A Dance in the DSM: My Tango with Postpartum Depression, Anxiety, and OCD

By Jessica Cuomo

A Dance in the DSM: My Tango with Postpartum Depression, Anxiety, and OCD is a memoir chronicles one mother's journey through mental health struggles. 

It is a story of hope that mixes the humor of parenting with the horrors of developing a mental health crisis and living with the rare disorder: p

• Language: English
• Publisher: Curly Girls LLC
• Release date: Oct 1, 2022
• ISBN: 9798986774114

Book preview

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Table of Contents

Preface

Chapter 1: A Duck Dynasty

Chapter 2: Hyperemesis Gravidarum

Chapter 3: Girl with a Dragon

Chapter 4: The Eleventh Hour

Chapter 5: Game Time

Chapter 6: It Starts

Chapter 7: Screen Time

Chapter 8: A Mother’s Day Present

Chapter 9: The Scarlet Letter

Chapter 10: A Weekend Getaway

Chapter 11: Mommyland

Chapter 12: Medication Time

Chapter 13: A New Hope

Chapter 14: Round 2

Chapter 15: The Evil Disney Princess

Chapter 16: Sleepless Beauty

Chapter 17: Yellow Wallpaper

Chapter 18: Rocky Road

Chapter 19: Trash Cupcake

Chapter 10: Fin

About The Author

Preface

This is the story of how I went crazy.

This story documents the years during which I was pregnant with my first child and into my recovery after the birth of my second child. It tells the good, the bad, and the ugly. For people struggling, this story may summon uncomfortable feelings. However, I promise you that this is a story of hope and recovery that is intended to help bring the same to other people who struggle with their mental health—especially young mothers. I know if I had read a book like this before or during my struggle, I would have sought help sooner and avoided countless hours of suffering and agony.

I wrote this memoir not only to bring the hope of recovery to others with mental illness but to also change our conversation about mental health in America. The brain is our most important organ (although my brother, the cardiologist, may beg to differ), and we as a society need to view mental health as we do our physical health. We don’t shame people or feel guilty for having a broken arm, strep throat, or cancer. Therefore, it makes no rational sense to treat diseases of the brain, no matter the severity, any differently. We need a cultural shift in thinking.

We also have to change the system to help people who are struggling. When a person has a broken leg, they do not have to use their injured leg to research and set appointments in an effort to be healed. When a brain is injured, it can’t be used well enough to get the proper help. Jails and social isolation should not be the last refuge of the sick. We all need to become a part of a larger conversation about mental health treatment and recovery, so that we do not punish vulnerable and suffering people in our population, but help them before and during their struggle. Our society needs more mental health awareness, more funding, more facilities, more trained professionals, more empathy. . . more everything.

The Diagnostic and Statistical Manual of Mental Disorders 5th edition (or the DSM-5 as it is commonly called) is the Bible of mental health disorders in America. It is published by the American Psychiatric Association (APA), and is used by most clinicians, professionals, and health insurance companies to identify and diagnose mental health disorders. I first learned about this book when I had my first real mental health crisis and was diagnosed with a mental health disorder at the ripe age of twenty-nine. Of my mental health journey, I like to say that I dance in the DSM, I don’t live there. There are times in life when I am symptomatic and times when I am in remission. My diagnosis doesn’t define me: It is a piece in the wonderful and difficult puzzle that is my life story.

This is the beginning of my contribution to the mental health conversation.

Chapter 1

A Duck Dynasty

I’m going to be a terrible mother.

The light blue room was highlighted with gray trim. The silver stirrups glared at me. Everything was calming, sterile, antiseptic—the opposite of all that I am and all for which I stand.

I closed my eyes and attempted to take a slow, calming breath.

Joy, a gentle and clearly amiable midwife, stood in front of me and gave me a reassuring smile. The grooves of her smile lines deepened as she spoke. Joy must have been at least fifty. Her pale freckled skin had fine wrinkles developing, and her russet hair had white sparkles at its roots. There was a maternal aura about her.

