If you’ve been following along my Beyond Pregnancy series, I sincerely thank you for your interest and hope that good, thoughtful conversations are being raised from it. I’ve had a lot of really kind responses, and I’m deeply grateful for the outpouring of support and love from everyone, even friends I may not have connected with in awhile. I took a little hiatus in writing, since the holidays were upon us. I wanted to be fully present for my daughter’s first Christmas so this was on the back burner. Then we all got sick after Christmas (womp womp). So albeit a little delayed, here is the final part of the series!

If you haven’t read Part 1 (My Battle with Severe Postpartum Depression) or Part 2 (My Struggle with Taking Antidepressants), it may be a good idea to read those first as this post will focus more on what I’m currently doing with my treatment regimen and how I live with it day to day. Again, as fair warning, there is a lot of text.

I left off last time talking about how I decided to take the Zoloft at my psychiatrist’s recommendation. I had also finally weaned off sleeping medicine after three months of taking them with a little bit of hand-holding from my psychiatrist. With a combination of medicine and alternative self-care, I finally started to see the light at the end of the tunnel…

7. The Present

So where am I now? What happened to the medication(s)? Am I still going to therapy? What was the timeline of all this? I’m sure people are wondering this if you’ve followed along this far, even my friends. And I don’t mind if you’re nosy; I’d be dying to know the answers to the above too if I were on the other side of this. So hopefully this satiates any burning questions.

I started the right dose of antidepressants a little after two months postpartum, along with a sleeping medication that finally seemed to work in the slightest. It was not the medication I myself might have chosen for insomnia in theory, but after trying so many different ones, I went with what worked and seemed like low risk of abuse. The choice of medications I would have recommended to patients caused side effects that I couldn’t determine if they were just coincidence or a true adverse event.

Just a little before three months postpartum, I slowly started to tell some of my closer friends and people who asked how I was doing that I was going through postpartum depression (PPD). I realized that isolating myself was not helping my depression and that it was in fact a severe symptom of it. So I forced myself to start opening up to my closest friends.

I also didn’t want the people closest to me or other new moms or moms-to-be have this false impression and to think that everything was fine and dandy just because social media reflected that. I had unplugged for over a month before slowly getting back into it. But I often was at a loss for how to react when people commented on how “great” I looked or how “easy” I made motherhood appear. It made me feel like a fraud and I would deny all of it.

I wasn’t trying to get pity, but I genuinely wanted people to understand that this motherhood thing is hard and PPD is common. Once I started getting help, I realized that it was okay to talk about it when people asked and to not be ashamed. Admitting I was battling this was also a step forward towards getting better, in my opinion.

Things started to marginally improve for me when my daughter was around three months old. At that point, I felt the Zoloft dose that I was on was finally starting to work, so I continued on it. On top of that, my daughter started sleeping through the night about 8 hours a night at least. That quickly progressed into 10 to 12 hour nights, which helped us out a lot since it meant I could focus on my sleep instead. (Thank you, my sweet girl.) I had regular follow ups with my psychiatrist and a LCSW therapist assigned to me. At first, it was about every other week that they would check in, but then it stretched to monthly and then longer.

I returned to work around four months postpartum and I am one of those moms who was not tearful about leaving her child at home because going to work felt like a break to me and was probably helpful to improving my overall PPD. I am not going to feel guilty about not breaking down and bemoaning leaving my baby behind. Working works for some moms and for others it does not.

I happen to be one of those moms who needs a work life balance. I actually felt productive about my work in helping other patients and not being the patient for a change. My anxiety also probably made it so that it was nice to get out of the house and keep myself pre-occupied with something else other than baby stuff. This isn’t to say I didn’t miss my baby or feel overjoyed to see her at the end of the day. I totally did. I am very fortunate that my husband was able to stay home and watch her. She was in good hands and I’d get plenty of updates and pictures.

By the time my daughter was six months old, I finally felt like my old self again, with just a little touch of anxiety every now and then. I could tell the anxiety was coming on when my stomach would clench tight and I would catch myself holding my breath. Over time, the anxiety decreased and usually only revolved around my worries about insomnia. But my appetite was back, the uncontrollable worries stopped plaguing me incessantly, my energy levels were up, and best of all, that anhedonia had dissipated and I was interested in life again. I stopped having these horrible, intrusive thoughts about myself.

