One Mom’S Journey to Motherhood: Infertility, Childbirth Complications, and Postpartum Depression, Oh My!

By Ivy Shih Leung

Author Ivy Shih Leung shares her not-so-perfect road to motherhood in this book that is part memoir and part self-help guide, reflecting lessons learned in the form of helpful tips and information to empower readers on the biological and sociological roots behind postpartum depression (PPD). She also seeks to raise awareness of the myths of motherhood and the stigma of PPD that contribute to the silent suffering of many mothers, as well as the importance of adequate social support in the early postpartum weeks.

A culmination of Ivys frightening PPD journey and her emergence from it with a passion to learn more about perinatal mood disorders, this book is fueled with passion to help other women and their families, anger from the unnecessary suffering Ivy went through from the lack of information available to the public about PPD, her doctors ignorance and lack of sensitivity, and public remarks like, There is no such thing as a chemical imbalanceall of which shows theres still a long way to go in terms of educating the public about an illness that is suffered by one in eight new mothers.

With side effects that include shame, helplessness, and despair at a time that is supposed to be one of the happiest in a womans life, Ivy wants to help fellow PPD advocates get the message out that PPD is not a mind-over-matter thing, as those who dont know any better tend to believe. PPD is an illness that must be taken seriously. We must all remember that the health of the family unit depends on the mothers well-being.

Ivy Shih Leungs voice as a storyteller is strong, loud, and clear. Ivy is a survivor of postpartum depression, and through the written words on each page you can hear her roar. Jane Honikman, Founder of Postpartum Support International

• Language: English
• Publisher: Abbott Press
• Release date: Nov 16, 2011
• ISBN: 9781458200228

Ivy Shih Leung

Ivy Shih Leung is a postpartum depression (PPD) survivor and advocate, the author of Ivy’s PPD Blog, and an active member of Postpartum Support International. A graduate of Mount Holyoke College with a bachelor of arts degree in biology, Leung lives with her husband and daughter in New Jersey.

Book preview

Contents

ADVANCE PRAISE FOR ONE MOM’S JOURNEY

Disclaimer

Foreword

Preface

Acknowledgments

Introduction

Chapter 1

Chapter 2

Chapter 3

Chapter 4

Chapter 5

Chapter 6

Chapter 7

Chapter 8

Chapter 9

Chapter 10

Chapter 11

Chapter 12

Chapter 13

Chapter 14

Conclusion

Endnotes

Bibliography

Other Resources

ADVANCE PRAISE FOR ONE MOM’S JOURNEY

"One Mom’s Journey to Motherhood is a wonderfully thorough and accessible treasure trove of research, compelling information, and encouraging advice. It is sure to become a favorite, like a great cookbook that you return to over and over, knowing that you’ll find just what you want and references too! Ivy Shih Leung has written a thoroughly informed book with such a warm approach, it is easy for the reader to take in the solid information and the message of hope and recovery at the same time. Reading that Ivy has overcome her own struggles and written such a wonderful guide is in itself empowering and hopeful. Every chapter is full of information, written with honesty, clarity, and perceptive suggestions. I am very careful about books to recommend to families and providers who want to learn about pregnancy and postpartum mental health; this is one book that I can recommend without reservation. Ivy’s background in biology, her careful research, and her strong spirit have worked together to create an insightful author, and we are all the better for it. Thank you Ivy for being such an inspiring advocate and sharing this contribution to the field of perinatal mental health!"

—Wendy N. Davis, PhD, Executive Director, Postpartum Support International

A heartfelt story of survivorship….compelling and practical. Every pregnant woman should read this book.

—Mariann Moore, MSW, ACSW, LCSW, Executive Director, Hudson Perinatal Consortium, Inc.

"Ivy Shih Leung’s One Mom’s Journey to Motherhood is a book women have been waiting for. Ivy is a passionate advocate who honestly shares like a friend to educate and empower others through her deeply personal experiences of infertility, childbirth complications and postpartum depression. Women on their own journey will gain hope and not feel so alone. Healthcare providers will gain valuable insight too."

— Sonia Murdock, Executive Director and Co-founder, Postpartum Resource Center of New York

The more women who speak out about their experience with postpartum depression, the more likely it is we will be able to eradicate the stigma that prevents new mothers from asking for help. I’m so grateful to Ivy for her courage and honesty, and the willingness to tell her story. This book has the power to help another woman see that she is not alone.

