Postpartum Mood and Anxiety Disorder coverage on the Diane Rehm Show (NPR)

I want to share some important take-aways from the recent coverage of Postpartum Mood and Anxiety Disorders (PMAD) on NPR's The Diane Rehm Show. If you want to listen to the show, click here, or you can read the main points below:

1) According to leading experts, baby blues last about 10 days. If your symptoms persist or become more severe, you are likely experiencing a PMAD. I wish I had known. I kept wishing away my symptoms and convincing myself they would pass.

2) Insomnia is a very common symptom of PMADs and is not normal for new mothers to experience. Chronic insomnia exacerbates anxious and depressive symptoms. My worst symptom of all.

3) Suicide is a leading cause of maternal death. Women are dying.

4) PMADs are the leading cause of childbirth - more common than postpartum hemorrhages yet doctors are not looking for risk factors or screening for PMADs after childbirth. My OB asked if I had experienced anxiety or depression in the past (a large risk factor) and when I answered yes, she said nothing...

5) Researchers are currently looking at a form of genetic testing to determine which women will be at risk for developing a PMAD. Specifically, researchers are looking at the role estrogen plays in at-risk women.

6) If a woman considers her birth experience to be traumatic (subjectively), she is at a higher risk for developing a PMAD. While by medical standards, I didn't have a traumatic birth, in my mind and still today, I believe I did. My epidural was mildly helpful for only half of the final stage of labor. I pushed for 3 hours and 20 minutes. Labor and delivery nurses told me the rule of thumb was to resort to c-section at 3 hours of pushing, simply because a woman no longer has the stamina to push any longer. They let me continue to push because my progress was "substantial." When I held my daughter for the first time all I remember is feeling angry and betrayed. I was in shock of what I had just endured and I couldn't shake the shock for a few days.

7) Placenta encapsulation - placentas are rich in nutrients but the verdict is still out on whether they can protect against PMADs.

Let's keep supporting and educating. This is every one's business.

My worst symptom of all

My bedroom scares me. When I walk into the dark room at night and slowly pull back the covers on my bed, I feel the anxious ball of energy beginning to form in my stomach. I hear the thoughts telling me my insomnia could come back - that there's no guarantee I'll get the sleep I need tonight. I struggled with severe insomnia for the first few months of my daughter's life. It was the beginning of my Postpartum Anxiety and by far the worst symptom I struggled with. I have waited to write about it because I still fear its unwelcomed return. When I talk out loud about it I'm afraid I might awaken that part of my brain again - the part that kept me up all night knowing I had a high needs baby to take care of the next day and everyday thereafter.

I think I could fill a book with my experience of insomnia and how it will probably haunt me for the rest of my life. It's so difficult to explain to someone who's never had it. People think that when they've stayed up all night out of choice or endured a sleepless night only to make up for the lost sleep the next day, that they understand. Oh no, there is a reason that criminals are made to stay awake for hours on end during interrogation. That reason is because insomnia is a form of pure torture. It's like having a monster screaming in your face all night, "I will not let you sleep." You hear the screams as your body simultaneously is trying to shut down - to get rest. Your brain won't let it though because your anxiety is in control now and you might as well give up.

I tried giving up here and there. I would leave my bed to read a book. Once I even tiptoed into my daughter's room while she slept and organized the clothes in her closet. I might as well be doing something right? Experts suggest you leave your bed after about 30 minutes of sleeplessness and return after you've distracted your brain for a bit. In short, nothing the so-called experts suggested worked for me. I felt doomed. And when I started to believe I would never be able to sleep well again, I lost hope in my ability to be me - to function as Becky, mother, wife, colleague, sister, daughter, etc. In sets a deep depression and relentless anxiety. The depression and anxiety gained more and more power which diminished the chances of me sleeping ever more. The cycle had started and it's ferociousness was no match for this scared new mama.

After trying every natural remedy known to man, I began the long process of trying out different medications to break the cycle. The journey to finding the perfect treatment for me was painstakingly long. I was sleeping an average of 3-4 hours every 3-4 days and if you were one of those people who suggested I nap during the day, I would have given you the death stare I'm sure. Napping was not an option for someone with Postpartum Anxiety like mine so I shuffled through the days on the very limited amount of sleep I was getting. Because of the support of some great professionals and my own built-in support system, I found a combination of treatments that worked for me.