No, dear, she demurred. You’re going to be a great mother. All first-time mothers are nervous. It’s natural. But you’ll figure it out. She rolled her chair away from me and over to her computer. She typed in her notes and began asking questions. Her motherly face brightened. Does your husband know?

No.

Will he be excited? she asked with rising excitement.

Uhh . . . Yeah. I think so, I paused, not entirely sure myself. Yes. Yes, he will be.

Was this planned or was it a . . . surprise?

I sat up straighter on the examination table and rustled my blue paper gown with my fingers. The table’s cushion was firm- without much give. "We weren’t trying, but we weren’t not trying, if that makes sense."

Joy rolled back around to face me. The folds around her eyes gently pressed together as she smiled. I hear that more than you would think.

I nodded slowly and let go of the gown.

***

I had never really wanted children in any tangible way. Lots of women I knew dreamed of having children. They knew names, numbers, and other details that can only be conjured after years of dreaming and planning. They knew they were meant to be mothers. Not me. In high school, my yearbook prophecy was that I was going to marry an 84-year-old billionaire, right before he died, and inherit the money from my one true love. Not exactly June Cleaver material.

My Italian American mother would talk to me about motherhood as if it was a foregone conclusion for me. We had frequent conversations growing up.

"Mom, I don’t want kids—I hate babysitting. I literally count the seconds until the parents come home," I would say.

Jess, my mom would respond, it’s different when it’s your own kids. I’m telling you.

I would repeat my mantra, Motherhood is babysitting without getting paid. No, thank you.

My mother’s response was always, I’m telling you. I didn’t like other children either. It will be different when it’s your own child. It will be the best thing you do in your life.

Over time, I had gradually accepted motherhood as my eventual fate.

***

I chuckled nervously and attempted to recover from my less-than-motherly first reaction. I bet you don’t get that reaction often, I continued, wanting to make her less nervous for my unborn child. I just was surprised it happened this soon. And by this soon, I meant the first time not trying.

My nonjudgmental midwife assuaged the guilt. It’s a lot to process the first time. You’ll be fine.

She rolled back to her computer and began to fire the regular pregnancy and medical questions in my general direction. As I answered her questions, I nervously smoothed the ends of my dark brown hair with the pads of my fingers. A few minutes into my family history foray, she asked about my mother. What were your mother’s pregnancies like?

What do I remember? Well, my mother got pregnant with my brother at 25. What were her pregnancy stories? They had two classifications: nausea and excitement. I remember her telling me about how sick she was and how excited she was to be pregnant.

She was sick with us. She said she threw up all the time, I recalled, tilting my eyes towards the tiled ceiling. I was seeing, but not looking.

How sick? she asked.

I paused, recalling our many conversations about motherhood., Very. She has mentioned it frequently.

Joy paused to write more notes on my chart and then responded, It is very common for a woman to have pregnancies similar to her mother’s. Morning sickness is a common part of pregnancy. It usually only lasts for the first trimester, and then it tapers off.

Neat.

***

The grocery store was a bouquet of smells. The housewife walking by me became a strong scent of perfume with hints of grapefruit. The bearded gentleman in the polyester blend was a horrendous mix of stale cigarettes and body odor. The elderly woman gently pushing her cart? Halitosis. The produce aisle was my jam. The oranges were sweet with a tang. Blueberries? Forget about it. I could do without the lettuce, but the herbs—ahh, the herbs were heaven! Who knew that cilantro could make life that much better?

I felt like I was becoming Spider-Man . . . or was it Spider-Woman? I didn’t know what was happening to me; I definitely did not feel stronger or faster. Logic told me not to try to climb the walls. But smell? If I tilted my head and sniffed, I could identify every olfactory graze. As I walked on, I realized that this was the worst superpower ever. I had never realized how many things smelled terrible in the world.

I grabbed some fruit and herbs and made my way back to the butcher. When my parents were first married, they decided my mom would only cook duck as a signal that she was pregnant. When she found out she was pregnant, she made my father a beautiful meal of duck, and he was joyous. It was a cute and weird detail that I found strangely romantic. My husband, James, and I decided that would be his way of finding out if we were ever pregnant.