— Katherine Stone, Author, Postpartum Progress Blog

For Edwin, a truly special husband and daddy, and Sydney, my miracle of a little girl for whom I will always be thankful.

*

Adversity has the effect of eliciting talents which, in prosperous circumstances, would have lain dormant. ~Horace

*

Knowledge Is Power

I am a PPD survivor, see me soar

Above those who choose to ignore

The facts about the core

Issues about PPD, women’s health, and more.

*

I write this book to help empower

All women regardless of race, social status, and culture

To suffer in silence no more.

Fellow women, do not let yourselves lose the war

Against this illness and those who think PPD is no more

Than one’s imagination or folklore.

*

Remember that with knowledge you have the power

To make a difference for yourselves and enjoy motherhood more.

Arm yourselves with knowledge about PPD before

Your baby comes into the world.

Disclaimer

I am by no means trained or qualified to give medical or psychological advice. The contents of this book—from the advice to the biological information and treatment options—are based on my own experience and research of PPD subject matter experts and are intended to help you or someone you care about get through this awful period. You should always consult with a health care professional (medical and/or mental) to determine the treatment, which may or may not include medication, that is best for you during pregnancy, lactation, and the postpartum period in general.

Notes: I will use the words father and husband, realizing there are situations like two-mom families that are not covered by my book.

Foreword

Everyone has a story to tell, but not everyone has the ability and passion to do so. Ivy Shih Leung has all three attributes. Her voice as a storyteller is strong, loud, and clear. Ivy is a survivor of postpartum depression, and through the written words on each page you can hear her roar.

This book is grounded with statistics, research findings, and scientific facts on maternal mental health. These facts are the foundation of Ivy’s theme to fight denial and ignorance that surround the perinatal period. Historically, the worldwide scientific research community ignored postpartum psychiatric illness during the first half of the twentieth century. In the 1980s a select group of perinatal psychiatrists changed history by forming the Marcé Society. These individuals started an international movement to increase awareness about the devastating disorders that can affect pregnant and new mothers. Slowly, government- and university-sponsored research has increased. Clinical and hospital services have improved. Sadly, however, Ivy didn’t receive what she needed.

My own postpartum journey began over four decades ago and, like Ivy, ignorance and denial were my enemies. I vowed to fight them. My involvement in the formation of a community-based, grassroots, postpartum social-support organization was the first step. Good fortune led me to the Marcé Society. Their founders encouraged me to link my position as a new mother to their knowledge. In 1987, I founded Postpartum Support International. This has become powerful, and, as a result, attitudinal and clinical changes have occurred in our society toward mental illness and motherhood. Sadly, Ivy’s experience reflects how much work remains to be accomplished.

It requires courage and insight to write down one’s experience with pain and suffering. It is a laborious and slow process. It is also very therapeutic. The expectation of the author is that the reader will be emotionally touched, helped, and, in time, want to become another agent of change. Ivy is counting on this response to her story. So am I.

Jane Honikman

Santa Barbara, California

2011

Preface

If asked what individuals inspire me, I would answer,

Those who overcome adversity and share their experiences with others to chip away at ignorance and enable others in similar situations to benefit.

Over the past two decades I’ve come to the realization that things happen for a reason and you learn from those experiences, with the goal of making the best of things. Had I not experienced postpartum depression (PPD), I wouldn’t have felt the passion I’ve felt in writing this book for the past six years. The pain I experienced was not like any other pain I’ve ever experienced before—it was both physical and emotional and quite debilitating. I’ve experienced many difficulties in life, but surviving PPD was a major turning point in my life.

At the time I had PPD, I didn’t even know that I was ill. My PPD so debilitated me that I could not function on a day-to-day basis, period. With panic attacks I couldn’t control and a feeling that I would not physically be able to survive my experience, I needed medication to return my brain chemistry back to its normal levels. As soon as that occurred—which was four weeks after I started taking it—I was fine and happily able to enjoy motherhood, my baby, and my life once again. Had I known that insomnia and anxiety are initial signs of PPD, I would not have gone down that incredibly painful journey. Had I not sought help when I did, I do not doubt that something tragic might have happened.

I did not have the opportunity to bond with my daughter Sydney to the fullest extent possible during the time I was transformed into a different person by PPD. Nor was I able to find an understanding individual to help me through the darkest days by assuring me that I wasn’t going crazy, I wasn’t alone, and I would get better. However, instead of looking back with regret that my days of PPD were months of lost opportunity for bonding with Sydney, I look at it as an experience that has truly made me a more knowledgeable and stronger person.

