16 July 2011

There's such a thing as being overvigilant

Sometimes recently I question whether or not I might be struggling with PPD again or with Postpartum OCD. I look at the fact that I'm irritable sometimes, having trouble sleeping at night, get aggravated and frustrated, and ask myself "Could these be warning signs?". The other day at the mall I started to have a meltdown, like actually had tears coming out y eyes (just leaking a little, I pressed it back in) and started to think (Do I need to go to the ER?". I tell myself that yes it's all stuff that could be warning signs of a deeper problem, but that it could also be perfectly normal reactions to stress (of which I certainly have an abundance right now) and the fact that due to several outside factors, my sleep schedule is ALL out of whack. Then I start to question whether I might just be in denial and finding ways to rationalize that no, I couldn't possibly have PPD. It's a vicious cycle of never-ending questions that go in a big circle ad nauseum.

The thing I keep coming back to is that I don't have thoughts of harming myself or others, and the fact that I'm aware of the potential and keeping an eye on myself is a good sign, that at least I'm aware of what's going on. I have to talk to a therapist anyways since I've been on Zoloft as a prophylactic measure, so of course I'll discuss all of this with them and request that they recheck my thyroid levels, but it made me think of something.

I think that for those of us who have dealt with PPD, one of the big problems in subsequent pregnancies and postpartum periods can be a sort of hyper vigilance, being TOO aware and almost jumping at shadows. Yes, it's good to be aware of how you're feeling, but I have to keep reminding myself of what Jan, my midwife, told me at my 6 week postpartum checkup. She said, to paraphrase because I can't remember exactly how she worded it, "You have to bless and release the past and live in the future, moving forwards instead of staying in the past". I have to remember that if I concentrate all my time and energy, or even a significant portion, on whether every tiny little thing could be a symptom of PPD, I'm liable to talk myself into it. Life will be so much more enjoyable if I can remember to focus on the here and now and the future instead of what happened 2 years ago.

The moral of the story, I guess, is to reind myself and anyone reading this, to be aware but not so aware you forget to live.

14 July 2011

Spot on, Washington Post, Spot on.

I read this article from the Washington post and I loved it so much I wanted to share it.
Janice D’Arcy is off this week. Guest blogger Jennifer Kogan is a clinical social worker who works with parents in Northwest D.C.
 As a mom who meets lots of new moms, I have noticed something lately. In my conversations with new mothers who breastfeed, there is an almost universal belief that breast milk is akin to the nectar of the gods. I hear words like “lazy” and “selfish” to describe mothers who choose to bottle-feed. Not surprisingly, women who choose to bottle-feed tell me that they feel judged, guilty, and not supported. Is breast milk better for babies? Maybe. But is bottle-feeding such a sin?
DC-area postpartum support advocates, Lynne McIntyre and Adrienne Griffin, have long believed that there may be a connection between a mother having difficulty breastfeeding and the onset of postpartum mood and anxiety disorders (PMADS). Their pilot data based on interviews with women who have PMADS revealed that external pressure in deciding whether or not to breastfeed largely came from other new mothers and pressure from society.
Why does this matter?  Katherine Stone, founder, editor and writer atpostpartumprogress.com, says that, on average, 20 percent of new mothers experience perinatal mood and anxiety disorders. This would mean around 1.3 million women are affected annually. While national statistics range and reflect only women who have actually sought help for PMADS, that is still a lot of people.
Some of the women from McIntyre and Griffin’s study commented, “I felt SO guilty for having to stop, but I realized that my son was going to be without a mother if I didn't do something to help myself.” 
“I wanted to NOT breastfeed. But I felt so much pressure that I continued despite my feelings,” said another.
It is heartbreaking to hear how hard some new mothers will work at breast-feeding. Stories of marathon pumping sessions, which yield little results, are common. One woman I know relayed the relief she felt when a lactation consultant finally told her, “Honey, it sounds like you tried hard but maybe you should stop now.”
 Joan B. Wolf’s book, “Is Breast Best?” sparked a widespread national debate recently. In it, she makes the case that breastfeeding advocacy is a lot of hype. Whether she is right or wrong seems beside the point to me. I am dismayed that how we feed our babies has become a kind of moral issue where mothers are grading other mothers on if and how long they are breastfeeding.  As if you are not a good mother if you don’t breast-feed your baby.
 When I meet with women who are struggling with breastfeeding and/or PMADS, I ask them to take some of the energy they are focusing on their baby and try to shift it to themselves.  This is harder to do then it sounds. It means a new mother has to try to see herself with kinder eyes even though she is feeling inadequate and depressed. It means that in order to recover, this new mother must breathe from the oxygen mask first so she can survive.
  How can we, as mothers, and we, as part of society, not support that?
 This is so on the nose.

11 July 2011

What do I have to live for?

When I was hitting my lowest point in my struggle with PPD, the night I decided to go to the ER, I had suicidal ideations. Making the choice to reach out for help, to say "Hey, this is how I feel" was incredibly difficult. It's not an easy thing to admit that you struggle with something that is as stigmatized as PPD is and that you need help, that you really can't do it on your own.

What helped me make the choice to make that call? What was it, when I was standing at the top of the stairs looking down and thinking how easy it would be to jump forwards, that moved me to step back and go get the phone and call the Chaplain, to get the car keys and drive to the ER? 

