I’m Baaack

I remember peeling off the cocoon of my bulky winter jacket one of the first times I came here.

Perching nervously on the edge of one of these same chairs.

Feeling completely vulnerable and exposed.

Wanting desperately for someone to mold me back together – yet not touch me.  Not look at me.  Not judge me.

For my weaknesses, my failures, my inability to just be.

It’s been awhile.  But I’m back.  And so are all the same feelings.

A Common Language

 

I’ve been thinking a lot about how to ensure that available mental health resources get into the hands of the women who need them. When and where resources are available, there seems to be a gap between the offering and the accessing. As always, I think back to when I first slid on the shoes of the women now making the postpartum trek.

Women of all socioeconomic, racial, and educational backgrounds share one extremely daunting obstacle when in need of such help: they must articulate their exact problem in order to get the help they need.

In a complex web of medical jargon, insurance restrictions and loopholes, and a frustratingly-absent physical presentation of symptoms (for the most part), it falls upon the sufferer to demand treatment for the condition that, no doubt, impairs the very confidence, decision-making skill set, and strength it takes to do so.

It’s an ironic catch-22. The doctor has the tools to ‘fix’ you, but you must lead her to the workshop. The doctor is the artist, but cannot pick up the paintbrush unless you led her to the canvas. The horse must determine the source of water before the doctor can lead it there.

There is no solution unless the patient gives the doctor information to determine the problem.

When I hinted that I felt like running away a few months postpartum, my midwife recommended I talk to a LISCW. This therapist helped me chip away at the enigma that dragged me down, but it was I who eventually had to request medication from my physician. When that dull cloud still hovered, I made the final call to increase dosage. More recently when I intimated to her that I still felt low sometimes, I apparently wasn’t descriptive enough because I was told the meds shouldn’t make me feel flat; there should be ups and downs.

How well my mental health situation is addressed directly correlates to how accurate I am in describing it. How empowering and crippling at the same time. If I do not share every pertinent detail in clearly descriptive language, I will not feel better. I will not get the meds, therapy, tests, information, etc. that I need to make anything resembling a full recovery.

Regardless of my level of medical literacy, the debilitating effects of depression and anxiety can keep me from adequately representing my plight. Regardless of the quality of care available to me, its benefits will not be afforded to me if I do not say just how much I need it. Nothing will be given to me unless I ask.

How do we on the receiving end of such conversations draw the stories out of the women who need help? How do we teach/speak the language to give them a voice? How do we release the language bubbling beneath their skin? In that wordless abyss is the bridge between therapeutic, wholistic maternal care and the women who need it.

word bubbles

 

The Brand of Crazy I Am

I guarded my postpartum depression diagnosis like a dirty little secret.

While I felt a certain measure of peace at having a name for the pit I seemed to be peering out of, it didn’t translate to shouting it loud enough to be heard above the rim of that pit.  It didn’t even encourage me to tell my family.

After I nursed the baby and put her down for the night, I’d tuck the other two into bed saying, “Mama’s going to the doctor.”  It was never the therapist, or my LICSW, or someone I need to bare my soul to in order to process what’s going on in my heart and head.

I didn’t want to be one of those people.  The ones who lie on the couch to be psychoanalyzed.  The ones who aren’t normal, who can’t cope, who have problems.

And that was just the ‘me’ stuff.  Slathered on top of that was a thick coating of mommy guilt, seeping down into the crevices and open spaces.  What kind of mother was I if I couldn’t care for my own brood?  Blessed with three gorgeous, healthy children, why couldn’t I be happy?

I didn’t want anyone to see what a failure I was as a mother or how broken I was as a person.

I still have misgivings about sharing TMI on my blog.  I invited all my Facebook friends, many of whom I haven’t seen in years and knew me in former incarnations, from my personal profile to ‘like’ my author page on which I share links to these blog posts.  But did I want these acquaintances to know just what brand of crazy I am?

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If I’ve learned nothing else during this experience, it’s that having nothing to hide takes away whatever shame there is.  Being completely open is what destroys the stigma.

And as far as postpartum goes, I believe it helps other women get the help they need.  In the surreal realm of new motherhood, it’s easy to feel completely alone.  Start adding feelings not featured on any Hallmark card and there’s no way in hell you’re going to seek someone out to admit to them.  But if you heard just one story, just one little anecdote similar to yours, you might, just might, open your mouth and let yours fly bit by bit.

The Perfect Storm

hurricane

When my husband and I learned of the imminent arrival of our third child, we were in shock.  Yes, we knew how things worked.  Yes, we’d always considered, even expected, a third child.  No, we were not ready for it right then.  After our second was born, we said we’d definitely want to wait until she was older than our first had been before we welcomed number three, which was just over two and a half.    The best laid plans . . .

Our second was eighteen months old when we found out I was pregnant.  In the weeks that followed, we walked around in a stupor.  As I went about my daily activities caring for the kids, I would find myself staring into space, lost in thoughts of third car seats, reconfiguring furniture in our already small house, finances, schedules.  The phone would ring – my husband calling from work – and we would stare into space together, our shock suspended in the telephone lines.  We knew we wanted this child and loved it already, but were totally caught off-guard by its timing.

It was also a difficult time in my extended family.  My uncle was battling a terminal brain tumor.  My announcement to my mother was made by way of my explanation for not visiting the ICU.  He died a few days later.  Four months later, my cousin was killed in a motorcycle accident.  My grandmother’s devastation was complete.  My mother’s own grief was wrapped up in worry for her mother.

