Postpartum Mood Changes

When parenting isn't all sunshine and joy.

The birth of a child is a major life change! Every part of your life is touched; physical, emotional, spiritual and mental. It is important for women and their support network to understand postpartum mood changes and disorders before they happen so that if a new mother experiences some of the feelings and physical symptoms associated with the various postpartum mood disorders she can be treated promptly, as quick intervention has been proven to reduce the length and severity of the issue.*

No one knows if a new mother will develop a mood disorder. It can happen to anyone and it is important to acknowledge that it is not the mother's fault. Postpartum mood disorders can happen anytime during the postpartum period. The length of a woman's postpartum period depends on many things, including how fast she heals physically, how long she breastfeeds for, how long it takes the baby to sleep through the night, etc. While medical text books tend to consider the first 6 weeks the postpartum period, most mothers would agree that it is a lot longer than that.

There are certain situations that increase a woman's risk of developing a mood disorder, but often women with no “red flags” can be affected.

 

Mild Mood Disorders:

The most common cause of mild, postpartum mood disorders in women with no previous mental health issues, are hormones* and lack of sleep.

 

Hormones:

There are 3 times in the postpartum period where mood changes can be caused by fluctuating hormones

  1. The first week when all those pregnancy hormones drop really quickly, and when other hormones increase to produce breast milk

  2. Weaning:

    A) Anytime you reduce the number of feeds/day. For example, when baby stops waking at 2 am and you move from 8 feeds/day to 7 feeds/day.

    B) When you wean completely. Baby lead weaning reduces hormone fluctuations as weaning is gradual. Weaning quickly, or stopping “cold-turkey” greatly increases a mother's chances of developing a mood disorder.

  3. 2-4 weeks before your period returns

 

How does sleep deprivation cause/worsen mood disorders?

  • Everything seems worse when you are tired.

  • Focus and concentration problems (chronic sleep deprivation is linked to ADD/ADHD)

  • You react quicker and out of proportion to situations

  • Increased anxiety, feeling overwhelmed

  • Increased irritability and anger

 

Healing Yourself:

 

What can you do to heal yourself?**

  • Identify what you are feeling

  • Identify what might be triggering your feelings

  • Decide what you can do to feel better about the cause of each feeling and make a plan

  • Follow through with your plan, this may mean enlisting help of someone you trust or reaching out to a therapist

  • Know when you need medical help and get it sooner rather than later.

  • Avoid caffeine and sugar!  Studies have shown that ingesting caffeine and sugar makes PPMD symptoms worse.*

This printable worksheet is something that I developed** to help myself and clients focus our thoughts and feelings in order to identify the cause of those feelings and actions we can take to feel better. If you find that your symptoms are not going away or are getting worse talk to your doula, doctor or a therapist, all of whom have referrals that may help you. There is a lot of help available don't be afraid to ask for it.

 

Other tips for healing from postpartum mood challenges can be found in my pathway to healing visual guide.  This guide is an adaptation of the Steps to Wellness found in Jane Honikman's book I'm Listening.

 

Dads, partners and adoptive parents can also struggle with postpartum mood disorders.  Don't be afraid to reach out for help and support!

 

Books and Online Resources

 

Books:

I'm Listening, Honikman

Overcoming Postpartum Depression & Anxiety: Sebastian

This Isn't What I Expected: Kleinman

The Postpartum Husband: Kleinman

Down Came the Rain: Brooke Shields

 

Online:

www.postpartumstress.com – self assessment tools, information

www.mooddisorders.ca/faq/postpartum-depression

 

 

PPMD Banner 1

Mothering the New Mother, Sally Placksin
** Please note I am not a doctor, therapist or counsellor.  The suggestions I give have been deleveoped from experience, reading and self education.  If you are struggling with any postpartum mood issues please seek appropriate support.

 

Early miscarriage: My Story

October is Pregnancy and Infant loss Awareness Month and in honour of breaking the silence on pregnancy loss I have written about my first experience with miscarriage.  Early miscarriage is not often talked about as often times friends, family and co-workers aren't aware of the pregnancy let alone the loss.  There are times when early loss is perceived as less traumatic than loosing a child later in pregnancy or after birth.  However, loosing a child at any stage is hard and all life deserves respect and validation, acknowledgement that a life that was there is no more.  With early miscarriage you just begin to dream about your child and suddenly it's gone. 

