Hostage in My Own Body

As I mentioned in an earlier entry, I stopped breastfeeding on June 1st. Because of this, I was able to go back on my old birth control pill that I had used for nearly a decade up until we started trying to get pregnant. So, let’s talk about how different I am now that I am back on that.

I feel like the little IT guy in my brain just noticed the “Not Everything Has to Suck” cable in my brain lying uselessly on the floor, said “whoopsie,”  and plugged it back in. It’s like the “Be Happy Sometimes” section of myself was blocked off for renovation or some bullshit and they just reopened it to the public. Like the last several months have been a roller coaster of bad to worse, but now I’m on the sky tram of “doing alright” coasting smoothly above all of it. Have I made enough weird analogies? The point is, I am back and who the fuck was that lady who’s been here raising my kid all this time?

Hormones are assholes. They come in whatever amounts they please (or don’t), and they do whatever they darn well want regardless of what you have planned. This is terrible because they make YOU do whatever they darn well please. I tried to come up with a clever and amusing example, but it’s just exactly like Patton Oswalt talking about his depression when he went off his Prozac for a month, so here’s that (from the start I set to 4:20 – watch the rest at your own risk/enjoyment):

I love this bit because until I saw it, I had never heard someone else personify their depression the way I do, and more importantly, I had never heard anyone else express the thought that it deserves to be “taken for a walk” every once in a while. I absolutely have had times when I give myself up to my depression and indulge it in whatever ridiculous ways it chooses. The difference between this and how I’ve felt over the past several months with PMAD is that the depression indulgences seemed more temporary. They felt like I could bargain with them. I’d say “Ok, the rest of today I’ll lay in bed and stare at the wall, but tomorrow I have to put on pants.” And a lot of times that worked. But with PMAD, I’d try to bargain and the hormones causing the depression and anxiety were like unrelenting little toddlers who couldn’t be reasoned with. I’d say “ok PMAD, today we’ll lay on the floor and cry and think about killing ourselves, but seriously, tomorrow, no more of these self injury thoughts.” and PMAD would go “NO!” and think REALLY hard about where all of the sharp objects were in the house. For days.

The personifying of the PMAD seems entirely accurate to me, because it feels alien and like someone or something else running me. I feel like a hostage in my own body. I was still in here, but I wasn’t in control. On so many occasions, it made me sit and think “why am I doing this?” or “why can’t I stop?”

The number one example of this for me was crippling, debilitating, absolutely agonizing Mom Guilt. I told my sister a few months ago “I just feel SO guilty ALL THE TIME.” She said “that’s Mom Guilt, every mom feels that.” To some degree, I think she’s correct, but I think mine was like Mom Guilt on steroids because of PMAD. Literally everything I did made me feel devastatingly guilty. If I was home with the baby all day, I felt guilty that I was “hogging” him to myself, but if I gave my husband time with him, I felt like I was ditching him and not helping out enough. If the baby got sick or hurt or sad, it was definitely my fault. I felt guilty because I worked and wasn’t the one caring for my baby all week, but I also felt guilty because he wasn’t in daycare socializing with other kids. I felt guilty in a box, I felt guilty with a fox. I was a walking Dr. Seuss book of Mom Guilt. And when I say I “felt guilty” I mean I felt a gross horrible ball of shame, sadness, and anger directed at myself swirling and burning in my stomach, and it almost always resulted in crying. So I cried, all the damn time. That’s what I mean when I say I think my Mom Guilt was in overdrive. And no amount of telling myself that something isn’t my fault would ever put a dent in the guilt. See the entry from when I stopped breastfeeding as evidence of that (you know, that time I pumped until I bled but wasn’t trying hard enough). It’s like I was in the passenger seat saying “well that’s not really something you can control” or “that doesn’t make you a bad mom” and the driving hormones said “LA LA LA LA I CAN’T HEAR YOU.” Since getting back on my medication (as I refer to it, but again, it’s just the Pill), my Mom Guilt is in check. Yes, I still feel guilty for some things, but I’m not unable to function because of it.

