Friday, December 21, 2007

Postpartum Psychosis Clarification

From now on when I write about my postpartum experience, I am going to use the term Postpartum Psychosis instead of Postpartum Depression. I was using PPD because it was easier and to be honest, postpartum psychosis brings to my mind lunacy. PPS is a level of PPD anyway and I thought PPD was an encompassing there. However, I now think I should be very clear about what I had because it was significantly different from standard PPD.

I think I wrote before about the three levels of PPD. There's the baby blues that hit 3 or so days after birth. This is caused by hormones leaving the mother's body. Moms become weepy and a little blue, but it passes within a week or two. Up to 80% of moms experience this.

Standard PPD is what most people think of when they think of PPD. If you read Brooke Shield's book, Down Came the Rain, it's what she had. PPD is a clinical depression that affects between 10%-20% of new moms. It can strike at anytime up to a year postpartum. Women who have PPD experience the usual depression symptoms of fatigue, sadness, hopelessness, insomnia, and appetite changes. They also may have feelings of guilt and worthlessness. They might think they are terrible mothers. They may worry about their babies more than normal. They often worry that their babies will get sick or injured. They may withdraw from their babies and feel detached. They may avoid their babies. They may isolate themselves and spend a good deal of time crying. In more serious cases, they may be suicidal. Some mothers may have intrusive thoughts and worry about hurting their babies.

Risk factors for PPD include having one or more episodes of clinical depression, having a difficult or disappointing pregnancy or delivery, lack of emotional support, major life changes prior to giving birth, marital problems, unplanned pregnancies, and a history of severe premenstrual syndrome.

PPD is a serious condition and can impair a mother's ability to care for her children. Families may have to use secondary caregivers because the mother is unable to care for the children. The good news is is that it is extremely treatable. Antidepressants and sometimes therapy are used to lift the mother out of depression.

The third level is Postpartum Psychosis. It is very rare and very serious. It affects only 1 out of 1000 mothers. This is what I had. PPS is what causes mothers to kill their babies and sometimes themselves. Mothers with PPS may experience the symptoms of PPD but also may have hallucinations, delusions, irrational thoughts, episodes of mania and delirium, obsessive thinking, paranoia and suicidal thoughts.

I went through all three stages on the spectrum, really. I had the baby blues, but they ended very quickly, within a few days. At around 3 weeks, I began feeling depressed. I felt a general sadness at first. It progressed to feeling hopeless about my situation. I cried most of the time and I fantasized about leaving. I isolated myself somewhat (not hard to do with a newborn anyway) and very early on began feeling very detached from Ladybug.

Very quickly though, within two weeks at the most, the symptoms of psychosis began. I basically lost touch with reality in a way. I become irrationally obsessive about taking detailed notes about Ladybug's eating and sleeping habits. If my husband did not cooperate with this, I would become raging mad, hysterical. I became paranoid about other people; I was convinced that my mother-in-law wanted to take my children from me. During one episode, I was convinced that my husband locked me out of the house at night and I became hysterical. I attributed thoughts and deeds to people that never occurred. I seriously thought that Ladybug was crying just to anger me, that she wanted to irritate me and that she hated me. I felt like everyday was a roller coaster. I would feel OK one minute and hysterical or raging mad the next. I felt absolutely out of control.

The scariest symptoms for me were the hate and anger I felt toward Ladybug and the secret desire to hurt her. I felt much more likely to kill Ladybug than myself, though I did attempt suicide at one point. As I said before, I was deemed homicidal and suicidal by medical professional. I hated having to see or touch my baby and I would think about all the ways she might die. Women with PPD often fear that their babies will die or become injured. I actually wanted Ladybug to die and I would think about ways I could do it. I would see pictures in my head, flashes of me doing something to her and I would often feel a strong urge to follow through with these actions. I never heard voices, but I would feel compulsions. I also would become hysterically angry at her and rage at her until my husband removed me from the room. And a handful of times I came extremely close to hurting her. I actually squeezed her very hard several times and shook her and I remember very roughly dropping her in to her crib in anger, almost throwing her in.

