Pregnancy is supposed to be such a joyous experience, but the darkest time in my life was when I was expecting my second baby. I wasn't diagnosed with perinatal depression and anxiety until I was about five months pregnant, when I finally started seeing a psychiatrist, but there's no question I was silently suffering from it from the very beginning. According to the New York State Department of Health, "the term perinatal depression encompasses a wide range of mood disorders that can affect a woman during pregnancy and after the birth of her child. It includes prenatal depression, the 'baby blues,' postpartum depression and postpartum psychosis."
For my partner and I, baby number one was carefully planned and scheduled. We had undergone genetic testing. I had mild PCOS, and we found that my husband was a carrier for the Cystic Fibrosis gene. I meticulously checked my cervical fluid, took my temperature, charted, and ingested all types of herbal supplements before getting pregnant. We read and researched every little thing. We were ready. More than ready. We were prepared. Four months after deciding we'd start trying, we found out I was expecting a daughter.
My second pregnancy, however, was nothing like my first. It was the result of a moment of passion that began with a goodnight hug. I'd only just started getting my period again, after nearly two years of breastfeeding, and so I guess I wasn’t so great at doing the math. As we were getting close to climax, I did a quick calculation in my head and figured it was still a few more days before I would ovulate, so the chances were pretty small. I mean, it had taken us four months of trying to get pregnant the first time around, so really, how likely was it that it'd happen on the first try?
Naturally, I ovulated the next day.
When I explained my poor math skills and subsequent ovulation to my husband, I laughed it off, saying, "Come on! The chances are so small, right?" He just looked at me solemnly and said, "You're pregnant."
He was right. I was.
If that sounds melodramatic, trust me, it's not. We'd decided not to have any more children just a few months earlier. I was in the process of putting together my application for a doctoral program, shifting my dormant career as an opera singer in a more viable direction. We didn't have the money for another dependent, especially with me supposedly going back to school for another four, possibly five years.
I spent the month following that positive pregnancy test trying to determine all the ways we could make things work. I spoke with friends, my academic advisor, my parents — everyone was very supportive and encouraging. But the world quickly began closing in on me.
When I went to the 13-week anatomy scan ultrasound and found out my son was healthy and in perfect shape, I didn't know what to think. I was relieved but disappointed, and that made me want to throw up.
I began to have these flashes — little intrusive thoughts of having a miscarriage. I hadn't exactly decided I wanted this baby, but at the same time, I didn't want it to lose it. Intrusive thoughts are sometimes a byproduct of anxiety or obsessive compulsive disorder, although many people experience them from time to time. Typically they involve images or thoughts of harm coming to you or someone you love, and they feel almost as though they were placed in your head, because they're just so foreign. I felt guilty that these thoughts kept appearing in my mind, unbidden, but I couldn't muster up any joy or excitement about my impending baby either.
I became convinced that I'd lose the baby before the end of the first trimester. I'm not sure if it was because I couldn't believe the universe was so completely screwing me over after I'd finally committed to a career path, or that all those little flashes I'd had of losing the baby were going to cause me to actually lose the baby, but losing my pregnancy just felt inevitable. And so, when I went to the 13-week anatomy scan ultrasound and found out my son was healthy and in perfect shape, I didn't know what to think. I was relieved but disappointed, and that made me want to throw up.
And when, a week later, a friend who was also pregnant had her anatomy scan and discovered that she had lost her baby somewhere between seven and eight weeks gestation, but she hadn't yet miscarried, I was overcome with a kind of survivor's guilt.
I found myself paging the midwife more than I intended to, for problems that didn't seem to amount to anything. I had trouble breathing; I had cramping; I had more trouble breathing. I seemed to be subconsciously turning my pregnancy into a high-risk one. Things felt wrong, and I had an inkling it was mood-related, but I was afraid to talk to anyone about it, for fear of coming across as a complainer.
It seemed horribly unfair to me that friends who were actually trying to conceive at the time had ended up without a viable pregnancy, while I continued to be pregnant with a baby I'd never intended to conceive; one I didn't yet know I wanted.
It sent me spiraling downward into a horrible, dark place.
