During the first couple of weeks after the birth of my baby girl in breech position (you can read the whole story here), I was an emotional mess. I could be very happy and suddenly be crying. This is known as the baby blues and completely normal after going through an emotional rollercoaster like childbirth. Most women start to feel better after a couple of weeks, for me, it, unfortunately, got worse.
The start of the Postnatal Depression
I can hardly remember anything from this time or from my little one so I can’t exactly say where it went downhill. Breastfeeding was unsuccessful as latching on still did not go well (my baby girl could not move her head due to the uncomfortable breech position she was in for weeks) and I more and more disliked to pump. Pumping felt very degrading to me and at some point, I just did not want to do in anymore. So I had to give up breastfeeding. This was mentally very heavy for me as I really wanted to breastfeed my baby. I hardly ate because I felt so miserable. This, in combination with breastfeeding, made me lose the pregnancy weight fast and I became even weaker.
Also physically I did not do so well. My pelvic floor was damaged so bad it hurt to even walk and turn in bed. This already caused pain before due to the delivery but afterward, it became much worse. The stitches from the episiotomy did not hurt luckily. The damage to my pelvic floor at one point was so bad that I was unable to stop feces. This was very embarrassing and of course, did not help my mental well being.
My boyfriend took a week from work and received the second week from his employer. After these two weeks, I was on my own. The first day he was back at work felt weird. I was extremely alert and restless. I just could not relax. Taking care of myself and doing household chores took me a lot of effort. Brushing my teeth and combing my hair felt like a day job. To me, it felt like time just moved very slowly. Looking back, these were the first symptoms of depression. I also had great difficulty with being alone. My sister in law advised me to make an appointment with my doctor. She already suspected something more was going on. Normally I have to wait over a week to see my physician. Now I could see her after 2 days. Apparently, my appointment had increased urgency.
Feeding my baby, in general, had become an issue because of the bad experience with breastfeeding and pumping. At one point I had a very hard time to even feed my baby with a bottle. I was increasingly having a hard time taking care of my baby. A day later I completely fell apart. I had panic attacks one after another. Hyperventilating, dizziness, tingling all over, and everything that comes with it. I could hardly walk, let alone take care of myself or my baby. My boyfriend came home and in consultation with his employer, he could take several weeks of care leave to take care of me and his newborn.
The next day I had an appointment with the physician. She immediately saw that this was more than the baby blues. She prescribed an antidepressant and slowly the dosage was increased. She also referred me to a psychiatrist. Just to be sure, she also checked my blood. Luckily, this was all normal.
Because of the long waiting period (3 months!) for the psychiatrist, I also saw someone from the mental care support of the physician's office. She mediated with several psychiatrists to shorten the waiting period. Another facility gave women with PND priority as it is a whole family that is affected. This facility had a waiting period of 6 weeks.
The time until the appointment with the facility was though. Before antidepressants start to work, the symptoms became worse. In short, I felt like all I have been doing those days was aphetic looking out of my eyes. I could hardly do anything. I could barely do personal hygiene. I had great difficulty eating and drinking. I felt numb and empty. I also felt very guilty because I did not feel any affection or connection with my baby. I cried a lot. Sometimes this was caused because I felt guilty or because I felt so needy. Sometimes there was no reason at all.
Every time, just as I began to feel a little better the dosage was increased. With every increase, the symptoms first became worse before it gets better. I spoke with my physician every week. Either face to face or over the phone. I also met with the women from the mental care support but this did not help at all. It was nice that I could take to someone but I did not feel like I made any progress. She gave me a book to help me with the panic attacks. I had to do assignments to find out what caused the panic attacks but I got stuck pretty fast. I still had multiple panic attacks per day and she wanted to know what caused them and what goes through my mind when they happen. I did not know what caused them and had no thoughts when they happen. The only thing that was constantly on my mind was that I no longer wanted to be in this situation. I just wanted to step into my car and leave. Away from everyone and everything. This also is a symptom of depression.
The weeks prior to the first intake at my psychiatrist were though. All the care for my baby was done by my boyfriend. With this, I really mean all the care for the baby both during the day and during the night. Every now and then I gave her the bottle but even though she was now bottle-fed, it was still difficult for me to feed her. Apparently, the breastfeeding period had hit me hard enough that even bottle feeding my baby was causing panic attacks.