In addition to taking care of a baby, I was capable of accomplishing a reasonable amount of things that I may have done in the past before I had her (e.g. grocery shopping, cooking, cleaning, etc.). As the one who usually planned all the meals for the household and knew what produce we had in the fridge, I had gone a very long time without being able to make non-frozen or microwave food. My husband had taken over pretty much all the household chores while I was slowly recovering. He would even have to prompt me to look at the weekly grocery ads and compile grocery lists when that was usually my arena. It’s shocking how much hand-holding I needed in doing basic living activities when I was shrouded in depression.

By six month postpartum, one of the biggest tasks I had to accomplish was being the maid of honor in two very important weddings in the same weekend, 300 miles apart! Even if I didn’t have a baby, all my friends thought this was going to be a crazy feat. Then after I had my daughter, I was thinking I might have to drop out of the weddings because I didn’t have the energy or (truthfully) desire to carry out my duties because I was so depressed and anxious. Luckily, by the time the weddings came around, I was able to get it together and write two speeches and coordinate our first family road trip. And the brides were also some of the coolest, non-Bridezilla ladies ever. Of course, none of this would have been possible without my husband. I’m glad everything worked out in the end because the weddings were for my sister and my high school best friend!

I also started to see a confidential (and complementary!) therapist that work provided around five to six months postpartum. I could make in-person visits to see her a lot more easily than to see my other providers, since the work therapist was at my work campus and I could just pop in during lunch hour. We met every two weeks in the beginning. Most of my follow ups with my psychiatrist and assigned LCSW were on the phone or video visits after seeing them once in person, so the in-person work therapist was a nice supplement on top of that. I do think in-person visits are pretty helpful to establishing a good relationship with your therapist, although I’ve had a lot of success with video visits with my psychiatrist too.

It took me three months to taper off of my sleeping medication, until I was only taking a melatonin supplement at five months postpartum. (Melatonin is considered a natural supplement because it is a hormone in your body to regulate circadian rhythms or sleep-wake cycles. I’m honestly not sure if the supplements are just placebo effect or not though…) So around the time I started seeing my work therapist, I was already almost completely off of sleeping meds. However, it would still take me another three and a half months to truly feel like I was able to sleep normally again. Because even after stopping sleep medications, I still had a lot of anxiety about waking in the middle of the night and wondering if I would fall back asleep.

I’d often wake up a few times a night to use the bathroom or because I heard a stirring noise on the baby monitor. Luckily for her, but unfortunately for the awakened me, she always put herself back to sleep without help. Then if I looked at my watch or my phone to check the time, seeing 2am and/or 4am would ignite my anxiety because I would develop an inexplicable panic that I wouldn’t be able to fall asleep again until 6-7am when the baby usually got up.

While my mood felt 100% better, whenever I thought about going to bed at night, the annoying, nagging anxiety would creep in. It was a bit of an irrational fear, but I think that time was really the most important thing that helped me build the confidence and assurance I needed to see that I indeed could fall asleep. The more my body showed me that I could survive the night, the less nervous I felt.

My work therapist was very instrumental in helping me work through my sleep anxieties and self-doubts. She taught me some helpful coping techniques, such as EFTs or “tapping.” We are currently working on eye movement desensitization and reprocessing (EMDR), which she is trained in, for trauma desensitization. I think that my sleep actually started improving after our first EMDR session.

Side note: While recently catching up on Grey’s Anatomy with my husband (yes, we are still watching it and they are on Season 16!!), one of the doctors (Jo Wilson) does a bit of EMDR herself at therapy! I was pretty excited to tell my husband that I was also doing that in therapy as well, and he could get an idea of what I was working on. So hey, this stuff is getting more mainstream and accepted, which I am overjoyed about.

***

About a month ago, I took the first nap I’ve taken since before giving birth over eight months prior (I don’t count that first month postpartum, though–that sleep is ALL messed up)! I was so excited about being able to fall asleep for a nap that I texted my husband (who was at work) that I had slept for half an hour while our daughter was down for a nap. He was also in shock because he knew how difficult that was for me and how the idea of a nap would cause me PTSD.

