Mommy, Deconstructed: - A Postpartum Depression and Anxiety Recovery Guide

Chapter 2

The Acute Phase

We can’t really let go of pain. We have to catch hold of something else that distracts us and then pain falls away on its own - A.B. Curtiss

If you are reading this book, you have suspected a PPMD or have a formal diagnosis of it. This means you have already made remarkable progress in your recovery. You know you feel like shit and you want help to feel better. I know that right now, your mind feels jumbled up and your decision-making skills are not at their best. Therefore, you are going to take each step one at a time, and I have strived to give you step-by-step, easy-to-follow suggestions.

I know you are scared. If I could, I would reach through these pages and hug you tightly and tell you it will all be okay, because it will… I promise. The recovery rate for PPD is one-hundred percent when it is treated. You will get better. You will feel like yourself again. Unfortunately, I do not come equipped with a crystal ball, so I cannot know for sure how long you will feel awful, but I do believe you can help yourself feel better in the meantime. These techniques are not meant to spontaneously cure you; they are meant as an adjunct to help until medication (if prescribed), therapy, and time can lessen and then eradicate the power of the postpartum dragon so that you can function as well as you possibly can.

I remember my PPMD hitting me like a ton of bricks. One day I was normal and then had a panic attack out of the blue, and the next day I couldn’t express my feelings to anyone. I just felt despair and hopelessness and complete doubt in my ability to be a mom. I felt out-of-control and thought I was going insane. Other women have a slow build-up of symptoms and it is harder for them to recognize PPMD because it comes on so slowly. Everyone’s story is different. So is everyone’s recovery. How you are feeling is a phase. It will get better. Here’s what to do in the meantime:

Before you delve into the self-help section, I would like to mention that you should make sure with your OB doctor or your medical doctor that you do not have a medical condition that may be mimicking the symptoms of a PPMD. Women who have just given birth can have thyroid issues, pituitary imbalance, or other medical reasons for the symptoms that they are experiencing. It will be beneficial to rule those out right away.

Breathe

Whenever I feel blue I start breathing again - L. Frank Baum

You will need to carve out time each day for deep abdominal breathing. You’re thinking “Great, I thought the magical answer was on this page and the first thing she tells me to do is breathe?” The reason it is the first thing listed is because it is perhaps the most powerful.

Before you slam this book shut, let me tell you the reason behind this simple exercise. Believe it or not, breathing has a direct effect on your nervous system. When you control your breathing, you have the power to stimulate your nervous system or to relax it. Shallow, erratic breathing can be the result of anxiety and stress, or it can be the CAUSE. Intentionally breathing with control, with slow, deep breaths helps to calm the mind. This is not bullshit. This is science, and it is why yoga can be so relaxing. Yoga helps you to be intentional about your breath. That kind of breathing relaxes the nervous system, which in turn relaxes the mind and brings forth feelings of well-being. Deep relaxing breathing functions to reduce stress in your body. Part of the reason you feel so unlike yourself is because you are sleep deprived and stressed, and your nervous system is too stimulated. Your body is saying, “Enough! I can’t take this anymore!”

In his book Unstuck: Your Guide to the Seven-stage Journey Out of Depression, Gordon (2009) ,writes about how symptoms of anxiety and depression are actually signs that we should play close attention to: “Your rumination and self-blame, your unhappiness and exhaustion, your weight loss, sleep disturbance, and pain-all these signs and symptoms are letting you know that your life is out of balance” (p. 57). Part of bringing balance back into your life is to reduce your body’s stress response. This is a simple but powerful way to de-stress.

The instructions for Diaphragmatic Breathing were taken from The Pregnancy and Postpartum Anxiety Workbook written by (Wiegartz &Gyoerkoe, 2009). Sit or lie down in a comfortable position. If you are more than twenty weeks pregnant, or if lying flat is uncomfortable for you, lie on your left side or sit in a semi-reclined position.

