Yesterday we talked about PPD symptoms in part 2 of our review of the postpartum depression memoir Sleepless Days. Today we will delve into treatment and recovery part of the postpartum journey.
Amber: On page 160, Sue describes when she finally reached her therapeutic dose of medication. She says, “I didn’t feel instantly better the day I took ___ mg of Zoloft. But finally reaching the proper dosage gave me the presence of mind to hold on until I could see how effective this amount was. I stopped questioning…” “With my head finally balanced, it’s so much easier to work on the psychological issues that have always gummed up my life. Make no mistake: antidepressants do not solve any psychological problems. But for me, at least, they have filled the ruts into which I kept getting stuck.” Did your treatment plan include medication? If so, how would you describe the difference that it made in your life? If not, what was a part of your effective treatment plan? How did you know that your treatment plan was “working”?
AC: It does include meds, thank God. For me, I take every thought I have personally, so one can only imagine how I have dealt with intrusive thoughts. The first dosage amount of Celexa I took was the amount I took years ago. That amount helped me then, not now. It took me some time to accept this and I finally increased. I wasn’t sure what it would do to me, but the minute I no longer felt the visceral effects of anxiety, I knew it was working. I actually just learned today that I should bump it up once more to try to stop the OCD frequency of my thoughts. Hopefully this dosage will help even more.
APR: My treatment has included meds – ___ mg Zoloft. It probably should have much earlier than it did. I probably should have gone on them by about three months postpartum, but didn’t until eight months postpartum. Medication made it possible for me to sleep which was number one on the list of treatments I needed. My brain needed to rest. Like Resnick notes, it gave me the clarity to see what was going on and do something about it. When I started sleeping, and being able to exercise and have time for myself, I started to know that it was working.
Amber: Susan Resnick closes her book by describing the fear of insomnia or sleep deprivation that was a major remnant of her postpartum depression. In her last paragraph she explains that her wellness was cemented when she had to endure an entire week of disrupted sleep due to her son’s illness and rather than being anxious about her sleep deprivation she was completely focused on him and hadn’t even thought of her own lack of sleep.
What fear or other remnant of your PPD experience were you left with? Have you come to a point where even that is something that is no longer top of mind? If so, when did you realize you had really recovered?
AC: I continue to have a fear of being alone with my son. It is more of an “anticipatory” fear that stems from the fears I had when I was with him and had no idea what was happening to me. Frankly, it sucks, and doesn’t help my self-confidence issues, but hoping it gets better as I continue to work on myself and my recovery.
BR: I still have remnants of my intrusive thoughts that pop up, mostly related to sleep, both my own and my daughter’s. The intensity is not nearly what it was, but I can still get triggered and experience anxiety. My return to work is what signaled to me that I was well on my way to recovery. When I was at my worst I could not imagine ever being able to return to work. Now, on challenging days at work I pause sometimes to recognize how far I have come.
APR: I have the same exact problem. I get really worked up if I lose out on sleep and that gets me so wound up so I can’t go to sleep. Then when I get overtired, I can’t nap to make it up. It’s a vicious cycle. Also, when I am overtired lots of my symptoms come back. It is so hard. Things that have helped are having better sleep hygiene, adjusting my medication dosage, having a simple bedtime routine for myself, and taking melatonin, Benadryl, and/or homeopathic sleep remedies.
Amber: There was so much in this book that if I had highlighted it, I would have practically colored every line, so I know it will be hard to choose. But, since we can’t talk about each chapter in depth, which one sentence, chapter, or page most spoke to or resonated with you? If a mom were to take away just one message from this book and hold it close to her while she is struggling through postpartum depression, what should it be?
AC: Ha. I too literally highlighted almost every page of the book. In looking back, Chapter 4 and a line in chapter 5 stuck out to me. In Chapter 4, Resnick describes the anxiety she experienced as a child and as I look back at my childhood, I see all these moments of intense anxiety that I only now understand as precursors to this part of my life … and, that if I really understood postpartum anxiety and OCD before I was pregnant might have used more to my advantage in terms of prevention. In this chapter, she also describes her intrusive thoughts about the oven, which made me feel “normal” for having mine. Finally, she describes her battle with taking her meds and her fear of the side effects. This, I feel, is a major reason (along with no sleep) that I got to the point I did. I KNEW my medication was successful for me. I had taken it for OVER FIVE YEARS before I had my son, and I LOVED taking it. But, I was totally convinced postpartum that I didn’t need it. That by taking it, I was “weak”. Susan wrote, “…I am too scared of the potential side effects of the pills to take enough to help me…It is an irony suffered by so many of the mentally ill: our illnesses make us too skittish to devour what will make us well.” Yup. So, I would tell a mom to be open to many types of recovery methods and to talk to someone, anyone, me, about what is going on. Read reliable stuff (like Postpartum Progress) and listen to those with experience. There are many people and methods out there that can help you and even if you do not want to do something, at least try it because it may end up being the best thing for you in the end.
BR: Much of the book resonated with me, but it was the epilogue that hit home the most. Perhaps it is because in many ways I feel like I am in the epilogue stage of my experience with postpartum depression. It has been a year since I was struggling, and my life has overall resumed to what it was before (back to work and daily functioning) with the addition of my daughter. However, my experience with PPD is not that far behind me, and there are still frequent reminders of what I have survived, and work I continue to do to heal and make sense of what I went through.
APR: I ate the book up in less than three days. Probably a record since I had the baby. I did not bother with a highlighter or dog-earing because it would have been everything. I guess the epilogue is most resonant with me. I am also in what Katherine Stone calls the ‘PTSD stage‘ of postpartum depression and anxiety: ‘I still worry that PPD will return. I’m constantly looking over my shoulder. Every time I feel bad I’m convinced that I’ve gone back there. I feel like I’ve lost a lot of confidence in myself and I don’t know if I’ll ever get it back. I worry I hurt my child in the long-term because of how I was when he was a baby.’ I would add to this that I worry about long-term consequences on my baby of taking SSRIs and nursing her. Here is a link to “The Six Stages of Postpartum Depression”: http://postpartumprogress.com/six-things-the-6-stages-of-postpartum-depression in case you’d like to learn more about this.
Amber: Thanks to all of you for reading and discussing this book with me. Sleepless Days is one of my all-time favorite recommended reads for moms and I hope that our conversation will be helpful and will provide hope to the readers of Postpartum Progress.
I look forward to reading and reviewing Carey Sipp’s The TurnAround Mom as our fourth and final book of the inaugural year of the Warrior Moms Book Club. Look for more information coming soon. If you’d like to join the Book Club, you may email Amber at atlantamom930 (at) gmail.com and join our Facebook group.
Editor’s Note: I removed specific references to certain dosages of medication, because we try not to share that type of information at Postpartum Progress, since it may lead a struggling mom to think a certain med or a certain dosage is the cure for her PPD. What’s best for you is to work with your own trained healthcare provider to find the best treatment for you.