While I am quite comfortable talking about my experiences with early pregnancy loss, I did find sharing this post difficult and, to be honest, I'm not sure why.  I am sharing my experience because when I lost my second pregnancy near the end of the first trimester I felt very alone and while I can't take the hurt away from another mother who has lost her baby, I can do a little bit to let her know she's not alone and that things will get better.

It has been just over 17 years since I had my first miscarriage and I still remember it as clear as if it was happening now.  I close my eyes and my brain replays it clear as a sunny day.  I close my eyes and they still fill with hot, stinging tears.  I remember the phone call from the doctor.  The way my heart sort of stopped and I had to sit down.  The tingling numbness that seemed to spread through my body.  While my mother's intuition had been bothering me for weeks that something was wrong, I clung to the hope that I was wrong and just being paranoid and the results from my ultrasound would be fine.

"Mrs. Lindquist, I'm so sorry to tell you this."  Pause,  "But the ultrasound showed that your baby has passed away.  We are not sure why.  Your baby was 10 weeks and 5 days, perfectly formed with no heartbeat."  Pause.  "We'll need you to come in for an appointment to discuss what you would like to do."  I sure she said more, about being sorry for our loss, but my brain didn't register anything else.

I knew before that conversation, though, that this little one was going to be gone too soon.  One night I just had a sense of unease come over me and I couldn't shake it.  I knew that feeling.  I had had it before.  When I thought I might be pregnant the first time and really didn't want to be, the same sense of unease had made my stomach drop.  This time, I prayed hard that I was wrong.

 I was so excited to be pregnant this time and had determined to share my excitement with those around me because I had kept my first pregnancy a secret for as long as possible and then felt that because others were not happy about it that I should keep my (eventual) joy about it to myself. 

We started sharing our good news within a few weeks of confirming the pregnancy.  We were met with some reluctant congratulations, but overall our friends were happy for us.  I was excited.  This experience was going to be different from the last one.  

Around two months I started to spot, and that sense of unease grew in leaps and bounds.  I researched, spotting was normal.  I search my brain for a memory of spotting with my first and it was there, I had.  I had hope that this would pass and all would be well.  But I kept spotting, nothing major, just a little everyday.  I went to the doctor, "It's normal."  She said.  Maybe see could see my anxiety, or thought the placenta was low, but she sent me for an ultrasound just to check things out.

I can still bring up the waiting room of the ultrasound clinic in my minds eye.  I only went there once.  In my later pregnancies I couldn't bring myself to step into that office again and always chose a different clinic for my ultrasounds.  I remember laying on the exam bed, the paper crinkling under my bare back.  I remember the clinicians face and when she excused herself to go and get the radiologist, I knew it was not good.  I remember how they refused to tell me, or show me my baby on the screen and just said my doctor would have the results the next day.  I remember driving home in a numb kind of trance, wanting time to slow to give a miracle time to work.  I remember crying, curled up on my bed, alone.

I just wanted my baby to be alive and okay.

I wasn't to be.  After the doctor called, I walked down the hall to my husband and just stared at him, the words just wouldn't come.  Eventually, they did, "It's gone.  Our baby's dead."  He held me, tight, while I cried and cried. I still remember the feel of his strong arms holding me up, the warmth of his lips on the top of my head, the steadiness of his voice when he told me everything would be okay.

I almost wished there had been something wrong, so that it would make sense that the baby wouldn't be able to survive and it was kinder to pass early, but it was perfectly formed with no heartbeat.

Later that night, and many nights after, as I laid in bed staring into the dark trying to understand and feeling unbelievably helpless, I tried to find the good.  If I can just find the good in this, I'll be ok.  God doesn't send trials that have no good.  I just have to find it.  Became my mantra.  It took years before I finally found it.