I learned that there is a long road ahead of us in getting mothers in this country the help they need during pregnancy and postpartum. I learned that one should never assume that everyone always has smooth deliveries and postpartum experiences or think that just because a new mother is smiling everything is fine and blissful.

Those impassioned about certain causes usually aren’t motivated in such fashion unless they are directly impacted by a life-changing experience, such as a serious illness, near-death experience, or surviving the death of a loved one. It takes these kinds of experiences to motivate individuals to try to make a difference in the world and to try to help others. Some are determined to help others by sharing their stories, like Brooke Shields, Marie Osmond, and Lance Armstrong. Others do what they never dreamed they would ever do, like run for United States Congress, which is what Carolyn McCarthy did after her husband was killed and her son was severely injured during the Long Island Railroad Massacre, but the representative in her district voted against an assault weapons bill.

For me, the following factors angered me so much that I started to think of ways to channel the anger and do something productive with it:

• All the ignorant comments made by people around me—including colleagues, acquaintances, my doctors, and their staff

• The way I was treated by my doctors

• No one telling me about PPD in the first place

• The lack of information that is given to the public via magazines, hospital training, doctors’ offices, and television

• The way society makes assumptions that all mothers have smooth and easy pregnancy, childbirth, and postpartum experiences

I was plenty angry, but I never would have thought of writing a book if it hadn’t been for Tom Cruise’s ignorant rantings on the June 24, 2005, Today Show that There is no such thing as a chemical imbalance. On the way home from work the afternoon of Tuesday, July 5, 2005, it was like someone turned on a light bulb in my head. I suddenly felt the urge to write a book about my battle with PPD. I decided I would channel all the energy stemming from my anger and do something positive and try to help others. I would tell my story in the hopes of helping and educating as many people as possible about this silent and potentially deadly condition. I would chronicle my experience and share the horrific feelings and manifestations of PPD that I experienced so that others could know better what to look for. Ed thought it was an excellent idea and a great outlet for my feelings.

So, fueled by the passion to help other women and angered by Tom C’s rantings, I set out seven months after my daughter Sydney was born and four months into my recovery to start writing my book and get the message out that those remarks couldn’t be further from the truth. But first I’d like to say this—and boy do I wish I could say it in person: Yes, Tom Cruise, there is such a thing as a chemical imbalance! There is a biochemical explanation for my PPD experience. I had to wait four years, when I started blogging, to blurt out those words in some kind of public forum that would be appreciated by others who understand, who’ve been there and know what it’s like to have suffered from PPD. I had to wait six years, until I published my book in 2011, to blurt out those words in this book … my dream come true.

There are so many reasons why I wrote this book, but these are my top three reasons:

1. To share my experiences with mothers currently suffering from PPD to help them feel less alone and realize they will get better with the right treatment. When you do not know what is wrong with you and yet you are suffering so intensely, all the while feeling guilty for not being able to take care of your baby the way you want to, it is not surprising that you can feel like there’s no hope and there is no end to the despair and pain. As a PPD survivor, I know how overwhelmed, helpless, and hopeless PPD can make you feel. I know what it’s like to be feeling so at the end of your rope that you just want to disappear into thin air, run away, or blink like a genie and all will be fine and back to the way it was before your PPD took a hold of your life.

2. To help expectant mothers become knowledgeable about PPD so that, if they succumb to it, they won’t be totally caught off guard. When you seek treatment from a doctor, you won’t be at a total disadvantage if the doctor doesn’t spend time to explain what is going on so that things make sense, answer questions you will undoubtedly have, and give reassurance that you are not alone in what you are experiencing and you will be fine, though it takes time for the treatment to be effective. You won’t feel so alone, guilty, and crappy thinking that all other new mothers are happy, content, and have no problems juggling care of their new baby, themselves, and the never-ending housework. And for those who return to work, their jobs as well.

3. To help new mothers to minimize their risk (or effect) of PPD. This book contains what I feel to be helpful advice in the form of helpful Do’s and Don’ts for you, your husband, and other family members and friends. I don’t want you to be as concerned and in the dark about PPD and child-care complications like colic, eczema, and cradle cap as I was. Pregnancy books and magazines tell you how you can quickly get your prepregnancy figure and weight back as well as your libido—things that shouldn’t really matter but somehow do.

