Monday, January 7, 2008

Signing Away My Life

From my description of the onset of postpartum psychosis, you might wonder why I did not seek help until it became severe. The answer is that it happened fast, that it became a crisis situation within days. 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 like what I felt, especially initially. But once the psychosis truely hit, I felt that and much more. I felt rage, violence, panic to an extreme. It was terrifying in its speed and depth. It came on very quickly and got bad very quickly.

At six to seven weeks postpartum, I was talking to my mother on the phone 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 and PPP 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.

As things were spinning out of control at home and I became less and less functional, we also 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 how serious it was. 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. She lives three hours away. If she had seen me at this point,she would have known immedidately that I was in real trouble, but it is easy to just omit things in a phone conversation. 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.

Between eight to nine weeks postpartum things climaxed over a period of a few days. I could not control my behavior or my thoughts any longer and we knew that if something did not happen, I would hurt Ladybug or myself. 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 to talk.

At the time, I didn't intend to tell her much, but now I think I must have known I had to and that is why I called her. She asked me how bad it was. Sobbing, I told her that I didn't feel I could go on another day. I simply did not feel I could continue. I didn't think I could physically take care of my children another minute. 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 thoughts about it, but I felt I was much more likely to hurt Ladybug then myself. I didn't tell her all this, but I told her I was very depressed.

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 will never forget the ride there. I could barely see to drive because I was crying so hard. 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 therapist 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. I did not understand why I could not be admitted that day, but she told me it had to be arranged first.

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 stabilize things.

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 called 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 mother took on the care of both the children and she and my husband were careful to make sure I was never alone with Ladybug. The next morning we went to the hospital.

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.

The woman doing the evaluation asked me various questions about how I felt and at several points she seemed taken aback, almost scared. I described for her how I had envisioned killing Ladybug, how much I hated her and how I did not want her. I told her about the intrusive thoughts and about the times when I had almost hurt her. I held nothing back. It was the first time I told anyone how I actually felt. After the questions, she conferred with someone else and then they both spoke to my husband and I together.

Their words were chilling. I was homicidal, they said. Homicidal. That is not a word often used to describe 30-something, white, well-educated, middle class mothers who live in suburbia. I can not adequately describe how hearing that made me feel. I knew then that things were way beyond serious. I knew that I was capable of killing someone and if I did not get help, I very well might. I knew I could have my children taken from me and be locked away in prison for life. I could be the Andrea Yates of the 21st century. I also knew at this point there was no going back. I would be admitted whether I liked it or not.

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 hugged each other and he kissed me goodbye. I cried, suddenly afraid of being left here alone. In the back of my mind I wondered if I would stay here forever. Would I be able to regain my sanity or would I be forever crazy? Would I be one of the girls in Girl Interruptted, one of the ones who never leave? Would I spend months or years in psychiatric facility?

I watched Big B 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. 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.

4 comments:

Mrs. G. said...

What makes me most sad about this post is that you and your husband were suffering behind closed doors. Why are we so afraid to ask for help when we most need it? What else are friends really for? I am guilty of this myself.

Susie said...

Liz,

Thank you for sharing your past history with depression and PPP. I cannot follow your timeframe, though. Did all of this just happen this Christmas, or in 06?
You mention a young baby, then you talk about a 15 month old baby girl. You sound so smart and interesting. How are things with your husband, has he made changes through the therapy? And, I was not sure, did he get the big V? Or do you still have to take care of the birth control?

Hope to hear more about your PPP experience. Why have you stopped writing about it?

Liz said...

Hi Susie,

My daughter was born in 06 and I went through all this between the time of her birth and spring of 07
I have written several posts after this one which finish up the story and they conclude in spring of 07. Did you see them? There is not much left to say after the spring of 07 because I was better.

My husband did get a vascetomy, thank goodness! He wasn't too thrilled having to have it, but he had no choice!
My daughter is now 16 months old.

Anonymous said...

Hey Liz,

How was the Disney show? Bet your children loved it, it can get alittle long, then all the children want to purchase all the vendor items. Now, that is a way to make money, sale all those Disney items.

Back to your blog, glad to hear that Big B had the V. You know, women do it all, we have the babies, we stay up all nite, when needed, and look so beautiful and happy in the AM, for the hubby. I think men want to always be "macho sperm donors". Clip clip is the way to go.

Sometimes when I turn and look at my hubby, I wonder why in the world did I pick you?? Yes, your spermies gave us 4 boys, that we love dearly, but sometimes he just get's on my nerves. Now staying at home, I am referred to as the maid, did the maid make the bed, oh the maid forgot to put toliet paper in the bathroom. What is wrong with their hands, they can make a bed, change out toliet paper.

It will be interesting when I return to work at the hospital, I am a looker, and those Drs love to put on the charm. If their wifes only knew how they come on to us. We smile, laugh at their jokes, even if they are stupid, but it makes them think they are god. They even get a rise in their pants, oh I better watch out, the first, second or third wifie will stalk the parking lot.
That is one profession, I would NEVER be married to a doctor.

Of course, you had a different experience with Doctors in the mental ward, but it sounds like they were jerks. Kinda fits why those kind of doctors work in a mental ward anyway. I guess they feel in control over woman. More power to them. Just keep the medication coming, and I will survive.

I reread your suffering, and to think that Big B would be so mean to you, you sound like such a nice, well educated, and FUN person. But, how could he say such things to you when he picked you up from the hospital. Is he still mean like that? Does he have to be like, so powerful in his mind, like so macho. He probaly feels like it is all you. And won't let you forget that. Wonder if he will feel different once you go back to work. You will be in your element, can he handle that.

I don't mean to sound so negative about him, but he was a big part of your depression and recovery.
Stay on the med's.