and they suggested Tylenol. My anxiety was so bad, I was terrified to give her any, because I was sure I would give her too much and she would overdose. She was so small, so fragile. I eventually caved and we gave her some when we couldn’t take the crying anymore, and she settled enough that we could all sleep.
A visit to the pediatrician the next morning confirmed a case of thrush and silent reflux, where instead of expelling her bottles, she would swallow her spit-up, leading to acid scorching her throat on the way up and then back down again. A prescription of baby antacid took away the pain from the reflux, but it didn’t stop the crying.
I remember asking at one well-newborn visit what level of crying and fussing was normal, to be told that newborns often had witching hours in the evening, it was normal, and she would outgrow it. We were rapidly evolving from witching hours in the evening to all-hours-of-the-day crying. Sometimes bouncing on an exercise ball worked. Sometimes walking up and down the hallway bouncing her on my shoulder worked. Sometimes bicycling her legs worked. Sometimes rocking in a quiet dark room worked.
Sometimes none of it worked, and we sobbed together as I begged her and begged her to stop crying.
I began to believe it was my fault that she had thrush, because how could I have not noticed that it wasn’t formula residue on her tongue because it didn’t go away? I also blamed myself for not noticing her reflux sooner, because what kind of mother doesn’t realize her child is in pain for weeks? I was spiraling into a web of depression, anxiety, and intrusive thoughts, each one more sharp and painful than the last.
“You can’t do this.”
“You made a mistake.”
“You’re a burden.”
“You’re a bad mom.”
Due to COVID-19 precautions, we were isolated in our home, unable to call for help when we needed it the most. I felt trapped with an increasingly uncomfortable and unhappy baby, on call 24/7, unable to take a break.
I was shutting down mentally and emotionally, and I felt numb to everything around me. My husband and I alternated nighttime feedings, but so many nights he got up with me when it was my turn and slept in the daybed in the nursery while I fed our daughter and rocked her back to sleep. I had become convinced that if she got upset, I wouldn’t be able to console her and calm her down.
We had no breaks. We had so many people who loved us and would have dropped everything to come hold our baby while we took a nap or even just sat in a room by ourselves, but we weren’t supposed to have anyone over. We tried to keep her happy, tried to get out ahead of the witching hours, switched formula, got her on reflux medication, and sometimes it seemed like it was all for nothing. She was colicky, and her screams were endless. We collapsed into bed each night, and many times I cried myself to sleep, tortured by a nonstop barrage of angry thoughts. I frantically googled colic remedies, only to dissolve into tears when the advice was “call for help when you need a break!”
There was no help. There were no breaks.
We didn’t know enough about COVID to know what level of risk was acceptable, how it would affect newborns, and if it was okay to call on our loved ones for help. I desperately needed help, but I was terrified of my baby getting sick. What if she got COVID? What if she got really sick? What if she got so sick that she had to be in the NICU, and I couldn’t be there with her?
We had to keep her safe, had to keep her healthy, at all costs.
I was sitting on the couch one afternoon when my OB/GYN’s office called me to tell me that due to COVID-19, my postpartum appointment was being moved to a phone call visit instead of in-person. Stunned, I immediately broke down in tears with the receptionist and tried every option I had to convince her to keep it an in-person visit. I had stitches that needed to be checked. I wanted to get the arm implant birth control. Each one was shot down; the arm implant was considered an elective procedure and those weren’t being done, she was sorry, but postpartum appointments were being moved to phone call visits.
In that moment, my one tether to the outside world – a doctor’s appointment that was about me – was gone. I had just had a major medical event, I had stitches, I couldn’t get the birth control method I wanted, and I wasn’t going to see my OB in person. How was this right or fair?
About a week after that phone call, I was up before my daughter and taking advantage of that time to do some laundry (truly a never-ending task when you have a baby with reflux, everyone changes outfits 3 or 4 times a day). I heard her start to whimper and cry in her bassinet down the hall, and I collapsed against the washer and began to sob. I couldn’t take the constant crying. It was all too much.
My husband, at the desk next to the laundry room, looked at me with concern and all I could choke out was “I can’t do this anymore.”
He immediately called his supervisor and told him he was taking the rest of the day off, got our daughter out of her bassinet and told me to turn on the white noise machine so that I couldn’t hear her, shut the door, and sleep.
When I woke up later in the afternoon, he begged me to call my OB/GYN’s office back, text my therapist, do anything. Something wasn’t right.
I still pushed back a little, said my phone call appointment was in just one more week, I could make it until then.
When I talked to my OB and she asked how I was feeling mentally, the floodgates opened. I explained I was struggling, I felt like I wasn’t adjusting well to motherhood, and I wasn’t feeling like myself. She explained that this was okay, I was going to get better, and that it seemed like every newly-postpartum mom she had talked to that spring had elevated depression and anxiety. She got in contact with my primary care physician, who immediately scheduled me for a telehealth visit the next day. After confirming a diagnosis of postpartum depression, she prescribed me Lexapro. I also got an email from my therapist that her practice was switching to a teletherapy platform, and I was able to get back on her schedule.
Therapy and Lexapro saved me, stopped the hateful thoughts, and lifted the darkness that I had spent the first 8 weeks of my daughter’s life in.
This is the part of my story where I feel lucky.
My OB and primary care physician were in the same healthcare network, so neither office had to request records from the other; they just called each other. My primary care physician got me in right away, knew my history of anxiety and we got lucky that Lexparo worked for me and I didn’t have to try other antidepressants to find one that made me feel right again. I already had a therapist, so I didn’t have to get a referral for one or wait to get into a practice. Even in a pandemic, everything lined up right for me to get a diagnosis and get help.
I am over a year out from my postpartum depression diagnosis. My daughter’s colic resolved itself around when she was 5 months old, and she is a silly, fearless, curious toddler. She is one of the greatest joys of my life and I adore being her mom.
Becoming a parent during a global pandemic is the hardest thing I have ever done. I think I may still have developed postpartum depression because I have a lot of risk factors for it, but the isolation due to lockdown and the heightened anxiety of having a newborn during a pandemic with an unknown virus certainly didn’t help.
There are so many things about my postpartum period that should have gone differently, and so many places that looking back, I can see where I could have fallen through the cracks. I was prepared to talk about my mental health during my postpartum appointment because I have a history of anxiety, and I’m used to talking about my mental health. How many moms were not, and managed to fake it because their postpartum visit was a phone call instead of in-person?
I consider myself lucky to have such a great OB and primary care physician and a wonderful therapist I see weekly, but we should not have to be lucky to receive great postpartum care. That should be the standard, not the bare minimum we receive now. My experience has made me a fierce advocate for maternal mental health, and why Beyond Postpartum Depression exists today. I remember scrolling hashtags on Instagram while I was nap-trapped, or googling symptoms in the dark while my daughter slept in her bassinet next to my bed, trying to figure out if what I was feeling was real. If you’re there, I want you to see that it does get better. The darkness ends, and the light comes back. You are not alone, this is not your fault, and you are a great mom. You can, and you will, be well again.