At the beginning of the year, I shared my conceiving journey. Today, as we near the end of the year, I share my postpartum tale.

Both are very personal stories, but I thought long and hard about sharing these vulnerable feelings and experiences. In the spirit of Thanksgiving, I made the choice to share my postpartum struggles in hopes of giving back to help other women out there who may be going through the same thing. Sometimes it really feels like no one understands. But that couldn’t be further from the truth.

You are not alone. Nor do you have to suffer alone.

My conceiving story was nothing special or out of the ordinary; there are many more women with much more difficult circumstances. But the emotions of constantly yearning for a child without success are just as anguish-filled in every  case, regardless of how long you have been trying. When I finally got pregnant after a frustrating and fruitless year of actively trying to conceive, I was over-the-moon elated! I thought that the hardest part was finally over.

Little did I know.

I mean, I “knew” that childbirth would be painful, that parenthood was not going to be easy, and that child-rearing would require a lot of hard work and sacrifice. But I thought that at least we would be so infatuated with our child that all of it would be a labor of love. I would be tired, but I would also be so utterly happy because this child I had wished so hard for was finally here. Motherhood would be this magical, rosy, glowing experience that I saw all my mommy friends touting on Facebook and Instagram. In that sense, I thought the hardest part was finally over because I finally got pregnant and my journey to motherhood was set!

…Then, postpartum depression happened.

And it wasn’t just the baby blues. Any form of depression is completely awful, but what I had was severe, raging, soul-draining, heartbreaking postpartum depression. It’s not something I’m trying to exaggerate, but it’s not easy to convey just how extreme it was. Surviving that depression was harder than anything I had ever experienced.

If you want to read on more, I’m warning you in advance that it is a lot of text and detail, like I shared about my conceiving journey. But it is the raw truth and some deeply personal emotions that I went through on this journey. I find that the little details are things people can relate to and find comfort in knowing that someone else out there is actually going through it in all its ordinary, mundane glory too. I know that’s what I find helpful anyway.

I also realized that after I had written out all my thoughts, it turned out to be over 9000 words…which is basically like a mini novel. So, I decided it was probably better to break it up into a few posts. This is part one of a few posts to come. (Probably one out of three.)

My hope is that if you know (or if you even think) you are suffering from postpartum depression (PPD), maybe my story will make you feel a little less scared or alone and provide some hope that you can make it through. When I was at one of my lowest points, my husband sent me a list of encouraging blog posts from other moms that had made it through postpartum depression during one night when he was up feeding our daughter at 3am. It gave me more strength to persevere and reminded me that this was more common than I thought. However, it’s possible some of this might be triggering too, if you have gone through something similar. So please use your judgement.

To those who are curious, I hope I can shed a little bit of light on the complexities of PPD. I do want to emphasize that this is only one story, but PPD manifests in so many different ways and in so many varying intensities. No one’s depression is ever the same constellation of symptoms. My version happens to be an unfortunately severe one but with a relatively fast rebound considering how bad it got. I know that when you’re in the thick of PPD, you just can’t see the light at the end of the tunnel. But I promise you, as someone who is recovering, it’s there.

And to those who don’t have anything positive to say, you can kindly escort yourself away from the rest of this series now. I realize that my blog is taking a turn in a slightly different direction, but that’s exactly why when I created it, I left myself some wiggle room on what kind of “pearls” I could write about. The core of everything behind this space was for me to share my passions and most importantly to help others.

So here goes…

1. “It Won’t Happen to Me”

I knew it was foolish, but I really thought that PPD could never happen to me. Being a healthcare provider myself and having done a few psych rotations while in school and during residency, I knew that PPD was a very real and prevalent occurrence. In fact, some CDC statistics cite 1 in 9 new moms have PPD, with the prevalence being as high as 1 in 5 women in some places. And yet, despite knowing all this, I still had a sort of stubborn denial that it could happen to me.

Call it hubris or whatnot, but I secretly felt there was just no way that someone with my history of resilience and good mental health could ever get postpartum depression. I was too strong for that. I had never had any history of depression or psychosis. I had been mentally strong all my life. I prepared myself by staying healthy and active during pregnancy, and I got very lucky that my pregnancy was smooth compared to most women’s. I count my blessings.

