Unlike postpartum depression (PPD), postpartum anxiety (PPA) can be difficult to diagnose. Thanks to increased awareness, though, more moms are on alert for signs they're experiencing something more than the baby blues. But if you have PPA, you won't necessarily present as depressed (although sometimes the two disorders go together). All you know is something is "off." Because it often goes unrecognized and untreated, it's known as a hidden disorder. I didn't even know I had it, so of course I was afraid to ask for help when I had postpartum anxiety.
I was aware that I had mental health issues pretty early on in my life. My obsessive-compulsive disorder (OCD) developed in junior high school, where it manifested as mysophobia, also known as a fear of germs. Shortly after my college graduation, I was diagnosed with major depressive disorder. I was 28 when anxiety first reared its ugly head. My mind isn't always a fun place to be, only because I have a cocktail of disorders to contend with. Knowing my own mental health, I decided to be proactive when I got pregnant.
I chose to stay on anti-depressants during my pregnancy to try to head PPD off at the pass. It worked really well. Unfortunately, my selective serotonin reuptake inhibitor (SSRI) did not innoculate me against PPA. It didn't appear until a few months after my baby was born, but appear it did. I found myself with racing thoughts, loss of appetite, and difficulty concentrating. I knew I was struggling, but it took me a long time to ask for what I needed, which absolutely included the following:
Time To Myself
I'd always worked, but suddenly I was a stay-at-home mom. With my husband as the sole breadwinner, I felt guilty asking for "me time." I guess I thought I should have been able to get the solo moments I needed during the day, like when my daughter was napping, but I was using that time to do chores. What I needed was time to read, meditate, and listen to music, but I was unwilling to give myself that when there were "things to do" (even if they were tasks of my own invention).
According to Postpartum Support International, sleep disturbances can be a symptom of postpartum anxiety. What makes that extra sinister is that a new mom is already in a sleep-deprived haze during the newborn stage. I needed undisturbed sleep, but I hesitated to ask my husband to respond to baby's nighttime wake-ups (although I'm sure he would have) because I knew he had to go to work the next morning. Never mind that I, too, needed to be functional.
We're military, and we moved to a new state when baby girl was 8-weeks-old. We were lucky to have three couples (our Army family) come with us, so I had three kid-free friends who were either working from home or not working yet. I know they would have been delighted to watch my sweet girl, but I didn't want to take advantage of them. I was already using them when I "really" needed them. (Like for dental appointments and when my cat died. True story.)
And paying for daycare? Well, I wasn't working, and it took me a few months to think of my husband's paycheck as "our money" (I know, I know). It just seemed like an unjustifiable expense, even though I know my mental health is a perfectly good reason to ask for some extra help.
Help Around The House
Again, I'd taken on a new role as stay-at-home mom. Maintaining our home was a point of pride. I didn't want to admit to myself that I couldn't handle it, especially because my husband was already great about pitching in (before I woke up, he washed and sanitized all the bottles and unloaded the dishwasher). Honestly, though, hired help would have alleviated some of my stress.
It took me several months to admit that I needed to get back into therapy. I was also under a new insurance plan in a new state, so I had to navigate all that. Fortunately, when I sent an email to my new provider saying that my anxiety was getting in the way of being "mom," I got a call from a consulting nurse within an hour. She gave me her personal phone number in case things got bad, and I had an appointment with a therapist the next day. Thank goodness other people were willing to give me what I was too afraid to ask for.
I never really got over this one. I was already on an SSRI for depression. During my prior bouts with anxiety, I'd been prescribed clonazepam. It helped me sleep and calmed the pounding in my chest, but it also made me feel like I'd fallen down Alice's rabbit hole. As in, I couldn't remember stuff. Like, apparently I made a pie, but I have no recollection. Knowing I had that reaction (which not all people have, by the way) made me very hesitant to try any anxiety medication at all.
I suppose I felt a little silly "going to my happy place," but I needed it. My therapist suggested mindfulness practice. He put me in touch with the mindfulness coach on post. She ran a weekly group, but I had an infant. She offered to coach me privately once a week with my baby in tow. I needn't have worried that it was too "touchy-feely." Mindfulness is empirically supported — in short, it works. So who cares if you need to fall asleep to the dulcet tones of k.d. lang talking about lion mind?
Most of all, I wanted the people around me to understand that what I was going through was difficult and as much physical as it was mental. The problem was, I didn't really let anyone "in" enough for them to be able to do that. My husband is very "mind over matter" when it comes to mental health, so I hesitated to let him know I was struggling.
When people, new moms especially, are suffering from postpartum mood disorders, I think what they need most is to know that they're not alone. According Postpartum Support International, 15-20 percent of women experience significant symptoms of depression or anxiety. We also need hope — reassurance from others who've been there that it gets better and that it's more than OK to ask for help.
If you struggle with depression, anxiety, or feelings of self-harm, please seek professional help or call 1-800-273-8255 for the National Suicide Prevention Lifeline.