Wednesday, July 27, 2011

Watch Out World - I'm (Almost) Off My Meds!

Last week, Casey turned 9 months old.  Each month birthday is documented by a picture of Casey holding a sign ("I'm 9 months old today!"), an entry in the baby book, and the checking off of various milestones.  But it also is a darker anniversary for me.  With each month, I think - "It was [9] months ago that I almost lost my mind."

As I've mentioned on this blog before, I had a serious bout of post partum depression with Casey. Serious in that it came on fast and strong.

The pregnancy had been uneventful, and the delivery surprisingly easy and fast.  I checked into the hospital at 3am on October 20th, and Casey was born by 8:50am.  I was up and walking around a couple of hours later.  He was perfect.  During those days in the hospital, I was a little weepy and very sleep deprived, but nothing out of the ordinary.  I had done this before, and I remembered the "baby blues" that pretty much everyone experiences those first few days or weeks.

When I arrived home, things quickly took a downward spiral.  Braden was very upset at the arrival of his new baby brother, and I remember coming home and holding him as he cried, and crying myself.  Not tears of joy, sleeplessness, or frustration - scary, sad tears.  I didn't know why.  That night, my mom stayed over ready to take on overnight baby duty, and I showered and got in bed at 9pm, ready to get a few precious hours before feeding time.  The next feed came, and I hadn't yet fallen asleep.  This pattern continued all night.  By 9am the next morning, it was official - I had not gotten a wink of sleep.

That day became a blur.  I started having anxiety attacks over the fact that I would never be able to sleep again.  By 6pm the next night, I had called my OB's nurse line and a doctor had prescribed me Ambien.  I took it, with my heart racing.  It worked - for three hours.  By the next morning, it had been another sleepless night, save for those 3 hours.  And by this point, it wasn't just insomnia that was the problem.  I had begun having uncharacteristic, depressing thoughts.  These thoughts ran the gamut, but the most prevalent was that I was going to end up in a mental institution and there would be no one to take care of my kids.  Obviously, something was wrong.

I called the OB on call that next morning and told him that I was about to lose it.  I remember him asking me if I had any history of anxiety or depression.  I answered yes, that in college, I had been on zoloft for a while.  But that had been pretty uneventful really, and I think it was more a product of an over-zealous over-prescribing GP than it was a real anxiety issue.  I'll never forget the doctor's reaction.  He scoffed, and then asked me if I had informed my OB of this fact.  I hadn't.  He then proceeded to lecture me how I always have to be completely informative about my past medical history.  As if by me doing so I could have saved myself from the situation I was in!  He prescribed me a dose of zoloft and told me to find a psychiatrist.  He gave me no recommendations.

As it so happened, over the years I had seen a therapist here in DC, on and off.  Her specialty was post partum depression.  This was a complete coincidence, as that was not the reason I had initially gone to her.  A bit of foreshadowing, perhaps?  I called her and she recommended a psychiatrist who specializes in post partum issues.  I made an appointment for the following week with the psychiatrist, and an appointment with my therapist for the next day.

In the meantime, I was struggling.  Big time.  I realized quickly that depression was not just an illness with mental symptoms - there were so many physical manifestations as well.  For the life of me, I couldn't eat.  I had no appetite.  I tried to force food down to the extent I could, since I was breastfeeding and still needed the calories, but it was torture.  My head felt heavy and my vision was blurred.  My arms and legs tingled intermittently.  The anxiety was there constantly.  You know that feeling in your stomach when you're nervous, like when your about to speak in front of a crowd?  Imagine that all the time.  I was in hell.  My upcoming psychiatrist appointment was the one thing keeping me going - each day, I would count down the days and give myself a pep talk to make it. When I say "make it," it's not that I was suicidal.  I wasn't.  It was just that I was so uncomfortable in my own skin I didn't know what to do with myself.

I lived this quiet torture in my own head.  Well meaning family members would tell me I just needed to relax, to calm down, to get some sleep (!).  They would tell me that this was just the baby blues, that I was just emotional, that this was normal.  I know they were only trying to make me feel better, but those comments just made me feel worse.  Because all of them implied that this was something I could, and should fix myself - that I just needed to snap out of it.  This was so beyond "snapping out of" I can't even tell you.  A few weeks later, some family got upset with us because we were unable to travel to New York for a niece's birthday.  They couldn't understand why my husband couldn't go on his own and leave me with the kids.  Again, I know there was no ill intent.  But if they only knew.

