Good Help is So Hard to Find

The two most common ways to treat PMAD are medication and therapy. I will start by coming right out and declaring that I am pro-medication. However, I have learned from talking to many moms (in group and on forums) that there is a LOT of misinformation regarding medication which may be causing undue avoidance. Unfortunately, I find that an alarming amount of this misinformation is coming from healthcare professionals themselves.

First and foremost: Sertraline and Zoloft are safe to take while breastfeeding. These drugs have been studied (along with many others) and it has been determined that no effective amount of the ingredients get into the mother’s breastmilk to be transmitted to the infant. If you seek antidepressants and your doctor tells you that you cannot have them because you are breastfeeding, PLEASE get a second opinion from another practice. Unfortunately, this is an example of how foreign PMAD still is in the medical world, and how much educating still needs to be done. I know I’m just some woman on the internet and you won’t want to listen to me over your doctor (that is safe and healthy skepticism, good for you!), but I am telling you this because the two mental health professionals who run my support group (a MSW LCSW-C, and a APRM-PMH BC who collectively have over 20 years experience and specialized, focused training and education regarding reproductive mental health) preach it regularly. If you have no reason to believe me, please believe them and their professional expertise – they have dedicated themselves to learning all there is to know about this. All I’m asking is that you seek a second opinion.

Personally, I used Sertraline for several weeks following my hospitalization. My doctor put me on 50mg at the beginning. This is a starting dose and is not considered a “therapeutic dose” (meaning it isn’t enough to actually resolve your symptoms). Antidepressants are often prescribed this way because, for best results, they should be slowly introduced into your body rather than all at once. This also gives you a chance to determine if you have any severe side effects on a low dose before you move up and they are potentially worsened. I did well on the starting dose, so I went back in 2 weeks and was bumped up to 100mg. My doctor wanted me to set a follow up appointment for 90 days after that to assess and see if we should increase to 150mg. She said if I felt like I needed more sooner than that (but after 30-45 days) I could reschedule and come back earlier.

As helpful as medications can be, this is the problem with them. They are not free. Doctors are not free. Every visit to my doctor cost me a copay (at minimum), not to mention the cost of the actual medication. Also, I had to schedule all of these appointments around my work and home life. This is asking a lot of women who are already feeling overwhelmed and having trouble juggling all of their responsibilities. Let’s look at a rough, low estimate breakdown of getting medication:

Initial visit and assessment: $20 copay
50mg prescription: $15
Follow up visit and assessment: $20 copay
100mg prescription: $15
Follow up visit and assessment: $20 copay

So already, assuming there are only copays, no deductible or coinsurance, and relatively inexpensive medication, this problem costs $90 (not to mention the cost of potentially missing work to attend appointments). But what if the first medication doesn’t work? That’s more appointments, more missed work, more copays, and more prescriptions as you keep trying. Also, this process is not a short one – these medications can take 4-6 weeks to reach full effect. That is a lot of time, money, and stress to put on someone who is struggling with a mental health issue. Also, if you are not satisfied with a medication, you have to slowly wean off of it which brings me to another potential problem you could encounter: antidepressant withdrawal.

It’s real, and it’s HORRIBLE. I had to stop taking Sertraline because it gave me insomnia and I found that when I didn’t get sleep, all of my symptoms were exacerbated. I’ve had issues with Zoloft in the past, so I was worried about this, but tried anyway. I told my doctor and she told me to wean off by going back down from my 100mg dose to the 50mg. I did this for a few days, but was so desperate for sleep that I stopped entirely one day and that was a bad idea. Even right before my hospitalization, I have never felt depression like this. This was thicker, this was darker, this was different. My mind was completely dedicated to horrible, negative, self-loathing thoughts. I hated myself more than usual. I wanted to hurt myself more than ever, but the lethargy and lack of motivation were so much stronger that I could’t get out of bed to do it. I barely survived until the sitter arrived, then I took days off of work to lie in bed. I did this to myself by stopping my medication the way I did, so I implore anyone who wants to stop an antidepressant to PLEASE wean down!