Last night I slept from 9pm-5am, woke for a few minutes to check the time and my baby on the video monitor, and back to sleep I went until 6:20am when my baby woke. I'm looking for wood to knock on as I write this. I'm on my way to being me again and I can't tell you how sweet a feeling that is, but I can't help but wonder how long my bedroom will haunt me. 

Our baby got better, but mommy did not.

“She doesn’t like to be passed around.” These words sounded muffled to me as I lay in my hospital bed recovering from the very hard birth of my daughter. I was sleep deprived, drugged, and still in shock from the amount of pain I felt during my first childbirth experience. Out of all the words uttered over those first days in the hospital, these words stuck with me, maybe because I sensed something even more overwhelming than childbirth was about to rear its ugly head.

By our daughter's second week of life, my husband and I were blindsided by the realization that our precious, beautiful daughter who we so anxiously wanted to welcome in the world, wanted nothing to do with the world we brought her into. We found out much later that our daughter had colic, but for many more weeks we struggled to understand why our baby wouldn’t stop crying. Each week her crying became louder, lasted longer, and sent us into a very confusing and heartbreaking oblivion. She needed constant movement and holding, our bodies becoming sore and tired from squeezing her tight and not letting go for hours at a time. The exercise ball I bounced on in hopes of inducing labor became a permanent fixture in her nursery as we found the higher we bounced on it, the more her little body relaxed.

From the first day I realized I didn’t have an “easy” baby, I began to have thoughts that I never, ever wanted to have. I wanted my old life back, I didn’t want this crying baby anymore, and I regretted what we had done by getting pregnant. It pains me to think my mind was capable of such thoughts, but that is what postpartum depression does. It hijacks the real you and turns you into someone you never want to be. Hopelessness comes quickly knocking at the door and won’t leave until you answer.

As her colic worsened and peaked around 6 or 7 weeks, I started to fear I was losing my mind. I knew there was something wrong when after hours of soothing her and finally getting her to sleep, I lay in bed wired and wide awake. I feared what tomorrow would hold. Would it be worse, would she ever get easier? The insomnia lasted months and left me so weak mentally and physically that there were days when I felt I didn’t have the strength to hold my own child.

As my anxiety and depression worsened each day, I decided to make an appointment with our pediatrician to get to the bottom of my daughter’s crying. I convinced myself that when my daughter got better, then so could I, and we could move on and live the life I had dreamed about during my pregnancy. When my daughter was 9 weeks old, the doctor confirmed that she did indeed have colic and that there was nothing we could do but wait it out and soothe her as best we could.

I left the doctor that day feeling relief. We knew our baby was healthy, that the crying would eventually end, and that we were doing everything right. I tried to stay positive, but my insomnia had become severe, and my negative thoughts didn’t go away. In the weeks that followed, my daughter became more content and easier to manage as the doctor had promised, but my anxiety and depression were worsening. Our baby got better, but mommy did not.

The day I realized I was sick was a day filled with complete disappointment. It wasn’t my daughter making me feel this way, it was something else. Something much more powerful and relentless. I cried in my mother’s arms telling her over and over, “I didn’t want this to happen to me.” I knew I was at risk for postpartum depression, but I never believed for a minute it would happen to me. I wanted to be a mother and I knew I would be a good one, but everything I wanted in those first months of my daughter’s life were taken from me. The constant pit in my stomach, the loss of appetite, the near panic attacks, the negative thoughts, the completely sleepless nights, the crying...I wasn’t me and I knew that what I was dealing with was outside of my control and I needed professional help.

I’m recovering now and everyday I’m beginning to see small glimmers of hope - in my baby’s smile, her infectious giggle, in the way my husband looks at her like he’s never looked at anything else. My daughter is my everything and she is the reason I will keep fighting. I won’t give up. Soon these dark days will be behind me and I will bask in the sunshine of motherhood like I always knew I could.

If you know someone struggling with postpartum depression or anxiety - reach out and send them here.