In my ideal projection of the future, I was going to be in that 80-90% of lucky women who were super moms from day one, happily basking in newborn bliss and effortlessly breastfeeding my baby. To that disillusion, all I can say is “Ha!” (More on breastfeeding in a whole different post because it deserves its own.) In hindsight, I guess I didn’t realize that resilience has nothing on female hormones.

What I also didn’t and couldn’t anticipate was that the first month would be littered with appointment after appointment because of different unexpected issues that popped up day after day. It seemed like we were constantly at a doctor’s office or the pharmacy for me or the baby. My husband tallied it up and it was something insane like 16 appointments in the first month alone.

Breastfeeding problems, latching problems, pumping problems, mechanical problems, under supply problems, over supply problems, sleeping problems, physical problems. Without going into detail on all the issues, I will just say that everything hit me like water gushing out of a broken dam. And I’m pretty sure that the circumstances I was dealing with on top of hormone withdrawal and sleep deprivation just pushed me to the edge of my sanity.

Some people have very obvious things fueling their depression–like a painful recovery or a sick baby. And I can totally feel for them. I know I was extremely fortunate that I had a beautiful labor story (likely due to the amazing doula I hired), quick healing time (down there), and a healthy baby. I can honestly say I had a good birthing experience, and I don’t look back on the childbirth portion as a traumatic experience at all. When I heard my daughter’s first cry and when I eagerly held her and locked eyes with her for the first time, I finally understood what love at first sight meant.

I thought that since I had a smooth vaginal delivery with zero tears (IKR?!), it would mean less risk of PPD for me. That turned out not to be the case, though. I’m sure a good delivery absolutely helps set you up for a better recovery, but at the same time, I’m not telling this to brag. I really want others to know that it is still possible to get PPD no matter your backstory. I had no flagrant risk factors of getting PPD, and yet it still happened to me in the worst way possible. True, it is a lot of work being pregnant, but I wish that I had known beforehand that I should also prepare more mentally for the postpartum phase instead of just buying cute nursery furniture.

I was totally naive and unintentionally arrogant to think that it couldn’t happen to me. Because it can happen to anyone.

Pregnancy is one chapter. Postpartum is another. And they can be very different.

2. Recognizing My Postpartum Depression

For the first two weeks after we came home from the hospital, the days were an utter blur. All I remembered was how hard the breastfeeding was and all the appointments we had to go to for the baby and for me in between the haze of trying to squeeze in some sleep. But I do remember that despite feeling somewhat stressed, I was also so incredibly content holding my milk-drunk baby after a feeding session. The feeling of her snuggling against my chest, heartbeat to heartbeat, was worth all the achy, chapped, painful nipples.

I made her. And she was perfect.

But then I noticed I was getting more and more frustrated and overwhelmed with every little thing.  Why couldn’t I get this breastfeeding thing down quite right? Why couldn’t I pump out milk sometimes? Why did I keep getting clogged ducts? Why did she sleep for such short periods of time (10-15 minutes) before waking again? I questioned every cry and every decision. Did she get enough milk? Should I feed her more? Was she gassy or in pain? Should I try to pump extra? For how long? Would it cause an over-supply and another round of mastitis?

I started to lose my appetite and felt anxious whenever I was eating a meal. Hurry and finish before she wakes up! It felt like every moment she was awake or crying, I couldn’t bring myself to do anything else but attend to her. I ate only because I knew I had to–not because I wanted to. Friends and family would ask me what I was craving and they could deliver it to me, but honestly I had no cravings. My husband thought that was odd because I love food. I didn’t even crave boba (which was something I would always get when I was pregnant) or sushi (which I constantly pined for when I was pregnant). It didn’t help that I had dietary restrictions set forth by Chinese herbalist rules that would interact with the herbal soups my dad made me that were supposed to help me heal in the first month. In retrospect, I would never do the herbal stuff again in such strict fashion if I had a second child.

I would constantly worry that my daughter was not eating enough or not sleeping enough or not everything enough. During the first two weeks or so, I probably cried every single day. Sometimes they were happy emotional tears when I looked at my daughter, and other times I didn’t know why I was sobbing so hard. Maybe I felt like I was failing this beautiful little human because I had so much doubt about my abilities to be her mother. I felt like I wasn’t “good enough” at anything. The tearing up eventually stopped, but then it progressed to something worse: anhedonia.