Somehow, the days wound on, the months passing.  Caring for two children while carrying my third was starting to take its physical toll.  The usual aches and pains of pregnancy were amplified.  My left hip and pelvis were giving me more pain than ever.  As my due date approached, I felt extreme pressure, a heaviness, different than impending labor.  Having nothing to compare it to, I just assumed it was my body’s worn-out response to doing this a third time.

In the delivery room, my midwife asked me if there’d be a fourth if we had another girl.  “I hope not,” I’d said.  By the time I was pushing, I was sure there wouldn’t be.  Even after two natural births, I’d never experienced anything like it.  I actually uttered the words that infuriate me when I hear them in television portrayals of labor: “I can’t do this.”  But somehow I did.  And the nurses placed a perfect little girl in my arms.

I’d like to say all the shock and worry evaporated as soon as I saw her face.  She was gorgeous, I loved her, but I almost felt like a stranger observing the scene from afar.  I still hadn’t wrapped my head around the idea of starting over again with a third child.  And I wouldn’t get a chance to right away.  In the hours and days following her birth, a new challenge presented itself: getting out of bed.

When the nurse came to get me the next morning, she asked if it was the first time I’d been out of bed.  “No,” I answered, nonplussed, until I saw her face as she watched me move.  My walk was more of a shuffle, getting in and out of bed was slower than glacial melt.  Finally, after many such episodes throughout the day, she said, “Maybe we should send you for an x-ray to make sure you didn’t break anything.”  Break anything?  You’re not supposed to break anything when you have a baby – except your water.  Now she was making me nervous.

An x-ray confirmed her suspicions – and my pain.  I had a slight case of diastasis symphysis pubis.  Thank God it was slight because it meant the ligaments in my pubic bone had separated.  And as slight as it was, it was excruciating.

Once the adrenaline wore off and the soreness settled in, I couldn’t roll over in bed without crying.  It took me 45 minutes to get out of bed early one morning when I didn’t wake my husband or call the nurse.  My father brought me the old karate belt I’d left at their house to lash my legs together as I rotated them off the bed to come up to sitting.  Hip adduction was simply impossible.

My husband had taken two weeks’ vacation to help with the baby.  He didn’t know that, in addition, he’d be doing everything for the other kids, washing and folding clothes, preparing food, and helping me to and from the car like a little old lady.  The helplessness that can afflict a new mother was magnified ten-fold by my handicap.

I told my mother-in-law, “I’m finding it hard not to feel sorry for myself.”

She said, “I don’t blame you.”

Her answer surprised me.  Were things really that bad that I should be feeling sorry for myself?

Apparently so.  I worked my way into some sort of routine with a newborn who fed at no particular time, a preschooler who had to be in school at a precise time, and a toddler who took off her shoes and socks whenever she felt like it.  Weekly visits to a physical therapist worked me through a regimen that gave me a tenuous, yet workable, physicality.  And yet, four months after the baby’s birth, I still couldn’t cope.

I would reach my breaking point over hair elastics stretched to theirs over the top of a dining room chair.  God help the poor soul who dumped out the basket of toys I just filled.  My two oldest would jump when I started screaming at the top of my lungs out of seemingly nowhere over seemingly nothing.  I felt like a pot about to boil over and I was trying desperately to keep the lid on tight.  It was a particularly grueling drop-off at preschool one morning that crystallized everything.

Sleet was just turning to snow as we pulled into the parking lot.  I strapped the baby into the baby carrier on the front of me and moved around to the other side of the car.  My toddler had already taken off the hat and mittens I’d fought to get on her at the house.  I reached into the back seat where the preschooler was seated to depress the red button on her harness, instructing her to unclip the top part while I redressed the toddler’s extremities.

“I can’t, Mommy,” came the plaintive cry from the back seat as she stared out the window at the passing kids.  I instructed her to focus on what she was doing and try again.  This conversation repeated itself over and over like an audio loop, her despair and my frustration escalating each time.  Finally, I lunged into the car, swearing like a sailor, the baby bobbing in her carrier like a cork on the ocean, undoing the strap and telling her to get out of the car.

Then I stopped.  I scanned the parking lot around us for parents going to and from their cars.  Had anyone heard me?  Had they seen this terrible little episode?  Shouldn’t I have known I was getting out of control before it was too late?  Once my oldest was safely in the classroom and the rest of us safely home, I dissolved into tears recounting the story to my husband on the phone.

“I need help,” I said.

A few weeks later, I started a new kind of therapy.  I met weekly with a licensed social worker to discuss and treat what finally had a name: postpartum depression.

At the end of my first visit, I said to her, “So, do I have postpartum?”  In classic counselor speak, she replied, “Would you like me to say you have postpartum?”  I laughed and she joined me.  “I can go through the indicators if you’d like,” she said.  One by one, she ticked off every single one of my circumstances: unexpected pregnancy, death of a loved one(s), stress, difficult delivery, physical trauma, demands of caring for other children, anxiety.  “Does that make you feel better?” she asked.  Oddly enough, it did.  For the first time in months, I felt light leaving her office.  I wasn’t a failure and I wasn’t crazy.

This perfect storm was not forecast, but at least now I had some sort of outlook for the future.

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