Even after my experience, I am still a supporter of medication for PMAD. In my case, my best medication so far has been the Pill, but that is because of my PCOS and is not going to work for everybody. What the Pill does for me is balance my chemicals in a way that optimizes me. That’s what other women can get from antidepressants, and the medical field could really stand to catch up on the latest information. While I do promote medication to treat mental health issues, I definitely understand and value the importance of therapy when treating PMAD, as well. But if you thought the hoops required for medication were bad, hold on to your butts as we go through the process of getting therapy…

The most important thing for therapy when it comes to treating PMAD is making sure that the professional you are working with understands the condition. Nearly every therapist will tell you that they have treated Postpartum Depression or that they handle “life transition issues,” but this is not at all the same as specializing in PMAD or reproductive mental health. Mostly mental health professionals have an idea in their mind of what PPD is and looks like. When I was being processed for intake at the hospital, I heard one of my nurses tell the other that she didn’t think I had PPD because she’d seen me with my baby in the ER and I had been making eye contact with him. To her, that’s what PPD should look like – I should be detached from my baby. However, as most moms suffering PMAD can tell you (especially in the spotlight of social media), we’re excellent pretenders. No one who saw me with my baby knew that I wasn’t bonded to him. Hell, I put on a show so the baby himself wouldn’t know. A properly educated mental health professional would know that potentially 1) I am a pretender because it is socially unacceptable to not be in love with your baby or 2) Detachment from my baby isn’t one of my symptoms.

Upon discharge, I tried to find a therapist that my insurance would cover. Unfortunately, both of the women who run my support group are out of network. At first I tried working with the insurance to find someone in network. I tried using their online tool which did not work, so I called and spoke with a rep. I described what I wanted (an in-network therapist within 10 miles of my zip code who said they treat PPD). The search yielded literally hundreds of results. I’ll tell you now, I know suburban life can be rough, but it’s  not “hundreds of therapists within 10 miles” rough. As I found out (by calling and emailing dozens of therapists suggested by my insurance), the insurance’s information was severely out of date. None of the people they recommended were 1) still in practice 2) still in the area and 3) still accepting my insurance.

I decided to talk to my insurance and request a special case agreement that would allow me to see a therapist of my choice and be reimbursed. I was told that because there were so many in-network therapists in my area that it would never be approved. I gave up and never found a therapist. Talking to my insurance was so defeating and painful that I stopped trying to find help. I want to mention here that I was a medical biller for 7 years before I decided to stay at home; it was my job to call and talk to insurances about these kinds of things, and I was good at it. But when it came to getting treatment for myself, I wasn’t able to get through the red tape and actually get help.

The difficulty (and ultimate failure) I encountered in trying to seek medical help for myself is disgusting. I hear similar stories from other moms in group and online all the time, and I am absolutely devastated by the lack of resources, education, and assistance available to women who are struggling with PMAD and other mental health issues. It’s bad enough that we often have to convince our families and friends that PMAD is real and requires treatment, but when that is not the hardest part of this process, the process is clearly broken.



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.


I Have No Right to Be Depressed 

There’s this feeling I can’t shake that I just have no right to be depressed. I finally got pregnant. My first pregnancy (despite complications) went to term. My son was born healthy and came home after a normal hospital stay. My job offered 6 weeks of paid leave. I was able to extend that leave to 10 weeks, and when I started working again it was from home and I still got to see my baby during the day.

Other women would kill for any one of these situations. And yet, here I am, thoroughly depressed. And do you know what makes it worse? Knowing these things. Thinking about these things and saying “I have no reason to be depressed” only makes the feelings worse, because chemical imbalances don’t double check with you first. They don’t look around and go “Oh, wait, this person has a pretty good situation, I don’t belong here” and then move along. They stay and fester and leave you looking at your situation and thinking “what the fuck is wrong with me?”

This idea of having no reason to be depressed or anxious is something that gets mentioned a lot in our group, and is something I often hear expressed by fellow moms. Personally, I think it also stems from the idea that upon pregnancy and childbirth, our lives TRULY begin, and any feelings that contradict the idea of this moment as being the pinnacle of our existence are frowned upon. But the truth is, it’s incredibly common for women who have just given birth to not feel immediately connected to their babies (I didn’t). It’s not uncommon for this lack of connection to go on for months, even (mine did). And all the while that it’s happening, the mom is feeling awful for it because she’s been told her entire life that the moment she looks at that precious little miracle, her heart will grow three sizes that day and she will never have felt anything like it before, and will never feel anything like it again. That’s an awful lot of pressure to put on a single moment that, in reality, could go any infinite number of ways.

So when other moms say “I have no right to be depressed” I imagine an unspoken “because I had ‘THE MOMENT’ which was supposed to be the highlight of my entire life, so from here on out everything is supposed to be sunshine and rainbows, and me being depressed is spitting in the face of my great purpose and flipping the universe the bird.” I am definitely guilty of it. Go back and read the first paragraph of this entry; I couldn’t stop myself from explaining why I understand that I am not justified in feeling depressed.

