This post is part two and a continuation of “Beyond Pregnancy – My Battle with Severe Postpartum Depression.” Again, I want to warn that these posts are long and text-heavy, as they contain a lot of detail and my thoughts in reflection. But my goal is to hopefully help someone who is going through postpartum depression (PPD) feel less alone than I did back then and to let new moms-to-be have awareness that PPD could happen to anyone. This part focuses more on the treatment I received and how I came to terms with it.

If you haven’t read part one, it may make more sense to read it first, but I won’t stop you from jumping in here at this point. I left off last time explaining that I saw my OB/GYN for a 6-week postpartum checkup and she really thought I should be on an antidepressant because it seemed like I had severe PPD. I had my doubts about taking medications and I thought if I physically removed what I perceived as the biggest source behind my PPD, I would be somehow magically cured. I believed that source to be breastfeeding. And so, with a heavy and guilty heart, I stopped.

Here’s how the rest of my treatment panned out…

4. The Tipping Point

I’m not sure why I felt so impatient and decided not to try the Zoloft, but if I had to guess, I’d say that the depression also clouded my judgement on top of my worries of all the side effects that I learned in pharmacy school. PPD made me extremely anxious, and I always felt like I couldn’t complete what I started. I’d spend much of my time second guessing myself and wavering back and forth. And again, I guess I thought as the breastfeeding ended, I would slowly get my sanity back. (Kudos to all those mamas that breastfeed, no matter how long! Breastfeeding is HARD WORK.) Once I stopped breastfeeding and pumping, I felt relieved…for a few days. But all those depression symptoms? They weren’t gone.

I found new things to worry about.

How much formula does my daughter need? Did she get enough? Is she crying because she’s still hungry? What if we overfeed her?? The pediatrician said not to exceed 32oz a day, but she seems to always want more! How do I know she’s had enough? She never refuses a bottle! Is she going to be obese? Is this sterile enough? Is she allergic to this? Is this formula causing her gas? Is her immune system going to be weaker than other kids? It’s going to be all my fault that I didn’t breastfeed her…

It comes with being a parent, but the worries never end. And I knew this was going to be a thing, but my worrying was honestly getting a little excessive. It was to the point that I couldn’t stop it from affecting my every day life and paralyzing and consuming me. That kind of worrying is usually linked to depression. I would ask my husband some of the same questions over and over every day. At some point, he was probably exasperated, but he patiently coached me through the same answers each time to settle my nerves.

I felt even more guilty that my milk supply had been stopped and my depression hadn’t resolved. So basically…I quit for nothing?! Should I have tried harder to breastfeed or pump if it wasn’t going to fix the depression anyway? I wondered if stopping the breastfeeding could have also made things worse because now I was going through an even bigger hormonal drop. Well, that sure backfired, didn’t it? Hopeless and defeated didn’t even begin to cover how I felt.

***

A first-time mama friend that I knew in high school but hadn’t talked to in years reached out to extend her support to me and meet up if I needed because she lived in my area now. I was very touched by her gesture, but I turned her down, playing it off like I was fine and way too busy to meet. Truthfully, I barely had energy to even shower let alone socialize. She had no idea what was going on, but she said almost knowingly, “One of the best things someone ever told me was that as new moms, we all wonder why we did this to ourselves. It doesn’t make you a bad mom. It’s a normal feeling and it will pass as you discover how much you love your little one.”

I pondered this revelation, as I did wonder a lot–why did I ever think I wanted kids or that I could even do this?? I didn’t feel capable of being a mother at all anymore. With our emotional conceiving journey, it just felt so unfair that on the other side of that achy pining was this unbelievably gloomy reality for me. Everyone kept telling me to savor and enjoy every moment of the newborn stage because kids grow up too fast. Well, I was not enjoying motherhood at this point, and I wondered why everyone else seemed to be handling new motherhood so much better than me. Another friend commented that his wife had a very rough pregnancy, but “motherhood fits her like a glove now.” Those words hit me pretty hard. Why was my motherhood glove the wrong size?…

The tipping point came about two weeks after seeing my OB/GYN. It was my husband’s birthday.