I have never before experienced psychosis before the birth of Ladybug. I do have a personal and family history of depression. I have been clinically depressed and suicidal twice before and was hospitalized in my twenties. But I am not bipolar or psychotic. This was a definite postpartum experience.

In reading all this now, I look like a total lunatic, I know. But I am fine now. I was put on anti-psychotics for a while and have been on antidepressants for months. Once stabilized, I never had another episode of psychosis.

I will never have another child though. The risk of the psychosis returning if I gave birth again is high and I have been advised by my psychiatrist not to get pregnant again. I am fine with this and I think for us, it is the right decision. I would never want to go through that again and I would never want my family to have to go through it again either. It almost destroyed my marriage and we'll never know what it did to my children.

Yesterday, we had a day of Christmas activity--baking cookies, listening to carols, getting ready to go to the grandparents' house. As we were doing all this, I looked around me at my children and was so deeply happy and felt so much love for them that it made me cry. I try now to give extra attention and love to Ladybug to make up for the hate I showed her as a baby. I try everyday to hold her in my arms a few minutes and rub my cheek against her head, nibble her cheeks and tell her how much Mommy loves her. My fear is that she will have lasting emotional scars from her early months and I want to do everything I can to heal them.

Thursday, December 13, 2007

Journey Part 3

When I was thinking about what I had written yesterday, I had a realization. Often, when I was rocking Ladybug and crying, I would look around her beautiful nursery, at all the work we had done to make it special. My husband had painted the walls a pale, soft pastel lime green. I had hung light pink curtains on antique-looking ivory steel rods. The stitched sampler prayer that had hung in my bedroom as a child was re-framed and hung on the wall. I had chosen pretty gingham and flower bedding from Pottery Barn Kids. There was a white lamp with a pale pink shade on it that cast a warm light in the middle of the night when I would go in to feed her. My old dolls were lined up on a white wicker chest that had been mine as a child. A cloud of beautiful butterflies hung over her crib from the ceiling, watching over her. It was a beautiful nursery intended for a much desired, beautiful child.

When I looked around, I would think to myself how disappointed I was that this experience, my first few months with my child, had been so awful. I would think about how disappointed I was to have this screaming baby instead of the peaceful, content baby that I had wanted. What I realized just today was that one of the emotions I had during this time was grief. I was mourning for the loss of my dream.

This baby did not match up to all of what I wanted her to be. I had waited 9 months for her arrival after having miscarried once before (very early on). I had imagined what she would be like and how much fun and joy I would have in taking care of her.I was thrilled to be having a girl. I looked forward to the mother-daughter bond and how I would help her through all those daughter things in life, play dolls with her, put bows in her hair, buy prom and wedding dresses and be there when loves were lost, read her Eloise and teach her to be a strong, confident woman.

But instead I was struggling to care for a child who never seemed to be happy, that seemed to be damaged in some way, imperfect. I mourned.

I began to fantasize about leaving. I would concoct escape plans. I would plan where and when I would leave. What I would take with me. I thought that I would go to the coast, to the beach. I didn't know if I would come back, I just knew I wanted out. Several times I came very, very close to leaving. Once, at night, I lay in bed listening to my husband snore and I thought, if I get up now, he'll never know and I can be hours down the road before he realizes I've gone.

The only thing that kept me from leaving was my son. Despite all the rage I felt toward Ladybug and my husband, I loved Sweet Pea more than ever. I never grew angry with him. I knew that if I actually left, he would never forgive me and I might be giving up my son forever. I couldn't do that.

You might wonder why I had not gotten help up to this point. As I said before, I have been depressed at other times in my life, but this was like no other depression I had ever felt. Imagine you are in a grocery store. Your husband and family are just outside on the sidewalk. The lights go out. It's totally dark. You can't see anything. You take a step forward and bump into a wall. You turn and try again. Again, a wall. Then you realized that the shelves and walls are closing in around you and you have no way out and can see nothing. You can hear people talking to you, but you can't understand what they are saying. You know you must get out to get to your children but you can't see a way. You are desperate, panicked, alone and you feel like you are drowning. That's a little what PPD is like.

