If It Looks Like A Duck, And It Quacks Like A Duck... It Still Might Be Postpartum DepressionMorgan Shanahan
I feel like before we get started I should introduce myself. My name is Morgan and today is my first day on Babble. I’m embarrassingly excited about the whole thing. Not to rehash my entire bio, since it’s right there to the right, but I’m a mom to one, wife to one, screenwriter and blogger living in that little heaven just on the other side of the Hollywood Hills known as the San Fernando Valley. Or sometimes just as “The Valley.” And other times as “The 818” which is also what my personal blog is called, and the temperature is, in fact, TEN DEGREES HOTTER here than it is in the rest of LA, thus the title of my new Babble Voices blog. (Actually, thanks to global warming it’s more like twenty degrees hotter lately. Oy.) Unlike most residents of la la land, I was actually born and raised in LA, and I also married my high school sweetheart here, so I’m basically an urban townie. You can learn pretty much anything else you could ever want to know about me and more on The818.com, where I also do a lot of drooling over design-y things and kiddo stuff. And I’m really bad at segues, so here we go…
I had never struggled with depression before pregnancy. Anxiety runs in my family … hell, it runs in my culture I hail from New York Jews; we practically invented irritated bowel syndrome. My grandmother died when I was 12-years-old, but I can still hear her sighing in the Brooklyn accent she fought so hard to squelch “Hang on meshuga, Grandma needs to take a half a valium.” (Oh, Grandma. HALF a valium.) So living in a community of neurotics (and I say that lovingly), I never realized that I HAD an anxiety problem. I thought everyone felt like ralphing all the time, so I basically squashed it and went about my life. And believe it or not, that actually worked — for nearly 28 years that worked — the pangs in the pit of my stomach didn’t slow me down. I managed them, and I moved on.
I didn’t really need to take a pregnancy test to know I was pregnant (I mean, I took one eventually, I’m not a cave person). I’d eaten McDonald’s cheeseburgers for lunch three days in a row (after a two-year embargo), and it was the only answer I could come up with when Scott asked me what I wanted for dinner. That’s when it hit me that the queasy-ness I was feeling was probably not attributed to quitting caffeine.
“All I want is a McDonald’s two cheeseburger meal. I think I’m pregnant.”
And pregnant I was. Scott was over the moon. I mean OVER. THE. MOON. But within a week my vague nausea had turned to full-blown morning all-day-long sickness. And when I look back, it all started with the morning sickness.
On January 1, 2009, I had a day job, I was about to make a pretty decent break in my screenwriting career, we were house hunting, and talking about *maybe* *one day soon* starting a family.
By Valentine’s Day I’d been laid off, my so-called “break” had gone up in flames, I left my first agent, we were considering downgrading to a smaller apartment, and I was vomiting four to six times a day. When I wasn’t vomiting, I was laying on the couch begging the pregnancy gods for mercy, listening to hypnosis tapes because I’d try anything, and spending what money we had on prenatal appointments and miracle morning sickness remedies while simultaneously fighting with my health insurance as they tried to call my pregnancy a pre-existing condition. Because job loss = loss of insurance coverage, and this was before the stimulus package made COBRA affordable, so blissfully unaware of the zygote in our midst, I’d declined that option and switched carriers probably AS SPERM MET EGG.
Three weeks of that, and I couldn’t remember life any other way. Six weeks of that, and I could barely get out of bed in the morning. Shortly thereafter Scott was shredded by a German Shepherd at work and, after a pretty terrifying Monday evening in the ER, he had to spend two weeks with both hands bandaged and stitched. Things were getting pretty effed pretty fast. At my 22 week appointment I was sobbing in my OB’s office, too ashamed to tell her what I was so upset about. I no longer wanted to have my baby. Or, more accurately, I no longer thought I deserved my baby. I mean, I was going to have her and love the hell out of her — there was never any doubt about that but the more bills piled up, and the more meetings I had to cancel because I was puking my brains out, all the while not telling my brand-spankin’-new agent that I was pregnant for fear that she would immediately drop me (because, OBVIOUSLY, right?) the more I was certain that I’d never clean up my mess of a life. That I’d ruined ALL our futures. That I was turning my elated, overjoyed, couldn’t-wait-to-be-a-Dad husband into almost as stressed-out of a mess as I was. That my uterus felt like a time bomb and I couldn’t shake the dread that sent waves of nausea so powerful over me that I could no long decipher between morning sickness and mental illness.
