The day before my baby turned 9 months old I told my husband that I was going to text my midwife and ask her to prescribe me an antidepressant because I had postpartum depression (PPD). He was immensely understanding and empathic. He didn’t take the opportunity to say, “I knew it.” He was simply with me in my moment of realization and pain. He’s the main reason that the months of increasing PPD symptoms leading up to that moment hadn’t been allowed to affect our baby to any discernible degree. He had always been there to take over when I became overwhelmed and needed to regroup. He always knew when to step in.
I’m not a clinician or a psychotherapist, but I am a developmental psychologist with more knowledge on psychological disorders than your average bear, so I found myself wondering how I could have gone nearly five months without realizing that I had PPD. I was disappointed in myself for not realizing I had PPD given that I had struggled with depression since adolescence. I should have seen the symptoms. I knew I was at a greater risk for developing PPD because of my history of depression.
As I waited for my midwife to text back, I thought back to my previous bouts of depression and realized it was these previous depressive episodes that had thrown me off the trail for sniffing out my PPD. The set of symptoms I had with previous bouts were different than my current struggle with PPD. My previous depressive episodes left me in bed all day. I would sleep up to 20 hours per day waking only to eat and use the bathroom. I ate a little less than I probably should have. When I was out of bed, I spent my time crying and watching depressing television. I socially isolated myself.
My PPD symptoms were nearly entirely different from these pre-baby depressive episodes. I had raging insomnia. I was ravenously eating 4,000 to 6,000 calories per day (Thanks to the miracles of breastfeeding, however, I was slowly loosing about a pound of the baby weight each week.). I was irritable. I felt constantly overwhelmed. I couldn’t manage to help around the house. I had a low-grade, chronic, generalized feeling of anxiety. When I was alone, I found myself ruminating on frustrating and depressing things that had happened in my life. I couldn’t focus. I found myself unable to enjoy just about everything that I loved. I couldn’t talk to my husband like I used to. I didn’t want to go to work. I couldn’t muster the energy to exercise. I couldn’t read more than a few pages of a book. The only thing I enjoyed was my baby, but as the symptoms grew, it was more and more of a struggle to delight in him. This was my breaking moment. My PPD was starting to threaten my relationship with my baby, so I reached out for help.
Another reason it took me so long to see PPD coming was that the symptoms didn’t come all at once and they started off as mild, growing over time. My insomnia started out in August as not being able to go back to sleep after the 4am feeding. By December, I was getting only 2-4 hours of broken sleep per day. My anxiety started off mildly too but had grown to the point that I had a few panic attacks by Thanksgiving. I had lots of good days without symptoms, but the good days became fewer and fewer, and the bad days became more frequent. The day I realized I had PPD I was starting what I knew was going to be my third bad day in a row. Bad days never lasted more than a day and a half prior to that. When my midwife called to talk to me, she said the anxiety is the most common symptom she sees in moms with PPD.
I also found it difficult to distinguish first-time momma struggles from PPD. It was easy for me to brush off a bad day by attributing my symptoms to fluctuating hormones. Babies are stressful, so it seemed plausible that I would be more stressed out and overwhelmed. My baby is a terrible sleeper so clearly I wasn’t going to get much sleep. Transitioning back to work is hard according to the Internet. Teething can be a nightmare said the baby books. I was making 24-48 ounces of milk every day, so of course I was going to be hungrier than normal. The morning I realized I had PPD, I looked at my husband holding our baby while I took my vitamins and asked myself why I didn’t feel as joyful as my two favorite guys seemed. Then, it all added up: changes in appetite, changes in sleep, inability to concentrate, rumination, irritability, no energy, anhedonia, feeling withdrawn. If someone else would have told me that’s how they felt, I would have told them to see a doctor for depression. It only took one look at this page to confirm my suspicion. I have PPD.
The day that I took my first Paxil, I stopped binge eating. I ate three normal sized meals and a small snack. I no longer craved carbs and sugar. Two days later, my anxiety was replaced by a feeling of peace. That day I also emptied the dishwasher and did two loads of laundry for the first time in five months. Five days later, my insomnia subsided. Now, I’m just the sleepy momma of a baby who wakes multiple times a night to nurse. A week after taking my first Paxil, I've exercised three times and lost as many pounds of baby weight. The most important transformation, however, has been my relationships. I don’t snap at my husband. I don’t freak out over stupid stuff. I’m calm and peaceful. My relationship with my baby has gone from good to amazing. I no longer find it a struggle to be present. It’s so much easier for me to delight in him. He also seems to delight in me more. He’s never smiled and giggled so much. Before I started Paxil, I sometimes had to fake it. Now, it’s natural. I’m looking forward to going back to work after Christmas break.
I’m not going to beat myself up over having PPD or for not recognizing I had it sooner. I’m going to forgive myself for the times I couldn’t be present for my baby. He seems to have already forgiven me anyway. I’m going to be thankful that I realized I have PPD when I did, rather than later. I’m going to be proud that I was strong enough to ask for help as soon as I realized I needed it. I’m going to celebrate my new start.