I mustered up some energy to leave the house to buy him a little cake and a card, telling him I needed to go get gas or something slightly believable. As small of a gesture as that sounds, it sadly took a LOT of effort and energy on my end. The whole time I was out (all of like 15 minutes), I remembered feeling extremely anxious and wondering if my daughter was okay back at home. At the same time, I was also anxious about returning home, almost wishing I could just up and run away from all these terrible feelings. I snatched the first decent birthday card I could find at Target, not even taking my usual time to peruse all of them until I found the perfect one.

I really tried to be cheerful that day, but I hadn’t slept again.  Even though my daughter was starting to sleep longer stretches of 3-4 hours at a time at night, the anxiety was still keeping me up. My husband ended up taking care of our daughter the ENTIRE day on his birthday while I just moped around and anxiously tried to fall asleep. I wasn’t hiding my feelings from my husband either, and so when he asked what was wrong, I told him about some absolutely terrible thoughts I had about myself.

And then he started crying.

That was a big deal because I have never seen my husband cry before in my entire life. And I’ve known him for over 15 years. He doesn’t cry or tear up during emotional movies or touching stories or the cute puppy and pony Budweiser Superbowl commercials. That heartbreaking rendition of DJ Sammy’s “Heaven” with the little girl talking about her father dying on 9/11 couldn’t even break him. He didn’t cry at our wedding; he didn’t cry when we found out I was pregnant after trying so hard for over a year; he didn’t cry when our daughter was born.

The man isn’t insensitive, but he just does not cry. But that day was the first time I had ever seen him cry. (Sorry babe, for telling the whole world this.)

So it was kind of a big deal. And it scared me.

I started breaking down too, as he pulled me close. I couldn’t bear to see him in pain, and I think it woke me up a little from my pity party. He asked me if I would please try therapy or medicine because I was scaring him and he was at a loss for what to do next. This was also a big request from him because my husband despises taking medicine or seeing doctors. He told me that he couldn’t understand what I was going through but he could see that I was clearly in a lot of pain, and he didn’t want that for me.

So for his birthday, I promised him I would start taking the antidepressant.

5. It’s Okay to Take Antidepressants

You’d think as a pharmacist, I’d be more okay to try medications, but maybe knowing too much is a bad thing as well. I think there were also some cultural factors behind it. Asian families tend to frown on mental health issues and we don’t talk about it openly. Therapy is considered unnecessary and a waste of money. And if you do need to try anything, hopefully it’s quick and then you don’t need it again.

I finally went to see a psychologist who told me that a lot of my issues were likely arising from a chemical imbalance of hormones. She mentioned that it wasn’t just the pregnancy hormones (or lack thereof), but also the cortisol and stress levels that were out of balance after my body had gone through so much drastic physical change too. I had never thought about it like that, but cortisol levels do take awhile to normalize and it was probably causing me the insomnia too. So she explained that perhaps trying an antidepressant could help with stabilizing or normalizing some of the neurotransmitters I needed to combat my anxiety, depression, and insomnia.

“So…do you really think the medicine will help?” I asked the psychologist. As if I didn’t believe any of the ridiculously expensive doctorate training that I worked my butt off to achieve. At that moment, all clinical judgement went out the window. I just felt like a scared child asking for a ray of hope and confirmation.

The psychologist just smiled. “Since you’re a pharmacist… You know that blood pressure medications work to lower blood pressure, don’t they? There are so many medications made to treat different things. Why should an antidepressant work any less better or worse? Why does it seem so much worse to take them compared to a blood pressure medication? You can’t see hypertension either.”  She had a point. So I started to feel more hopeful about trying the antidepressant, though I was still impatient.

Well, things got worse before they got better.