To my obstetrician’s credit, she takes perinatal mood disorders very seriously. For a few weeks, we checked in every few days. She told me to start walking 20 minutes three times a day, fast enough to get my heart rate up, and use my endorphins to counter-act the depression. We talked about medication, but at that point in my pregnancy, despite the intense feelings of dread and horror I had in relation to actually having the baby, I didn’t want to add meds into the mix … since y’know … she was already getting a shit lot in life by having my starving-artist-self-loathing-pathetic-ass as her Mom. After a couple of weeks without improvement, she asked me if I had ever seen a therapist. I had. There was a guy I’d seen a few times about six months earlier when I was frustrated at work. I’d ended up in his office by accident when my internist had referred me to his wife. They had the same last name, and I didn’t realize there were two, so the receptionist had inadvertently scheduled me an appointment with the MALE Dr. Suckface* (*name changed to protect, well … me.) I decided it probably wouldn’t make any difference if I saw a man or a woman, I went a few times, determined that I didn’t need therapy. I just needed a new job, and filed his number in my rolodex under “who-the-ef-says-rolodex-in-2012.”
And here is where I made the biggest mistake I could have possibly ever made in relation to my mental health. At 22 weeks pregnant, with no experience with depression, no light at the end of the tunnel, and a total inability to speak the words that plagued me without LITERALLY VOMITING, I went to see a therapist who I had already deemed useless. In my defense, I was blinded by misery. And shame. SO MUCH shame. Devastating shame, really. I called his office and left a message on his voicemail I could barely speak, except to eek out that I was really, REALLY sad, and I was pregnant, and my obstetrician thought I should come in. I remember I was standing in my friend’s backyard when he called me back. I snuck off into a corner, and kept my public happiest face on through the entire conversation in which I made an appointment to see him the following day. The next day, I sat on his couch and filled out a questionnaire. I remember writing “may be pregnancy related” next to nearly every symptom (trouble sleeping, nausea, appetite, etc.) When I was finished, he took the paper from me and went down the list and asking me about my answers while I sat there and wept. I couldn’t open up. We mostly talked about my career, because that was the only thing I could point to as the source of my misery. Unshakeable feelings of failure. Certainty that things would never improve, no matter how hard I worked. After years chasing the same dream, I suddenly (and seriously) believed that I was destined to be a hopeless failure and should give up altogether. After a few weeks he diagnosed me with adult ADHD and said that pregnancy brain was rendering me useless, thus triggering the depression. He told me how depression can be damaging to a fetus. That terrified me. I had just found out we were having a girl, and we’d decided on the name Delilah. She wasn’t just this toxin making me sick any more. I’d seen her face in 4D. I could feel her little tushie under my ribcage. My best friend’s little sister had given me this tiny sweatsuit, the first baby gift I got, and I used to take it out and stare at the butt of those little orange pants and it was the only time I felt anything like a twinge of happiness or peace. Those pants are 3-6 months size, and I refused to retire them well in to her second year because, well … they got us through a lot, those pants.
Even now, nearly four years later, every time I broach this subject I feel a familiar twang of nausea that I don’t think will ever go away. Being depressed while pregnant is a special twisted kind of hell. Every person you see your family, friends, colleagues, people who stop you on the street — see a pregnant woman and assume she is joyous to her core. They want to soak up that joy. They want to gush. They want to celebrate. They want to rub your belly. I had imagined what it would be like to be pregnant my entire life. I wanted a baby so bad. I fantasized about those nine months for as long as I can remember, and when they finally arrived, they were like slow emotional torture. How could I say that out loud?
I can talk about these things now because (I’ve obviously been through a lot of therapy, and) I now know that my love for her can stand up to those horrible tricks my mind played on me in the dark days of my pregnancy. I know my love for her will comfort her and leave her without a doubt that those feelings were not my own if she stumbles across this post doing a deep internet search for a school report later in life. I know my love for her is so strong that if anyone read this and doubted its strength, it wouldn’t matter. But when I carried her inside of me, I didn’t know any of those things. I didn’t know that Delilah’s light would be bright enough for me to fight my way through that darkness, through the pitch-blackness that followed, and keep me from becoming the miserable, shriveled up, shell of a person my mind and my hormones had me hoodwinked into believing I was condemned to be. All I knew was that nobody could ever know the horrible things I felt inside. All I knew was that the answer to “Oh my god, isn’t pregnancy exciting aren’t you excited!?” was “YES, YES I AM.”