It was terrifying in its speed and depth. It came on very quickly and got bad very quickly. I remember at around six weeks postpartum, I was talking to my mother and she said, "It sounds like you are a little depressed. Maybe you need to see someone." I told her that yes, I thought I was, but I would probably snap out of it and it wasn't too bad. I told her I'd wait and if in two weeks I still felt depressed, I'd call my OB. Well, in two weeks, I was hospitalized in a psych ward. That is how quickly the situation became deadly serious. The rapidity of PPD is something that all new mothers need to keep in mind.

My husband knew, of course, that things were terribly wrong. He would leave for work, kissing me goodbye through my tears and he would return later to a still-crying wife. He had witnessed the rage I felt. He had had to remove me from Ladybug's room, fearful I would hurt her. He had heard me say over and over how much I wish we had never had her. He heard me say I hated her. It got so that he was afraid to leave me alone with Ladybug. He saw how obsessed I was with her eating and sleeping habits and how I had to compulsively check my logs. He knew that even touching Ladybug disgusted me and I avoided talking to her or even looking at her.
He had also born the brunt of some of my rage. I would turn it on him, telling him how much I hated my life and I should have never married him. He knew something was very wrong, but he was scared and didn't know what to do. He was barely hanging on himself, feeling stress at work and coming home to a nightmare.

My husband is not a strong believer in mental disorders. He was of the opinion that depressed people need to get over it and stop feeling sorry for themselves. It is a weakness in his eyes, one that he would never succumb to. He sees it as selfish. He had no faith in psychiatrist or therapists.

He began to resent this chaos that I had inflicted on our family. He resented that he was shouldering a huge burden. He resented that he had to come home to an unhappy wife everyday. He resented that he had to be the one to hold everything together while I stopped functioning. He lashed out at me as I lashed out at him. Ours has never been a marriage that handles stress well. We began arguing on a daily basis, the arguments often escalating to dangerous levels. We were totally unable to step away from each other and we often argued in front of the children. I would become hysterical, unable to calm down, throwing everything I could get my hands on, screaming and out of control. Divorce was bandied about. Words were weapons and we did all that we could to hurt each other.

There was another factor at play that discouraged me from getting help immediately. I was ashamed at what I was feeling and I was scared to tell anyone the full extent of my anger and unhappiness. I was afraid of being judged, of being told I was an unfit mother, of being labeled as crazy. I was terrified that someone might try to take my children away from me. It's funny that I was so fearful of this, isn't it, when I hated one of my children. But deep underneath the depression, I know instinctively that I did not want her taken from me. I knew there must be love down there somewhere.

As things were spinning out of control at home and I became less and less functional, we felt a need to cover things up. We did not want my husband's family to know about the situation and even now, they don't know how bad it was and some don't even know it happened. We didn't tell friends. Later on, my friends would be an invaluable source of support, but at that time, I was too ashamed and afraid to tell them everything. Many of my friends were pregnant and I did not want to scare them. Also, whether we acknowledge it or not, I think all mothers feel at least a twinge of competition with other moms. I did not want to be the "bad" mother of my group, the one people were afraid to leave their children with. I didn't want them to see me as a failure. I didn't tell my mother how bad I was feeling. I was especially worried about my mother-in-law finding out. One of the symptoms of postpartum psychosis is delusional thinking and I began to believe that she wanted to take the kids from me, that she always had and that she would jump at any chance to get me away from. I believed this as much as I believe the sky is blue. I became paranoid at people's intentions.

Eventually, at around nine weeks postpartum, I reached a breaking point. The day that I finally reached out for help was in the middle of November. Ladybug was screaming as usual and my husband had just left to go back to work. I was sitting in the rocker sobbing. I called my mother and told her that I didn't feel I could go on another day. I simply did not feel I could continue. Both my husband and I were very concerned that I might hurt Ladybug or myself. I was not really suicidal yet, but I knew I could be very easily. I had had casual thought about it, but I felt I was much more likely to hurt Ladybug then myself. More than that, I just didn't think I could physically take care of my children another minute. My mother asked if it would help if she came to visit. I told her yes.

