The events leading up to the birth of my second child set the stage for the perfect storm that occurred after he arrived.
Around the time I found out I was pregnant, I was offered a rare opportunity to buy the physical therapy practice where I had been working for the past five years. The owner was terminally ill and could no longer maintain an ownership stake. The sale occurred when I was seven-months pregnant.
One month prior to giving birth, my husband was laid off from his job. He quickly acquired a new job, though it came with a substantial pay cut, poor hours, and no job satisfaction. Little did I know how these major life changes would affect me at a time when I was feeling so fragile.
Being a new owner of the clinic, I decided I was only going to take six weeks maternity leave; after all, I had a business to run. I ended up working some during those six weeks anyway. I attended meetings and dealt with stressful situations while adjusting to the demands of being a new mother to a two-year-old and a newborn. I also had to manage my husband’s job stress, which had projected into our home life.
The day I officially returned to work from my maternity leave I received the news that the former owner, my mentor, had lost his battle with cancer. I felt my whole world dissolving. How will we survive as a clinic? He built its reputation and without him in the picture, will clients accept me as the new owner? Who will be my mentor in this new venture? Do I really know what I’m doing?
It was about that time I noticed subtle symptoms of anxiety: heart racing, palpitations, and difficulty sleeping. At eight weeks postpartum I began full-blown panic attacks. I had a constant feeling of dread, a lump in my throat, and felt I could “lose it” at any minute. I woke in the middle of the night an anxious wreck. I lay on the floor and cried. I feared being locked up in a mental institution. I questioned by ability to properly care for my family and my business. I felt lost and scared all the time.
Not sure what to do, I sought the help of my primary care physician. He suggested I begin using an antidepressant. “An antidepressant?” I wondered. “I’m not depressed; I’m anxious. I just wanted some Ativan … something to calm my nerves when I need it.”
The doctor refused to give me an antianxiety pill, stating I would get addicted to it. He told me to give the antidepressant several weeks to work and that I would feel better. “Several weeks? I can’t feel like this for several more weeks!”
So I referred myself to a psychologist.
By that point I was having trouble leaving the house. Any time I had to go out I had a panic attack. I started feeling depressed because of the limitations the anxiety placed on my life. The depression and anxiety fed off each other. The psychologist I spoke with—and still work with—was the best thing for me.
I believe you have to hit it off with your psychologist if the process is going to work for you. My psychologist tells it like it is, and I like that about her. Basically, when we first started working together, she told me that I had been introduced to some major life stressors, and that it was natural for my body to break down. She told me I needed to take care of me, first and foremost. She told me that I needed to admit that I had a chemical deficiency in my brain, and that much like any other ailment in the body that requires a person to take medication, I needed to take the antidepressant medication to get better. She also suggested that I speak with a psychiatrist who prescribed antianxiety medication to help me get through it.
I relied on Ativan for the several weeks it took for the Celexa to kick in and have never taken another Ativan. I practiced meditation and mindfulness, and read self-help books and everything I could find on postpartum mood disorders. I started exercising again, and started enjoying my family and work.
About eight months after the birth of my second child, I felt that I had finally regained control, had a good routine going, and achieved a good balance of work and family. My husband’s job situation turned around when he joined my physical therapy practice, which in turn took a tremendous amount of managerial stress off my hands.
Just when I thought I had it all figured out—how to balance everything and be happy and anxiety free—I found out I was pregnant again. We hadn’t planned it, and the news brought a new dose of anxiety into my life. I feared a repeat of what I had just gotten past. The memory and horror of it all was still too real.
Every doctor I dealt with suggested I stay on the Celexa, which is exactly what I did. I was able to remain in control and free of anxiety throughout the pregnancy without having to use Ativan.
Today I am three weeks postpartum. I still fear going through it all over again, but I now know the early signs to look for and what I need to do to get better quickly. I take life one day at a time and continue my mindfulness and meditation whenever I get a chance. I continue to use the Celexa and see my psychologist and psychiatrist on a regular basis.
I also talk to other women about what I went through and feel comfortable doing it. I don’t have the shame I did a year ago. Plus, in talking to other women, I have realized just how common postpartum depression is and that so many women are quiet about it for fear of being labeled crazy.
I have learned how to ask for help and graciously accept help when it is offered. I know that I cannot do everything and be everything to everyone. I have three children under the age of four. There is no doubt this will be a difficult thing for me to handle along with my business, and that’s okay.
As I write this, I am happy to say that I have had no symptoms of anxiety or depression. I am looking at my newborn son with awe. I am looking at him knowing how hard a job it is being a mother, but how wonderfully rewarding it is. I am hopeful, because I know that if I ever go through postpartum anxiety again, I will get through it, just as I did before.
A Note from Dr. Shosh
We have the opportunity to learn so much about ourselves as we go through these illnesses. Because of this, the experience with the next baby can be quite different. Here are some highlights from Juli’s story:
— Making a big adjustment (such as buying a business) during pregnancy is not ideal. Our systems cannot tell the difference between positive and negative stresses. They are interpreted the same way by our bodies. Generally speaking, pregnancy is not the time for significant changes and they should be avoided whenever possible.
— Late in her pregnancy, Juli experienced the unavoidable stress of her husband losing his job. Situations like this set us up for anxiety and make us feel insecure, like the rug is being pulled out from under us when we need security the most. It’s no one’s fault, of course. It’s just good to be aware of it. If something does happen like this, try your best to rally extra support.
— Juli found herself in the position of owning a new business and feeling like she had to work during her leave. If at all possible, use your maternity leave to rest and recover.
— Experiencing the death of someone close to you is a big stressor. This feeds into anxiety and depression. Juli was saddened by the death of the previous practice owner and she was also worried. She felt the future reputation of the business rested fully on her shoulders. Support is crucial during such times.
— The more stressors you experience during pregnancy, the higher your risk for anxiety during pregnancy and postpartum. Heightening your awareness is the first step toward combating the effects.
Photo by Anne Worner CC BY 2.0