I continued to see Dr. Suckface and I worked as hard as possible to stuff those awful feelings down and get pumped up. And I did okay. Mostly I think it was the distraction of having to get everything ready. In July it appeared that the number of therapy sessions my insurance covered had run out and I told Dr. Suckface I couldn’t see him anymore. He told me that on the contrary, he was familiar with my policy and because he had made a diagnosis (adult ADHD, remember?) I could still see him and BONUS! our sessions would be fully covered. By August, I decided I’d had enough of Dr. Suckface, and I told him I was feeling much better and could no longer make the drive to his office all super pregnant like I was. I followed my OB’s advice and walked when I felt anxious. I pushed through. By the time Delilah was born, looking back, I had done a pretty brilliant job of making myself completely emotionally numb. When I didn’t spend the two weeks following her birth weeping like I’d heard so many other new moms tell it, I marveled aloud to anyone who would listen how well I thought I was handling the adjustment. And then, when I got a letter from my insurance company telling me that my premium was doubling, I called up my provider and asked to change to a different plan. I filled out the appropriate paperwork, and I redid the family budget accordingly. And I thought that was that. Until about two weeks later, when I got a rather disturbing letter in the mail.
I had been flat out denied insurance coverage by my own insurance company. Not rated 50 percent higher. Not even rated 150 percent higher. FLAT. OUT. DENIED. The reason they were citing was my recent diagnosis of MAJOR DEPRESSIVE DISORDER. A diagnosis I had never been given. At least not to my face.
I called the insurance company, certain a mistake had been made. To my dismay, it had not. That was the diagnostic code they were given, beginning in July. A parity diagnosis. A diagnosis that kept me covered for unlimited therapy sessions under California state law. A diagnosis that would prevent me from being insured under any plan other than my current $1,000-a-month plan for the next five years (unless I continued to need treatment for my parity diagnosis, in which case, five years from when I stopped needing said treatment.) A diagnosis that could not be undone without releasing the notes from my personal, private therapy sessions to the underwriting department of a massive, faceless corporation so they could make their own judgments about my mental health. I called Dr. Suckface. He called me back and suggested I come in, not to worry, we would get to the bottom of this he would help me.
The following day I trekked to his office with newborn Delilah in tow, still thinking that somehow this was all a big misunderstanding. That all came crashing down when I realized he wasn’t there to help me at all. Instead, I sat there for an hour and a half as he defended his diagnosis and proceeded to re-hash three months of sessions, reading aloud from his notes, forcing me to attempt to explain comments and innermost confessions taken out of context. He told me I’d presented with “unexplained sadness lasting longer than two weeks and coupled with difficulty sleeping, excessive appetite, and mood swings” and then showed me a book from his shelf in which those were listed amongst the criteria for Major Depressive Disorder. You know what else they are criteria for? Fucking pregnancy, you fucking asshole.
I sat in shock, squawking newborn in her carrier by my side, as he used his notes from my sessions to create a case in front of me, and told me that my allegation that he had submitted the diagnosis so I could continue care was very hurtful. He used the word hurtful. As if it didn’t occur to him that he was singlehandedly taking a cat-0-nine-tails to my mental health and shredding my faith in therapy and therapists all in the same blow. When I pointed out that he had never mentioned that diagnosis in our sessions and had in fact given me a COMPLETELY DIFFERENT DIAGNOSIS he looked me straight in the eye and said, “Would it have really made any difference?”
At that point I stood up, put on my coat, grabbed my sleeping newborn and what little dignity I had left, and got the hell out of dodge. It felt so unjust I couldn’t even cry. Unless I was willing to have the notes from our sessions made public and waive my right to patient/doctor confidentiality, I had no course of action. All I could do was stay as far away from any and all mental health professionals as possible for the next five years until a diagnosis that was never my own fell off my file and I became insurable again. (That hasn’t changed. Despite the fact that two separate MD’s have since written letters disputing Dr. Suckface’s diagnosis, my insurance company maintains that I will need to allow his [copious, as I learned that fateful day] notes to be reviewed before their underwriting department will consider removing the diagnostic code from my file.) A few days later he left me a message saying that he was “distressed” over the way we’d left things, and wanted to let me know that he was pleased to see how well I was obviously doing postpartum, how bonded Delilah and I clearly were, and that he hoped I would call should I ever want to “talk” again. After I finished laughing maniacally at the absurdity of it all, I deleted his message and his phone number from my phone, and wished like hell I could do the same from my memory.
