Nothing I learned during nursing school or my career could have prepared me for the hormonal mood changes of pregnancy and the postpartum period.
I discontinued the low-dose SSRI I had been taking for premenstrual dysphoric disorder before I got pregnant. For the most part, my mood remained stable. Sure, hormonal swings early in pregnancy gave me the super-human strength to rip a banister from a wall in a fit of anger, but this ruffle aside, the pregnancy was uneventful.
As I prepared for the delivery of my baby girl, I experienced what I believed to be normal anxiety. Will I make it through labor? Will my baby be healthy? I rang in the New Year with a bang and started having contractions on January 3, 2017.
That morning marked the beginning of a two-month struggle to regain normalcy. It started with excruciating pain that was false labor ––real contractions and real pain without dilation. It was a setback, but 35 hours later, I was handed a beautiful baby girl. So it began, my blissful postpartum journey into motherhood… or so I thought.
No one tells you that your expectations surrounding pregnancy and postpartum life should be thrown out the window, because nothing goes as planned.
Postpartum day two began with my first shower in two days. My mind was racing. Something was not right, but I couldn’t put my finger on it. I told my nurse something was wrong. Maybe I had an infection, low blood sugar, or was dehydrated? I thought I was going to die, but my better judgment told me not to mention my horrible feeling of doom.
Self-diagnosing is what nurses do best, so how could I be mistaken? I knew this was a physical ailment and my low score on the Edinburgh Postnatal Depression Scale confirmed this to me. I was convinced that there was something physically wrong with me that no one would diagnose until it was too late.
I was discharged home with my baby after three days, ready to tackle any obstacle. Why wouldn’t I be, with over a decade of nursing experience in top hospitals as my training?
In my first three weeks home, anxious thoughts reared their ugly heads until I broke. I was paralyzed by fears that I would unintentionally harm my baby or wake up to realize she’d stopped breathing. Or maybe something would happen to me, leaving my husband alone to raise her. I had become a shell of myself. I couldn’t drive. I couldn’t take care of my baby. I was barely taking care of myself. I was too scared to sleep, but I needed sleep so badly.
Digital Art: “Poker Card” by Kathryn Zorych
I tried to seek help. I went to the ER twice and my OB/GYN three times looking for a medical cause for my symptoms of incoherence, anxiety, and insomnia. Postpartum depression and anxiety were never mentioned in the ER. My OB/GYN asked if I felt depressed, but I said no. This wasn’t the depression I knew… I felt lost and alone in a deep abyss of confusion and insecurity. To make matters worse, I thought I was becoming “the problem patient” dreaded by healthcare providers.
At 4 AM on January 28, I woke up sweating, gasping for air, heart racing, afraid for my life and the lives of my entire family. At 4:40 AM, I started googling “postpartum anxiety” and discovered endless articles, websites, and discussion boards as my husband called my OB/GYN. I had heard of postpartum depression, but never postpartum anxiety. I didn’t know it existed.
“Postpartum depression,” were the first words out of my doctor’s mouth when I nervously took the phone. I was still confused, but I felt relief for the first time since giving birth. Finally understanding the many different ways postpartum depression can present, including anxiety, difficulty focusing, sleep problems, and physical symptoms, I realized it fit me perfectly.
Why doesn’t anyone talk about this? How could I have gone so long not knowing what was going on with my body and mind? Even as a nurse, I didn’t know what to look for. I missed the warning signs, sure that everything wrong with me was a physical, not psychiatric, issue.
My doctor prescribed Zoloft and Xanax, which I started immediately, hoping for quick relief. Within a week, I started feeling better with less racing thoughts. Finally, I was sleeping. Ten days later, I saw a psychiatrist who adjusted my Zoloft dose, discontinued Xanax, and started Klonopin. Soon, I felt normal. Really normal, like a new and improved version of myself!
I am thankful for the patience and kindness of my OB/GYN and family and for the medications, because without them, I don’t know where I’d be. Now, I’m armed with the tools to face the future and finally able to really enjoy my new little human.
Lauren Hauck is an emergency room nurse who worked at New York Presbyterian Weill Cornell Medical Center prior to taking maternity leave.