1. Let go and relax any tense muscles.
2. Turn your attention to your breathing and take a few deep, slow breaths through your nose. Focus on your breathing and feel yourself starting to relax.
3. Place one hand on your chest and the other on your abdomen, right above your belly button.
4. Try to move the location of your breathing from your chest to your abdomen. Your chest should remain still. Your stomach should expand and contract easily and effortlessly with each breath.
5. Once you’re breathing into your diaphragm, try to slow your breathing down by counting to three as you breathe in and again as you breathe out.
6. When you’re breathing at a pace of three counts in and three counts out and you are breathing into your diaphragm, continue for approximately ten minutes.
7. Focus on the feelings of relaxation deep breathing creates. Enjoy. (p.37)

Do deep breathing at least twice a day. The purpose is to relax your overworked nervous system. Breathe in calm and peace, and breathe out anxiety and tension. You can even say that to yourself as you slowly breathe in and out. You will probably notice an improvement right away, but you will benefit from continuous practice. In fact, you should do this sort of intentional breathing for the rest of your life, even when your symptoms of PPMD are gone.

Today’s world is overly stimulating. There are always lights on, phones ringing, TVs, kids whining, etc… We have to all find a way to sit in silence and focus our breathing and release the built up tension that we might not even be conscious of.

You may also want to try Progressive Muscle Relaxation as a way of reducing tension. The reason I love this exercise is that it teaches you what tense muscles feel like and it teaches you what relaxed muscles feel like so it guides you to be more conscious of tension in your body. When we are tense, we tighten our hold on things; we store that tightness in certain muscles. Becoming aware of that feeling of tension helps you to recognize it and then release it, thereby releasing the body’s stress response.

When you are feeling better and would like to explore additional breathing exercises to help avoid anxiety and depression, please read Weintraub’s 2003 book Yoga for Depression.

Support

Support from every direction will help you immensely. Throughout this book, you will see all the various ways you may find and utilize support. To support is to bear part of the weight, or to keep upright. If you don’t find a way to be supported, you will always feel like you are bearing more weight than you can handle. This increased need for support is temporary, but essential to feeling better, faster.

Find a Psychiatrist Who Specializes in PPMD

This will feel like a gigantic task; therefore, I think it would be helpful to ask your husband, best friend, mom, or other support person who loves you to help you to do this. This task is of utmost importance, because finding the right doctor the first time around will help you to recover faster.

It would be lovely if you lived in Rosemont, Pennsylvania or Turnersville, New Jersey because then you could schedule an appointment with Karen Kleiman at The Postpartum Stress Center. (Karen is an expert in the field of PPMDs and authored several books on the topic.) At that center, you would have access to experts in the care and treatment of women with PPMD. There would be psychiatrists and therapists who help postpartum women all day every day.

All of us deserve the kind of care that is offered by Karen, and on her website,(postpartumstress.com) there is a list of therapists and doctors who have gone through Karen’s training program. If you cannot find a practitioner in your area, you will have to find a specialist by contacting your local hospital’s postpartum support line, or you can call your OB to see if they have any recommendations. You may want to start by calling Postpartum Support International. You can leave a message and a volunteer will call you back, supplied with your local area’s postpartum support coordinators who can direct you to the right help.

In general, I believe that if you can, you should see someone who specializes in PPMDs, and those coordinators have a list of psychiatrists and therapists who treat patients like yourself every day. The telephone number for Postpartum Support International is 1-800-944-4773. A volunteer will call you back and will give you the name and number of your local coordinator.

When you see this doctor, they should be educated about PPD and its varying symptoms. They should be compassionate and confident in their ability to help you to heal. They are usually experts in medication but not talk therapy so it makes sense to see a therapist in addition to your psychiatrist. If your symptoms are not acute, your first step can be to see a therapist.

Find a Therapist who Specializes in PPMDs

Every mom that walks into my office is there because she is a great mom….even if she can’t see it yet. -Kate...