Six Ways of Coping with Postpartum Depression & Anxiety
It had only been a day or so since I gave birth; my husband was snoozing on the chair next to my hospital bed and our baby girl was sleeping in her bassinet, basking under the blue light to help reduce her bilirubin levels. Slowly, I inched out of bed, and started shuffling to the bathroom. “I can do this,” I thought to myself as I tried to build up the courage to change out my adult diaper. It was like watching a sandwich be made at Subway: first comes the bread (diaper), then a layer of Tux pads like slices of cheese; then some cooling antibacterial spray, lidocaine and hemorrhoid cream to reduce the pain and swelling on the affected areas. I had seen the nurses follow this routine several times and given that it was the middle of the night (then again, who knows, I was so sleep deprived, it really could have been any time of day!), I didn’t want to bother them yet again.
Slowly, I rolled out of bed like a swollen blob, holding onto the wall as I shuffled to the bathroom. The pain in my lower section was excruciating; I couldn’t even stand up straight - I literally felt like the Hunchback of Notre Dame with two swollen hotdogs and a giant meatball between my legs; all I wanted to do was cry. But I kept it together, pulled my hospital undies down and started changing out my diaper. The next thing I knew, I was staring down at my feet, covered in a pool of blood - all emanating from my poor, torn-up vageeg. I was so horrified, I just started balling. Several nurses heard my cry and came to my rescue. If ever I had a lowest point in my life, I am sure this was it. It was also the most humbling experience, I must admit. Here I was, buck naked and hunched over with my underwear below my knees, covered in blood. I couldn’t have possibly imagined showing myself like this to strangers. But here were three amazing nurses, so kind and caring. They cleaned me up, helped me apply all of the necessary sprays and creams, and helped me get back in bed. They were true heroes.
My physical recovery took a long time, but so did my emotional one. Let me tell you, no one shares this with you when you are pregnant - and certainly not after you’ve had a baby - but recovering from birth is no joke! Not only do you suddenly have this (beautiful, magical) infant to care for - a baby that is completely and utterly dependent on you for its survival, and you have no idea what you’re doing because, let’s face it, no one gives you a manual on how to care for a newborn (!) - but you also aren’t sleeping AT ALL and your hormones are taking a deep dive, sending you on an emotional rollercoaster ride. One minute you are floating on cloud 9 because you can’t believe how amazing life is and how lucky you are to have such a breathtakingly beautiful, healthy baby girl, and the next you are crying your eyes out because you are just so exhausted and overwhelmed.
As time went on, depression started to set in, along with dreadful intrusive thoughts: One day, after we made it home, my husband was replacing the smoke detectors and I thought to myself: What if the smoke detector doesn’t work and there’s a fire in the house? What if I hear my baby scream and I try to come to her rescue but it’s too late? I imagined countless scenarios that, frankly, are too awful to share. The problem was, I knew these thoughts weren’t real but I couldn’t find a way to stop them. They pulled me deeper and deeper into a black hole, a psychological abyss. The next thing I knew, I was so caught up in these dark thoughts that I couldn’t stop crying. It was a vicious circle I couldn’t seem to escape.
I had heard about the “baby blues” but what I didn’t realize at the time is that I was experiencing postpartum depression, a much more serious condition which studies have shown affects 1 in 7 parents.
So what is the difference?
Postpartum blues or “baby blues” is a fairly common condition affecting between 50% and 75% of people after delivery. I say “people” because the blues can affect men as well as women, whether they have delivered or not. Baby blues are characterized by “frequent, prolonged bouts of crying for no apparent reason, sadness, and anxiety. The condition usually begins in the first week (one to four days) after delivery and usually subsides within two weeks without treatment.”
Postpartum depression, on the other hand, is a little more serious as it manifests in “alternating highs and lows, frequent crying, irritability and fatigue, as well as feelings of guilt, anxiety, and inability to care for your baby or yourself. Symptoms range from mild to severe and may appear within a week of delivery or gradually, even up to a year later.” And although we primarily talk about postpartum depression, the anxiety can be just as severe or even worse.
In my case, I think I may have transitioned from baby blues to postpartum depression over the course of 2 months before finally realizing I was in trouble. Thankfully, I am now seeing a therapist and, under the supervision of a postpartum expert, I am participating in weekly sessions in which I learn to deconstruct my thought patterns, transform negative thoughts into positive ones, and approach my postpartum experience with kindness and compassion. I mean, I literally created a human!! It is no wonder that women need a little time to regroup and adapt to all of these physical, emotional, mental, and big life changes.
Additionally, I started treatment with a psychiatric nurse whom I was referred to by my therapist - someone I am very grateful for because I know how hard it is to find a good psychiatrist, nevermind one who also accepts insurance! In working with my “psych guy” as I call him, I now have the right cocktail of drugs to address my hormonal imbalance and stabilize me. Although at first I’ve felt like somewhat of a guinea pig - and trust me, that is NOT fun, especially when it comes to medication that affects your mental and emotional state - the intrusive thoughts have become less and less frequent and I am now able to use my coping skills. These are tools I have always had in my tool box but which I was incapable of taking advantage of during my most anxious of times.