This contradiction of having a good life and still being depressed is a huge hurdle for me. It wriggles deep inside me and gets at the very roots of who I am and how I interpret the world around me. It has gotten far worse since I developed PMAD and have been dealing with it, and I now sometimes have difficulty trusting myself or my own perceptions, which in turn lowers my sense of self worth (since my opinion is clearly skewed and therefore has no value).

I have tried several methods of handling this contradiction with varied levels of success (and definitely levels of failure). I can say what does not work, though. The common advice that most depressed people have heard: “have you tried not being depressed?”
It turns out that was the secret all along! Depression is like fairies, and it only exists if we BELIEVE in it, but if we ignore it and don’t believe, it will die! WE’RE ALL CURED.

Yes I’ve tried not being depressed. I’ve tried when I feel this way to say “no I don’t” and act like that’s true. I’ve also tried to tell myself that I am not someone with depression, I am someone who has to entertain depression every now and then like the annoying cousin who comes to live with you for the summer. Guess how these methods work out? Not well, because if you refuse to look at depression and you refuse to acknowledge it and do something about it, then it just learns to function without you looking at it, and on its own terms. It becomes a wild beast that can’t be reasoned with who rampages through your life like Godzilla in Tokyo (see previous entry about how my Black Friday went).

Unfortunately, I don’t have an answer for how to deal with these feelings. It’s something I am still struggling with regularly, and something that I will probably continue to struggle with for as long as I keep refusing to give myself any slack and just let myself feel crummy without judgement once in a while.


Not Everyone Makes It Out Alive

I wanted to publish this post today in particular because tomorrow is PSI’s annual “Climb Out of the Darkness” walk. I am participating at a local park because I personally know how bad PMAD and PPD can be when left untreated, and I want to do what I can to help anyone in need know that there are resources available and that what they are feeling can be overcome.

This post comes with trigger warnings for depression, anxiety, and self-injury

As I’ve mentioned before, I have PCOS and a history of anxiety and depression. This combination makes for some inexplicable and intense mood swings, and at times in the past has resulted in me cutting and contemplating suicide. Sorry to get so real so early in this entry, but I’m very serious when I say that PMAD and other hormonal and mood disorders are not to be taken lightly.

It was these past experiences with mood swings, self-injury, and suicidal thoughts that made that little voice in my head warn me to watch out for PPD. The therapist I saw years ago told me that she herself had regularly suffered from depression, but it mostly went away when her children were born. She said that something about being in charge of these little people who weren’t able to care for themselves seemed to make everything that was getting her down seem insignificant.
So imagine how awful I felt when I had my own little helpless person to care for, and my depression seemed to be getting worse.

It was Black Friday and I had no explanation for it, but I woke up that day and I wanted to die. Thanksgiving itself had gone great – we had a good time visiting with family and we didn’t have any of the awkward disasters that so many other people unfortunately have. I think that might have made it worse – I always feel worse about my depression and suicidal thoughts when I can’t seem to find any explanation for them. When I’m not experiencing them, I feel confident saying “that’s because it’s a chemical imbalance in your brain and you can’t see or touch that, so it’s hard to identify,” but when I’m in it, I think “aren’t I just a result of all my chemistry? How can we identify one process as an ‘imbalance’ and not just as ‘how Aly works?’ Maybe Aly is just broken.”

That whole day I just couldn’t stop thinking about how much I was messing up being a mom and ruining my baby’s life by being in it. I felt so much like he would be better off without a broken mom who could barely function. I thought about how he would think of me if I did kill myself and he grew up without me. I thought he would probably resent me, and he would probably be angry that I had done something so selfish, but I wasn’t sure if it was worse to not be there for him, or being a burden to him his entire life – for which he’d still resent me. They really seemed comparable, and honestly, knowing that his father (a better person than me) would raise him without me dragging him down, I really thought that option sounded better.

My husband could tell at one point in the morning that I seemed down, so he asked me if I was ok, and I said yes and that I was just tired. Then I felt myself starting to break down, so I left the room and went across the house into my bathroom, closed the door, and sobbed in a heap on the floor.
I broke down several more times that day: in my kitchen, in my bed, and every time while I was sobbing and could hardly breathe, all I could think was how much I wanted to hurt myself.

Despite my depression coming and going almost constantly (but often only mildly), I had not wanted to self-harm in nearly 13 years. Yet on this day, the urge was as absolutely fresh and clear as if it had never left. I felt broken and terrible inside; I was sure I was ruining my entire family’s lives, and I wanted to punish myself for it. At least if I cut, anyone who saw it would know that I was paying for what I was doing to everyone around me.