When I stopped breastfeeding, my son developed yeast diaper rash. It got horrifically bad for a while there, and it was agonizing for him. Every time we’d go to change his diaper he’d start preemptively crying knowing what was coming. His poor little bottom was broken out, red as a beet, and in the worst areas, raw and cracked to the point of bleeding. Seriously, fuck yeast diaper rash.
We fought with it for weeks with several different medications, several different tricks (like diaper-free time in an inflatable pool in my living room), and several trips to the pediatrician. At one visit his doctor said “I want to get to the cause of the problem… has his diet changed recently?” She had a hunch that the change to 100% bottle feeding might be the issue and had us switch to soy-based formula instead of milk-based. That, in addition to some serious medication, solved the issue. But why am I telling you about my baby’s butt rash?

I started my pills when I stopped breastfeeding. Shortly after this, my baby developed his rash. After a few weeks, we determined that the formula was causing (or at least exacerbating) his rash, and I felt a twinge of guilt knowing that if I was still breastfeeding, this wouldn’t be happening. But that was it. I felt a twinge. It was a sharp little jab, and then I moved on to just being determined to treat it and get rid of it. If news like that had hit me under the influence of my full blown PMAD hormones, I would have been unable to function for days. I would have sobbed uncontrollably, I would have made someone else change nearly every diaper because I couldn’t face it, and I can almost guarantee you that I would have self-injured (as penance, because that’s how mine tries to work). But I didn’t. I had a few times when it did make me cry (I think this is nearly impossible not to do when your baby is bleeding and screeching in pain), and there were definitely times when I thought “if someone came to my door right now with a stranger and a gun and said ‘if you kill this person your baby’s rash will go away.’ I would hardly let them finish the sentence before I fired (these are the thoughts you have when you’ve set alarms to change diapers at all hours of the night), but it didn’t destroy me. I don’t know if I’ve made my point yet, but what I’m getting at is that that’s a really big deal, you guys.

Now that I’m back on my original pill (which was first prescribed to me as a teenager to treat my PCOS) I really feel like a bunch of old wires that hooked up the “functional” section of my personality have been plugged back in. I know things won’t be perfect all the time forever now, but I feel so much more functional and capable of handling things than I have in nearly a year.



So, in case you were wondering, no you can’t go to a support group that meets at a hospital and is run by two mental health professionals (one of which used to be an RN in that very hospital), tell them you spent the last three days wanting to hurt or kill yourself, and expect them not to suggest that you voluntarily check yourself into said hospital for a few days. So, that happened and I said “yeah, ok.”

Just a heads up – this entry will seemingly go back and forth and all over the place in terms of promoting/discouraging hospitalization. I want to say early on that if hospitalization is something you have considered, I am not in any way trying to sway your opinion for or against it; my goal is to report my honest experience. This also is ONLY my own experience and can in NO way speak for all hospitals, nurses, therapists, medications, patients, etc. Please keep in mind that if you need help, you have options and whatever your personal fears, reservations, beliefs, preferences, or opinions, you should get help over not getting help, whatever form that takes for you.

As I have discussed previously, I woke up on Black Friday last year and wanted to kill myself. When I talked about it in group the following Monday, a fellow mom shared her recent experience of a suicide attempt, and another mom talked about how she had previously been hospitalized due to an episode of postpartum psychosis (she wrote about it, actually, and you can read it here). These women, along with the group coordinators, strongly encouraged me to try hospitalization for a few days so I could have a break and, if nothing else, get some fucking sleep.

I agreed to do so, and one of the group coordinators walked me down to the ER to be admitted. When I had left the house that morning, I had planned to come home again, so I only had the clothes I had worn, and no plans lined up for who would care for my baby. I called my husband on the walk down to the ER and he left work and came to see me and get the baby. Now that I have the experience, this is the first thing I would have changed. I would have preferred to have brought at least one change of clothes, and to have planned in advance for someone who could watch the baby so my husband did not have to leave work. I guess this means I also would have called my employer in advance or at least emailed rather than making my husband do it once I was admitted because they didn’t let me keep my phone.

So what was it like? Well, in the hospital I was in, there is an entire floor dedicated to “behavioral health” (that is the technical term in the healthcare world). This way they only have to secure one door that leads to elevators rather than a few so if anyone wants to make a break for it, it’s harder for them to get out unnoticed. However, the facility I was in was also strictly voluntary admission, so all of the patients who were there had willingly agreed to be admitted, like I had. Patients with conditions or symptoms that would require them to be admitted against their will would be sent to a more specialized facility. Since the patients here had voluntarily admitted themselves (or agreed to be admitted), they were generally friendly with each other, and I saw absolutely no violence or “crazy” (pardon the terminology) behavior.

