Me, Post-Partum Depression, and the People Who Sat with Me in the Dark

it is a serious thing just to be alive on this fresh morning in the broken world Invitations, Mary Oliver

Dear Grandma Vera,

You’ll be delightfully surprised to learn that I have a daughter. I know you did not expect me to have kids. I don’t think anyone did at this point (not that I am ancient, I just spent the last decade sure that it wouldn’t happen). But it did! Her name is Maia Jillian. I named her after Jilly because Jillian was the brightest light I ever knew and my eternal hope is that Maia feels that light.

I’m writing to talk about some hard stuff. Stuff I had no intention of sharing publicly as I was experiencing it. But post-partum mental health is shrouded in secrecy and shame, and I don’t want to be part of that. It is always easy to talk to you, so here we go.

I entered post-partum life with privileges many people don’t have. Good health insurance, six paid months off work, a network of family and friends to help, and most importantly (as you know) a competent, present, and emotionally intelligent partner. None of that warded off what became the most intense mental health struggle of my life. 

I knew before we got home from the NICU that something wasn’t right. To be completely honest, I started feeling wonky during my third trimester and later learned that post-partum depression can start during pregnancy. I digress. I felt an overwhelming affection for Maia three days post-partum. I remember saying to my mom, “I don’t know why I waited so long to have her.” And then it just vanished. I woke up on day four and I felt completely disconnected from her.

I told myself it was just the stress of the NICU, but of course it wasn’t that simple. When she came home a few days later, she was an alien in my home. An outsider, an intruder. I wanted someone to come take her away. I fantasized about giving her up for adoption. I dreaded holding her and her cries sent my body into full panic. I felt a powerful urge to escape and began to feel constantly claustrophobic. Thinking and feeling these things gave me such unbelievable shame. I was scouring post-partum depression boards nearly nonstop trying to find posts I related to to me feel less insane. (Shout out to Candice here, who sent me the first account of PPD that I saw myself in and made me feel much less alone.)

Soon, I began having repeated intrusive thoughts about harming myself, believing that surely Maia was much better off. My dumb brain told me I was failing, incapable, worthless. I contemplated multiple methods, including intentionally crashing my car. I developed a strong aversion to leaving home by myself because I was afraid to be in control of my car (and later learned Lindsay Clancy stopped driving due to the same fears). I did not leave home alone until Maia was nearly 8 weeks old. I even got the bizarre idea that Chas would recognize how important it was that Maia didn’t have me as a mom and kill me himself. The disturbing nature of these thoughts made me feel unstable and scared. But no matter how hard I tried I could not make my brain stop thinking these things. 

We took walks, watched TV shows that I like, I tried to read books, we had several friends and family members over, and my mom came regularly to help. Chas did everything he could to help me feel better. But what I was doing didn’t matter. The thoughts of needing to escape my child and my life ran like a loop through my mind. I was so outrageously exhausted from masking these thoughts around people that I would run to the bathroom and break down in tears after people left. I didn’t recognize myself.

When Maia was a few weeks old, I reached out to my therapist and made an appointment with a perinatal psychiatrist. I reluctantly told a few close loved ones some of what was going on so that I felt a sense of accountability for getting better and felt like people had an eye on me. It’s not that I did not want to be honest with my people, but I felt like such a burden and vulnerability is just hard.  I went into pregnancy knowing about PPD and post-partum psychosis, my risk factors (especially my preexisting insomnia), and how those conditions escalate without intervention. I felt my control slipping and it absolutely terrified me. I needed my village and they showed up. (You were always so good at building strong friendships, grams. I am grateful that is something you taught me.)

The fastest appointment I could have with the psychiatrist was five weeks away. In the meantime, I talked with my OB and she prescribed Zoloft. My medication anxiety is intense and let me tell you, I did NOT want to take these meds. I had no good reason other than a nonsense fear that they were going to make me worse. Still, I decided to try.

Over the next several weeks some things worsened while other things got a little better. I was crying less and finally eating again, but I still couldn’t sleep and my feelings of claustrophobia and detachment around Maia got worse. The weight of how ashamed I felt got harder to carry and it was increasingly difficult to separate the lies my brain was telling me from reality.

By the time I saw the psychiatrist, I was completely worn out from the wars I was waging against myself in my head. She diagnosed me with post-partum depression, generalized anxiety disorder, and insomnia at our first session and recommended a medication called Zurzuvae. It’s a 14 day medication that restores hormone levels that plummet after birth and which are thought to be closely connected to post-partum depression. This medication costs 16 thousand dollars, which is abhorrent, especially considering it is the only drug specifically approved to treat PPD. I hit my out of pocket max with my delivery complications and Maia’s NICU stay, so I didn’t pay anything for the meds in the end. 