At some point while battling the crushing depression and the self injury thoughts, my brain finally did what it usually does when I am at my worst and I detached entirely. I can’t tell you what happened the rest of that weekend, but I didn’t die (spoiler alert), and I didn’t find any cuts afterward.

Not everyone who suffers PMAD can say the same. Here is a story I came across the other day about a father whose wife lost her battle with PMAD.

I came across this story while leisurely scrolling through Facebook on a Saturday morning, and it struck me to my core. If the slightest thing had gone differently for me that day, this could be my husband’s story.

At group the following Monday, I told them how my weekend had gone and one of the facilitators said, “It’s so important to make it clear how serious these feelings are and how much they are disrupting your life. So many women going through this don’t tell anyone, or don’t find support, and it’s heartbreaking, but not everyone makes it out alive.”

I thought that my brain turning to suicidal and self-injury thoughts was just another way of coping with the stress – these thoughts had been my go-to in my last serious depressive episode, and in some twisted way that made them comfortable, or at least familiar. But after hearing my experience, another mom in the group admitted that she had actually attempted suicide only weeks before, and luckily her husband got to her in time to get her medical help.  Then, a number of other women in the room actually confessed that they had experienced thoughts for the first time since becoming a mom, but hadn’t acted on them. In a lot of instances, the feelings were as simple as thinking “my family would be better off without me.” For some that was interpreted as a suicidal thought, for others it was more an idea of getting in the car and driving far away, not telling anyone where she’d gone.

I wish I could say that after that weekend I never had the suicidal or self-injury thoughts again, but they’ve come and gone. I still haven’t acted on them as far as I can tell (breathing check – yep… still breathing), so I take that as a victory.

I  know this post was heavier than some of my previous, but again, I can’t stress enough how dangerous it can be to leave PMAD untreated, and anyone who thinks they’re “crazy” for having suicidal or self-harming thoughts (or even just the idea that your family is better off without you), you are absolutely not alone. Please reach out to friends, family, or even PSI and get help.

If you want to help others in need, please consider donating on my COTD page. 100% of donations go directly to PSI and they help support community outreach programs (like the support group that has helped me so much) for families in need.

Going Back To Work

In response to the fiasco with my disability leave, I was able to add all of my saved up vacation time to the end of my leave, and I was able to stay home for 10 weeks total. Also, “going back to work” was less of a transition for me than I imagine it is for most moms, because my supervisors had agreed to let me work from home. For me, “going back to work” meant “logging on to my work laptop and dedicating 40 hours a week to work.”

It was still torture. For the first time in 10 weeks, I had to put my body on a somewhat “normal” schedule, right after I had started to adjust to bursts of sleeping and waking with the baby. I had to get myself up at a reasonable time and start working while the baby was still asleep (hopefully), then I would have to pause for a bit when he woke up and take care of him until his sitter arrived (we hired someone to come to the house and care for him while I worked, but we couldn’t afford to have her more than 30 hours a week, and daycare prices were absolutely out of the question), then I had to work like mad while she was here, and once she left, I had the baby again and had to take another break until he napped again or my husband got home and I could work.

The good thing about this schedule was that it was relatively flexible, so when the baby had an awful night (which he still had many of – he was 10 weeks old) I could sleep in a little later, at least until the baby got up, but I would have to make that time up later in the evening. The bad thing about this schedule was that it extended my work days to far past 8 hours and left me even more drained and exhausted. I think back to this time period and wonder how I survived.

It still blows my mind that new parents are expected to return to society and function so shortly after bringing home a new baby. Yes, I’m having THAT conversation now. It really feels like these policies were written by people who never actually cared for a baby and have no idea what life is like with one.

The sleep deprivation alone is enough to drive you mad – literally. When used on prisoners for too long, sleep deprivation can violate the Geneva Convention, but when it comes to new moms, buck up! That baby’s plenty sturdy at 6 weeks old! Get back to your full-time work schedule! And that’s if you’re lucky enough to have a job that has any kind of paid maternity leave at all.

So, upon my starting working again, my depression and guilt increased severely. I was terribly depressed that my “just me and you” time with my baby was over, and the guilt of paying attention to something other than him for so many hours a day was absolutely crushing me. It continues to be a main source of anxiety for me as I feel I am always torn in two. I sit in my office in the morning working, and the monitor will flick on with a little coo or squeal from the crib, and my first thought is “Oh no, it’s too early, I have too much work to do!” and immediately I am struck through the heart with Mom Guilt. It actually happened once that I was standing in my home office holding my baby and crying because my phones were ringing and I had work to do, but he was fussy and wanted me, and I couldn’t stand the pressure from both being so insistent.