I didn’t intentionally try to take that nap though, because my psychiatrist said I should just consolidate all my sleep at night. But the fact that it accidentally happened made me so ecstatic, even though it seems like such an insignificant, trivial act to be able to do. I’m not sure I could ever express how monumental waking up from that nap felt–like a sign that I was really normal again. Since then, for the past month, I have even been able to skip my regular melatonin dose or cut it down to just one melatonin gummy a night instead of two gummies that consist of a serving dose.

Side note: As a pharmacist, I don’t tend to recommend gummies for any kind of vitamin or supplement because they are usually less bioavailable and probably do work not as well as a pill form. But since someone close to me gave me a sample of these yummy blackberry gummies in the cutest Olly bottles, I started to regularly use it, since I didn’t want to mess up any of my routines that seemed to be having a slight success.)

And the antidepressant? Yes, I’m still religiously taking my Zoloft everyday, even though I am stable and have been for awhile. But the truth is, SSRI antidepressants are also mainstream anti-anxiety medications, so perhaps it was a good thing I stayed on them because maybe they also helped me over time with my sleep anxieties.

In the beginning, I wanted nothing more than to get off all medications as fast as I could, for fear that I would somehow be dependent on it for life and the negative connotation of being on an antidepressant or sleeping medications. But my psychiatrist told me she was pretty confident that I would be able to taper off of it eventually since I really had no prior history or risk factors for depression or insomnia. (Not that there would be anything wrong for staying on the medications if I truly needed them.) She recommended that I take the antidepressant for at least a year to maintain remission at our most recent appointment this month. And since she had taken me this far, I decided to trust her clinical judgment.

After all, she did promise she would get me to sleep again. And so she has. She has been one of the best providers I have ever had the pleasure of working with, and I’m so grateful for her.

8. Learning to be “Normal” Again

After my daughter was born, I often wondered how I would go back to being my old self again and doing all the daily tasks I used to be able to do. My husband kept hearing me say I wanted to be “normal” again. The truth is, I was looking for the woman I used to be –not realizing I would become more than that and that the past me could never truly exist again. In the darkest depths of my depression, I felt so lost, confused, and worthless.

I would stare at pictures of myself with my husband and wonder how that girl could even be smiling that hard. And I would wonder if I could ever be happy, confident, and independent like her again. I would look into the mirror and literally not recognize myself. I know that sounds so cliche, but I never understood that phrase more than in the first months postpartum. I felt really disconnected from myself, sometimes wondering if I was having an out-of-body experience watching my life miserably ooze on by.

My past identity felt completely foreign to me. Would I ever be able to go grocery shopping again? Would I ever be able to cook a full meal from scratch again? Could I even bake a simple item like banana bread? (Spoiler alert: yes, I would!) These simple ordinary tasks seemed so hard in the moment because as much as I wanted to be “normal,” I also had so much anxiety and worried about the most insignificant things to the point that it paralyzed me to go out on my own with my daughter.

I wanted a step-by-step instruction manual on how to live my life now; I wanted someone to tell me what to do, down to the minute. I was so unsure of myself and any decision I made from deciding whether to pick up my daughter when she was crying or to try letting her self-soothe to sleep on her own. The anxiety of not feeling in control of my life anymore was terrifying and overwhelming. Quite frankly, it was very demoralizing too. Because even though I could excel in school and my career, I somehow couldn’t get my act together for something as basic as caring for a baby–what women have been doing for eons before me.

But once the depression started to wear off and I got my energy levels back, finding a new “normal” didn’t seem quite as daunting anymore. One thing is for sure–having the right partner to have a child with is so essential. My husband was extremely supportive and crucial to my recovery. Besides for taking a drastic cut in hours at work so he could take care of me and our baby, he tried to find ways to make it easier for me to take care of our daughter whenever I was by myself with her. He bought extra bottles and nipples so I wouldn’t have to wash or sterilize anything all day until she was asleep if it came down to that. He packed my diaper backpack for me and made sure I always had plenty of supplies in stock.