It was the knowledge that my daughter needed her mommy, that I didn't want to hurt her in any way, that my husband loved me and would be so hurt and lonely without me, that did it. I don't even remember that going through my mind as a rational, logical thought process, I just remember that it was there in my thoughts, that I didn't want to end up another Andrea Yates. 

I did it for my daughter, and I would do it again for my daughters. I realize now, on the other side, that I have so much to live for. I have two beautiful, wonderful, healthy daughters. I have a husband who loves me, treats me better than a queen, and who would do anything for me. I have a home, pets I love, family and friends who would (and have) drop anything to help me. To anyone who's reading this who struggles with feeling like their life is worthless, like you don't matter and you and/or anyone else would be better off if you were dead, like you're alone, you're not alone, you are not worthless, you do matter, and someone out there cares. When you ask yourself "What do I have to live for?", stop and think, you might have more to live for than you first realize.

06 July 2011

PostPartum OCD

I recently read about a condition I had never heard of before called Post-Partum Obsessive-Compulsive Disorder.

"Postpartum Obsessive-Compulsive Disorder (OCD) is the most misunderstood and misdiagnosed of the perinatal disorders. It is estimated that as many as 3-5% of new mothers will experience these symptoms. Symptoms of perinatal OCD can include:
  • Obsessions, also called intrusive thoughts, which are persistent, repetitive thoughts or mental images related to the baby. These thoughts are very upsetting and not something the woman has ever experienced before.
  • Compulsions, where the mom may do certain things over and over again to reduce her fears and obsessions. This may include things like needing to clean constantly, check things many times, count or reorder things.
  • A sense of horror about the obsessions
  • Fear of being left alone with the infant
  • Hypervigilance in protecting the infant  
Moms with postpartum OCD know that their thoughts are bizarre and are very unlikely to ever act on them.
Risk factors for postpartum OCD include a personal or family history of anxiety or OCD.
Postpartum OCD is temporary and treatable with professional help. If you feel you may be suffering from one of this illness, know that it is not your fault and you are not to blame. You can use our resource page to reach out now. We understand what you are going through and will connect you to people who understand and can help. http://www.postpartum.net/Get-the-Facts/Postpartum-OCD.aspx"

From http://ppdcenter.com/What_Is_PPD_.html:
"Postpartum Obsessive Compulsive Disorder (OCD)
The PPD symptoms may also be mixed with anxiety symptoms that take on an obsessive (thoughts) and/or compulsive (behaviors) feature OR these may be experienced without depressive symptoms.
According to Postpartum Support International, "This disorder is one of the most under-recognized and under-treated types of perinatal mood disorders. It occurs in approximately 3 to 5 % of new mothers, yet it can be most alarming for a new mother. The symptoms include intrusive and persistent thoughts or mental images and a sense of horror about the thoughts/images. The thoughts are typically accompanied by behaviors to reduce the overwhelming anxiety that accompanies the thoughts."
These compulsive, ritualistic behaviors often include checking baby frequently, obsessively searching for information on the internet/books, etc. For example, a mother may have an irrational fear that she is going to drop the baby down the stairs. Consequently, she may avoid using the stairs or even going near a staircase. These mothers are NOT in danger of harming their infants and are disturbed by these troubling thoughts."

Again, if you or a loved one are experiencing the afore-mentioned symptoms, call your physician because help is easily available. "

The bolded is actually one of the biggest things I worried about when I was experiencing PPD before I got treatment. I wish that this was something that was more widely known about. Do your part to help spread the word and educate people about the various PostPartum disorders and to combat the stigmas that so often come along with them.

Changes ahead!

I'm almost 3 months post-partum and no signs of a need for hospitalization. Things have been going well. It's been kind of crazy. 2 weeks after I gave birth, Eric went on a 3 1/2 week TDY to Ft. Hood, leaving me home alone with the daunting task of a newborn and a 2 year old. But, we survived, sanity intact.

Now, we're getting ready to move to a different state. We found out a couple of weeks ago that he is going to a new duty station and his report date is August 1. It's been the cause of a lot of stress for me, especially when you tack on that it's my first PCS (Permanent Change of Station), the fact that Prissy Britches started teething at all of 2 months old, Her Majesty is in the Terrible Two's, and I spent this past weekend back and forth between the ER and home thanks to an infected salivary gland, TMJ, and swollen lymph nodes. And when I was home, I was doped up on pain meds and unable to eat much besides soup, jello, and pudding. Now we find out that he won't get his actual orders until 2 weeks before we need to leave to drive out there. Great! We can't arrange for the movers to come pack us up and get our things until he has orders.

Like I said, it's a lot of stress but I keep reminding myself to try to take things in stride and to breathe and remember that families do this all the time and that we'll make it. I try to remember to use the stress relief techniques they taught me after I had Elizabeth. One of the biggest things that I think has helped me avoid PPD this time around has been the use of those techniques. Stopping to take some deep breaths when I feel overwelmed. Examining a situation to sort out the reality from my perceptions. And most of all, making sure I get a little bit of time out of the house by myself each week. Not isolating myself has been a big help.

I'm not out of the "Danger Zone" yet, but I'm moving towards it and I am confident that I will get through this in one piece.