Looking back, I can see how mentally distressed I was that I couldn’t even feed my own baby.
For my boyfriend, who was now fulltime taking care of his little girl and me, this was also very hard. While he enjoyed taking care of his baby, he saw his girlfriend sink further and further. I could feel this happening but I was unable to stop it. I had very bad anxiety and felt very guilty towards my boyfriend and the little one. I did not feel any bond with her at all. I felt like I had to take care of her but I could not make my body do it.
It was weird not being able to feed her while I had no difficulty changes a very full diaper. I actually somewhat enjoyed changing her diapers. Maybe it was because I could finally use the cute cloth diapers I bought a while ago. Also bathing and dressing her I did not mind doing. These are very clear signs that somewhere during the breastfeeding period something went very wrong.
While I waited for mental help, I saw my pelvic floor physiotherapist often. With her help, I could do exercises for the recovery of my pelvic floor. Within a week I no longer had incontinence and after a few weeks, I was able to walk again without pain and could even turn in bed without it being painful. After two months I could even workout again. I have always done a lot of weight training but towards the end of the pregnancy, this was no longer possible. When I started lifting again, muscle memory kicked in and soon my strength was returning. This also helped with my mental well being. Before I always thought that people who are depressed should just work out more. Maybe I was a little naive. All I knew was that working out makes your body produces endorphins and endorphins make you happy. This should help people who are suffering from depression. Now I know better.
Exercising can indeed make you feel better when you are a little down. When you are severely depressed working out does not help with your mental well being. I have always been very disciplined. Also when I was severely depressed, I worked out twice a week. Only now I did not feel better after my workout. I did like the fact that my body was recovering so well after the delivery of my baby but my mind did not follow.
First talk with Psychiatrist
The first consultation was though. This talk was not with a psychiatrist but with a psychiatric nurse of the department. I had to tell my complete story again even though they received everything from the doctors. Every time I tell my story it remains difficult but it also helps to digest everything that happened. The nurse wrote everything down so the psychiatric team could diagnose me. Afterward, the treatment could start. Next to telling my story I also cried a lot (again). Lots of questions were asked about what happened and how I felt.
Unfortunately/Luckily (?) I can’t remember details of what happened. In the end, I also had to answer questions on a computer. These were much more general about alcohol, drugs, anxiety, and suicidal thoughts. It all took about an hour but I was completely drained afterward. I couldn’t do much the rest of the day and also the days afterward I still felt how tough this was for me. After each talk with the mental care support of the physician's office, I was also tired but now it was much worse.
I have memory loss for the most part of my severe depression so I don’t know how bad I used to feel but there is a big downside. I don’t remember how bad I felt back then but I also don’t remember my little girl from that time. This last part is hard for me. She is so small for only a little period of time and I can hardly remember anything about it. Luckily, my boyfriend took lots and lots of pictures that I now can look at.
It took about two weeks between the first consultation and the diagnosis. I really had to recover from the consultation with the psychiatric nurse. I slept a lot and had severe headaches.
By now my baby was also not doing well. We went to the hospital a lot (during this time I was in the hospital about once a week. Either for me or for my girl). My baby hips did not develop properly because of the breech position and the breech birth. She had hip dysplasia. Her setbacks were not good for my mental well being either.
About two weeks after the first consolation with the psychiatric nurse I got a phone call with the diagnosis and the plan of action. I actually did not care so much about the diagnosis as long as there was someone who would help me but apparently, my health insurance company also wants to know. I hated feeling like this and having these negative feelings towards the baby. I did not want to feel like this but there was nothing I could do about it.
I was diagnosed with postpartum depression. This was not really a surprise. next to this, I was also diagnosed with post-traumatic stress disorder (PTSD). I did not suspect this. I always thought that only people who have been through something terrible (like war) could have this. Apparently, anybody who feels like they have been through something horrible can have this. It will differ per person how they react to certain situations. Some will have no problem with it while others have to go into therapy. In my case, the fact that my midwives did not notice the breech position of my baby was something so severe to me that it traumatized me.
The plan of action would be therapy sessions with a psychiatrist for the depression and EMDR for the trauma. I had never heard of EMDR. EMDR (Eye Movement Desensitization and Reprocessing) is in short, resetting of the memory that caused the trauma by alternating left and right images or sounds.