Anhedonia is just a fancy way of saying I found absolutely no joy or interest in anything or anyone in life. (You might see it being used in psychiatric diagnoses so I mention it.) I couldn’t find pleasure in anything anymore–not food, not TV, not anything. I felt like a horrible mother because I didn’t feel like I was really bonding with my daughter anymore. I couldn’t concentrate on any of the Hulu shows that I was behind on and I felt like I could never finish anything I started. I tried filling out some supplemental medical reimbursement forms, but only filled it out half way–each time saying I would finish it tomorrow. I barely returned my disability paperwork in time.

I started ignoring people’s texts for long periods of time because I just didn’t have the energy to act fine and perky and like I had all my sh*t together. In fact, I didn’t have the energy to do anything. I isolated myself and turned down people’s requests to visit. (Although, honestly, you really shouldn’t try to visit new parents in the first month postpartum anyway unless they invite you.) Even family visits felt like torture and I would wear a fake smile plastered on my face and try not to look too tired or glazed over.

My husband would ask me, “What do you want to do today?” And I would look at him like he was crazy. What do I want to do today?! I just want to get through the day and survive–that’s what I want to do!

I wanted to take a nice long rest and sleep for an extended period of time. But at the same time, I couldn’t sleep. My mother-in-law would come over during the day and force me to go take a nap, but I was so anxious that I couldn’t fall asleep, even when I actively closed my eyes shut for an hour. WHY CAN’T I FALL ASLEEP?  Hurry up; sleep now while you can! Sleep while the baby sleeps! That’s what everyone says, right??

But that didn’t help and the anxiety and pressure to fall asleep just made it worse.

***

The insomnia was getting to be a big problem. I remember there was one stretch where I went for at least a day and a half without sleeping, even though I spent the entire day trying to! It was all just superficial lying there with my eyes squeezed shut, praying and willing myself to fall asleep while my daughter was sleeping because once she woke up, I knew I definitely wouldn’t be able to go to sleep. My brain just felt like it was constantly alert and active and would not power down.

I asked for prescription sleeping medicine from the doctors, but it didn’t seem like any of the different ones I tried really helped me get restful sleep either. So every time I went to sleep, I’d be anxiously wondering if I would be able to fall asleep or stay asleep. I used to be able to fall asleep almost instantly and nap on the couch…not so anymore.

My dad would ask me, “Did you eat yet?” and I would also look at him like he was crazy. More like, did I sleep at all?? Who wants to eat? But I ate just to make other people happy–basically doing the bare minimum to stay alive and try to keep my milk supply up by drinking enough water.

I remember at the 3-week mark, I was chatting with one of my best friends who is a doctor and had just had his first kid about 6 months before me. He asked how I was doing and I told him that I didn’t really feel like myself or know who I was anymore. Then I laughed it off and said something like, “I’m sure it’ll get better though!” At that point, he actually seemed alarmed and asked if I wanted to seek help. I didn’t think much of it and was grateful for his concern; however, I genuinely thought I would shake off whatever this was soon once I got some decent sleep… At some point, the baby would have to let us sleep more, right…?

But I was ticking off all the symptoms (look up DSIGECAPS) for diagnosing depression–and it looked BAD. I’m pretty sure I had almost every one of those symptoms for a month or more. As each day dragged on, my energy levels dropped exponentially until all I did was lie on the couch (not falling asleep, though trying to and feeling exhausted) when I wasn’t holding my baby or feeding her or changing her. At t he same time, I was scared to be alone with her, and I was extremely fearful of the day my husband had to go back to work when I would be responsible for her all day by myself. Apparently, this is an irrational fear many new moms have. Mine felt amplified times a hundred.

I literally felt like a shell of a human, just trying to get by. I would tell my husband everything about how I was feeling, but I think we both kept hoping that as each potentially contributing factor got resolved one by one, perhaps I would slowly get better. By 5 to 6 weeks postpartum, though, I knew this was not just baby blues and it was not getting better on its own…

3. The Breastfeeding Factor

Something needed to change. What was fueling this weird funk? Why was I constantly worried and anxious and wired? Why couldn’t I sleep when I felt so depleted and exhausted of energy? A lot of my issues and worries went back to breastfeeding and breast care.

Without getting too detailed about the breastfeeding right now, I finally admitted to myself that the breastfeeding was not helping my mental health. Even though I loved how close the breastfeeding brought us, it was starting to take a very physical and mental toll on me–more than I was willing to let on. So I made a very difficult decision to stop. It pained me so much and I felt so much guilt over stopping so much earlier than a year (which was my original goal). We had tried so many lactation consultants and positions and contraptions that I felt bad for wasting all that money and time.