My husband isn’t a man of many words; he is big on actions speak louder than words. But in those months of postpartum depression and recovery, I heard a lot more words of encouragement and support than I have since before we started dating. [Hint hint, honey–it’s sexy and awesome when you do that. ;)] He cheered on all of my baby steps and often had to remind me of things I really didn’t believe in anymore because my self-image was so shattered and broken. He would tell me that I was strong, that I was a good mom, that I was still beautiful and brave to him. He would remind me of the things I did for our daughter. He would join my psychiatry appointments if I wanted him there; he would encourage me to take me-time at the gym or with girlfriends.

It sounds crazy, but because of my husband being around and letting me take baby steps to recover, I was never my daughter’s sole caretaker for the entire day until after she was four months old! I’ll always remember it because it was the day following my first day back at work and I was more nervous about that day alone with her than going back to work after being away for 5 months. And then after that milestone day of being the sole caretaker, I felt like superwoman. I felt like I could do anything.

I started planning things to do with my daughter when my husband went to work once a week during his intermittent leave. I remembered just two months before going back to work, I absolutely couldn’t stand to be around big groups of friends. I feared judgment, and I would be so anxious and irritable to be around other people. But now I was able to chat with my coworkers normally and not feel like I had to put an enormous amount of effort into being fake cheerful. They were patient and sensitive around me without making things awkward.

It took a few months, but I was genuinely happy again. I know “a few months” doesn’t sound like a long time, but in postpartum world, those first few months stretch like the longest slow-motion video you’ve ever seen or those sloths working at the DMV in Zootopia. So to me, it felt like quite awhile before I was able to feel true joy again. But I was falling deeply in love with my daughter and the little person she was becoming with each and every day. And boy, was she turning out to be quite the brightest and liveliest firecracker that I ever did see.

We are so thankful that she is a good eater and a good sleeper. I know that things could have been a lot worse if I had a colicky baby or one that didn’t sleep through the night or a baby who didn’t feed well. I honestly have no previous experience or other babies to compare mine to, but looking back now, I am so grateful she is actually quite well-behaved.

I also stopped trying to be the person I was before. Instead, I accepted the new person I had become in order to be the best mother I could be to my daughter. Acceptance plays a huge role in expanding the capacity of one’s heart to fill with even more love. I realized I didn’t need to be “normal.” I needed to be present, and I needed to be healthy –physically and mentally. You often hear that when babies arrive, they are not the only ones that are born. I was also reborn as a new woman–as a mother.

9. Afterword — Name it to Tame it

To be honest, this post has been the hardest one to write. I’m not entirely sure why, but maybe it has to do with the fact that I truly had to process my thoughts and organize them in a logical manner and timeline. But this action is similar to “Name it to Tame it” in the book The Whole Brain Child—which I highly recommend to any parent. The authors are a neuropsychiatrist doctor and a psychotherapist PhD who discuss 12 key strategies parents can implement to help foster healthy brain development in children and the brain science behind it.

I found that a lot of the principles in this book about child development applied even to myself as an adult. The strategy “Name it to Tame it” sounds exactly like it means. This strategy is about how telling a story or defining a feeling and labeling it can really help us overcome trauma or fear:

“The right side of our brain processes our emotions and autobiographical memories, but our left side is what makes sense of these feelings and recollections. Healing from a difficult experience emerges when the left side works with the right to tell our life stories. When children learn to pay attention to and share their own stories, they can respond in healthy ways to everything from a scraped elbow to a major loss or trauma.

..Sometimes parents avoid talking about upsetting experiences, thinking that doing so will reinforce their children’s pain or make things worse. Actually, telling the story is often exactly what children need, both to make sense of the event and to move on to a place where they can feel better about what happened.” (pp. 28-29)

And honestly, this is probably why therapy is important. Because we are forced to confront and dissect our feelings and then let them out verbally and try to make sense of everything. Writing things down was a way for me to cope, organize, and untangle my depression as well. I started off with a very simple sleep journal to chronicle my progress night by night. In the beginning, it really didn’t seem like much progress. But looking back, it really was a process and journey that I didn’t realize was unfolding.

I also would sometimes just jot down a note on my phone whenever I was feeling particularly down or hopeless, reminding myself that this too shall pass. I wrote that phrase on a little post it note and stuck it to the back of my phone so I would frequently see it. I didn’t fully believe it in the beginning, but it did happen–it did indeed pass. Journaling is just as powerful of an expression modality to organize your thoughts. So this blogging experience was as much a tool for me to heal as I hope the content will be for others out there suffering through PPD.