For the next several months, I continued to sleep walk through life. I avoided leaving my house at all costs, and returned approximately zeor percent of phone calls and emails that came my way, but I was so furious at Dr. Suckface, and so defiant of the diagnosis he’d one-way-or-another given me that I convinced myself that this was totally normal behavior. That parenthood was hard. That life was busy. That days and weeks and months blurred together like that for everyone. That the sound of a ringing phone, or an incoming email gave all new mothers diarrhea. (Sorry.) That reading tragic stories on the internet all day long and sobbing and sobbing over other people’s more glaring misfortunes so I wouldn’t have to look at my own was all par for the course. That I wasn’t showering for horrifyingly long periods of time because it just didn’t make my hectic new schedule. That breaking out in a fire-y hot sweat that made me feel like I was melting every time I had to interact with other people was “hormonal” and “because of the breastfeeding.” Even my closest friends. Even the cable guy.
At my post IUD check up , FIVE MONTHS POSTPARTUM, my OB noticed me dripping with sweat. She asked me what was going on. I laughed and casually told her I’d been meaning to ask her that same question: Was it possible breastfeeding was making me so sweaty and short of breath? She put down her computer, put her hand on my leg, and looked me in the eye. “I’d like to give you a referral to talk to someone about postpartum anxiety.”
The numbness traveled from the top of my skull through the tips of my toes. I laughed. “I don’t think so.”
“Morgan,” she leveled, “What you’re describing is a panic attack.”
I laughed again. It echoed through my head, which was still numb. “No, I don’t think so.”
“You’re having one right now.”
And I was. I was having one right then. Denial is such an amazing thing. I was sweating, and hot, and cold, and nauseous, and short of breath, and laughing and shaking, and I was just pretending that none of it was happening. But the denial was strong. I wasn’t going down easy.
I argued. She argued back. I told her that I had had a pretty serious falling out with my previous therapist, and that the entire profession could sodomize themselves and videotape it before I would step foot in “treatment” for one more minute. She wrote down the name of a therapist who she said specialized in postpartum depression and working with new moms. I told her I couldn’t afford it, and I couldn’t put it through my pathetic excuse for insurance. She told me to go talk to her anyway. Tell her my story. See if she could help. I took the card, mostly to end the conversation, and I was on my way.
I drove home, confused. That night, I mentioned to Scott that she’d suggested I had PPD and should see a therapist ASAP. He didn’t flinch. He answered gently, “Well, then maybe you should call.” And there it was. It was getting harder to deny.
I was lucky. Thanks to Scott’s urging (and my OB’s diligence) I did go to see Glinda the good shrink (again, name changed) and she slowly but surely helped me to lift the debris off my psyche left by months of untreated peripartum depression and anxiety. It was recently noted in the Journal of Affective Disorders that the length of recovery time from PPD and its associated disorders can have a direct relationship to how long it takes the sufferer to begin treatment. My recovery began at five months postpartum and it took me almost a full two years to recognize myself again. I fought so hard. I acted “as if” so often. I lost so much time. I’m a lot stronger now, and my perspectives are forever changed but nothing I do will ever get me those two years back. Not with my husband and daughter. Not with my parents and sister. Not with my friends.
One in five women will suffer from something similar. Like me, most of them won’t recognize it for what it is. I wasn’t suicidal. I didn’t have a psychotic episode or end up in the hospital. I didn’t want to hurt my baby. And so I didn’t think it was PPD. We’re so used to seeing postpartum depression painted as a duck that we don’t realize it can look like a goose, or walk like a swan, or chirp like a robin and still take so much from us in the formative days of our parenthood. For some, untreated, I fear that they may never recognize it and that pesky bird may build a nest in them forever. So I share my story. And I hope that someone reads it, recognizes, and excises the duck/goose/swan/robin/peacock that’s perched atop their new life, sinking it’s talons in to their happiness.
Thanks for letting me join you, Babble. I look forward to this ride.