A teacher, she made arrangements for a substitute and planned on coming in two days. She thought she could stay until Thanksgiving. She told me to call my OB, get a prescription for an antidepressant and get a name of a therapist. My OB called in a prescription for Wellbutrin XL and gave me a name. Unfortunately, the therapist he referred me to was no longer practicing. I summoned my courage and emailed some friends to see if I could get a recommendation. I told them I thought I had PPD and wanted to see someone. I didn't tell them how serious the situation was, just that I was a little depressed. One of them was able to give me a name and I was able to make an appointment for the following day.

My husband stayed home with the children while I went to therapist's office. I cried the whole way there. I could barely see to drive. Panic overwhelmed me and I felt desperate to get to the office, like I could wait no longer. Once there, I could not stop crying. Other patients in the waiting room stared as I tired to get myself under control. I could barely explain to the woman what was going on. I struggled to tell her how unhappy I was, how I felt about my baby and how we were terrified I was going to hurt someone. Alarmed, the woman realized very quickly that I was in the middle of a total breakdown and I needed help immediately. She arranged for me to be admitted to an inpatient program at a local hospital. It was not ideal, she said, but it was the only program that our insurance would pay for. I would be admitted the following day and remain there until I was stable and no longer a threat to anyone. I was to wait for a call in the morning to tell me when to report to the hospital.

As I left the office, I felt an enormous sense of relief. I called my mother, explained what was going to happen and asked her to come immediately. She left Nashville an hour later and arrived at our house that afternoon. Once she arrived, I felt like there was some hope for the situation. She could care for the kids while I was in the hospital and my husband was at work. Her presence served to stablize the situation.

That night my mom tried to divert our attention and lighten the mood. The next morning, we waited to get the call from the hospital. By 2 pm, no one had called and I began to get very agitated and worried. We did not understand why we were going through this routine anyway. Why couldn't I have just been admitted yesterday? We tried to call the hospital repeatedly and finally reached the therapist I had seen. Apparently, the psych ward intake coordinator was on vacation. They would try to get me in the next day. This should have been our first clue that this hospital was not the best place for me. But what other choice did we have? Our insurance wouldn't pay for another hospital and we knew I had to get help immediately.

I managed to hold it together enough to make it to the next day. My husband took me to the hospital the next morning. Complicating everything was that my husband's father is a well-known OB at that hospital and we wanted to insure that he would not find out I was there. We quickly filled out the paperwork, hoping to get out of the admitting area as fast as possible to lessen the chances of seeing someone we knew. We made certain that my files on the hospital-wide computers would not be accessible to anyone other than my doctor. We kept our heads down on the way to the elevator and hurried upstairs.

An orderly took us to the psych floor and we were left to wait in their outpatient area. I looked around. The furniture was all old and the area looked dirty. There were all kinds of posters on the walls with tips for job hunting and ways of reducing stress. I saw lists of homeless agencies and food banks. There was a whole wall of information on taking the GED. There was information about drug and alcohol rehab facilities and on halfway houses. It did not look to us like I was in an appropriate facility at all, but nevertheless, I underwent an evaluation. They determined I was indeed in crisis and a threat to myself and others and admitted me for an undetermined length of time.

My husband escorted me to the actual inpatient section. The only patient entrance to the ward was a door in a glass-walled receiving area. I had to hand over my overnight bag so that it could be searched. My husband had to say goodbye here, as only patients were allowed behind the locked doors. We held each other and he kissed me goodbye. I cried, suddenly afraid of being left here alone. I watched him walk out of the receiving area and turn to look at me before getting on the elevator, tears running down his face. I felt very alone.

I was escorted to an intake area where I signed paperwork and filled out histories. A counselor came to explain the process to me. He explained that because I had been admitted and deemed a suicide or homicide threat, I would not be able to leave until a doctor felt I was stable. The word homicide exploded in my brain. Homicide. I felt a chill and something in me turned and I understood how serious my condition was. I also was taken aback by the knowledge that I could not leave when I wanted to. I thought that since I was entering voluntarily, I could leave when I wanted. Too many movies and TV shows I guess. I realized now that I had lost all control of my future. I was entirely dependent on the doctors here.

I told myself that everything would be fine now. A large part of me welcomed the time away from my children. I wanted to get better. I told myself that I would get help here. Unfortunately, I was wrong and things got much worse before they got better.