Determined to learn more about this misunderstood, underdiagnosed, and undertreated illness, I read many books. Reading about other people’s experiences was, needless to say, extremely therapeutic. Speaking of therapeutic, writing this book has not only been therapeutic, it has turned out to be one of the most fulfilling accomplishments of my life. My personal goal that I’ve had for the past decade or so is to be able to create a piece of work I can feel proud about. Back on February 6, 2009, I started my very own blog—something I never dreamed I would ever do—with the encouragement of college alumna Kristin Davis. With that I took my writing to a whole new level and one that is easily accessible by the public. Prior to the release of this book, my blog was the closest I’ve ever come to feeling some sort of satisfaction at creating something from which others could benefit. If I can help one person with this book, which means one less person to suffer and learn the hard way like I did, my goal for this book will have been achieved.

At the time I was learning more about PPD, I discovered that, though there are a lot of recently published books on PPD, they are for the most part guides written by doctors and others about the statistics from research that has been performed on the subject. I found them at times hard to digest, since they are laden with scientific information. If I found them hard to digest—and I was a biology major (look, Mom and Dad, I did use my major after all…well, sort of)—I’m fairly certain the majority of moms out there will not have the patience to read them. In those books might be a line or a few lines about certain individuals and their experiences with PPD. But they are merely snippets that don’t reveal enough information to be of much help. I was amazed at how few books there were about people’s own experiences with PPD. The only books about personal experiences were written by Marie Osmond and Brooke Shields, both of whom are celebrities and not very representative of the average mother. I’m comfortable speaking for other women in saying that women in the throes of PPD will gravitate toward personal stories more than a scientific book written by a health-care practitioner, because they are looking for reassurance that they’re not crazy and there are others like them who have experienced and survived PPD.

Well, I am no Brooke Shields or Marie Osmond. I am just your regular mother and PPD survivor who is willing to tell her personal story to add a voice to the growing number of voices who have the courage to make their personal stories available to others so that the ignorance about PPD will hopefully one day come to an end. It’s a long road ahead of us, and we must never give up!

I certainly hope people will read this book and suggest others read it as well. This is not a matter of trying to sell a lot of copies for financial gain. In fact, I don’t expect to make a profit out of this self-publishing effort at all. I absolutely enjoy the experience of having full control over the rights of this book, not to mention the cover design, content, layout, and even release schedule. Self-publishing is certainly the way to go nowadays, especially since you can get beautiful books that are just as accessible as traditionally-published books, thanks to online booksellers like Amazon! Sorry, I didn’t mean to digress. Anyway, the more people read this book and others like it, the more the public will be aware about PPD, the realities of motherhood, and the need for an increase in support services for new moms.

I am a PPD survivor. Hear me roar. Will you join me?

Acknowledgments

First and foremost, I must thank my husband, Edwin, who is also my best friend. Thank you for your love, support, and patience through both good times and bad. If it hadn’t been for your constant presence, dedication, patience, and support during those dreadful weeks of PPD, I most definitely would have suffered much worse than I did. You have changed my life so much! It is because of you that I have a home in a town I love and the family I always wanted to have. If it weren’t for you, work/life balance—comprised of a delicate balance that depends on the constant, close coordination and reliance on each other’s schedules—would not have been possible. Thank you for your constant support throughout the writing of this book, which at times felt like it was never going to end. Thank you for helping to make this dream of mine come true. I am so lucky to have you for my husband, and Sydney is lucky to have you for her daddy. I love you very much.

Sydney, watching you grow and learn has been such an amazing experience. You make me smile and laugh in amazement and amusement, and you fill my heart with warmth and love. I am so lucky to have you for my daughter. I love you very much.

I would like to thank Mr. Oakley F. Roark, my tenth-grade biology teacher at West Essex Regional School, for his friendship and support through my senior high school years. If it weren’t for him, I would not have majored in biology at Mount Holyoke. Unfortunately, I did not have a chance to show him this book in person, as he passed away on April 24, 2009. I would like to think that he would’ve been so proud. Mr. Roark was my inspiration for taking on such an interest in biology in high school and college. He was one of the only friends I had in those six dreaded years in high school where I didn’t really have any friends at all. If it weren’t for him, I might never have made it through those years. We exchanged Christmas cards every year since I graduated from high school. I’m glad I had a chance to see him about a decade ago on a trip Ed and I took down to Maryland. I’m glad Ed had a chance to meet him then. I miss Mr. Roark dearly. The memory of him will always stay close to my heart.

