Tuesday, September 1, 2015

Postpartum Anxiety

The fool says in his heart, "There is no God." 
They never call on God. 
But there they were overwhelmed with dread, 
where there was nothing to dread. 
Oh that salvation for Israel would come! 
Psalm 53 

"What does an unused prayer link look like? Anxiety. Instead of connecting with God, 
our spirits fly around like severed power lines, destroying everything they touch. 
A godlike stance without godlike character and ability is pure tension." Paul Miller

Allow me to start by saying that I'm hesitant to share this. The very last thing I want is for Noah to read this one day and feel like my postpartum anxiety/depression is somehow his fault, because it's not. Never for a second would I blame him! My inability to cope with the realities of motherhood, however, was a problem. No, scratch that. It was my reaction to my perceived inability. Mom-guilt and insecurity quickly turned into a fundamental shame in who I was as a person. That I was too much and not enough all at once. The shame was the straw that broke the camel's back. It was the tipping point in the perfect storm that had been brewing for, well, years according to my therapist. I went from extremely stressed, to anxious to the point of dread on a daily basis.

Walking around clinically depressed and anxious feels like staggering about, alone, on barren, deserted island. It can make you feel like you have no mooring; no place to throw an anchor; no shelter from the storm that tossed you ashore in the first place.

So in the end, I'm sharing. Because no new mom should feel ashamed when she's on the verge of tears and someone tells her to be grateful that she "only" has one kid and that it only gets harder from here on out. No new mom should be made to feel inadequate when someone tells her that they've never seen anyone else struggle so much with postpartum recovery. No new mom should feel the soul-crushing disappointment in herself when she's surprised by motherhood in all the wrong ways. When she's eating her pre-baby words and struggling to adapt to the role of motherhood, no new mom should feel ALONE.

This is the story of my pain, and maybe you will find in it an echo of your own story or that of someone you love. Consider taking the EPDS or reviewing this symptom checklist if anything henceforth sounds familiar to you.


It all started when Noah started sleeping through the night consistently a few weeks after his first birthday. It seemed like suddenly I found myself at the beginning of July, after a month of rain, and I could see the sun for the first time in a LONG time. I had a few weeks of sleep under my belt, seemingly out of nowhere I had a toddler who could walk and talk and play, and life was so different than it had been just one or two months prior. I missed my baby, to be sure, and I still feel a familiar sadness when I think about all the sweet early moments I missed out on due to pain and anxiety, but mobility (and sleep) changed everything this summer and I couldn't deny that Noah was an awfully fun little guy to hang out with. Every stage is bittersweet, but I'm finding that each one is also progressively more fun as I get to know Noah better and better.

With the sun out at last, we could take playdates to the pool! We could take long walks every morning in the beautiful summer light! I had energy again! I could workout if I wanted to! I lost the last bit of baby weight and had a whole closet of clothes accessible to me again that I hadn't worn in almost two years! I could, and did, go to the farmer's market and start eating more vegetables after far too long of a hiatus. It's no secret summer is my favorite season. I felt like a new dawn was rising as I re-entered the land of the living and emerged from babyville. But it didn't take me long to realize I was not okay.

I was functioning. I was having fun! I was no longer having insomnia or heart palpitations, but I couldn't shake the feeling that I wasn't quite living either. At first I thought, okay, this is life as a mom. I will never be the same. And I WILL never be the same (thank God)! But I like to think that's because more has been added to my life and I've changed and grown into this new shape as I adjust. Not because the substance of my old self has been taken away.

This summer, Noah and I took daily morning walks and I started listening to sermon podcasts again. It was refreshing to just let truth wash over me. It's so easy for forget that I'm not the center of my life and that I'm certainly not in charge of it.

This summer, I realized I needed to change jobs. Again. But this time, the decision was not terribly debilitating. Now that I'm getting more settled into it, I'm relieved to find that my instincts were right, and this job is a great fit. But still, because of, or perhaps in spite of this decision, I was anxious. I was fearful. I had a certain peace that I was doing the right thing, that this was the best choice for my family, but I still wasn't okay.

This summer, Ross and I went to an amazing marriage conference once a week for 5 weeks. We started to reconnect and we were shocked and saddened at how far apart we'd grown in such a short time.