I awkwardly moseyed up to the counter. Luckily, I was the only person nearby because I had no idea how to prepare duck, and because of my ignorance, I feared this conversation was going to be embarrassing. Hi, I greeted the lovely gentleman at the counter. I need some duck.

The smell of dead flesh permeated the air. The large man in an apron, who smelled of salami, stepped closer to the case and asked, You want a whole duck?

A whole duck? That seems like a lot. Images from A Christmas Story flashed through my head. There is no way in hell I’m cutting off something’s head. And would it have its innards shoved up its ass? Hard pass.

Uhh, can I have just, like, the breasts? I stammered

Sure, He gestured toward the refrigerated deck cases. They’re in that center case. Help yourself.

He walked into the back and left me to my own search. I picked up a few bloody packages, randomly selected one, and headed home.

After a dastardly attempt to follow an online recipe for duck, I created something that a rescue dog would happily eat out of a dumpster. I say that because in a restaurant, it surely would have ended up there. All I had to do now was sit and wait for James to get home. As I waited, vague anxiety simmered and began to give way to excitement. We were doing this. It was happening. We had been married for five years and were having a baby at the ripe old age of 29. We were becoming real adults. I might have a little James. I was going to be a mom. We were going to be a family. We were going to mold and love a child in this world.

As the duck was finishing in the oven, my thoughts began to race. Where are we going to live? We’re in a starter home, not our forever home. We can’t live thirty minutes from my parents, who live forty minutes in the opposite direction of my work. I’d be in the car two and a half hours a day on top of my work day. I’ll never see my kid. And I can’t be an English teacher as a mom. Between the preps and grading essays, I’ll be the worst mother ever. I need to finish my certification to become a librarian before the baby comes. Is that possible? How many credits do I need? I’d better log in after dinner and check my plan of study. . .

Thankfully, James came home from a long day at work, which freed me from my anxiety cyclone. James stood in the doorway an even six feet tall. His brown hair was tousled and the look in his azure eyes expressed both his weariness from the day and his relief to be home from work. He was wearing his standard engineer uniform, a polo shirt with jeans, and greeted me in the kitchen with a peck on the lips. I’m starving, he announced. What’s for dinner?

Relax, I responded. Have a seat. It’s ready.

James and I frequently become hangry. When either of us hits a certain time of day, we need to eat something right away or somebody might lose a limb. He had that look on his face.

I laid his plate in front of him, Here you go.

He hunched his broad shoulders and immediately started eating. James would eat garbage out of a dumpster when he is hungry, so my culinary delight didn’t faze him. I just stared.

What? he looked up uncomfortably.

Do you like it? I responded, my sudden vocalization involuntarily rose in pitch.

What is it? he parried as he paused his shoveling.

Duck.

He blinked for a second and then looked down, Yeah, it’s pretty good.

He forgot. I realized that our casual agreement may not have been cemented so romantically into his head as it had been in mine. I stared at him a little longer, and after an awkward pause, I repeated, I made you duck.

A spark of recognition suddenly hit his face. His face lit up as he turned toward me. Are you serious? His voice rose with excitement.

Yup, I responded, patting my nonexistent baby bump. Confirmed by the doctor today.

He pushed out his chair with enthusiasm, and I stood up to meet him. He hugged me hard and then reminded himself I was pregnant. He instantly lessened the squeeze, pulled away, and touched my stomach. I can’t believe it! he replied with a mixture of wonder and astonishment.

Me either.

Chapter 2

Hyperemesis Gravidarum

Week-six hormones came in like a lion. I stopped finding food enjoyable. I had the worst hangover in the history of the world, and I began puking my brains out. It happened in an instant- the flip of a switch. My pregnancy craving? Saltines. And by craving, I mean it was the only thing I could hold down long enough to potentially retain some nutrients.