I will be forever thankful to Dr. Alan Copperman at the RMA of New York. If it weren’t for you and your dream team of doctors and nurses, I would not have had my precious Sydney.

I must thank my Mom and Dad for raising me to be honest and hard working—these attributes, in addition to the resilience that I seem to have developed over the years as a result of the challenges I faced during my earlier years—have served much purpose in my life’s journey thus far.

I would like to thank Kristin Davis, a fellow Mount Holyoke College alumna whom I happened to stumble across on LinkedIn in January 2009. She encouraged me to start my own blog, which I finally got up the courage to do on February 6, 2009. Having my own blog gave me more courage in speaking about my PPD experiences. Oh, and thank you Kristin, for referring me to Alison Stanton who helped me chip my mammoth manuscript down to a much more manageable size.

I am so, so grateful to Esperanza Gaffo whose artistic brilliance enabled me to carry out my vision for my cover design.

I would like to extend a very warm thank you to all the staff at the Westfield Y Child Care Center for taking such great care of Sydney for the four years she was there! Especially Miss Mary whom Sydney misses seeing each and every day like she did for all four years she was there. I’m so glad fate led us to you during our desperate search for quality child care, which is so very hard to find.

I would like to thank Mr. Richard Clarke, my tenth grade English teacher at West Essex Regional School, to whom I credit my grammar skills. If it hadn’t been for his teaching methodology, standout humor and drills on grammar lessons and poetry, I would not have excelled in English in high school, and I would not be as confident as I’ve always been with my writing skills. Little did I know that I was going to write a book one day!

Thank you, Mary Jo Codey, Richard Codey, and former Governor Jon Corzine for making history by helping New Jersey to be the first state to require medical professionals to screen all new mothers for PPD. You are setting the stage for the rest of the country to follow. In so doing, you are coming to the aid of countless women who will get the treatment they need in the early stages of PPD, thereby reducing the unnecessary suffering and possibly even death in cases like that of Andrea Yates and Melanie Stokes, who, as a result of not receiving the correct treatment they so desperately need, end up killing their children and/or themselves.

Thank you, Senator Robert Menendez (D-NJ) for championing the interests of new mothers who have suffered—or will someday suffer—from postpartum mood disorders through your support of the Melanie Blocker Stokes MOTHERS Act, which became law with the passage of Health Care Reform in March 2010. There were many individuals who worked hard to make this possible, including all those who signed the petition and made phone calls. But if it weren’t for your unwavering commitment, the MOTHERS Act would never have come this far.

Oh, yeah, and lest I forget … thank you, Tom Cruise. If it weren’t for your public display of ignorance, I would never have been motivated to write this book.

Introduction

Having postpartum depression (PPD) at a time when mothers are supposed to feel nothing but absolute bliss is one of the motherhood myths I touch on in this book. It is so embarrassing and difficult to talk about, that most women will not tell their stories to people they know, let alone to the world. There’s this fear of being judged, criticized, and labeled as inferior mothers. Well, I am not afraid to tell my story, especially if it means helping other mothers. I want to make a positive impact by empowering women with knowledge about an illness that is more prevalent than people think. One out of eight (or up to 20 percent) of new mothers suffers from PPD. And I’m not talking about the baby blues either. Approximately 80 percent of mothers experience what is referred to as baby blues—the tendency to be teary and/or emotional due to the huge hormonal changes that occur with childbirth—within the first couple of weeks postpartum and resolves on its own.

PPD is a very debilitating illness that can occur anytime within the first year postpartum and in nearly all cases requires the help of medication and/or therapy. Research has shown that PPD has neurochemical causes—for instance, a decrease in neurotransmitter serotonin levels—which is why in so many cases SSRI (selective serotonin reuptake inhibitor) antidepressants like Paxil are prescribed and are effective in treating large numbers of PPD patients. There are so many people out there—Tom Cruise for one—who are vehemently against medications and even the fields of psychiatry and psychology. Hey, all I can say to naysayers and doubters of PPD is, Mind your own business and stop passing judgment on others. Until you’ve actually experienced PPD, keep your opinions and negative comments to yourself.

If asked what the number one complication of childbirth is today, most people would probably say C-sections. One would never think that depression is the leading complication of childbirth because no one ever talks about their experience. As a result, so many cases go unreported and untreated. This is more than likely the reason why, aside from ignorance about PPD and stereotypes of motherhood, postpartum illnesses don’t receive the attention of health practitioners, hospitals, and funding for education and public awareness that they deserve.

