Today’s post comes from Dr. Aparna Iyer, a board-certified psychiatrist and assistant professor at UT Southwestern in Dallas, Texas. She also has a private practice in Frisco, Texas.
By Aparna Iyer
I am a psychiatrist who treats mental health issues during pregnancy and the postpartum period. I had thought that this would somehow make me immune to postpartum depression, as though I could have seen it coming from a mile away and warded it off. But I was wrong. Quite frankly, I never thought it would happen to me.
After nine months of a blissful, uneventful pregnancy, I had an emergency c-section when the baby’s heart rate dropped. Although I imagine I could have been thrilled with the prospect of simply having a healthy baby, I instead found myself in a fog afterwards. People kept gushing over the baby, saying how beautiful he was, but the reality is that I couldn’t see anything past that fog.
My family and friends started to notice as I became progressively more detached and dysphoric. Many friends wondered why I kept dodging their calls or avoiding their requests to come over to see the baby. It just seemed like such a unsurmountable chore to even get dressed in the morning and to put on a smile to meet people, to give off the semblance of the romanticized mother-baby experience that we are all so convinced we will have.
A rock amidst the choppy waters — it’s what we psychiatrists aim to be. We strive to be the calm that our patients need during their darkest times. But in those moments, I found myself immersed in the deepest of those water, grasping for anything that would give me a moment of relief. I was shocked that I, someone who works to give her patients relief from such struggles, could be experiencing it myself.
The reality is that postpartum depression does not discriminate. Although it can impact certain groups of people more than others, it really can happen to anyone. It doesn’t care whether you’re younger or older, rich or poor, healthy or medically complicated. Frankly, it didn’t give a hoot that I was a psychiatrist either. It arrives, often unannounced, angry and ready to plunge us into a vortex of sadness and irrationality. It drives a wedge between us and our friends, family, partners. It leads some of us to act dangerously, towards ourselves and our newborns. In fact, around 80 percent of women report mood changes in the postpartum period, and about 15 percent go on to experience postpartum depression.
And yet, we cannot talk about it. The reality is that we’ve spent the better part of the last nine months preparing for this beautiful experience. We’ve had the baby showers, sifting through countless names to find the perfect one, reading numerous books on parenting philosophies to find the one that fits you best, wondering how you’re going to do anything productive on your maternity leave when all you want to do is stare into those gorgeous little eyes. And now this — is this the ultimate failure, many of us wonder? It’s hard not to believe that it is, although thankfully the world and the medical community have slowly started to truly understand postpartum depression for what it is: an unfortunate but common medical phenomena, one of the most common side effects of pregnancy.
Oftentimes women come into my office seeking help for postpartum depression and various other postpartum ailments. Many describe the struggle to keep their symptoms a secret, trying so desperately to maintain the image of that idyllic beginning of motherhood. Those of us who have experienced postpartum depression know that can be a strong sense of shame and stigma surrounding postpartum mental illness; likely some of this stigma is perpetuated by the pressure placed on mothers to do it all in a seemingly effortless, fashionable way in a society that sneers at the very concept of depression.
Depression and anxiety during the postpartum period need to be taken seriously, by the postpartum mother, her partner, her family and her physician. It is everybody’s job to compassionately support the mental health and wellbeing of the mother and her baby. Untreated postpartum depression can have terrible consequences. These mothers are less likely to get postnatal care, more likely to self medicate with drugs and alcohol, and ultimately this may all result in their babies experiencing worsening outcomes.
Luckily, postpartum depression is very treatable. In many cases, these women can opt for talk therapy, which is often sufficient and a great source of relief and support. In some cases, we might have to also add an antidepressant. While this can make a patient nervous, especially if that patient is breastfeeding, many of my patients feel more confident with this decision once I present the data regarding the risk profile of antidepressants versus the risks of uncontrolled depression or anxiety.
Depression at any stage of life can be a debilitating experience, and I am not glad to have had it, especially during a time I would have wished to have enjoyed bonding with my baby. However, I suppose that this could be viewed as an extension of my training, an opportunity to have experienced what many of my patients experience. Sometimes when my patients are in their darkest times, I express to them that I can see the light, the relief, at the end of this tunnel, and that they have to trust me that we can get there. As I write this and pause frequently due to my now three-year-old rambunctious toddler smiling up at me and vying for my attention, I smile back and am grateful that I reached the light at the end of my mine.