But the hardest thing was the thing that wasn't changing: the pain that I'd been having since I was 16 weeks pregnant. Ebbing and flowing with my hormones, but always there, always worse at the end of the day, was the pain. Somewhere in the haze of the early days of motherhood, my pelvic pain went from being a source of frustration to a source of concern to a trigger for hopelessness and despair. I'd been a compliant patient in physical therapy for 9 months by the time summer rolled around, and initially it was a life-saver. But the pain plateaud around March no matter what I did. In fact, certain aspects of it were starting to get worse again. It was so depressing. It was so painful. It was so discouraging. I was starting to feel like it would never ever go away. Like I would never feel normal again. Like I would never feel well enough to have another baby. Like I would never be able to love this baby the way I wanted to, because it hurt to lift him, it hurt to hold him, it hurt to rock him.

That kind of pain... I wouldn't wish it on anyone. By the end of most days, it was debilitating physically. I couldn't find it in me to stand and make dinner or tidy up. But emotionally? The pain was devastating. I felt like I was missing out on those "pay off" moments of parenting. Sure, having a toddler is chaotic. But people say, oh, when they snuggle up on your lap or fall asleep in your arms, it's so worth it. I felt like I didn't have that. I'd never been able to hold my crying or sleeping baby without my body screaming in pain. So I went back to my Midwife and thus began two months of constant appointments in August and September.

Back to the pain management OB, back to get another ultrasound, back to acupuncture, ramp up the physical therapy visits. Meanwhile, onto all of Noah's one-year appointments: pediatrician, shots, ENT, audiology... And then, I'm not sure if this was a cause or effect of additional stress and anxiety, but abdominal pain started waking me up at night. So I had an endoscopy. I had more labs drawn. More ultrasounds. More appointments. And more medical bills. And more hopelessness. Feeling like I was getting nowhere, and just spinning pointlessly in a cycle of pain and debt.

After Noah was born, I spent a very long time focusing on Noah's needs and putting him at the center of my life. This summer, I started to feel stifled by those expectations, and started feeling like it wasn't fair that I never got a break. Like I was physically worn out. Like I needed a spa day or a vacation or... something. Every time something else spun out of control, I thought: I'm terrible at this. I'm terrible at being a mother. I cannot balance this. I cannot manage this. Those were the sermons I preached to myself: I can't. I just can't.

And maybe I wasn't sharing enough, or maybe I cry wolf too much, or maybe it's simply that no one in my life was able to speak into that for me, to point out Satan's lies, to look me in the eye and remind that me that God CAN. To say, "Remember every other time you've reached the end of yourself and God drew you out of the muck and mire? He's still there. He's always there, but how gracious would it be for you to invite Him to partake in this moment with you? Into this embarrassing season of feeling hopeless as a mother and desperate for physical relief."

But it took me months to get to that realization. Until then, I was just in endless dialogue with myself: It wasn't supposed to be like this! I wanted kids! We prayed and planned. I take care of babies for a living! I loved Noah more than life, and I COULD NOT HANDLE the feeling that I was failing him day in and day out. In the isolation borne out of a long, dark, cold, anxiety-ridden, sleep-deprived winter, I had no one to bounce these thoughts off of, nor the mental clarity or inner confidence to do so. I had no barometer of 'normal.' Just occasional and seemingly benign comments here and there from people who didn't-- couldn't-- understand. Those words hurt. And made me feel more inadequate. And more abnormal.

Then, blessedly shortly before Noah's birthday, something clicked and I thought: what if this doesn't have to be normal? What if it's pain AND ... ? What if I'm depressed? What if my hormones are so out of whack that even though I'm a year out, I have had postpartum depression this whole time?

I truly don't know where this thought came from, but some freedom came with it, immediately. What if it's not my fault!? What if it's not just because I'm not trying hard enough or balancing well enough or doing things just the right way? So I got a referral and filled out the counselor's paperwork, and I was shocked. Shocked. At how many boxes I checked. How many symptoms I had.

Like many new moms, I was given a postpartum depression quiz shortly after Noah was born, when I was tired and sore, but also still riding the endorphin train. It's supposed to be hard at that point! I totally expected that! I did not expect to feel almost exactly the same, physically and mentally, a year later. I have no idea why I didn't think to take the survey again in the middle of December, when I dreaded going to bed only to be woken up every hour. When family obligations felt like a physical weight in my sleep-deprived state. When the long days started at 4am and I truly didn't know how I'd get through them in our drafty, unfinished house. (I don't know how I did, actually. I don't even remember.)