There are classes to educate expectant parents about breast-feeding, childbirth, and infant care. But what about PPD? Is it mentioned at all? Even the hospital I went to with its well-known excellence in maternal and fetal care and education failed to offer any information—or even mention it at all—during their classes in childbirth, child care, or breast-feeding. Many women who’ve had PPD feel they were not adequately warned or prepared to deal with it.

Frankly, I’m amazed that there is still so much ignorance about PPD. That ignorance is perpetuated by the lack of information about PPD available to the public, not to mention the general unwillingness of people to talk about it. Had I known about PPD before I had my baby, I would not have suffered the way I had suffered, not knowing what in the world was wrong with me. Ignorance, or the fear of not knowing, can intensify an already bad situation exponentially. There is no need for that kind of suffering, especially at a time when you should be enjoying your baby. After all, you only have one shot at experiencing your baby’s first few months.

Before my own experience with PPD, I’d never really heard much about it before. I thought it was rare. I’d heard of the occasional sad news of a stillbirth or miscarriage, but in terms of experiences after the baby’s arrival, I’d only heard women rave about how great motherhood is. I’d never heard of any terrible motherhood experiences. Sure, having babies is universally viewed as a joyous and miraculous life event. But somewhere along the way people in this society started taking the actual process of childbirth—and the weeks following that, otherwise known as the postpartum period—for granted. Since the 1960s women have wanted to appear like they could handle it all: a job, a baby, a house, and a spouse. Women have become more career-oriented. Consequently, women are having babies later in life and experiencing fertility issues. Maybe trying to maintain the Supermom image isn’t such a good idea, after all?

Women who experience PPD try to keep their experiences to themselves, ashamed for not being able to live up to such high societal standards. The fact is there is absolutely no denying that all parents have to go through some amount of adjustment when they become parents for the first time. Some adjust easily. Yet others adjust with difficulty. This makes sense because everyone is unique and everyone’s situation is unique. It all makes perfect sense, right?

Sound like you? PPD? Nah, it could never happen to me. Especially now that I have a baby I’ve always dreamed of having. I’d never let it happen to me. I’m a strong person. I’ve overcome many challenges in my life, both on a personal and professional level. I can handle taking care of a baby. Plus, I’ve never been depressed before, so how could I possibly get depressed all of a sudden now? I’m busy enough as it is with preparing for the baby’s arrival. I’ve read all there is to read on infant care, breast-feeding, etc. I don’t have the time, or need, to read up on PPD.

Like me, many people have heard of postpartum depression but don’t know what it means, at least not until it affects them directly. Before my own PPD experience, I didn’t know anyone who had had it. I never thought it would be something that would happen to me. I thought it was all a matter of mind over matter. Had I known that as many as one out of eight new mothers develop PPD, I would’ve tried to become familiar with what it is, its risk factors, and its symptoms before having my baby, and I would’ve never traveled that long, lonely, and dark road during those dreadful weeks I was sick with PPD. But I emerged from my PPD experience much smarter and stronger than before, and for that, I am grateful.

Having babies is, without a doubt, one of the most momentous, joyous, and life-changing experiences in a person’s life. The possibility in becoming one out of the eight women who will suffer from PPD couldn’t be further from the minds of the new mother who just had a successful delivery and now has a healthy baby in her arms. After all, who wants to think unpleasant thoughts during such a happy occasion?

All mothers should be able to enjoy motherhood. The words joy, magic, miracle, and love are associated with the birth of a baby and motherhood, while the words sadness, hopelessness, and pain are associated with PPD. In reality, for every woman who uses the words magic, joy, and complete fulfillment to describe her experience with motherhood, there is another who will use the words stressful, difficult, and exhausting (physically/emotionally). PPD all too frequently deprives new mothers of the joy in bonding with their infants, experiencing all their firsts—their first smile, the first time they roll over, the first time they sit up, their first words, their first steps—and even memories of their baby’s first year. PPD has the power to turn what is supposed to be such a happy time of a mother’s life into a sad time, and a traumatic one at that. It is sad to think of how many mothers are robbed of the joy of motherhood for weeks, months, and even years. No mother should have to experience such a traumatic initiation into motherhood.

It seems there’s this attitude that if you don’t know about PPD then you won’t suffer from it. But PPD is a silent epidemic. You don’t hear much about it due to stigma that comes with mental health, particularly around childbirth and motherhood, and not knowing how to even recognize that what you’ve got (or had) is (or was) a postpartum mood disorder. Just because you don’t hear about these illnesses doesn’t mean they don’t exist.

