Postpartum Awakening

I knew I had to refocus my journalism career on maternal mental health the moment I realized prenatal and postpartum depression, anxiety, obsessive-compulsive disorder, bipolar disorder, and psychosis were real biological conditions instead of the existential crises I once believed them to be.

The realization happened after I started experiencing strange symptoms following the birth of my second daughter, Celeste.

I’m awake. It’s dark. That means I shouldn’t be awake.

I check my phone. It’s midnight. Damn. Why am I awake again?

This better not be… It can’t be… I won’t let it be…

I look over and check on Celeste. She’s still sleeping. Good. I can’t deal with an awake three-month-old right now. Not in this state. As long as I don’t make too much noise and keep my boob nearby, she should stay asleep.

We co-sleep so I can sleep because without sleep, I’m a mess. We’re a mess. Having her in my bed next to me is easy. Easier. When she stirs, I lean over and guide her quivering lips to my nipple. She suckles herself back to sleep. No crying, no fussing, no rocking. Just sleep. Sublime, cavernous, essential sleep.

This isn’t cute, interesting, or blissful. This is motherhood. This is war.

This is exhausting, mundane, and obstreperous. This is a battle of the mind – a battle for my mind – and the only way I know how to survive life with a baby.

The house is quiet, almost quiet. Down the hallway, my husband snores next to my six-year-old in her purple bed, in her purple room, the two of them snuggled under her purple comforter, surrounded by purple walls and dozens of Monster High dolls. I co-slept with Eva until I had Celeste. Now John has taken over. He doesn’t mind. His mind is sound, sounder than mine.

I listen. Everyone is OK. Everything is fine. Good. Now to me. Am I OK? Am I fine? I’m not sure. I’m scared but I don’t know why. I know I’m scared because my heart is racing and I want to run away from something terrible and frightening but nothing is chasing me down except for irrational, horrifying thoughts.

This better not be… It can’t be… I won’t let it be…

My arm is asleep and parts of my face feel numb. This can’t be good. This is something to be scared about. Here’s a thought for my fear to grip onto. Now it all makes sense. Why I’m scared. Something awful is happening to my body. What if I’m having a…? I can’t think it because the thought sends ice-cold adrenaline surging through my body, jolting me upright. I need to do something about this.

RIGHT NOW.

“911, what’s your emergency?”

“My left arm and face are numb, my heart is racing and I’m feeling panicky and anxious,” I calmly inform the operator.

This better not be… It can’t be… I won’t let it be…

“Are you breathing OK?” she asks.

“Yes,” I reply.

“An ambulance is on the way.”

The night before, I had a nightmare that I drove off a cliff with Celeste except that I couldn’t remember if it was actually a nightmare or if I was awake and the thought just randomly, no intrusively, popped into my head. Sometimes I see an image of her drowning in a bathtub.

I feel like I’m drowning. For the past week, each day I’ve felt my mind sinking deeper and deeper into a dark abyss of crushing waves as I frustratingly attempt to penetrate the surface to no avail. The light at the top is growing dim and the people and things, though right in front of me, are getting harder and harder to see and hear. At any moment I fear I’ll just slip away forever. The thought shocks me back to the present for a fleeting moment, for a desperate gasp of air before I grow heavy and begin to descend once more.

This better not be… It can’t be… I won’t let it be…

If it is, this isn’t what it was like the first time. Then, I was anxious, but not this anxious. The heart palpitations terrified me but I was also sad and angry, really angry. So I meditated, changed my diet, did yoga, and bettered myself. Because it was actually my fault, right? That I was just too spoiled and immature to deal with the ultimate sacrifice of motherhood then, right? The despair and anguish I had felt was something I just had to get over by working on myself by myself, which I did, and eventually got better because of it. I triumphed over it. I caused it and I cured it. I was in control all along.

Or so I thought.

If that was the case, then why is it back? Don’t say that, it’s not back. Everything is OK. Everything is fine. I’m OK. I’m fine.

I’m not sad and I’m not angry. I don’t have heart palpitations. But I do have chest pain, muscle pain, fatigue, and now, numbness. Those aren’t symptoms though, are they? Hard to know when no one talks about it: not my obstetrician, not my midwife, not my family doctor, not anyone at the hospital during labour and delivery.

No, I’m supposed to figure it out while I’m in it. Don’t say that, I’m not ‘in it’. Everything is OK. Everything is fine. I’m OK. I’m fine. This time, my marriage is solid and my baby sleeps through the night. This time, I’m not overwhelmed. This time I’m happy – euphoric, in fact.

This better not be… It can’t be… I won’t let it be…

So if it’s not, then what is it?

“John,” I whisper. “John!”

“Yes?” he whispers back.

“I woke up and my arm was numb so I called 911. The ambulance will be here soon.”

He slips out of bed trying not to wake Eva and joins me in the hallway.

“You have to stop doing this, Patty,” he says. “There are people who really need that ambulance tonight.”

Not me. I don’t need it. And part of me knows he’s right except my logic is temporarily out of service and anxiety has taken the wheel. Fear is in control. I start back towards the master bedroom, change out of my breastfeeding nightgown and into a pair of yoga pants and a t-shirt. I notice how loose my clothes are getting. I’ve been losing a lot of weight.

The doorbell rings. They’re here. I pick up Celeste and rest her head on my left shoulder which I notice isn’t numb anymore. I probably don’t need to go to the hospital after all, but if I do end up going, she’ll be coming with me. I don’t go anywhere without Celeste.

I head down the stairs and to the front door and let the paramedics in. We go into the family room and I sit on the couch as the team of three unfasten their tools. John sits down on the couch next to me. He’s calm as calm can be. I’m still anxious even though my numbness is gone and I’m annoyed that I can’t calm myself down. We settle in, both knowing what comes next: vitals.