So in August, when the counselor tallied up my postpartum depression score, looked right at me, and said, "how did you get to this side of winter? How were alarm bells not going off everywhere?" I felt the weight start to lift. She said, "of course, the Scale is just a tool, and not necessarily diagnostic, but these scores suggest that you were terribly, frighteningly depressed. How did you get to the other side?!"

At those words, I wanted to cry tears of relief. Those feelings hadn't been normal! I wasn't inadequate for feeling like I was trapped and unable to talk myself out of it! But also, I saw God's hand. How had my depression score dropped from 24/30 to 11/30 in 4 months? Time helps. Sleep helps. Perspective helps (some of those extra-hard weeks really were just a phase). Sunlight helps. Exercise helps. A balanced diet helps. But really when it comes down to it, it's not hard for me to see that God was gracious and he removed me just far enough from the forest that I could see the trees again. I had been lost in a very dark place, and I couldn't recognize that because all I could see was this sleepless night, or that cranky day, or this extra-painful week. But once I could see the big picture, I could ask for help. More importantly, I could RECEIVE help for what it was, instead of a threat to my sense of capability.

When I think back to that symptom checklist, I think I was most shocked at the reality of the line I checked and starred near the end of the list: This is the worst that I have ever felt. When I saw that truth for what it was, and when I let it sink it, it hurt. Last winter was worse than being 15 and anorexic. It was worse than being depressed senior year of high school when I couldn't get out of bed and couldn't do school and cried about everything. It was worse than freshman year of college when all that unresolved depression left me unmoored and unable to recognize this girl who couldn't just sit down and study like she needed to. Worse than the bad breakups that haunted me. Worse than the hardest days of marriage.

The worst I'd ever felt... not only was that a bold statement in a season that I thought would signify that hard times were behind us, it was a disappointing realization in itself to feel this way during what I'd always envisioned to be one of the happiest times of my life. To be sure, the happiness did come in bits and pieces, slowly, and then all at once. Big love is winning over big heartache. Today, the exhausting is from keeping up with an active toddler and not from sleepless nights. And the joy... it overwhelms me at times. Our child is a delight, and I'm so grateful that he's ours, but there are a lot of things I would be tempted to change about the first year, if I could. (Things about myself, not about Noah.)

But I can't. Instead, this fall I started saying no to some things, but yes to others. No to the old job. No to a semester of Gospel Community. Yes to the support group, yes to MOPS, yes to spending allthemoney on acupuncture in a last-ditch effort to ease my physical pain.  Each of these steps would normally have felt very vulnerable, but for some reason they just weren't. I had nothing left to lose. What I was doing-- surviving-- wasn't working.

It was a breath of fresh air to sit at a table with other moms at my first MOPS meeting, toddlers safely tucked away in the childcare rooms, and to hear that God promises to send his people out in joy and lead them forth in peace (Isaiah 55). I thought, what a perfect way to end this summer. There IS more. There's joy to look forward to. There's peace regardless of circumstances.

Because now I see. Joy is not something to be attained. It's something to be received. A gift freely given, but often turned down in the pursuit of happiness. Here's the thing about reaching the end of yourself: depravity can be fruitful. God can plant the seeds for a harvest of plenty in the most barren soil. In our time of need, he loves to show us that he loves us. As a parent, I've garnered a new appreciation for the way God calls us to seek him for rest, comfort, reassurance, guidance. I can learn to give well as a parent when I, in, turn, receive these gifts as a beloved child.

I'm starting to get excited about motherhood as an opportunity to be enjoyed (as I first envisioned it) and not just an obligation to be feared (as I came to feel it). It's an opportunity to see God work in a new way. An opportunity to make new friends and have new eyes and, most of all, a new heart. A heart of freedom and not of burden.

I'm thankful for those uncomplicated moments this summer when I started to see myself in there again. After being buried for so long, it feels like catching a glimpse of a friend in the mirror when I say yes to the spontaneous outdoor concert, when I reach out to a neighbor and let our kids run around while we talk about everything we have in common, or when I'm running errands alone in the evening, car-dancing to CDs of music from high school. In those moments, I find a certain lightness of being, a simplicity, a reassurance, a whisper of hope. All is not lost. God can rebuild the years the locusts have eaten.