We tried getting me to go into the office a day a week to get away from the baby and see other adults, but ultimately it didn’t work out. I still could only go for a few hours while the sitter was here, because that was the whole point. I could not afford for her to be here enough hours for me to go into the office full time, so that fell through, as well.

Honestly, now I completely understand the coworkers who never seem to stop talking about their kids. It’s because, even though they’re at work, in their heads they’re counting down the minutes until they can leave and get home again and actually see their families. I’m already that coworker, and my baby is just in the other room!

Today is a Bad Day

So far, all of these entries have been written months after they initially happened. I have had time to reflect, and time to think about how to discuss what happened and how I felt. I have had lessons and pearls of wisdom to give at the end, but I don’t have that today.

I have good days and bad days, and lately I’d say I have more good days than bad. But today is a bad day, and I felt it was important to make an entry while I’m in the thick of it to document where my mind is at times like this.

As of June 1st, I stopped breastfeeding. My immediate instinct now is to go into my list of justifications as to why.

  • My son has not nursed since he was 6 months old. He just has no interest in it. I have been pumping exclusively since then. This week he will be 10 months old.
  • My PCOS makes my supply difficult to maintain (as the lactation consultant warned me in the hospital).
  • My breasts just hurt. Attempting to grow my supply to keep up with him through pumping alone has been excruciating and there just isn’t enough nipple balm in all the world.
  • I want my body back. If none of these other things were true, this wouldn’t be a factor and I’d keep breastfeeding through at least the first year (I really wanted to hit that one year mark). But in light of all of these other things, I just want to open my bra drawer and put on a cute bra with underwire that can be worn with a V-neck shirt.

The funny thing is, if another mom told me she was no longer breastfeeding, I wouldn’t need her to give me any reasons at all. I would say “Oh, ok.” and if she seemed upset by the decision, I’d say something like “you know what’s best for you and your baby, not me.” However, these things don’t seem to apply to myself. Other moms wouldn’t need to justify it to me, but I have all of my reasons at the ready for rapid explanation. I think other moms are the most qualified people to make these decisions about themselves and their babies, but who the fuck am I to know what’s going on with me? I think we’ve already determined time and again that my reasoning and mental processes can’t be trusted – you’re going to just let me make this decision?

To be fair, the morning that I stopped, I talked to my husband about it first. I wanted his input since it is his son, too, and I know he would ask me if things were reversed. He had known of my growing discomfort in the last few weeks and was absolutely fine with me stopping. We also had already been supplementing formula at night since my son was about 4 months old when we started sleep training because (to me) it was the most reliable way to know for sure that the baby was getting a big enough meal to sustain him through the night before we put him to bed (there’s me justifying myself again because maybe if you hear my reasons you’ll think I’m just a bad mom, not THE WORST mom).

So, I feel like my reasons justify my decision. However, I also feel like I don’t need all those reasons, and honestly a good enough one is “I don’t want to anymore.” So why did I tell my sitter that my doctor ordered it?
I said “I’ve stopped breastfeeding, so when we use up the supply in the freezer, he’ll just be on formula.” Then I saw a look on her face. If you ask me, it was instant judgement and condemnation. Could it have been? Yes. Was it? Probably not. For all I know she was thinking “I wonder where they keep the formula” or “what was the name of the guy who played that guy’s dad in that one movie?” or “Do I smell toast?” But of course in my head it was disapproval. So I hastily added “my doctor said I can’t anymore.”

Today I started washing and sanitizing my pumping supplies to pack into storage. At first I was just objective and disconnected from it, then I went to pack away the bottle warmer, and I broke. I’m not sure why that item made it so real, but suddenly I was standing in my kitchen bawling my eyes out and feeling like the worst mom in the world. “I gave up too easily. I am so selfish for doing this – I did it for me, not him.”

Once again, I am completely unable to be understanding or forgiving with myself. I wish I knew why that was.
Saturday night my breasts were full and sore and I was miserable, so I tried to pump out the last bit, but they wouldn’t give, so I spent the rest of the night in pain from it. Yesterday I pumped until I bled. Literally. I made myself bleed from pumping. If another mom told me she did that and followed it with “I’m so selfish, I gave up too easily.” I’d thinking “are you kidding me?!” But for some reason it’s not ok for me.

Like I said, I don’t have a great lesson with this entry or any wise words to leave you on. I’m just feeling crappy and wanted to capture it, and to show that, despite these entries mostly taking place months in the past, this is still something I am very much in the thick of and still fighting.