My struggle with PPA

Hello again, and welcome back to my internal monologue! There’s no good preamble to this post, and it won’t be as (mildly) witty as my usual entries. It’s important to me to talk about mental health so we can raise awareness of the ubiquity of struggles everyone has, moms included. I’d like to tell you about my struggles with Postpartum Anxiety. I hope my experience resonates with and helps some of you.

I don’t know how many of you readers are mothers or parents, too, but I’m going to hazard that regardless, the majority of you have tangled with anxiety at one point or another in your lives; that would be normal. It’s that sweaty-palmed, flipping-stomach, hairs-raised-on-the-back-of-your-neck-before-a-presentation feeling. For a lot of people, that’s their experience with anxiety: they meet it occasionally, at realistic, understandable times, and then they wave it a hearty goodbye as they move on mentally from whatever stress they were feeling.

And, too, one would expect that feeling anxiety while having a child is a fairly normal experience, and that it is even more likely when you have your first child. Hormonally, women are all over the place after having their babies, and couple that with the fear of the unknown that accompanies adding a child to your family, and you have a recipe for anxious nights and jittery days. According to the NIMH, up to 80% of women struggle with the “baby blues” after giving birth, and 15% of those women may additionally struggle with Postpartum Depression (PPD.) An even higher, though as-yet unstudied, number may also be contending with Postpartum Anxiety (PPA.) Troublingly, while PPD is well-documented and has been the subject of many high-profile campaigns for mental health awareness, no such exposure has been given to the symptoms of PPA. Women are told anxiety is a normal side effect of having a new child, and anxiety can often be seen as a positive manifestation of a mother’s love: after all, being concerned about your child even to the extreme (i.e. helicopter parenting) is lauded. Anxiety is further normalized by partners, families, and friends, who can generalize PPA as part of a normal emotional set after giving birth.

The distinction between the experience of serious, chronic anxiety because a mother is struggling internally with her mental health, and less serious, acute anxiety about external pressures about how to be a good mother, is a blurry one at best. They bleed into each other, and many women are told that their concern that their child is still breathing at night, is meeting their milestones, or is generally developing properly, is completely normal to the experience of a new mother. To an extent, it is normal to wake up and check on your sleeping infant (it reduces the rate of SIDS, even) and what good would a parent be if they didn’t at least show some interest in guiding their child’s development? The devil is in the details, and here the details are all about severity, appropriateness of response, and length of suffering.

I have struggled with mental health my whole life, specifically with anxiety, and yet I was woefully unprepared for the absolute deluge of anxiety that I felt after having Briar. It hit me like a freight train, and it came out of nowhere. Briar’s pregnancy was surprisingly easy, and I had zero “baby blues” after she was born. A few weeks into it, I wasn’t sleeping, but I also wasn’t the sad or unstable typical to sufferers of PPD. I felt fine, until I didn’t. And when I wasn’t fine, well, let’s just say I REALLY was NOT fine.

It started inconsequentially enough. We struggle with asthma and allergies in my family, and my brother was in and out of intensive care from the time he was born, so naturally I was concerned that my child would have breathing problems. I would stay awake full nights watching Briar’s chest rise and fall in the bassinet next to our bed, ignoring Thomas’ calls to get some sleep for the scant periods she would close her eyes. (Yeah right, no mother sleeps when their baby sleeps! I would rationalize. This is totally normal.) Indeed, no one seemed to see an issue, not even when Thomas and I called my parents because we were both worried that our infant’s totally normal cyclical breathing was in fact abnormal. The experience of “this is totally normal” was corroborated by my husband’s anxiety; the issue was, his anxiety dissipated when my parents came over and reassured us all was well, while mine continued at a fever pitch. Eventually, my mother-in-law gifted us a pulse oximeter to put on Briar’s foot while she slept, my only request for a birthday gift. I would stare at its pulsing green light all night, its presence keeping me somewhat sane.

But during the day, there was no remittance of my anxiety. For example, Briar was never good in the car: she would scream until she was purple in the face and start to cough and gag. I was convinced she was suffocating in her very expensive carseat, what amounted to a hangman’s noose in my head. I would pull off the road no matter what the conditions or location: on the highway, in random neighborhoods, in the middle of rush hour, in the pouring rain, to bounce a screeching, hiccuping infant desperately, tears rolling down my own cheeks as I asked her what was wrong, what was I doing wrong, Briar, tell me!

And after nightfall again, during the 30 to 45 minute lulls when Briar would sleep on my chest, I would frantically google everything I thought was wrong:

Why is my 2 month old not sleeping?

What do chest retractions look like in a 5 week old?

What color should my 6 week old’s lips be?