A note about “voluntary” admission: it was explained to me by a counselor that upon admission, you essentially sign your right to judge when you are ok to leave over to the staff psychiatrists. So if you change your mind after 18 hours and want to go home (which I did), and you tell this to the psychiatrist you are assigned, and he disagrees, you aren’t going anywhere. Potentially you could be more insistent or continue to discuss it with them, but if you are me and you are exhausted from sleep deprivation and being in the throes of a major depressive episode, it took everything you had to even make that request in the first place, and having it shot down broke you again and now you need to go lay down and cry some more.

I was in the hospital across four total days: I was admitted on a Monday and discharged Thursday morning. Each day had a schedule of events starting around 7-8am and ending with 10pm lights out. The nurses and counselors wanted to see the patients participating in all events, but technically they were optional. By optional, I mean before they happen someone goes around to the rooms and if you are in your room rather than the common area, they will tell you “an event is starting” and will try to encourage you to go, and you have to be pretty adamant about saying no if you don’t want to go. This annoyed me for the first 24 hours or so of my stay, because I was SO tired, I thought I could FINALLY get some sleep, but as I was lying in my room, a counselor came and told me an event was starting, and basically stood there until I got up and joined. Once I was at the event, while we were going around and talking about how we were feeling at that moment, I mentioned how tired I was and the counselor running the event said “you just got here, right? You should be resting.” I was very frustrated by that response.

The staff also encouraged the patients to wear their personal clothing rather than the papery clothes they give you upon admission. This is why it would have been nice to have a change of clothes – I wore the same ones for my entire stay except to put the papery ones on as pajamas. I also didn’t bring any of my own toiletries, so I had to use whatever I could get from the nurses (it seemed to depend on which nurse you asked as to what you would get, but they did not have anything fancy). You certainly weren’t allowed to have a razor, but it would have been nice to have brought my own deodorant, and I would have done anything for some lotion. Washing my hands so much with harsh hospital soap was brutal and my skin was in misery by day two.

Visiting hours were every day from 6:00-7:30 pm. That’s it. Only an hour and a half each day in which your family could come see you. Oh, and here’s the kicker for me: due to liability issues, visitors had to be over the age of 12. No one could bring my baby to see me for my entire stay. I didn’t find this out until my first full day there, and I REALLY wish someone had thought to mention it (to the woman being admitted for freaking PPD) BEFORE I was admitted. My husband was all ready to bring the baby that night and I had to call him during the day and say “you can’t bring him.” And then I had to go lay down and cry again, because holy fuck, I can’t see my baby as long as I’m here?! So if you are considering hospitalization, I strongly recommend researching the visitation policy for the facility you would go to, and if it’s a regular hospital, be sure to check the behavioral health policy, because it may be different than other visitation rules and hours. At least, if you would want visitors or specifically if you would want your child(ren) to be able to visit. Instead, in addition to my husband having to find people to watch the baby during the work day, he now also had to find someone to watch him in the evenings so he could visit me.

I also went into the hospital expecting to get a lot more one-on-one time with a psychiatrist or therapist. It was a huge reason that I went, because I recognized my need for a therapist, but I hadn’t been able to get one due to insurance issues (there is a future entry coming that will talk about that). During my entire stay, I think I spent a total of 12 minutes with a psychiatrist, and 25 minutes with a social worker. It was significantly less than I’d hoped for, and it was the least productive 12 minutes ever – however he was the person who had final say on whether or not I was well enough to discharge. He himself admitted to not spending much time with me, because upon discharge, the nurse going over everything with me said my discharge diagnosis was “major depression” because, and it’s relevant that these next words are in quotation marks, because she herself spoke them aloud and I am not paraphrasing: “the psychiatrist didn’t think he spent enough time with you to diagnose ‘postpartum.'” Seriously. Symptoms like “I had a baby 15 weeks ago and now I am a hormonal wreck who wants to kill herself because I just can’t fucking stand the mom guilt that is crushing me every second and I’m sure I’m fucking everything up; oh, and I’m in a support group run by two mental health professionals who have agreed it’s PPD” left him unsure about the diagnosis.