The first therapy session took place soon after the diagnosis. These talks were hard for me and it took me a long time to recover from them. Each time, there was an hour planned for but I never held on that long. I found it hard to carry and follow conversations. Especially when they were about a personal or hard topic like with the psychiatrist. These were extremely hard on me and after a while, I could not register or answer the questions that were asked anymore. I could feel it in my head that the conversation was getting harder. It felt like my head was getting foggier.
Some sessions were better than others. Sometimes I could make it to half on hour, sometimes only 15 minutes was enough. I just couldn’t hold on longer. I could hear something being said but the information did not register. These sessions continued for several months. The sessions were mostly about the obstacles I encountered, what was going through my mind that week, and how I was doing as a mom.
Sometimes the period around my labor came up. I often had to cry during those sessions but I did not mind that. I was making progress very slowly but talking to someone about this once a week was nice. She also advised me to track my daily well being by grading each day and reflect on how that day went and if it did not go so well, why. I like this because this way I was also able to track my progress day by day.
After a couple of months, I started to feel better and after a while, I felt so good that I want to reduce my medication in consultation with my psychiatrist. I thought, if I get to be pregnant again, at least I don’t have these meds anymore. My psychiatrist agreed and wanted to guide me in this as I had been doing better for a while now (about 8 weeks).
Reducing antidepressants has to be done very gradually as immediately stopping would almost certainly result in a setback. I received a lighter dosage of my medication so I could reduce it in small steps at a time. The first two days with the new dosage were fine as I did not notice any differences. Then the withdrawal symptoms started. I had severe headaches and fatigue. I was hardly capable of doing anything. I felt like my body was working very hard for something while nothing was shown on the outside. I did not feel down or sad which was positive. The headaches and fatigue lasted about 3 to 4 days after which I felt a lot better and was functioning again.
The next step in adopting a lower dosage, this whole cycle happened again. The first days were ok and then the headaches and fatigue started again and after 3 days I felt better again. As I felt like I was taking a too big step in medication reduction I consulted my psychiatrist and we decided I should stay on this dosage a while to give my body some rest. When I felt strong enough again I would take the next step.
Unfortunately, I started feeling worse again. I felt down and started to cry a lot again. The psychiatrist wanted to increase the medication again but I wanted to wait and see what happens. I had been through so much with the reduction of the medication that I did not want to throw that again. I really did not want to go through all those withdrawal symptoms again.
The next days only got worse. I cried even more and by now it was limiting me. Also, the negative thoughts about my baby girl started again. The latter I thought was horrible so as soon as I noticed this I started using my former dosage of medication again. Maybe I should have been more subtle about this by increasing in small steps but it was a weekend and I wanted to get rid of those negative thoughts immediately. This resulted in being a bit hazy the following day.
In short, this attempt at quitting with antidepressants was not a success. I do know what to expect next time I give it a try and I will take more time in doing so.
Quitting antidepressants (again)
All in all, I have been using antidepressants for about 2 years before I did a second attempt to quit. This time, I took similar small steps and the withdrawal symptoms were not as severe. The most difficult step was the last step, so completely quitting the antidepressants. This last step did result in withdrawal symptoms but because I determined to not start taking these meds again I was looking for something else. The first day with heavy withdrawal symptoms I took oxazepam which is basically changing one addictive substance for another which is not solving the problem.
As my withdrawal symptoms mostly involved feeling very anxious and restless I very carefully googled what other people did. Using a different medication was not something I was looking for so I skipped that but I read one story in which running was recommended. I used to run but haven’t done it anymore since the pregnancy. As I still had all the gear available, I changed clothes and started my first run in years.
Right before this run I was experiencing server withdrawal symptoms and felt very anxious. When I start this run I immediately felt like a weight felt from my shoulders. If felt so good and I ran so fast… I immediately ran the same lap I used to run (about 5k) without problems. It completely cleared my mind and gave my body so much peace afterward.
Running became my new antidepressant. In the beginning, I ran every day, just to prevent myself from feeling anxious. Nowadays I can run every other day before my body starts to feel restless.
All in all, my entire depression chapter has changed me and made me a better person and I hope that my story will help other women who are currently fighting a PND.