The taboo surrounding this subject has lifted somewhat. We have come a long way in the past couple of decades in terms of the numbers and kinds of resources available to new mothers in the postpartum period. PPD is now discussed more openly among mothers and in the media, thanks to such public figures as Brooke Shields and Marie Osmond. If it weren’t for these celebrities speaking up about their own experiences, society would still be treating the subject the same way society has been treating it for the past few centuries. I’m no Marie Osmond or Brooke Shields, but I share the same goal as them: to empower other women by sharing what it’s like to live through PPD.

From all the books I’ve read, it appears that denial, embarrassment, and/or pride keep women from admitting they have any psychological issues. Out of curiosity to see if this holds true, and since I am unafraid of admitting to anyone, even a stranger, that I suffered from PPD, I’d try to broach the subject whenever possible to try to get a new mother to tell me she had PPD. Other than a couple mothers who thought they had PPD when in actuality they probably only had postpartum blues (based on the description of their experiences), I couldn’t find a single woman who had actually experienced PPD. Or I just didn’t find anyone who would admit that she’d suffered terribly, too ashamed to admit to having such a negative experience at a time when everyone expects her to be happy. It wasn’t until after I started blogging that I realized there are a lot of women out there who are currently suffering from or who have suffered from PPD. Perhaps it’s the anonymity that comes with blogging under, in many cases, aliases that is encouraging more and more women to speak up about their experiences.

In Depression after Childbirth by Katharina Dalton and Wendy M. Holton, when some British colleagues decided to develop a BBC broadcast on PPD, they couldn’t find people who were willing to admit that they had suffered from it.¹ But after the broadcast aired, hundreds of letters poured in from women who were suffering from depression. The recurring theme in all the letters was that each woman thought she was alone. People openly talking about their own experiences encourages others to do so as well. Whether it is via online media (blogs, discussion forums, Psych Central, WebMD, etc.), newspapers, magazine articles, or public service announcements, we need more of this!

Chapter 1

The Statistics: A Wake-up Call

Before I begin to share my story and what I’ve learned from my PPD experience, let me provide you with the following eye-opening statistics. Per the World Health Organization (WHO) report from 2004, depression is the third most disabling condition worldwide.¹ In the year 2030, the WHO estimates that depression will be the number one disabling condition across the globe, with ischemic heart disease and traffic accidents coming in second and third.² Women are 50 percent more prone to depression than men.³ The WHO indicates that mental disorders contribute to healthy life years lost among women between the ages of 15 and 44, which happens to represent the average span of a woman’s reproductive life.⁴

Studies have shown that a woman has a greater risk of being admitted to a hospital for a psychiatric episode within the first year postpartum than at any other time in her life, particularly the first month, with peak prevalence of and hospital admissions for psychiatric episodes occurring during the first six weeks postpartum.

Generally speaking:

1. Approximately one out of eight new mothers experience PPD. In New Jersey, between 11,000 and 16,000 women suffer from PPD each year.⁵

2. Approximately eight out of ten (or 80 percent of) mothers experience the baby blues.

3. Research has shown that less than half of those who experience PPD ever seek medical help.⁶

4. Anxiety is a common symptom of depression. In fact, anxiety disorders occur in 4.7 percent of pregnant patients.⁷

5. PPD is a term often applied in a general way to a spectrum of disorders that can affect postpartum mothers, including (aside from postpartum depression):

• Postpartum panic disorder: Occurs in up to 11 percent of women following childbirth.⁸

• Postpartum OCD (obsessive compulsive disorder): Occurs in approximately 3–5 percent of women following childbirth.⁹

• Postpartum PTSD (post-traumatic stress disorder): Occurs in approximately 1.5–6 percent of women following childbirth.¹⁰

• Postpartum psychosis (PPP): Occurs in approximately 1-2 of every 1,000 deliveries.¹¹ There is a five percent infanticide/suicide rate associated with PPP, which is why immediate treatment is required.¹²

Antenatal (or antepartum) depression:

1. Approximately one out of ten women experience antepartum depression (depression during pregnancy), though many cases are undiagnosed. Depression during pregnancy can lead to premature labor and delivery, not to mention low birth weight babies. Depression and anxiety during pregnancy can also cause bleeding and even miscarriage. In fact, there is a correlation between severe anxiety in pregnancy and a heightened startle response and/or colic in newborns.

