Thursday, February 12, 2009

Postpartum Drama is Private Practice

Thanks to Katherine Stone over at Postpartum Progress I watched ABC's "Private Practice". I usually don't watch it because it seems like every episode begins with lots of shots of people having sex or just having finished having sex and/or going for more sex. Not what I'm really into, ya know?

However, tonight they had a story line that was supposed to highlight postpartum psychosis. They even had a PSA on I watched the show. It was hard.

There was a new mom whose baby didn't sleep well so of course the mommy didn't sleep either. She was giving the baby a bath and the baby slipped under the water and instead of immediately pulling the baby out the mommy held her under for a moment--thinking that if the baby died she could finally get some sleep. The mommy was so freaked out by what she did that she went to see her pediatrician and the whole story came out. The postpartum psychosis story was regrettably overshadowed by the drama of one of the other character's unexpected pregnancy, but, well, it wouldn't be television if the didn't keep trying to one up itself.

My husband watched with me and he asked if I identified with the character. My first thought was, "Heck no! That girl looks too good." Her clothes were stylish and matching. Her thick, brown hair was so long it cascaded down her back; it had obviously been styled with a blow dryer AND curling iron. She had make-up on. Those are some of the first things to go when I'm in the dark places.

But I did identify with her babbling. If I had verbalized my PPD thoughts they would've sounded like hers: fast, disconnected, anxious, and overcompensating. She was clearly desperate. One thing that seemed to be missing from her rambling, though, was the guilt. During my bouts of PPD (which IS different from postpartum psychosis like the girl on the show had) my constant companion was guilt. Guilt for not eating enough to support breast milk production. Guilt for eating too much and not losing the baby weight. Guilt for not playing with the baby enough. Guilt for playing with her too much. Guilt for loving her too little and guilt for obsessing about her. Guilt for hating her crying. Guilt for not knowing how to make the crying stop. Guilt for wanting it to stop no matter what and guilt for feeling angry that it didn't. Guilt.

What I did like about the show was that the doctors were extremely supportive of the new mommy. Several of them got together to discuss her case and take care of her baby while the mommy was admitted to the hospital. It's a pipe dream, but if all offices could provide that level of attention fewer women would suffer in silence and fewer children would be harmed. The show worked hard to emphasize the two huge factors in postpartum issues: sleep and support.

After the birth of my second baby, E, the postpartum education nurse emphasized sleep. She said if I could find a way to get at least a five hour chunk of sleep my symptoms would lessen. E wouldn't take a bottle and I couldn't find a way to sleep. I actually enjoyed holding her close at night and slowly rocking her while looking at the moon. It was the only peace I could find.

After the birth of my third, J, I told my therapist that I didn't think my medicine was working and I might be slipping into the depression again. We did a couple diagnostic things and surprise: I wasn't depressed, I was tired. She prescribed 24 hours of sleep. Never did figure out a way to get that either. But that had a lot to do with the other big PPD issue, support. I could sleep for 24 hours, but WHO would watch my kids and feed my infant? My breasts would have exploded!

I've had all three of my kids with a minimum of support but with each successive birth, I found more people to lean on. Since my husband and I are alone out here with no family nearby we've had to create those emergency networks from scratch. With N I wandered around alone and sad for almost a year before I started bugging another Mormon who lived within walking distance. (I had no car.) Her husband hated me, but I was around a lot anyway.

With E I told the Relief Society president about my previous PPD but, in the same breath, also told her I didn't need any help. I had everything handled. At three weeks postpartum a friend came to babysit the kiddos so I could get my depression evaluated and start treatment. That friend did dishes and picked all the raisins out my carpet that N, who was two, had ground in. She even hung around the entire afternoon to just chat about whatever.

With J I told everyone about my PPD and how nervous I was about it and, thank you Jesus, people showed up. One friend watched my kids, cleaned my kitchen, and put away laundry when my husband picked me up from the hospital--even though she had family visiting. Another friend came and rocked my acid-reflux-y baby while I struggled to get the other two to sleep and my husband was working late. That same friend, who happened to be seven months pregnant with her fourth, accompanied me on a sweltering afternoon outing the county fair when J was only ten days old.(For that first little postpartum period I can't stand to be alone or be in the house too long. The curtains start looking like bars and I feel like I can't see straight and like all the noises are too loud. It's better if I get out, no matter how tired it makes me. I'm too anxious to be still and restful.) So many people brought meals that we had leftovers for more than a week.

PPD gets progressively worse. Every time I have a baby I need more intervention, more exercise, more help, and more drugs. But strangely, the more babies I have the better I am at asking for and finding help. The postpartum period with J was marked by PTSD type dreams, knife obsessions, and soul fatigue. But it was also full of surprising reminders that I wasn't alone. I felt better than I ever knew I could.

And that what this PSA is all about. (Amy Brenneman comes off a little cold, but hey, that's okay. She's trying to help). So, spread the word. Tell people if you struggle with this. Ask the pregnant women you know if they are depressed. Surprise someone with a meal or with a babysitting offer. If you are struggling, let someone fold your laundry and scrape the yuck out of your sink. (For more on meaningful service check out this Blog Segullah post, Seeing Past the Smile.)Over at Postpartum Progress, Katherine Stone calls us warrior moms. I like that. Let's fight this thing together.


Misty Lynne said...

I do think that sleep has a lot to do with it. My first, though she slept decent at night, never took naps during the day. She demanded almost constant attention from sunrise until way past sunset. She was the only one of my kids that I honestly thought about chucking out the window. I felt no real connection with her until she was almost three months old, sleeping through the night, and finally taking naps during the day.

On the reverse side, my second slept all the time, and I got in a lot of naps (even with my by then not napping two year old). She also started sleeping through the night at a very very early age. I never knew having a baby could be nice! I actually liked my baby.

With my third, he slept a lot too (which was very nice), but it was really hard on me that he took a while to sleep through the night. I was resentful of my lost night time sleep, a bit stressed by it, but no where near as depressed as I was with my first.

I can only guess how much worse sleep depravation must be for those already suffering from depression.

m said...

Good post Laura. It is good information to have available to all mommies. Experience is so important- you can really shed a lot of light on this difficult/consuming/joyful time of life.
It is so nice to know I have you as a friend to help me. Even though I've done well postpartum, it is always nice to talk to you because you understand everything. Maybe you and I could strike up a deal. You grow all the babies and I'll take care of them as newborns. It would be the best of both worlds, except you love babies too. I just flat out hate pregnancy.
Ok, I'm being silly, better go lay down before I hurt myself!

Charlotte said...

Such a beautiful post, sister! You are so right about the sleep and support thing being critical. I am so glad that you have gotten better about asking for help and that those around you have been so willing to jump in and help you out! It sounds like you guys have really created a wonderful life out there for your family!

And I can totally relate to what you wrote about the anxiety for the first few weeks after the babies are born. I am exactly the same way - I cannot be left alone in the evenings or I have horrible panic attacks. It must be a hormone thing tho 'cause after a couple of weeks it goes away all on it's own...

Suzanne C said...

I appreciated your post. I watched the episode you referred to. I kept thinking,"Dang! She looks good!" Artistic license, I s'pose. I had my 4th a year ago and am still stuggling, but making progress. Thanks for writing about soemthing that helps me feel not so alone!