postpartum depression

Every once in awhile I receive an email from a complete stranger asking me about my experience with postpartum depression. In many cases, the writer found me by searching for things like "crazy to want a second kid after postpartum depression?" and clicked on the link for the State of Grace that Google provided.

I feel humbled that my post, written one year ago, continues to resonate with people. I wrote it, in large part, because I wanted my long distance friends and family, for whom the blog is one of our only forms of communication, to know that I was fine, fully functional after the birth of Julia. Yesterday, I got another email from a woman in the midst of postpartum agony, and my heart aches for her, as it aches for the former me that struggled after Grace's birth.

With that in mind, I thought I would re-post my original entry about PPD. There's no two ways to cut it, depression sucks, but the person I am today, a woman for whom I feel a great deal of pride and compassion, is a much better human being and mother for having weathered the storm.

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How are you doing, really?

I’m asked this question, or some variation of it, nearly every day. I listen to the quick intake of breath as the person asking waits for my answer, hoping for a positive response. About a month ago, my mom asked about my state of well being, and I replied “I’m okay.” “Just okay,” she said, worry creeping into her voice. “Yeah, Ma, just okay, not I’m getting depressed-okay, just okay.” She sighed in relief.

My loved ones ask these questions for good reason. In the three months following Grace’s birth I slowly descended into a devastating depression. By the time everyone, including myself, realized that I needed intervention I had stopped feeling nearly every emotion, save for overwhelming sadness. My depression was so deep and dark that my parents came running to Augusta. When they left, my sister started her vigil, traveling to Augusta every weekend for two months. Slowly I regained my life, rebuilt myself and finally bonded with my beautiful little girl, my Grace. It was a long road to travel.

There were a lot of things that contributed to my depression, including a traumatic birth experience and a difficult recovery, a colicky newborn who screamed for hours on end, refused to breastfeed or sleep, new motherhood in the absence of geographically close family support, and perhaps most importantly, my own history of depression. While the signs of depression were painfully clear, both Craig and I failed to read them, and I think in my own case, I didn’t want to read them because admitting I was depressed meant I was a failure as a mother. Or at least that was my thinking at the time.

With help from Craig, my friend, Quentin, and my family I did make a full recovery, but not without outside help. This help came in the form of psychotherapy and medication, and it wasn’t until Grace was seven months old that I could say with absolute belief and confidence that I was, in fact, a good mother, the best mother Grace could have. Who else knew her so well, sacrificed so much, and grew so much as a result of being her mother. Yet at the same time I felt that having made it through postpartum depression I would never have another child.

So it was with great deliberation and some hesitation that Craig and I decided to conceive another child late last summer. My biology had started whispering in my ear when Grace was 20 months old. That whisper turned into a roar when she turned two. To my great surprise I wanted to have another baby. As soon as we made the choice to try, I became pregnant.

We knew that in order to be successful during the postpartum period of this pregnancy, we would need to take a number of steps. First, I would need a healthcare provider whom understood not only postpartum depression, but my depression in particular. My search for a caregiver eventually led me to a wonderful midwife: a woman who listened intently as I related the story of Grace’s birth and my subsequent depression. This was also a woman who intuited how and why my depression occurred even before I gave her all of the details.

Second, I knew that I wanted and needed a different birth experience. Unknown to me at the time, I was not a good candidate for an epidural with Grace’s birth. Unfortunately I got one, with disastrous consequences. Epidural out, I needed to have natural childbirth with this baby. To birth naturally, one must be physically and mentally prepared. Jeri, my midwife, got me in contact with a natural childbirth educator, Belynda. Over eight weeks Belynda prepared Craig and me for what to expect. In the end, I think her greatest gift to us was self confidence. We knew with absolute certainty that we could birth naturally. We also read a lot. Ina May Gaskin’s Guide to Childbirth was our bible. We actually became pretty militant about our birthing style.

As another step, Craig and I made a pact with each other. It’s pretty long, and it includes all the watch signs. It also gives him permission to watch over me, worry over me, question me, and probe my state of mind. It reminds us that we can and will get through another depression should it occur. The depth of my relationship with my husband makes the pact unnecessary in many ways, but reading it aloud to each other cemented our commitment to a healthy postpartum period, come what may.

Finally, the last step was to take preventative medication. I started six weeks before Julia was born. This was a difficult choice to make, but one that both Jeri and Craig felt was absolutely necessary, and in the end, I did too. Why run the risk of losing precious time with my baby to a depression that we could prevent? I worried about the health consequences for the baby. In the end, the consequences for me if I don’t take medication, are far scarier.

So this leads me back to the question I posed at the beginning, how am I doing, really? I can answer that easily. I’m well. Happy. I had a wonderful, wonderful birth experience. Rather than feeling broken, I felt empowered and full when Julia came into the world. Julia, as it turns out, is not a colicky or difficult newborn. She sleeps and eats like a champ. She smiles at me constantly. It’s easy to be a mother this time around.

I still keep watch. I know Craig does too. I also know that the medication works. I knew it before Julia was born. Like it or not, medicine helps me keep an even keel. It allows the rational voice to come through. It helps me to roll with things, not blame myself so easily. It may be a crutch, but I don’t care. I am able to enjoy both of my girls in a way that I couldn't enjoy Grace after she was born. This is an immeasurable gift. I wouldn’t trade it for anything.