There is a lot of talk about how we need to de-stigmatize the negative context of PPD or mental health issues in general, but in order to do that, we need to not fear talking about it openly. That’s another part of the reason why I decided to write so much detail about my journey. During my deepest, darkest hours, I kept wondering why this was happening to me and why I was failing myself and my baby so hard. For someone who has been fairly high achieving all my life, I was shocked at how something as basic as taking care of a newborn was utterly destroying me.

But I’m a firm believer that things happen for a reason and timing is not coincidental. So to answer myself, I think all of this happened to me because I was meant to help others through it too. I survived a soul-crushing, severe depression so that I could be there to empathize with other mamas going through it and to give them a voice.

I had a good teacher in high school once tell me not to waste my talents and that if I had a gift for something, I had a responsibility to use it to do good. I never felt I had anything worthy of sharing or a bigger responsibility to bring something to light as much as my postpartum depression experience. And I am not trying to say I have a gift in writing. There are much better writers out there, but since I do have this platform available, I believe I should use my power of words to illuminate some of the harrowing details of PPD in my experience. I’m trying to turn my negatives into something positive.

If being vulnerable to the world means I can even help just one person through my words, then it will be worth my efforts. Through all this, I’ve learned a lot about myself and others. I’ve learned who matters in my life and who truly cares about me; I’ve learned about what really is important in life. I have been deeply humbled by motherhood, even more so than by my conceiving problems. I have so much more empathy for my patients who are parents, especially new moms, and those who are going through depression themselves (postpartum or not). I have so much more respect for my own parents now.

In conjunction with my medication, I have tried other holistic approaches like acupuncture, meditation, and mindfulness. I believe that good mental health is usually achieved with a blend of both medicinal and natural remedies. My thought processes are always a work in progress, and I constantly have to work on redirecting my train of thought or cutting the guilt and anxiety short because I know it is irrational. Just remember that no two people have the same solutions to “curing” their depression or anxiety, and that’s okay. My story and my recovery is only one of so many.

***

Of course, it’s not all rainbows and sunshine now. Parenthood is still challenging, our household suffered a pay cut, and some of our goals and plans had to be put on the back burner for now. But the most important thing now is that I feel so much more healthy and vibrant and at peace. I am more able to focus on the big picture, appreciate the little things, and roll with the hurdles that come my way. Things are certainly looking a lot brighter for our humble little family, and there is so much love brimming for this little one.

There’s a lot more I can say about recognizing PPD, preventing PPD, and what can be helpful to recovering from PPD, but this series has been long enough and those would have to be for another day. I do think there is still a lot to be done on the mental health front for postpartum women. It’s not an easy thing to tackle because the depression itself can make seeking help the first major roadblock, and I’m sure it is often under-diagnosed or recognized.

If you have read this far along in the series, thank you. My hope is that you can take something helpful away from it or develop more empathy for those who go through PPD. I hope you can understand more how PPD is multi-faceted, debilitating, prevalent, and tragic. But above all, I hope you realize that even though this intangible dark cloak can make someone feel guilty, hopeless, and utterly, utterly worthless, it. can. be. beat.

It’s okay to seek help, and it’s okay to try medications. It’s not your fault. I personally know these things can be hard to believe; I was that disbelieving person too. They are uttered so much that they just roll off like oil on water, but you need to be repeatedly reminded of their absolute truth until you believe it. And if you need a place to start with help, my door is always open to chat more in private if you need. Also, you can get off of antidepressants too–see my last post of this series here.

If you are suffering from PPD, think you may be suffering from PPD, or know someone suffering from PPD, please remember you are not alone. Try self-administering the Edinburgh Postnatal Depression Scale if you are not sure if you have PPD. This questionnaire is much more tailored and specific than your typical PHQ-9.

I am no expert. I am merely a survivor. But I am living proof that you can survive and overcome postpartum depression. It can be beat. By time and by love.

***

[Update] September 2020 – I recently wrote a resource guide for PPD, PPA, and insomnia if you would like to learn more about how to support someone going through these things or if you yourself are looking for more ideas of how to get help but don’t know where to start. Please check it out!