I have just learned that when you give birth your thyroid becomes underactive. Looking like I had post partum depression I actually became full on hypothyroidism. I thpught I was just tierd.. Maybe if I got some more sleep I would be ok. Then I realized due to the tramatic birth of my child I had stress from that. After a year of nursing I thought maybe my hormones are changing when my hair turned dull and skin went dry. Then I thought maybe it was because I had my first baby in my late thirties when I developed wrinkles all over my face and quickly went gray and couldn’t loose the baby weight. Then I thought it was the weight and that I was always mommy and didn’t feel like a woman anymore when I had no libido and didn’t even want to be touched. I tried food I tried exercise I quit shampoo I made all my own lotions soap deoderant all in vain. I just kept getting worse with random aches and pains and stiffness not being able to get out of bed. Then when I did I had to sit or lay down on the couch. I got random allergies one cold after another the worst was when I had bronchitis and laryngitis ay the same time! I was convinced there was mold in my house. A change of season came and no mold was found so finally I went to a dr about my hormones I thought maybe that was the problem. I had the nextplan put in my arm. I also thought this would help my libido because I was afraid of getting pregnant so I wanted nothing to do with sex. I thought that was the problem. I thought I was angry at him too. It was like he didn’t listen or didn’t get me anymore. Let’s be honest he was tired of anytime he talked to me I said I don’t feel well or I’m sick. So when I got the birth control the dr said your TSH is elevated come see me if you feel like your thyroid is causing too many problems. I now know that means the thyroid is not doing its job so the pituitary gland is working harder to get your thyroid to keep up with the demand. Originally I didn’t think much of it not until the next set of symptoms hit. I had always had some constipation since I had quit smoking when I found out I was pregnant but it got bad. One point a hasn’t gone for a week! When I did I had to sit there for like 30 minutes and it felt like it was stuck and was horribly painful just to get a few pebbles out. So this was not the worst part what finally broke me down completely was the heart palpitations. I had a resting heart rate of 126 and it felt like I couldn’t function at all! I just laid there and felt sicker than I had ever felt. I’d try to get up to take care of my son who is now 3 1/2 and I couldn’t. I googled hypothyroidism and the heart and thats when I went to the dr. Turns put for the most part you have a slowed heart rate but at times the heart will race and the throid controls it by sending signals but the resting racing can cause the heart to start beating the wrong way causing permanent damage. I was at the dr the next day asking for thyroid medication! It will take a few months but I am also eating food that is good for the thyroid and taking supportive herbs and vitamins. This is only week two and I am still exhausted but at times I feel normal. Even if it is only for an hour or two it feels good and gives me a glimpse of what I use to be and what I could be again. I am writing this because now I know that after every women gives birth they go into a hypo thyroid state between baby month 3 to 6 many women come out of it. I didn’t. Hypothyroidism also causes brain fog and depression not able to loose weight eye problems immune problems and on and on. Before antidepressant existed depressed people were treated with thyroid medication. I thought I had mental trauma from birth I thought I was depressed I thought there was mold in my house I thought I developed allergys I felt like I was having heart problems and I routinely forgot how to do every day stuff like turn my dryer on. It is all just my thyroid. So mommy’s every where please please if you are having a hard time do seek counseling do reach out to friends and family and do get your thyroid checked! It is a much friendlier road to travel then getting hooked on anxiety meds or a.d.d. meds or painkillers. Due to all the symptoms of hypothyroidism you could accidentally get prescribed any or multiple kinds of those meds. Just fyi I am 38 years mom of 1 boy and weight 150lbs and I’m 5`7″. All my other numbers are in a healthy range. I still make my own shampoo and conditioner and deodorant and lotions and toothpaste. I’ve been to tierd and have been out of my supplies and bought natural products and I don’t even like thoes any more. I hope this helps.
Thanks for sharing! I am Nurse and after giving birth to my second child I find myself in the deepest darkness I ever been. The guilt hunts me more than anything. I have everything, a wonderful husband, a home a job, healthy beautiful kids, why do I feel this way?? The baby is now 7 month old and he doesn’t sleep through the night. I blame it all in the lack of sleep, but lately I’ve had visions of hurting myself… of “ending this miserable feeling” and I am so scare! I can’t bear the thought of never seening my kids again…. I have been avoiding going to the M.D. because well I know what they’ll say. “You have to take care of yourself, talk to a friend, get pamper” I know that, but I don’t have that luxury, I am calling my pcp today.
By reading your post and others, I find hope that I too will be okay.