Thank You

Before I continue with my PPD story, I want to thank all those who have left encouraging comments. To be honest, once I started this, I really had second thoughts about being so open about it. However, after I started getting better last year, I read several other women's accounts of their experience and they seemed sanitized, like maybe they were glossing over some of emotions that go along with PPD. At the time, I really wished that someone would tell me that they had gone through exactly what I had, even the darkest parts. So, I am going to continue on with this in the hopes that mother who are struggling with this can recognize that they are not alone and they are not monsters.

Journey Part 2

Let's see, where were we? Oh, yes, about 3 weeks postpartum. As I was saying, Ladybug was crying constantly and I was spending hours rocking her.

I began to tell everyone that something was wrong with her. On this point I was correct, but nobody believed me. I would tell my mother, my husband, and our pediatrician that something was wrong. She was not acting normally. A baby shouldn't cry as much as this. My mother thought it was just me reacting to the differences between Ladybug and Sweet Pea, who was a relatively calm baby. The pediatrician didn't understand the extent of her crying and told me it was just newborn behavior. Friends would tell me it was colic and I'd have to wait it out. It would be 4 more months until we finally figured out the root of her problems. It was lesson to me in mother's intuition. Always trust it.

It was at this point that I became obsessed with keeping notes on Ladybug's eating and sleeping habits. I had already read every baby book I could, trying to figure out a way to get her to stop crying. One of the books suggested keeping a log of eating and sleeping habits to try to discern a pattern. I kept a journal on the bookcase in the hall next to her room. I would record the times she ate, when she fell asleep and when she woke. I made my husband follow along and I became very angry when he forgot. I would worry about it throughout the day and check and recheck my notes. This type of obsessive attention to detail is one of the symptoms of postpartum psychosis.

I started feeling very guilty about the lack of time and attention I was able to give my two year old. Sweet Pea was upset from the beginning. When my mother-in-law brought him to the hospital to see us, he wouldn't look at me and refused to let me hold him or sit on my lap. When we got home, he continued to ignore me. It was very obvious to all of us that he was mad at me, which was understandable. He went from being an only child who spent every day with his mother to having to share me with a screaming, needy baby.

Before I had Ladybug, Sweet Pea and I did all kinds of things together. I'm a member of a local chapter of the MOMS Club and we went to playgroups, play dates, The Little Gym, Kindermusik, etc. We were very active. I did it as much for myself as for him. I was bored stiff just staying at home and I tried to fill our days with activities just to get us out of the house.

Because Ladybug refused to sleep anywhere other than her crib, we were housebound. I was also terrified to take her anywhere because of the constant crying. I didn't want to subject others to her noisiness. When we were home, the majority of the time I was rocking her trying to get her calmed down. I would put Sweet Pea in the playroom next to Ladybug's bedroom and tell him to play quietly while I rocked her. What two year old plays quietly? He would make all kinds of noise and come running in and out of the bedroom, inevitably waking up Ladybug just when I had gotten her to sleep.

I began to feel very guilty about not being able to play with Sweet Pea and not being able to provide him with his usual activities. This quickly turned to resentment. I began to deeply resent Ladybug. I resented her for disrupting our lives and stealing time from Sweet Pea and I. I resented the loss of sleep I was suffering. I resented her constant crying, which often upset Sweet Pea. I resented the loss of my free time. I resented her for being born. This was the first very serious sign of PPD.

I would sit, rocking her, and think of all the things I could be doing. I would think of all the things my son was missing out on because of this baby. I would think about the friends we weren't seeing much of. I would think about the story times we were missing and how much Sweet Pea loved to go to the library. I would think about the lack of exercise I was getting. How would I every lose the baby weight if I couldn't exercise? I would think about the books I could be reading. I would think about how I was never able to make dinner anymore and we were never able to sit down together as a family and eat. I would think about how miserable I was and how I was going to have to endure this for months to come. I could barely see how I was going to make it to tomorrow, let alone months from now. I began to feel that my life had become hopeless and there was nothing I could do about it.

The resentment festered inside me and grew. Within days, the resentment changed form and blossomed into hate. What a horrible and horrifying emotion for a mother to have. I cringe to think of it now. But I began to hate Ladybug. I started to try to avoid having to touch her. If my husband was home, I wanted him to deal with her. If relatives were over, I would happily hand her over. I did not want to have to see her, hear her, or touch her. I didn't want her, period.

