Those are some big, ugly words, aren't they? It's something I thought I knew plenty about until the last six months or so. For years I spoke to patients about it, but mostly on a superficial level. When I was pregnant with Brennan, I knew I was at higher risk for PPD because I had struggled with depression in college. But I had him, experienced some normal baby blues, and continued with life. I thought I was in the clear.
Fast forward a few years. We move to a different state, 1000 miles away from our family and friends. I (temporarily) give up my career and put my Masters degree on hold to become a stay-at-home mom and ease the adjustment for our whole family. A few days after we moved, I found out I was pregnant. A few short weeks later? Twins. My whole entire world was, in the words of a young Fresh Prince, flipped-turned upside down.
In retrospect, the depression probably started during pregnancy. I endlessly stressed over my inability to keep the house "clean enough" and my difficulty balancing 3 kids before they were even born. I missed my family, our traditions and routines, being able to call someone at the last minute to babysit or just to hang out. I struggled to keep up with Brennan and keep the house running smoothly and resented that I was in this position "alone".
Life got a bit easier when our help began to arrive. One by one, family members took turns staying for a week to lighten my burden as my belly grew bigger. Having help and company lightened my mood, and this continued after we brought the boys home. Even after all of our help was gone, I managed to stay in good spirits. Maybe it was a survival mechanism, maybe it was adrenaline. Who knows. But into November my mood began to sour. I was getting more sleep, but felt more exhausted. I was edgy, panicky, sad, agitated. Short visits from family and friends helped, but I still didn't feel "normal".
These feelings were scary. I felt completely out of control. I felt like I was drowning in my own life, barely keeping my head above water. I've always thrived on stress. My best papers were always written at the very last minute. I was not just a member, but an officer of every single club possible in high school (except French club, cuz well, when you don't take French that's a difficult club to join). I went to one of the top nursing schools in the nation, was president of my senior class, and gave a speech at graduation in front of hundreds of people. In my career, I preferred the fast pace of triage to the slow, steady marathon that is labor. I loved how our team worked as a well-oiled machine during emergencies and there was nothing like the adrenaline rush that came from getting a healthy baby out of a healthy mom. Even when I found my own Brennan unresponsive and bloody in his crib when he was just shy of a year old, I remained calm and did what needed to be done.
This uncomfortable feeling from chaos was ... uncomfortable for me. Brian would look at me "the wrong way" and I would spiral into a fit of rage. I called my mom one evening when Brian was working late and all three boys were screaming and lashed out at her as she tried to calm me down. I cried. A lot. Food helped calm my nerves so I just ate. Snacked and snacked and snacked all day long. I had terrifying thoughts of awful things happening to my boys and stressed about my inability to save them. My whole body ached, I was exhausted beyond belief, but struggled to fall asleep. I didn't want people around because they would inevitably say the wrong thing that would make me doubt that I was doing this "right" or make comments like "are you sure you're getting enough sleep?" or "are you getting out to go for walks?" or "you don't look depressed". All things said with good intentions, but not good for my mental health. Worst of all, I felt guilty for all of these feelings. I had three beautiful, healthy boys and an amazingly supportive husband and I still felt sad and anxious and terrible.
In December, during a visit to my Ob-Gyn for an unrelated problem, I mentioned to him that I was feeling a bit "off". We discussed my feelings and determined that they were in fact, more severe than "baby blues". Dr. W suggested therapy and offered medication. I've been down both paths before. In college, meds helped more than therapy because I truly felt like I had nothing to be depressed about. But now, having experienced so many changes in the past year, I felt that therapy might be a better option. My doc was supportive of my decision, but also said something to me that stuck with me - he said that he'd never had a patient regret going on antidepressants, but had plenty that regretted not going on them sooner. I promised to make another appointment to discuss medication if therapy didn't do the trick.
I started therapy in January and by the end of February I was feeling a bit better. I was learning tools to battle my depression and anxiety, some of which were helping and others that weren't. The depression was beginning to lift, but the anxiety was getting worse. I can't tell you how many times I burst into tears during the day because I just had too many thoughts running around in my head that I didn't even know what I was thinking anymore. Simple, everyday tasks seemed insurmountable. Brian would suggest a family outing and I would either veto it on the spot or stress and stress about, complain, cry, be on edge the entire time, and then maybe stop to enjoy it for a few minutes before stressing about the return home and the chaos that would ensue. One afternoon, Brian was at work and I was dealing with yet another afternoon of cranky babies and I just lost it. I called him, sobbing hysterically, and told him I needed him to come home. A few days later, at an appointment with the nurse practitioner at my OB's office, I asked for meds. When the NP went out to discuss with Dr. W which med would work best, he came into the room to discuss it with me. I told him that while therapy was certainly helping, he could add me to that list of patients who regretted not going on medication sooner. He smiled and told me that we'd get me on something and get me feeling better.
I've been on Paxil for almost 8 weeks now and I'm feeling so much better. My anxiety attacks are fewer and farther between and I'm feeling less despondent and hopeless. Therapy continues to help and give me not only tools to get through life, but a place to vent. I've taken the boys to the zoo by myself on a whim and even gone grocery shopping at Target - all 4 of us. Brian and I have become quite skilled at taking the boys places that require 2 adults - like to the beach or out to eat. These outings make me feel accomplished and are often good reference points when I start to doubt myself or get anxious about something. But I still have my moments of anxiety. They're nothing if not irrational, but to me, in that moment, they're real. Terrifyingly real.
Last week the boys were having an especially whiny morning and I decided that we needed to get out of the house, somewhere other than a simple walk (yes, we walk. we walk plenty, and I must point out that our walks are not generally simple and relaxing) or out in public where we would undoubtedly have a million meltdowns. So I packed them up and went for a drive. We drove out by the ocean and Brennan pointed out the birds and the boats while I listened to relaxing music and the babies dozed. Then we headed to Brian's office to surprise him. That morning I discovered that he left his drivers license and debit card on the counter, so I decided to take it to him. On the way from the beach to his office I called. Then texted (while at a red light - don't get all worked up). Then called. Then texted (red light again - chill). I couldn't get ahold of him. Cue anxiety. It built and bubbled until I pulled into the parking lot at his office. It was lunch time, so I wasn't even sure if he was there. I didn't want to pack up the boys to go inside and discover he wasn't there or was in a meeting. I didn't have Brian's office number. There weren't any parking spots close to the door. Starting to panic. His car was there and unlocked (not shocking) so I put his ID and card inside and decided to leave. But I really needed to see him. Circles in the parking lot. Bubbling anxiety, swirling emotions, racing thoughts. I'm literally probably 200 feet from him and can't get to him. Deep breathing and centering exercises. Finally the spot in front of the door opens up. I turn on the remote start, lock the doors, run up to the office door and knock, all while being at most 10 feet from the car. Brian's coworker comes to the door and calls to Brian. Brian walks outside and I erupt into tears and fall into his arms. So many emotions flood over me - relief, frustration, confusion, sadness.
There were a million simple options I could have taken. No reason for tears or panic. Poor Brian is confused by my reaction and yet isn't completely surprised. He's seem me like this before and does what any great husband would do - just holds me and comforts me and reassures me that everything is alright. Looking back at the situation, I have no idea why I got so upset. But that's anxiety. It's not rational at all, but it's very real.