I really considered just exclusive pumping, but when there were times that I would pump for half an hour and NOTHING came out, I would get freaked out that I never got a let down. That, in turn, would cause me more anxiety because then I would worry about engorgement. And I so did not want another round of mastitis and antibiotics that I got on week 2. Every time I was about to pump, my heart would race and I would wonder if I was going to be able to produce anything this time or just waste another half an hour. I probably read every single Kelly Mom blog post out there and self-diagnosed myself with contradicting diagnoses.

Guilt and feelings of failure hovered like a black cloud over me all the time. But in the back of my mind, I also knew that I needed to rescue myself at this point. I was torn but I was also floundering.

My husband and family were super supportive of my decision to switch to formula, which I am thankful for. It didn’t ease all the guilt I felt, but at least it didn’t make it worse. When I went to see my OB/GYN for the 6-week postpartum appointment, I already knew my doctor was going to think I had PPD. Physically, I had healed just fine. However, when I filled out a PHQ-9, my doctor was shocked at my score of 19. (The maximum is 27, for reference.) We had known each other for almost 6 years now and we worked at the same medical site. She knew that I was clearly not myself.

“I’m worried about you…” she told me. “Honestly…very worried. It’s pretty severe and I think you should start an antidepressant. Can I start you on Zoloft?”

I secretly knew in my heart how severe it was too because I also cheated a bit on the PHQ-9 and downplayed some of my answers. I started breaking down and crying in her office. I told her that I was scared to start antidepressants and the side effects were just a laundry list of symptoms that I was worried about. Being a pharmacist, I also knew they would take 4-6 weeks to even start working, and I just felt so impatient that I wanted my problems to be solved NOW. Plus, one of the many possible side effects of Zoloft was insomnia…that wasn’t going to help my sleeping issues! (Although, technically, Zoloft is dosed in the morning since it is more activating.)

My doctor said she would leave the choice ultimately up to me, but she really thought I would benefit from taking the medicine and working with behavioral medicine. She left a very small dose of Zoloft (sertraline) 25mg on file for me to try if I wanted to. I told her that I had decided to wean off breastfeeding recently and that I thought my depression would be resolved once I didn’t have to worry about all the breast issues anymore. I truly believed that I had figured out the source of the depression and that things would improve once I weaned off fully.

I think my doctor wanted to believe that as well, but a small part of me could tell that she still thought I needed more help. The thing is, when you’re told that you need to seek more help and let medicine take its dear sweet time to work (or not), it can feel extremely daunting and impossible. And when you’re expected to navigate the health system by yourself, even if you work there, it often feels very lonely and overwhelming.

As a pharmacist, I used to wonder why people with mental health needs didn’t just ask for more help. Plenty of people were willing to give it. Or why didn’t they just address the root causes of things? But being on this side and the one who needed the help for once, I learned that it’s really not that simple. I have so much more empathy now for people who are struggling with their mental health.

It’s one thing to say “go seek help” or “try therapy” or “start antidepressants” to someone, but it’s a completely different feeling when you are already drained of any energy or the will to care enough to GO to therapy. It’s totally a catch 22. Each day when you are recovering in postpartum can seem like a year. Four weeks for an antidepressant to START working seemed like a lifetime. And I’m talking about four weeks on the RIGHT dose and the RIGHT medication…so it could potentially take even longer switching around and titrating up! But my OB’s argument was, “Then you better get started on it now so we can figure out the right dose and right medicine!”

She had a point. But I was still in some denial. So I went home that day without filling the medication. I was giving up the breastfeeding so I wouldn’t need to be on medication…right?

***

If you made it this far, I thank you for your interest and for following along. It’s scary putting myself out there, but I believe writing is also a form of therapy. So this process is also a way to heal myself too. In the next part, I’ll talk more about the treatment I got and what I ended up deciding to do about the medications.

Happy Thanksgiving to everyone, and I hope you hold your loved ones tight and never take anyone for granted. There is much to be thankful for in this life, especially health. And by health, I mean both physical and mental.

xoxo,
Jasmine

Part 2: My Struggle with Taking Antidepressants
Part 3: My Recovery from Postpartum Depression
Part 4: Getting Off Antidepressants for Postpartum Depression