I began to tell my husband I wished she had never been born. I thought we had made the biggest mistake of our lives in having her. I would suggest to him that we try to give her away, laughing as I said it, but meaning it deep down. I started to fantasize about taking her to the hospital and leaving her there. I thought we could look into putting her up for adoption. Intellectually I knew I should not be feeling this way but I chalked it up to all the difficulties we had with her and her constant crying.

The hatred fueled rage inside me. Not only did I hate her, but I began to get furious with her. I would yell and scream and rant at her for not going to sleep. I would rage at my husband for not doing what I thought he should when he was caring for her. One day, as I was trying to get her to bed, dead tired myself, I lay her on the floor and screamed at the top of my lungs. I told her I hated her and I wished she had never been born. I yelled at her to just shut up and go to sleep. I cursed at her. I continued to rage at her until my husband had to remove me from the room. This was the first of several such episodes. I can only imagine how it must have terrified her. Her mother's ugly, hate-filled face looming over her screaming obscenities.

I also began to cry. I cried everyday, often for hours. I felt on the verge of tears all the time. I would sit in the rocker and look out the window crying. I cried in the middle of the night and in the morning. I cried every time I had to care for Ladybug. My husband would come home at lunch to help me. I don't think I ever actually asked him to stay, but inside I begged him to just stay home with me and give me some relief. I would sob as his truck pulled away to go back to work and I would count down the hours until he returned.

I began to have what intrusive thoughts, another sign of PPD. I would picture ways Ladybug could get injured or die. I would have visions of her strangling in the crib or suffocating. I would picture her flying out the window. I would imagine myself smothering her with a pillow. I would imagine cutting her with a kitchen knife or her accidentally impaling herself. All these thoughts came unbidden. They just popped in my head periodically and proceeded like a slide show.

Together with the hate, they planted in me a tiny and secret desire. Alone, in the darkest corner of my mind, I almost wished she would die. I remember actually thinking to myself that if she died of SIDS, I wouldn't really care. I didn't think I'd even cry. I thought to myself, well, it would mean an end to all this. It would mean relief. Maybe we'd all be better off. Yes, maybe she'll die, accidentally of course, but maybe she'll die. I began to welcome the thought and even wish for it.

Another night, in the middle of the night after a feeding, she would not go back to sleep. I began to cry, sobbing at the frustration of it all. I felt the anger build up in me and I seethed inside. I roughly grabbed her by her arms, squeezed and shook her for just a second. I stopped myself before doing anything else. This experience terrified me. I realized how close I had come to crossing that line and doing the unthinkable.

Wednesday, December 12, 2007

My Journey to the Worst of Motherhood, 1

Yesterday, as I was taking the kiddos on walk, I remembered something my mother had told me while on one of our walks around this time last year. She said, "Just remember, time passes. Before you know it, you'll be walking with the kids next Christmas and everything will be different."

And she was right. Everything IS different this year.

At this time last year, I was living in hell.

At this time last year, I was incapable of caring for my children.

At this time last year, my mother was living with us and was more of a mother to my children than I was.

At this time last year, divorce was something my husband and I talked about on an almost daily basis.

At this time last year, I had spent time in a psych ward twice in the last month.

At this time last year, I had downed a bottle of Xanax in a moment of despair.

At this time last year, I couldn't stand the sight of my baby.

At this time last year, I was in the deepest depth of postpartum depression, postpartum psychosis.

I have thought about writing about my experience many times, but today I read a post by Lindsay at Suburban Turmoil that inspired me to go ahead and do it. I can't do it all at once, so I think I will break it up into several posts. This will be the first. I ask that you please read this without making any judgments.

One reason I have wanted to write about this is that, despite increased awareness and media coverage of Hollywood stars with PPD, many people have misconceptions about the disease and often the worst judgments about mothers with PPD are made by other mothers.