So were there any benefits? I did sleep more than I would have at home. As I’ve learned from group, sleep is one of the single most important resources for treating PMAD, but very difficult to actually get (due to having a baby in the house). From this alone, I felt more ready to resume my mom duties when I left, because for the first time in nearly four months, I had slept for more than four hours at a stretch.

I also have been more willing to ask for help when I need it since my hospitalization. When my husband was left with the baby on such short notice, he had to call on several people to help him out and he had to explain why he needed the help. Suddenly, the idea of “Aly is going through a rough time” became “Aly is now in the hospital because things are that bad” and that got people’s attention. So now,  when I reach out to people asking for help, I find that they are willing and come to me. However, since I did not easily ask for help before, I can’t say this wouldn’t have been the case the entire time. An unfortunate side effect of this is that I feel like people see me as broken now. I can’t just voice that I’m having a bad day without people having at least a brief moment of wondering if I’m going to snap again.

Negative effects like this are, unfortunately, more of what come to mind when I think of the results of my hospitalization. When I went to group the following week and they asked me how it went (with excited faces hoping to hear that the hospital had worked a miracle), all I could say was that hospitalization felt like the single most self-indulgent thing I have ever done. It just felt like I took everything that was bothering me and threw my hands in the air and said “this is not my problem!” and then my husband had to take care of it all with no notice. The women in group insisted that taking care of myself first would in turn take care of the rest of my family and invoked the popular oxygen mask metaphor (when on an airplane they tell you in the event of an emergency, adults are to put on their own oxygen mask before helping children). While I completely agree with the sentiment, I don’t think this hospitalization was the “taking care of myself” that I had expected or hoped it would be. It left me feeling indebted to my husband, and then I overcompensated with more work around the house which burned me out quickly and undid any of the progress I might have made. I have told my husband how I feel and he has assured me that he does not bear me any grudge, but my paranoid PMAD mind refuses to believe him.

I was also very worried that my sudden four-day separation from my baby whom I’d never left for more than a few hours would negatively impact our relationship. I’m sure his age was a factor (he was 15 weeks old at the time), but he did not seem different afterwards. The only difference I noticed was that for the first 48 hours or so that I returned home, he did not want to take his eyes off me (not even to fall asleep), but he wasn’t especially fussy or clingy.

As I warned early on, I feel like this entry went all over the place and ultimately sounds against hospitalization. However, as mentioned above, if you came to this entry considering hospitalization, I don’t want my experience to make you dismiss the idea. Therefore, I wanted to end with a clear list of things to consider to maximize the potential for your hospitalization to be positive and productive:

  • Research the visitation rules for the specific facility (and department) you would go to so there are no surprises about who can visit you and when
  • If you are breastfeeding, inform the staff. This is definitely something that the staff where I was went above and beyond with. They brought me a pump from the Maternity floor and supplied me with small bottles so I was able to continue pumping during my stay. They kept the full bottles in the staff fridge and sent them home with my husband each night when he visited. I did have to be monitored while using the pump (usually staff stood in the room behind me and turned away – no one ever insisted on looking directly at me while I pumped), but the important part is my hospitalization did not interfere with my ability to breastfeed my baby
  • Pack a VERY small bag. I’d say one change of clothes and absolute minimal toiletries. Perhaps your own breast pump if you prefer, but they will probably lock it up when it is not in use. Keep in mind the facility probably has rules about what you can have (they made me pull the strings out of the hood of my jacket) so pack carefully
  • Make plans for your absence. Find someone who can watch your child(ren) during the day. If possible, someone who can stay at your house to help your spouse and kid(s) just as a support person would be great
  • Have a goal in mind when you go in and share it with the staff. If your goal is to get sleep, tell them that. If something is getting in the way of that, politely make them aware
  • Talk to your spouse or anyone close to you about how you are feeling. Make sure they understand why you want to go and what you hope to get out of it. It is likely that the psychiatric staff will call them in to speak to them (the social worker spent more time with my husband than she did with me) so it’s good to have this conversation in advance

Like I said above: if you are struggling and not sure what to do, please get help rather than not getting help. If you don’t think you could handle some of the rules or situations mentioned above, hospitalization may not be for you, but please don’t think that means you have no options. You can try reaching out to close friends or family and letting them know how bad you are feeling – they may surprise you with how understanding they are and willing to help. If you are not able to get any support from friends or family, though, please consider reaching out to PSI and they can help you find support.