2. Untreated cases of depression during pregnancy have a 50 percent chance of worsening after childbirth.¹³ Depression during pregnancy generally does not go away once the baby is born.

3. Per Michael O’Hara, a research psychologist at the University of Iowa, 25 percent of women with the baby blues will go on to develop PPD.¹⁴

Risk for PPD

1. The child of a parent with a mood disorder will be approximately three times more likely to develop one too.¹⁵

2. Studies have shown that women with versus without a history of depression have a 25 percent versus 10 percent chance of developing PPD, respectively.¹⁶

3. One in five women with bipolar disorder will experience PPD.¹⁷

4. Per Venis and McCloskey, The single greatest predictor of PPD is a previous episode of PPD. You have approximately a 50 percent chance of developing PPD again with subsequent deliveries if you sought help the first time, and the odds increase even further (to 66 percent) if you didn’t.¹⁸

5. There is a 60 percent increase in the risk of developing a postpartum mood disorder in women with a personal and/or family history of clinical depression, anxiety/panic disorder, eating disorders, PPD, PMS (with emotional symptoms like significant mood swings and teariness), OCD, or bipolar disorder.¹⁹

6. Once you’ve had PPD, you have a 50 to 62 percent chance of experiencing it again.²⁰ Chances increase to 70 percent if you’ve already had two episodes of PPD.²¹

7. The risk of the recurrence of postpartum psychosis has been estimated as high as 40–60 percent.²² One study even shows the risk is 100 percent for women who give birth within twenty-four months of their previous episode.²³

8. Per Lusskin et al, First-degree relatives of patients with depression are 1.5 to 3 times more likely to develop depression.²⁴

Partners and PPD

1. Studies indicate that nearly one-third of women with PPD have a partner who is also depressed.²⁵

2. Approximately 10 percent of men experience postpartum depression, with rates being higher during the first three to six months postpartum.²⁶

3. Research shows that the occurrence of paternal depression can be as high as 50 percent when the mother has PPD.²⁷

Chapter 2

Sharing My PPD Experience

For the first few weeks after delivery, I shed tears of joy. Later, I shed tears of anxiety and guilt that seemed to all start on the day after my six-week postnatal exam, after Ed and I took Sydney in for her one-month exam. The pediatrician asked us if we were considering hiring a nanny or leaving Sydney at a day-care center. We told her we decided to go with a day-care center. She asked us what the ratio of providers to infants would be and we said 1:4 but that there would be two providers and eight infants under twelve months old. That’s when she frowned and warned us that we should expect Sydney to be sick for half the year with respiratory ailments from being in one room with more than four infants at a time. As soon as she said that, it was like she turned on my anxiety switch. I started to obsess that I’d be responsible for making Sydney sick.

Right about that time, Ed came down with the flu. Try as I might, I couldn’t avoid coming down with it too. My greatest fear at the time was giving the flu to Sydney. Fortunately, she didn’t come down with it, even though Ed and I both coughed like crazy for two weeks. They say that the immunity of newborns is boosted from the nutrients they get out of breast milk. It made me feel so gratified that my effort to pump milk was already deriving benefits for Sydney!

And on top of everything, I was breaking out in massive numbers and sizes of hives every day. The only places my hives didn’t appear were my back, shoulders, and calves. Occasionally, my top lip would swell as if bitten by an insect. This, I later determined, was a more severe reaction called an angioneurotic edema.

Insomnia Sets In

On my 45th day postpartum, I suddenly couldn’t sleep at all, even though I was completely and utterly exhausted from sleep deficiency that started at the hospital and never let up. When I told my OB/GYN about my not being able to sleep, he automatically prescribed Ambien, which he instructed me to take as needed. Since I wanted to see if I only needed half the pill to help me sleep, for the first three nights I broke the ten-milligram pill in half. But then the doctor’s office advised me to take the full tablet each night, as prescribed. Before I knew it, I needed to take an Ambien to sleep each night. Since both the doctor and directions for the medication indicated that I needed to be able to devote seven to eight hours to sleeping, I had my doubts about taking the medication since I had to get up during the night and feed the baby. But then Ed so graciously offered to do the late-night feedings until I got better. I felt so guilty about that, since he was the one that had to go to work early each morning.

There was a window in which I had to take my Ambien each night. The fear of waking up too early was a primary factor in my daily ritual of calculating the time I should take the Ambien. Ambien was so effective