I felt no difference in my anxiety or sleep for the next week after I told my husband I would start the antidepressant, and I was starting to feel hopeless again. Every day felt so incredibly sluggish, like I was dragging myself through a thick tar from hour to hour. The guilt cloud hadn’t left.

I had the worst first Mother’s Day ever–not because I wasn’t spoiled silly by my husband and in-laws. In fact, it was because they showered me with so much love that I felt even more miserable about myself. In my mind, I was such a colossal failure that I felt completely unworthy to receive their praise. I didn’t deserve any of it. I didn’t feel like a good mother and yet here everyone was lauding my sorry excuse of “motherhood.” I was so disgusted at myself and self-loathed like no other.

After that weekend, I made the executive decision to self-increase my Zoloft dose to 50mg, but it also seemed to be doing more harm than good at this point. It gave me horrible stomachaches, and I wasn’t so sure I liked it. I felt these little zaps and tingles in my arms and occasionally would get a sudden hot flash all through my abdomen area. Honestly, I wasn’t sure if these symptoms were all just in my head or not because besides for gastrointestinal problems, the medicine is not really known for the other odd side effects I perceived.

The doctors were also perplexed by my reports of the weird side effects. Obviously, I started over-analyzing and wondering if I needed to change antidepressants or if my body just couldn’t handle all the serotonin. Just for background’s sake for non-medical people, Zoloft is an SSRI or selective serotonin reuptake inhibitor–which basically means it keeps serotonin, the happy neurotransmitter, around for longer. Many antidepressants fall into this class, but the chemical properties can make them work differently for each individual and have slightly different side effects.

I was starting to feel blasé about all of it. The days were still blurry, and I was so ashamed that I could not enjoy my daughter like all the other new moms seemed to be doing with their newborns. My sister tried to ask me to go outside to take walks with her so I could get some fresh air, but I couldn’t even find the strength to do that. I remember getting as far as the last set of stairs to the front door before sitting down, shaking my head, and bursting into tears. Many times, I toyed with the idea of checking myself into the hospital for my insomnia problems. These ideas would be especially intense when I would lie awake for hours in the middle of the night (praying to fall asleep) only to feel hopeless and tell myself that there was nothing they could really do for my sleep even if I did check myself in.

Finally, my husband dragged me to see a psychiatrist. As a side note, a psychologist is a PhD and a psychiatrist is an MD. Both are doctorates with scopes of different but equal importance. The psychiatrist adjusts medications mostly, while a psychologist can be a therapist. It took all of my husband’s patience and convincing to get me to go see a psychiatrist, and I’m pretty sure if he had not gone with me, I would have just missed the appointment.

That appointment was probably the most important one ever, though, so I’m extremely glad I didn’t blow it off. It’s also very hard to get mental health appointments sometimes due to shortage of qualified staff. Thankfully my mother-in-law helped us babysit that day so my husband could come with me.

My psychiatrist immediately made me feel understood, being a mom herself. It’s a strange thing, but I almost feel like depression makes you believe no one else could possibly be going through what you are going through. So you feel quite singular and when others try to empathize, all you can think is, “No, you just don’t get it entirely.” Yet at the same time, way deep down, you’re hoping maybe some of this is not so uncommon and that there’s a way out.

My psychiatrist didn’t judge; she didn’t pity. She made me feel like my problems were simultaneously unique yet also common. And I finally felt like maybe there really was a light at the end of the tunnel, albeit faint. My psychiatrist increased my Zoloft dose again because 50mg just seemed too low. She told me firmly and confidently, “Jasmine, I am going to get you to sleep again.”

And somehow, I believed her… because, what other choice did I have at this point? I had hit rock bottom. And she just seemed like she knew what she was doing.

 

6. Antidepressants Can Work

It didn’t happen over night and I still struggled with the sleep for much longer than I had to deal with my mood, but I slowly did start to get my energy back. I had a few days of initial tingling and spasms when we increased my Zoloft dose again to 100mg, but I tried to just ignore it. Luckily, the feelings went away eventually. And I found that if I actually listened to the advice I would have given a patient and ate a good breakfast while taking the Zoloft, my stomach would not get as upset. Lo and behold, practice what I preach…and it worked! I started tolerating the medicine much better.