By the time I saw the psychiatrist, the depression had subsided a little, but the anxiety was still in full force.  She didn't give me news I wanted to hear.  She told me that the zoloft can sometimes take up to six weeks to fully kick in.  She said that if I really got to the point where I needed instant relief, I could take a xanax.  But that would mean I would have to stop breastfeeding.

This became my struggle for the first month of my son's life.  Despite the fact that this was not my fault, I knew that I would never forgive myself if I stopped breastfeeding so I could be medicated into a zombie like state.  So I took it one day at a time, and tried to get through each day.  And I did.  By the time Casey was around 6 weeks old (just as the psychiatrist had predicted), I was almost back to normal.

Almost.  As I've documented in this blog, the sleep issues have remained.  But I'm happy to say as of today, I have been two weeks sleeping pill free.  And, as of last week, I have started to wean off of the zoloft.  I should say, I see absolutely nothing wrong with taking anti-depressants.  In lots of ways, I probably would have benefited from being on something even pre-Casey.  But now, getting off of these medications is a sign to me that maybe, just maybe, I'm fully back to normal.  That I'm out of the woods.  That the fine line between sanity and insanity won't be crossed again anytime soon.

This experience has given me such a respect and awareness of mental illness.  It is so easy to tell someone just to snap out of it, to get over it, to feel better.  And because of that, there is a lot of self loathing involved with depression, because it's hard to shake the idea that you are doing this to yourself.  But my therapist told me something that first week that really stuck.  She said if you had fallen and broken your leg on your way home from the hospital with Casey, you would have taken care of yourself.  You would have lied in bed and taken your medication and allowed people to take care of you.  You would have given yourself time to heal.  You would not blame yourself for having to scale back your childcare duties or relax.  Post partum depression is no different.  You can't will your broken leg to heal in a day, in the same way you can't snap out of the dark hole post partum depression puts you in.  Thank God, there are medications that work.  And thank God for my husband, who was so incredibly supportive and patient, even when I'm sure he didn't want to be.

My personal PSA?  If you have recently had a baby and start feeling down, or just not yourself, go see someone (not your OB!).  And, even though it may seem like you will never get better (a line I would constantly feed myself in those dark days), you WILL.  The greatest thing about post partum depression, as opposed to other mental illnesses, is that it is inherently temporary.

I have a lot of guilt for not bonding more with Casey during those first few weeks.  I took care of him, I breastfed him, but I was so focused on myself and getting through each day.  I also struggled daily with the fact that I was taking an anti-depressant while simultaneously breastfeeding (which was okay-ed by the doctor).  But guess what - Casey doesn't remember a thing, and he is thriving.  Today, he is the joy of my life, and I could not love that baby more.

And the craziest thing?  I'm thinking of doing this a third time.  Maybe I am insane.  But undoubtedly, it's all worth it.


  1. Hopefully you will avoid SSRI withdraw.

    For me that's always a major problem, being that it makes me...enraged and furious. This would be of benefit if I were in, say a war zone. Otherwise, it's not much help.

    And the side effects don't kick in right away, either.

  2. @1:48 - Ugh, I hope so! It's been a few weeks, and so far so good. I am going off very slowly and very gradually though. But maybe I will use it as an excuse if I get in a fight with my husband. :)

  3. Congratulations on feelig better. I wish you all the best in going off your meds.

    I was first prescribed anxiety medication during during my second year of law school (anxiety no doubt caused by my high-achieving, perfectionist personality and raising three kids while working full-time and going to law school at night!). I then suffered from depression during a difficult, bedridden pregnancy and then lack of sleep after my daughter was born. She and I both had medical issues that first year. It was just too much for me to deal with.

    I was off medication for 7 years until my dislike for practicing law caused anxiety and insomnia and now physical ailments to return full force. I'm now on anti-anxiety and sleeping medication and in physical therapy for migraines and neck/back pain.

    My family's great and all doctors have told me these illnesses are completely work-related so I'm on a one year plan. Pay off all debt with my salary and live on my husband's. Just having an escape plan has helped reduce the stress immensely! Hopefully, I can start going off my medications soon.


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