After a few days of this constant nausea, I became desperate. I was teaching English, and I asked my students the journal questions: What food do you eat when you have a stomach bug? What brings you comfort? I actually had students journal their answers, and we discussed them as a class. As they read their answers to the class, I pictured each piece of food and waited to see if it would cause the bile in my stomach to rise.

I had been a high school teacher for the past five years, and it was an all-consuming vocation. Every day I was preparing for three different lessons, reading the material, grading papers, talking to parents, and, my favorite part, building a relationship with my students. There wasn’t much time left in the day for a life. I had no real hobbies- work took up ninety percent of my thoughts and time. It was an exceptionally satisfying and enjoyable career; however, I usually ended my days, scrambling to make dinner, stumbling onto a couch, and zoning out while watching Law & Order. It was not a lifestyle that was conducive to motherhood. I realized this in my fourth year of teaching English and enrolled in classes to become a Library Media Specialist. This new career would still allow me to teach and be around students and books, but it would be gentler on the correcting, which I abhorred. Until I changed careers, I would have to suck it up and try not to puke in one of the students’ backpacks, which was becoming harder by the day.

After living in what felt like extreme torture, I gave in and called my midwife. She asked me to come into the office to assess the situation. So, a few days later, I found myself back in the same sterile office, with my ass hanging out of a stupid blue gown.

Okay, so how can I help you today? Joy chirped, entering the room with a smile.

Uhh, hi. So, uh . . . I . . . uh . . . can’t eat without puking, I blurted desperately. I’m super nauseous all the time, and sometimes when I’m not eating, I throw up bile. It’s so painful that I drink water when the nausea gets too much, so that the water soothes my throat a little when I puke it back up again.

Joy blinked at me and then tilted her head slightly with empathy. I’m so sorry. That is so painful. Only on the bright side, that means you have a lot of progesterone and a strong implantation into the uterine lining.

I searched her face for a clue as to what she was saying.

She translated, More hormones mean a stronger pregnancy. You are less likely to miscarry.

Well, this kid must be an invincible superhero because I haven’t stopped puking in days, I responded flatly. I have found that I can throw up during the four-minute passing time between my classes and make it back before the bell—which is the shittiest party trick in the world, by the way.

Well, let’s see if we can give you some relief, Joy chuckled as she went to the computer. I’m going to give you a subscription to Zofran. It’s a medicine that will quell the nausea.

Medicine? I asked with clear concern.

In the two weeks prior, I had been turned on to all of the popular baby/mommy apps and websites. These resources required me to enter my baby’s due date and then proceeded to pelt me with helpful information related to my pregnancy and growing fetus. I loved hearing it was the size of a poppy seed or whatever, but the specificity of dos and don’ts were overwhelming and, honestly, anxiety producing. I had no idea that babies in utero were so fragile. Caffeine, sushi, and unpasteurized cheeses were potential death sentences (not that I could hold them down anyway). I couldn’t eat, like, fifty of my favorite things- as delicious as frying cold cuts sounds.

They also taught me that there are about one million chemicals in everything around me. My shampoo and conditioners had sulfates and parabens (which are apparently bad), my mattress was flame retardant, my water bottle was plastic, and so much more. Cancer was everywhere, and it was all waiting to harm my unborn child. Natural was best, and everything in my life needed to be holistic. So, when my midwife mentioned medicine, I was nervous.

Am I going to hurt the baby? Am I already a bad mother?

Joy snapped me out of my uneasy reverie. Women have taken it for years. It is perfectly safe for your baby. It’s given to cancer patients who have nausea from chemotherapy.

Cancer patients? Are you sure it’s safe? I asked again skeptically.

Yes, she answered. It’s been used for years and has no effects on the baby at all." (Five years later, I saw commercials searching for formerly pregnant women to be plaintiffs in a Zofran lawsuit, and I nearly died.)

Okay, I agreed to the medication.

Making sure that your baby has nutrients is the most important thing right now, she continued. Try and keep your food down as long as you can, so your stomach can absorb the calories you eat.