We tinkered with a variety of medication choices for sleep, and my psychiatrist forbade me from trying to nap, lest my anxiety would act up again from trying too hard. It took a few painfully long days, but the first night that I finally felt like I got some rest, I was able to sleep for 4-5 hours straight. It wasn’t the most restful sleep, but sleeping for that long was equivalent to a miracle for me. I tried to follow everything down to the exact timing the following night to try to replicate the sleep.

My angel of a husband had been making me sleep in our bedroom alone while he slept in the nursery with the baby and fed her and changed her in the middle of the night. Again, I stirred up a lot of guilt over this because I felt my husband was taking the brunt of the work in caring for our newborn. I felt like a bad mom because I wasn’t the one taking more care of my baby. I felt like a bad wife because he had to take extended leave to care for me too. I felt like a bad friend for ignoring everyone who was trying to check in with me. I didn’t feel worthy of deserving the title of “mom” when I was so fragile myself for something so innocuous-sounding as depression.

But my psychiatrist quickly berated me for thinking these things. There is nothing innocuous about depression. She said some words that I still remember to this day because it highlights how much we still need to work on mental health stigma and the inequality of gender roles in parenting. She told me, “Postpartum depression is a very real disease. It’s an unfortunate and sad disease that no one expects to get. And I am so very sorry you are unable to enjoy this precious time in your baby’s life, especially when you tried so hard to conceive her. But if you were diagnosed with cancer instead, would you feel as bad about people having to take care of you? Just because you cannot see the PPD and it doesn’t feel like a physical ailment, it doesn’t mean it’s any less debilitating. It is an illness. And in order to be a better mom, you need to take care of you to be there for her.”

Her words hit home. In essence, happy and healthy mama = happy and healthy baby. And “healthy” encompassed both physical and mental aspects.

Over the next month, I tried harder. I religiously took my Zoloft every morning. I tried to forgive myself and not be so hard on myself. I forced myself to exercise more, starting off slow with just a walk to the park before gradually returning to the gym. I finally responded to some text messages that were weeks overdue and set up small one-on-one dates with friends. I tried to schedule one outing a day, even if the outing was just walking a block to the boba shop right by my house.

People probably thought I was crazy for getting boba almost every day, or that it was sad that a boba trip was the highlight of my day. I definitely got some snarky comments about it. (#hatersgonnahate) But what they didn’t realize was that these were incredibly difficult things for me to start doing. It was a HUGE improvement for me to get back my appetite and to even have the energy to leave the house. I started to genuinely enjoy my daughter’s first smiles, coos, and laughs for the first time. I also started to get back on social media and catch up with my friends one by one.

My sister gave me some wise reminders: just because I was taking medicine, it didn’t mean I would wake up one morning and suddenly feel entirely better or know that I had been “cured.” She went on to say, “Think of it more as a process or a path and one day you’ll look back and realize that you actually got quite far. But in the moment, you can’t tell that you’re actually moving forward.” This thought helped me through those days when I struggled to stay calm and felt impatient that I couldn’t see the tunnel’s end.

I finally told my work family that I was in the midst of battling PPD but it was slowly getting better. They were nothing but supportive as I knew they would be, but the difference this time was that I finally let them be there for me. Many of them had been reaching out to check in with me, and I had been pushing people away. Letting them in on my story felt strangely relieving, like a small load had been lifted off my shoulders.

***

Another coworker was also going to give birth soon, and I shared how difficult my first few months were with her. She told me that HR had mentioned to her that PPD technically is a postpartum complication and that I should look into extending my state disability for it. Uhm, what?? How did I not know that PPD was considered a postpartum complication?! Is this common knowledge that I was just oblivious to? Nevertheless, I was glad to learn that the state of California recognizes mental health complications are also a postpartum disability. Because they are.