Just a few days before Christmas, Toronto, where we live, was hit with an ice storm that decimated the city. Many neighborhoods were without power for days, including our own. Streets were impassable due to the downed live wires and detritus everywhere. It was beautiful and terrible, and we were fine (though without power for days), but it just obliterated me. As friends and family made the best of it, all I could see was destruction. I spent time every day locked in either the bathroom or the bedroom, sobbing silently. Every holiday event we were scheduled to attend filled me with dread, and I had several anxiety attacks just trying to leave the house.
At this point, I found myself paging the midwife more than I intended to, for problems that didn't seem to amount to anything. I had trouble breathing; I had cramping; I had more trouble breathing. I seemed to be subconsciously turning my pregnancy into a high-risk one. Things felt wrong, and I had an inkling it was mood-related, but I was afraid to talk to anyone about it for fear of coming across as a complainer.
Luckily the midwife I was seeing for this pregnancy had also been my midwife for my last pregnancy. She could see that I wasn't myself, that something was terribly wrong, and asked me some very specific questions about my general mood during the first year after I'd had my daughter (I definitely had a hard year, and wondered if I might've had PPD, but was never diagnosed). She asked if the pregnancy had been planned. She asked how I was feeling about it, and whether I felt supported. And she asked me straight out if I was feeling depressed or anxious.
Knowing for certain that there was a reason for my feelings and my behaviors made me more willing to share these struggles I'd been dealing with silently. I felt validated, and worked up the courage to reach out to my immediate family to let them know what I'd been going through.
She told me I was likely suffering from prenatal anxiety and depression, and informed me she was referring me into a special outpatient program devoted to women's mental health issues related to hormonal changes. I was on the waiting list to be assessed by a psychiatrist for two very long months, but by early spring, I was in the program (which included assessments by a psychiatrist specializing in women's reproductive mental health, counseling by a social worker, and a 12-week PPD support group).
When the psychiatrist assessed me and told me it was clear I was suffering from perinatal depression and anxiety, I felt as though a weight had been lifted. Knowing for certain that there was a reason for my feelings and my behaviors made me more willing to share these struggles I'd been dealing with silently. I felt validated, and worked up the courage to reach out to my immediate family to let them know what I'd been going through. Having even just a few more people in my court who were willing to check in with me regularly was huge, especially since I'd withdrawn more and more throughout the pregnancy.
After a few months, she began instead to say, "OK, Mama, just let me know when you're done." It was the exact phrase I'd use on her during a meltdown. I felt like I'd been punched in the ribs when she said that to me. Here I was needing my daughter, only 2, to mother me.
From the moment I stepped into the women's mental health clinic, I felt taken care of. The medical team did everything they could to support me and my choices, offering me material to read about my condition to guiding me through mindfulness meditation. They helped me manage my mood disorder in a non-judgmental way, and I credit them for helping me get through my pregnancy.
Beyond the help I got with the program, there were still so many days I felt utterly unequipped to be a mother to my 2-year-old daughter. I cried, and my daughter got used to seeing that. In the beginning she asked me if I was OK and asked me why I was crying, but after a few months, she began instead to say, "OK, Mama, just let me know when you're done." It was the exact phrase I'd use on her during a meltdown. I felt like I'd been punched in the ribs when she said that to me. Here I was needing my daughter, only 2, to mother me. I felt like I was a terrible parent.
I felt guilty because of the ambivalence I felt toward my pregnancy, and then felt guilt over feeling that ambivalence. I had intrusive thoughts of my daughter dying all kinds of horrible deaths, of me being injured and surviving, but my unborn baby dying. They were awful to experience, and my psychiatrist mentioned the possibility of starting a mood-stabilizing drug, but when I went home and did some research on what the effects could be on my unborn child, I had even more anxiety. Thankfully my doctors respected my wish to stay off of drugs during pregnancy, and I never felt pressured to take medication.
In the end, my doctors were able to help me pinpoint the source of much of my anxiety: I felt like I was abandoning my daughter by having another child. I felt ambivalent toward my unborn son because I was afraid I'd be betraying my daughter by loving him, too, and I was incredibly anxious that my ambivalence would lead to an inability to bond with him once he was born.
What was most shocking (and relieving) was that I fell in love with him virtually immediately after he was born. Though I never experienced a "normal" moment throughout my entire pregnancy, I am thankful to my midwife and the mental health team for their interventions, their support, and their unwavering belief in me. I know how lucky I was to have them — and it's something I'm thankful for each and every time I look at my son.