As one paramedic takes my blood pressure, the other takes my temperature and checks my heart rate. I hate having my blood pressure taken. It’s a phobia, one of many I have along with flying and snakes. As the cuff gets tighter on my arm and my heart beats ever faster, I tell the paramedic that I have a history of anxiety, that I have white coat syndrome and that this isn’t the first time I’ve called 911 for a panic attack which is probably what this is. I tell him and the other paramedics that I’m sorry for taking up their time and valuable resources and that I’ll just make an appointment to see my family doctor first thing in the morning.

“Your blood pressure is high,” says the paramedic. “We’re looking at stroke or heart attack when it starts getting this high. You need to come with us to the hospital right now.”

Well, there’s something to say to a person with anxiety. Another shot of adrenaline rushes up through my chest and wraps around my shoulders. I turn to look at John. He shrugs his shoulders. Does that mean he’s not sure about whether I have it or this could be a life threatening, imminent crisis? I search his face for reassurance.

“Maybe you should go,” he says.

F*ck. Now I’m petrified.

On the way to the hospital, the paramedic chats with me in the back of the ambulance where I share a black plush-covered bench with him while Celeste is strapped onto the stretcher, still sleeping, so peaceful and oblivious to the urgency unfolding.

I am terrified but to look at me you wouldn’t think so. The paramedic strikes up a conversation about how he doesn’t live far and that he jogs up this very hill we’re on every single morning. I feign interest and placate him with nods and one-word answers. I figure I can get away with not having to be cordial in this situation since it’s possible I could actually be dying in this very moment. You jog? Great. Good for you. I’ll just sit over here frozen in fear and wait for the most terrifying event of my life to occur.

This better not be… It can’t be… I won’t let it be…

We get to the hospital and check in. The nurse asks about my symptoms. I tell her about the numbness and about my history of anxiety. And that’s all. I don’t venture there…yet.

Thankfully, we’re given a room with a stretcher to lie on. It’s small but it’ll do. Celeste is still asleep.

Hours later, I’m given blood tests and hours after that, the results come in. In the meantime, I’ve been Googling.

Turns out, numbness can be a symptom of it, as can chest pain, intrusive thoughts, a spike in blood pressure, panic attacks, sadness, anger, and something I’d never heard of before called ‘derealization’.

The drowning.

The doctor walks in. It’s now been six hours.

“Everything looks OK,” he informs me. “Everything looks fine.”

I’m relieved to hear I’m not at death’s door. But if I’m being honest, I know I’m not OK. I know I’m not fine. And I know the onus is on me to say something if I want help.

This better not be… It can’t be… I won’t let it be…

I look up at the doctor and finally say the words I’ve been dreading to say out loud.

“I actually have a history of postpartum depression and anxiety,” I offer. “And I’ve been having some of the same symptoms I had a few months after the birth of my first daughter, along with some new ones. I think that’s what’s happening to me.”

The offer is shut down. With a wave of his hand in an effort to dismiss my concerns, the doctor smiles and tells me simply not to worry.

“Enjoy motherhood,” he counter-offers. “Everything is normal. Just take deep breaths and look at the miracle right in front of you.” Looking down at Celeste his smile grows wider as he takes a deep sigh and says, “They grow up so fast.”

BUT THIS IS NOT MOTHERHOOD! I want to yell back. This is postpartum depression and postpartum anxiety and who knows what else? Postpartum obsessive-compulsive disorder? Postpartum bipolar disorder? Postpartum psychosis? These are real maternal mental health issues that for the first time I’m beginning to realize are biological, physical illnesses that require medical attention and not Deepak Chopra.

The last time this happened to me, I didn’t know it was happening. Following the birth of my first daughter, my postpartum bipolar psychotic delusions had me believing I was communicating with angels. I ascended and descended into a state of hilarious, yet dangerous, mania which had me doing all kinds of extreme, out-of-character antics from renting a theatre and starring in my own one-woman musical to quitting my job and losing my home.

This can’t be happening again.

The doctor senses that his wisdom has not been imparted well. He offers an olive branch.

“I can schedule an MRI if that would make you feel better,” he says. “Numbness can also be a symptom of MS.”

“No thanks,” I reply. “I’ll go see my family doctor tomorrow.”

The doctor finishes writing up his report, looks at Celeste, then at me and says, “Good luck.”

The next day I’m prescribed antidepressants. Though I don’t score high on the Edinburgh Postpartum Depression Scale because there aren’t enough questions about postpartum anxiety, given my history my family doctor is pretty sure that’s what we’re dealing with. I ask for therapy but since there aren’t any good psychiatrists in the area, according to my doctor, I’ll have to go without and rely solely on medication to help me through.

Tears flow as I swallow my first pill. Within a few weeks I’ll start to feel better. Within a few months I’ll feel the best I’ve ever felt in my entire life, and I’ll begin to question why I wasn’t ever screened, assessed, and treated for maternal mental illness during either of my pregnancies and postpartum; why I wasn’t ever screened, assessed, and treated for anxiety as a child; why I wasn’t ever screened, assessed, and treated for depression as an adolescent; why I wasn’t ever screened, assessed, and treated for panic disorder as a young adult; and why, unless I ask for it, probably won’t be screened, assessed, and treated for a mental illness going forward – after all, I’ve still got menopause to contend with.

More than question, I’ll begin to write about it and connect with researchers and advocates across the country. I’ll become an advocate myself and participate in rallies to demand political change because it’s unfathomable to me that women in Canada still aren’t being properly screened, assessed, and treated for maternal mental illnesses.

This better not be. It can’t be. I won’t let it be.