I also think that many mothers are in denial about the possibility of PPD affecting them. I was one of them. Despite having a history of depression, I thought that PPD was not something that would happen to me. It was something that happened to other people. I'm not a monster like Andrea Yates. There is no way I would ever hurt my children. It couldn't happen to me. Wrong. It can happen to anyone who gives birth, it can be deadly serious and it is important for women and their families to be aware of the symptoms of PPD and to seek help if needed.

There are three levels of PPD. The first is the "baby blues" that most mothers have about 3 days after giving birth as hormones leave their bodies. Symptoms are feeling weepy and emotional.

The second stage is postpartum depression which can occur anytime from a month postpartum to one year after giving birth. It is a major depression that occurs in about 10-20% of mothers. Symptoms include sadness, loss of appetite or increased appetite, irritability, trouble sleeping, crying, feeling guilty, obsessive worrying about the baby, thoughts of harming yourself or the baby, feelings of detachment from the baby and and general hopelessness.

The third level of PPD is postpartum psychosis. This is the stage that can drive women to hurt their babies or themselves. It is very rare, but very serious. Symptoms include hallucinations, delusions, irrational thoughts, frantic behavior, obsessive preoccupation with trivial things, and paranoia. This is what I had, minus the hallucinations.

My daughter, Ladybug, was born on August 31, 2006. She is my second child. I did not have PPD after my first and it was the farthest thing from my mind when we brought Ladybug home. One of the risk factors for PPD is a difficult delivery. My delivery had some problems but nothing serious. I was induced about 4 days before my due date because of low amniotic fluid. I had hoped to give birth without drugs, but because I was induced, I had an epidural. The epidural, however, cooperated with my desire for a drug-free birth and did not work. At first I was only numb on one side and then it was the other. After a while it stopped working altogether. I gave birth with essentially no pain meds, but it was not a bad experience at all. I kind of liked feeling it all.

Ladybug was healthy and had no serious problems. She was jaundiced and required a bili-light at home, but that was not a big deal. She was a great breastfeeder, which made me very happy because my first was not able to breastfeed. Our stay at the hospital was 2 days and we got to come home on my son's second birthday.

The first couple of weeks were the normal sleep-deprived adjustment period. I was exhausted trying to care for a new baby and for a two year old. The afterpains were worse this time and it seemed to take my body longer to bounce back. Luckily, my husband was able to stay home for three weeks and help all of us make the transition. I stopped breastfeeding after two weeks because I couldn't take the sleep deprivation and wanted my husband to be able to help out with night feedings. I pumped for a couple of days and then we moved to formula. At first everything seemed OK.

I should explain that I am not a baby-person. Some people absolutely love the baby stage. That's not me. I am very much a creature of habit and schedule. I have a definite problem with the lack of schedules and craziness of newborn days. Unpredictability makes me very anxious. I also don't like not being able to do the things I regularly do. I didn't like not being about to exercise or read a book during nap time. I need regular sleep, as do we all, but I have insomnia. This meant that when I had to get up to feed Ladybug, I often couldn't get back to sleep. I would worry that she wouldn't go back to sleep or that she'd wake up in another 30 minutes. I couldn't relax enough to drift off. So already, I was suffering big time sleep deprivation and was struggling to adapt to the new lack of routine in my life.

Then Ladybug got past that early newborn stage where they sleep all the time. She went from always sleeping to never sleeping. She required darkness, silence and endless rocking to get her to sleep. I tried in the beginning to follow all those experts' advice about putting her down awake but she wouldn't have it. I read every sleep book written. I tried everything. She wouldn't sleep in her bouncy seat or her swing or the car. The only way to get her to sleep was rocking her.

Also about this time, Ladybug started crying.
And crying.
And crying.
All. The. Time.
Screaming at the top of her lungs for hours. Arching her back and balling up her fists. She'd hold her body as rigid as a bow and her face would look like she was about to explode. We took to wearing earplugs. I was amazed none of the neighbors complained. She literally cried 80% of the time she was awake. Turns out there was a reason for this, but we didn't know that at the time.

So, I was stuck at home, in a life that bore no resemblance to my life just weeks ago. I was spending hours listening to a screaming baby and I was spending hours in a darkened room trying to rock my baby to sleep. Combine all this with a personal history of depression and it was a recipe for disaster.

I have to cook dinner now, so part 2 will have to wait until later.