What does it mean when your baby won’t stop crying?

Am I a bad mother if I just want my baby to sleep?

And this went on, and on, and on. Specifically, it went on for over a year. I was coming undone at the seams. I was so sleep-deprived on top of my completely out-of-control anxiety, I didn’t know who I was anymore. But amazingly, throughout it all, I thought it was a completely normal part of matrescence. And it’s no wonder: we have no clear statistic on PPA as to how many women it effects, how long it lasts, and what it’s triggered by. The CDC notes that it is likelier that you will experience PPD if you have already been diagnosed with depression, so it seems reasonable to assume the same about anxiety and PPA.

I wish I hadn’t been blindsided. I finally knew something was wrong when Thomas and I had a parents-only vacation that was suddenly in jeopardy. Suddenly, it looked like we would have to take Briar with us instead of leaving her home with my family. I had a total emotional breakdown, and frantically called my mom. I begged her to take Briar for three days so I could have a break from the anxiety that was boring through my psyche. She, sensing perhaps that there was something more wrong with me than the typical new-mother burnout, obliged. In that time away, Thomas and I worked to begin to reckon with the complete emotional waste that I had been left with in the wake of a year of motherhood. Motherhood had its bright spots, even bright periods, but the overwhelming emotion I felt was anxiety. I was forced to acknowledge that I needed help, and despite my own best efforts, I couldn’t be an island forever. I started to seek out help from friends, learning that a few of them had also gone through this level of anxiety. Knowing that what I was experiencing was not normal, and yet not entirely individual, was a great help. Looking back, I probably should have sought out therapy, but luckily not even PPA lasts forever.

The fog of anxiety started to dissipate at around 15 months into Briar’s life. I didn’t realize it was ebbing, and when it was gone, I didn’t notice anything had really changed. The only difference I felt was passive: just that there was no lurking cloud of anxiety hanging over everything. Such is the nature of parenting: you have to keep on keeping on. One day, I just stopped checking the camera over Briar’s crib every 15 minutes, and I didn’t cut all of her food into microscopic pieces. I stopped worrying about every sound she made in the car. The anxiety was just gone, like it hadn’t laid waste to my life for almost a full year and a half. I had nothing to show for the struggle, except the feeling that I was freer than I used to be, and a healthy 16 month old who did not choke or suffocate or run away into the street from me. All the worst case scenarios never happened, though my anxiety wouldn’t have prevented them even if they had occurred. I was left emotionally exhausted, but whole.

It is a real wonder, being able to think about the insane level of anxiety I had rationally, now that it’s over. I completely remember the feeling of that anxiety: it can still give me goosebumps to recall certain instances. There is a real concern that women with PPD suffer from it again with their subsequent pregnancies, so I had braced for the worst during my most recent pregnancy. Anxiety about my anxiety kept me up at the end of term, and contributed in no small part to my passivity during my second pregnancy. I was so worried that I was going to fall down the same fraught rabbit hole again. Despite my concern, however, I’m surprisingly calm and level-headed with Violet. Surely some of it comes from being a second-time mom, but it feels different than that. I still have moments of anxiety (like the nightmare of a situation when both girls start crying in the car and no one is there to help me soothe them) but for the most part the episodes are rational, self-contained, and short-lived.

What I know now is this: PPA is a beast of a mental illness. It is terrifying, irrational, and makes you feel unhinged. Unfortunately, it is difficult for the sufferer to spot, and is even more so for their partners, friends, and family. If you have any shadow of a doubt about your anxiety postpartum, I urge you to seek out help, whether with a professional or just by speaking to your support network. But maybe even more importantly, I want to remind you that it ends. I promise, one day you will come out the other side. PPA doesn’t receive the same press as PPD, but inasmuch as anxiety feels just as destructive as depression, it’s important to know that the feelings will ebb as your hormones stabilize, even if that takes a year. Pregnancy and parenthood change everything, and your mental health may not escape unscathed either.

Sitting here on the other side of PPA with another pregnancy and birth under my belt, I can tell you that it gets better. Not every night lasts forever. Know you are not alone in this struggle; or, know that your partner may be suffering silently, not knowing she is not alone in her pain. We need to think critically about anxiety and mothers in this country, but that is a post for another time. In the meantime: sunlight is the best disinfectant: let’s not wait to ask for help or extend a hand to the people we love.

Yours always,

Taylor

One thought on “My struggle with PPA

  1. Thank you for sharing your story! I’ve definitely been there. The sleep deprivation. The non-stop anxiety. I’m still working on mine, but you’re right, it does get better! It’s important to have these conversations so that new moms know they’re absolutely not alone!

    Like

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