At first, I didn’t want to pursue the extension because I thought it would be a huge hassle. And it was. I’m not sure why they make it purposely so difficult and why you can never reach ANYONE live at California State Disability. But I was proud of myself for being able to figure out all the disability paperwork, contacting my work HR, and seeing the whole process through. It sounds pathetic, but this was another small step forward in my mind–a small victory that indicated I was on the mend because I could actually finish a task without having a nervous breakdown and giving up. (See my related post on Maternity Leave in California.)

The last thing to address was my sleep. At the recommendation of my psychiatrist, my husband and I established a very regular sleep routine. The sleeping medicine would make me drowsy enough to fall asleep, but in the beginning, I would wake two to three times a night, even up to four times some nights. It was these middle-of-the-night wakings that would trigger a sort of PTSD and make me wonder if I would be able to fall back asleep again.

Routine was good, but sometimes I would also get anxious if we didn’t follow it exactly, causing me not to be in bed on time. I remember there was one night we were at my mother-in-law’s for some reason, and I was so anxious about getting home in time to prepare for my bedtime routine. I got a little snappy with my husband when we weren’t leaving soon enough because we were waiting around for dessert or something. Looking back, that was still the depression and anxiety acting up, and I didn’t trust my body enough to do what it naturally should.

It would take me three months to completely taper off of my sleeping medicines until all I was taking was a natural melatonin supplement. I finally stopped the medicine two days before my sister’s bachelorette party. It made me nervous to be off the medicine, so I decided not to stay overnight at the party with her (which she totally understood). I’m proud to say, that once I stopped the sleeping medication, I haven’t been back on it. It would have been okay to use it again if I needed to, though. My psychiatrist always reminds me that it’s always there if I need it, but truthfully, I just have not required it.

Another thing my psychiatrist told me was that sleep is usually the last thing to be fixed in depression. This definitely gave me comfort knowing that it was normal for me to be taking longer to work on my sleep anxieties than my overall depression. It was very much like a chicken or the egg scenario–was it the anxiety or the insomnia or the depression that came first? Whatever it was, they fueled each other and I’ll never know what came first. But what mattered was that on the surface, I definitely was improving in mood, energy, appetite. Most importantly, that numbing anhedonia was fading away. The fact that I’m even able to blog right now is a huge leap forward.

I attribute a lot of the improvement to the Zoloft, and my outlook on taking antidepressants has changed a lot. Even though it was probably a multi-factorial effort that rescued me from drowning in my own worst thoughts and feelings, I do think that the medicine played a role. Though waiting over a month to see an effect from the appropriate dose did seem long to me in the beginning, when I look back now, I’m pretty surprised at how fast I seemed to bounce back from extreme lows to almost my normal self (aside from the sleep anxieties).

A pill won’t cure everything. That’s not what I’m trying to promote. You still have to put in the other work, and mind you, it is a lot of work. But I now believe that medicine can be one of the tools that helps you along the way. With the severity of my symptoms, I’m not sure I could have seen such a fast turn around with just talk therapy or waiting it out. I am grateful for the part that medicine did for me on my recovery road, and I hope that my experience with it can help other women who are also worried about trying antidepressants.

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In the last part of this series, I’ll talk about where I am today and future plans for therapy, as well as a few lessons I’ve taken from this whole ordeal. Thank you again if you read this far and if you have more questions about the medications, please feel free to ask. I am not an expert on psychiatric medications, but I can speak towards my personal and pharmacy experience. And I know of resources to ask should you need more advice. 

It is my hope that society stops judging those who take antidepressants because, like blood pressure medication, they might be very crucial to extending quality of life for someone if appropriately titrated and if it is a good fit for the individual. I was guilty of perceiving that stigma before, but now that I have gone through it myself, I have a much deeper appreciation for the fragility of mental health and what it takes to recover.

Thanks for reading this far! <3

xoxo,
Jasmine

[Edit: Since writing this post, I have also written about getting off of antidepressants a year and a half later!]