After I had my first baby, I learned that my entire network of medical professionals were on the lookout for Postpartum Depression, or PPD. I confessed to the pediatrician I just met that before I could leave the house to take in my 6-day old son, my husband had to remind me to stop crying for a minute to put on my pants. At my two-week post c-section check up, I couldn’t stop crying through the whole visit, and the very kind OB gave me a hug. She told me she didn’t need to see me until the six week mark, but I better come back in two more weeks. My son’s online milestones questionnaire also had a questionnaire to gauge my mental state.

All of this crying was technically considered “baby blues” aka the rather normal, common, and still totally shitty crash that comes after the birth of your baby, and tends to dissipate relatively quickly, sometimes as soon as a few weeks. I stopped crying over everything somewhere around the one month mark. The follow-up to the OB proved to myself that I was much better, and the medical team all seemed satisfied that I was out of the woods.

I was afraid of PPD, the big bad wolf of terrible and unpredictable mental illness that could strike me down after I had my baby. I was right to be afraid, and as I’ve said in another post, PPD is incredibly serious and must be handled with support and professional help. What I didn’t know about – and my team didn’t mention to me – was PPD’s offshoot, Postpartum Anxiety or PPA.

Postpartum Anxiety is a version of Postpartum Depression

Postpartum Anxiety is actually a manifestation of Postpartum Depression, and that may have been why I didn’t see it coming. I was waiting for the crying to continue, or the thoughts of hurting myself or the baby. But that’s not what happened to me.

Instead, while I struggled with nursing my lip-tied, tongue-tied, food allergy-addled infant who wanted to nurse every hour, it became harder to leave the house. I had my reasons, like the constant nursing which I wasn’t able to do covered if I wanted anything close to a decent latch, and I felt like I couldn’t do it at all out of the safety of the house where I could be topless if I needed to be. Winter was coming, it was cold, and I was very busy watching the entirety of The Wire.

If my husband was five minutes later coming home than I expected him to be, I immediately thought he was dead in a car accident. I would be thinking of how I would have to raise the baby alone by the time he walked in the door.

I called my old therapist who I hadn’t seen in years. She said that when we have a baby and realize how much we love something in a way we didn’t ever know was possible, all the other things that we love come into sharp, sometimes painful focus. Perhaps that’s what was going on with my growing fear that something would happen to my hubs.

It was stupid, but I didn’t call her back when the insomnia hit me. At night I would lay awake from the time I went to bed until the first time my son woke up, sleep for a couple of hours, and then not be able to go back to sleep when he woke up the next time. I was already sleep deprived from my son’s terrible sleep patterns, and I figured this was just an awful side effect of a bad schedule. I was averaging about four hours of sleep a night, with maybe two uninterrupted hours if I was lucky.

My thoughts  during the day weren’t about hurting myself or my baby, but they also didn’t make any sense. I was struggling to string the words in my head into sentences that could come out of my mouth in a coherent manner. I was fuzzy all the time. In social situations I felt like I couldn’t keep up with conversations, like anything I wanted to say was out of place and a beat behind.

I’ve learned through past experience that when my anxiety goes up, I become incredibly controlling. Sometimes, like as was happening then, I wasn’t in touch with the anxiety, I was just acting like a total control freak. I was trying to micro-manage everything I could, which was all channeled into baby care.

It wasn’t until I was chatting with a mom friend and I told her about my sleep issues that she mentioned PPA. She told me about her experience, and I could see more clearly what was happening for me.

Somewhere around the nine month mark when my baby started sleeping more, my anxiety started to lift. By the year mark, I could see in retrospect how many of my decisions in the early days, like not attending a neighborhood moms group or having plans with more mom friends, had been made from this anxious place.

I decided that if this happened to me again, I would get help sooner and I wouldn’t be ruled by the anxiety. When I had my second baby 21-months after my first, I got to test this new resolve.

This time I didn’t have the baby blues in the same way. While I had moments of annoyance, or being more sensitive in general, I wasn’t a sobbing puddle. I made sure that I left the house. I communicated with all of the medical professionals in my life that I was concerned about PPA, and that I could see I had been affected by it the first time around. I felt more in control of my life.

Anxiety vs. Sanity – Round Two

My baby is just over six months old. The anxiety is here again, but it’s different this time. I still get gripped with fear that something will happen to my husband, or one of my babies. Somewhere around the two-month mark and lasting until a few weeks ago, my anxiety had been showing up physically, in a way that was different than the first time around. I’ve had the feeling in my chest like I can’t breathe –  every day like this feels like I’m drowning, like I’m being suffocated by this postpartum anxiety.

I’ve struggled on and off since I was a teenager with mood swings, periodic depression and anxiety. Because of this, I go to the psychiatric resident’s clinic at a medical school near me. It’s been a good enough solution as I don’t really need much and haven’t been on regular medication for years, and while the residents change every year or so, I’m generally pleased with my care. Unfortunately, this current resident isn’t very good. I’ve been meaning to call her attending and give feedback, because it is a learning experience for her, but I just haven’t. Her suggestions included a medication I’m allergic to and another option that would tank my supply for breastfeeding. Um, nope. So here I am.

What I’m doing is trying to manage the anxiety as best I can.

Thanks to therapy in my twenties, I have some tools to deal with my anxiety in general, and I’m trying to apply those here. I am a big believer in talking about my feelings and being honest with those around me. My husband knows how I feel, as do some of my friends. My sleep is starting to fall apart, so I’ll be starting with some melatonin to try to get that back on track. The more sleep deprived I become, the more likely my anxiety is to spike. At night I do a trick to help me sleep. I go through the alphabet and I think of a person for every letter. Sometimes I think of something they are going through where the thoughts of others may help them (A is for Adam who lost his mother), or sometimes I think of a good quality of theirs  or something I’m grateful for that they have done (A is for Amy who taught me how to work when I was young and wild). I pass their names and these thoughts through my brain like beads through my fingers. It helps to focus my racing thoughts, and if I’m lucky, it will allow me to still my mind enough to get a little sleep before the baby wakes up to nurse.

This isn’t a topic where I feel qualified to give advice to others in the form of a tips list. Thankfully, there are resources available from people that are qualified. I’m glad that I have tools that help me after years of practice, but if I wasn’t allergic to the medicine that’s safe to take nursing, I would have taken it by now. Really, if my sleep continues to fall apart, or if my moods get worse instead of better, I will consider some other options.

I don’t have the time to fall apart right now. There are days where I’m cooking dinner while I feel like I can’t breathe, and I have to calm myself down. There are little people depending on me and my emotional stability, and I need to do whatever I can to be stable for them. Really, I need to do whatever it takes to be stable for me.