Unfortunately, the medication made me acutely worse. I made it to day 5 and my psychiatrist told me to stop taking it. She recommended that I go inpatient and admit myself to the women’s unit at UAMS in Little Rock. I declined to go, and maybe that wasn’t smart, but I thought that environment would make me feel worse rather than better.

During our third visit, after a very long conversation about the character and pattern of my thoughts and past experiences, my psychiatrist suggested that I have OCD. Despite scoring between moderate and severe on the screening tool, I fought the diagnosis. The joke was on me because it turns out a lot of things I’ve experienced since I was a teenager that I attributed to anxiety are plain old OCD. My doctor started me on an antipsychotic at a low dosage to reduce the persistent cycles of rumination happening in my brain and transitioned me to an SSRI that is used to treat OCD. 

Here is where the story turns in a positive direction (woohoo!). After only a week on the new meds, I felt a shift. I started experiencing a decrease in the intensity of my ruminating. By two weeks, my ruminations decreased by over 50%. By three weeks it was 75%.  I went full days without intrusive thoughts of suicidal ideation. The relief this brought me cannot be overstated. I also got an Ativan prescription which finally enabled me to get some sleep, which my brain desperately needed.

With the ruminations starting to quiet, my brain made room for my relationship with Maia. I am slowly, finally starting to bond with her. At ten weeks old, I told her I loved her for the first time.  She is twelve weeks old this week and for the first time I look forward to holding her when she wakes up in the morning. Her smile brings me joy, and I wish I could bottle the sound of her tiny voice and carry it with me forever. While I am not completely out of the woods, I can definitively see the sunlight breaking through the trees at the edge of the forest.

I have no way of knowing how out of hand my condition would have gotten if I didn’t have the support system and doctors I do. I do know that I needed intervention. I know how imperative it was for my providers to do their jobs well. I know that post-partum mood disorders need so much more research and understanding and attention. Arkansas is the only state in the country that ends Medicaid benefits for pregnant people at 6 weeks post-partum. Six. Weeks. If I was someone relying on Medicaid for health insurance, I would not have been able to see my therapist, my OB, or my psychiatrist when I desperately needed them. This is a disgusting policy choice that does harm every single day. 

Several friends who are moms shared with me that they experienced PPD and various other post-partum mental health struggles after I shared my own struggles with them. I hate that I didn’t know they were struggling when it was happening. I hate even more that some of them said they were too afraid to mention anything to anyone, even their doctor, because they were scared no one would understand them or be able to help. And I hate that there’s a chance they were right—that their doctors would not have understood or done enough to help them. 

Having babies is hard. I know everyone says and technically knows that, but it is a kind of hard that a person cannot know until they experience it. For anyone reading this, be like my grandma and check on people. If someone in your life has an infant or young child, show up for them. Hold space for them. Take care of them. Having kids is obviously something millions of people experience, but that doesn’t make it easy or simple. No one is meant to do things like this alone.

I missed you so many times over the past three months, Grandma Vera. You and Jillian. I know you both would have reminded me that I am not broken. You would have taken a blunt approach and told me there’s no way through it but through it and Jillian would have shared with me the bottomless compassion that made her so special. I wish Maia could know you both, and in her own way, she will.

I don’t know how to wrap this up other than to say that the people who spent time with me while I was in such a difficult, messy place made all the difference. There is no better counter to shame than love and boy am I lucky to have a lot of it. To my parents, Chas’s parents, Beth and Jim, Kelsey, Candice, Sarah, Nikki and Colin, Hope, Chloe, and Carol, and everyone else who sat with me in the dark: you mean the world to me and there aren’t enough ways to say thank you.

To my Chas (Grandma, you are still right about him being a good one): there is no one else on this earth I would choose to do hard things alongside. You insisted on loving me loudly when I wanted to hide from the world out of shame and guilt. I will never forget the ways you show up for me.

To my Maia: man, oh man does this life hold some hard seasons. I hope your tiny brain doesn’t hold onto my sunken eyes but instead my songs and smiles. I am glad you’re here. I don’t really know what I am doing, but we’ll keep figuring it out together every day. You are already so strong and curious, and I feel incredibly privileged to see the world through your eyes.

I hope everyone reading this has people who will sit in the dark with you when you need it, too. At the very least, you have me. ♥️

Lexi