I do believe that having a strong faith, whether in God, the Universe or the Divine, is instrumental in recovering from postpartum depression and anxiety - any depression and anxiety, in fact. (To this day, my mom tells me to pray to God and Mother Mary. She swears it does the trick!). For me, yoga has been a saving grace throughout this tumultuous time. At its core, yoga (which comes from the Sanskrit word yuj meaning “yoke” or “union”) is about uniting body, mind, and soul. It is an ancient philosophy dating back 5,000 years that is composed of six branches - each with their own pathway or focus. “Hatha” yoga is the branch we are most familiar with as it involves physical poses, concentration, and deep breathing. The ultimate goal is to self-reflect, achieve deep relaxation, and grow through mediation as we challenge the mind and body through a sequence of “asanas” or poses.
In the beginning, it was hard to accomplish any poses as my body was healing. After I was released from the hospital, I was bedridden for 3 weeks before I finally ventured out of the house. First, it was only to the end of the driveway and back. The next day, it was around the corner; the day after, it was down the block. It literally felt like I was learning to walk all over again. And the same went for yoga. Not having practiced in over a year (Let’s be real - the prenatal yoga videos you see on Instagram simply do not reflect reality; I could barely get on all fours without vomiting!), I had to start with gentle stretches and Downward Dogs. My Chaturanga Dandasanas involved supported planks and, at first, I could barely hold them for more than a millisecond before lowering down. But bit by bit, day by day, I regained my strength. And as my body grew stronger, so did my mind and my spirit.
I also recently started going to acupuncture, an ancient Chinese form of alternative medicine that revolves around Qi, an internal force that regulates your body’s balance and energy. I had seen an acupuncturist before, years back when I was struggling with inflammation and arthritis, and I swear his method works - particularly when used in combination with western medicine. (It also doesn’t hurt that my acupuncturist has a quirky sense of humor so makes the otherwise uncomfortable experience of having needles stuck into your skin - dare I say - enjoyable!)
I am still working towards ultimate recovery. But the point is that the postpartum birth experience does not have to be as traumatizing and isolating as it has been for me and for many other moms out there. So for all of you new mommas and mommas-to-be, what can you do to prepare yourself for the first several weeks and months after birth? Here are a few suggestions based on my own, personal experience:
Family: Lean on your family and friends for support. For some, this need for support may be too much to handle, so you may find that your usual go-to person may not be the right one to help you through this experience. Try not to be disappointed. Every person has their own stress threshold and there is only so much a person can handle. Know that your loved ones will be there for you in the best way they know how to. It truly does take a village and you will realize in time how blessed you are to be supported - even from people you wouldn’t normally consider to be within your tribe.
Therapy: Find a therapist whom you feel comfortable with - preferably through a personal referral - and book your first session asap. Ideally, this therapist will have experience working with pregnancy and birth complications, postpartum mood and anxiety disorders, and life role transitions. If that is not the case, make sure to ask your therapist whether your case can be supervised by someone who does. Therapists tend to have a network of colleagues who specialize in various areas of psychology and they often share information on case studies. Working with a postpartum specialist ensures your therapist is receiving the proper guidance she needs to help you navigate this challenging time.
Medication: If you feel like your mind and emotions are completely out of control and you cannot take it anymore, seek help! Psychiatrists that accept new patients as well as health insurance are not easy to find these days, but please do not give up! As I learned, there are other options, including psychiatric nurses who can prescribe and monitor medication, so those, too, would be a good resource. The science on the meds isn’t 100% - it tends to be more trial-and-error so learn to be patient, even when experiencing unwanted side effects.
Acupuncture is another great option for treating postpartum depression and anxiety. By inserting very thin needles through your skin at strategic points in your body, acupuncture “jump-start[s] your body’s natural ability to heal itself by resetting the nervous system from its fight or flight activation to rest and digest setting.” In addition to promoting a healthy appetite and digestion, acupuncture can be essential in mitigating postpartum symptoms by easing body aches, reducing anxiety and improving quality of sleep. Try to find an acupuncturist who also has a Doctorate of Medicine (MD) degree, so he can also prescribe medication, if needed.
Yoga and meditation are key ingredients to a successful postpartum recovery. “Yoga in the postnatal period is all about honoring your post-baby body and calming your mind. Giving birth and sustaining life is quite a journey. As you continue to adjust to life with a new little one at home, yoga allows you to breathe, balance, and tune in with yourself when you may otherwise put ‘me’ time on the back burner.” The end result? Balanced energy, lower blood pressure and - yes, you’ve guessed it - reduced stress and anxiety. And if yoga is not your thing, try to do some gentle stretches and take a walk in the woods. I’ve found that connecting with nature is the most “natural” (pun intended) way of meditating - a benefit to body, mind, and spirit!
Sleep! I probably don’t have to remind you, but getting enough sleep is SO important to your recovery. Studies have shown that sleep deprivation leads to compromised decision-making, irritability and mood swings. When it continues long enough, it can lead to hallucinations and even trigger mania in people with bipolar disorder. Other risks include impulsive behavior, paranoia, suicidal thoughts, and - yup - anxiety and depression. So, if you have a support partner or another family member who can help you, make sure you agree on a schedule for “night time baby duty” (e.g., bottle feeding and changing diapers). If you are breastfeeding, you may consider a combination of breastfeeding and pumping/bottle feeding, which helps baby bond with the other parent/family members early on - and gives momma a much-deserved break!
And, finally, make sure to extend an extra touch of kindness and compassion both to yourself and to your partner and family. Raising a baby and getting through the newborn stage is TOUGH!! It will test you in more ways than one, but it is worth every ounce of sleeplessness, every bit of frustration, and every tear. Because bringing a baby into this world - YOUR baby - is the most beautiful and rewarding feeling you will ever have the opportunity to experience in this lifetime.
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