In the days that followed I met with my doctor to discuss what I wanted to do.  As my miscarriage was incomplete, meaning the baby died but didn't spontaneously pass from my body, I could either wait and let nature take are of it or go to the hospital and have a D&C.  If I waited, it could take months and the child would deteriorate and possibly pass in pieces or all at once, the doctor couldn't tell me for sure.  The thought of walking around with my dead child in me for months broke my heart.  I couldn't do it.  I needed to make my peace and start to heal.  I felt I couldn't emotionally and mentally handle dragging it out for weeks or months.  

We made an appointment for a D&C.  I don't remember much.  I don't remember driving to the hospital.  I don't remember waiting my turn.  I don't remember going into the operating room.  I remember laying on the bed talking to the obstetrician on call.  I remember she was kind.  I remember she double checked that the baby was dead.  I remember she did the ultrasound herself and showed us.  I wish I had asked for a picture.  

I was not awake for the procedure and I am thankful for it.  I knew what was involved with a D&C and I didn't want to be awake, it was too much.

After we went home.  I felt physically fine.  I didn't cramp.  I didn't even bleed much.  I wished I had, focusing on the physical pain would have freed my mind for a bit longer.

Part of me now wishes I had of asked to deliver, to induce labour, to see my child and say good bye.  But it was too much for me back then, and I didn't know it might have been an option.  Now I can picture my baby as I want, beautiful and whole.

The weeks following were hard.  My hormones were a mess, my heart was broken, I didn't have anyone to talk to about it.  I was only 21 and none of my friends had a clue what being pregnant was like, let alone what loosing a baby felt like.  My husband was great but admitted he didn't feel as bad because the pregnancy wasn't real to him yet.  I'm glad he told me that.  I was angry that he wasn't as sad as I was.  Then I understood.  It's different.  We all grieve differently and I needed to let him do his own.

Two weeks to the day after the D&C my older sister got married.  It was great.  Sunny day, ugly dresses, good times.  Unfortunately family had heard that we were expecting and not that we had lost the baby, so I spent the reception being congratulated and having to say actually we lost it a couple weeks ago.  Awkward.  We left early.   I needed to go home and cuddle my daughter.

Very few people know what to say to a women who has had an early miscarriage.  We got the standard; You're young, you can have more.  There must have been something wrong.  At least it was early.  You'll be fine soon.  It wasn't meant to be.  While I remained polite and thanked them for there concern inside my brain was screaming Shut up!  SHUT UP!  I don't care that I can have more kids, I don't care that there was most likely a reason, I don't care that it was early.  I WANT MY BABY!  My brain understands this, it's my heart that doesn't.  My heart is broken.

But there were other things said about our miscarriage, things that were hurtful and I'm sure never meant to reach my ears.  But whispers have a way of floating around and getting back to the person they are about.  There were those that thought I deserved it, because I had gotten pregnant with my first child before I was married.  There were those that thought it was for the best, heaven forbid we have two children when we were still so young!  Then there were those that thought it would have been better if we had lost our first pregnancy.  They thought it would have been better if my daughter had never been born…if my then 2.5 year old never existed.

It's funny I can forgive the people who thought I deserved it, that's just ignorance and misplaced righteousness that is not worth my time, but I still struggle with the fact that there were people that actually thought it would have been better if my daughter had died.  How could someone say that about a beautiful little 2 year old.  And we were doing a good job parenting and for the love of Pete, we were already beating the odds for teen marriages.

Physical healing came quickly.  We were told that as soon as my cycle had come around once we were good to try again if we wanted.  My doctor recommended waiting a few months to allow for emotional healing.  We thought that was a good idea.

Emotional healing was harder.  I felt that that baby was a boy.  I never knew for sure, but my gut told me it was a boy. I named him.  It helped.  Giving my baby a named validated the life and was one of the most helpful things I did.

When we decided to try again it was scary.  All I wanted was to be pregnant by the time my due date from my lost baby came around.  I didn't know how I would deal mentally and emotionally on that day if my womb was still empty.  I have always been thankful to God that our second daughter was conceived shortly before that date.  While I was sad for what would never be, I had hope for the future.  It was a nervous and cautious hope, that needed to be nurtured daily, but it was hope none the less.  

The first trimester has remained scary for me since this experience.  I was never again simply overjoyed about finding out I was pregnant.  There was always a little piece of my heart that I held back.  We never again shared our news with anyone until we made it safely through those first 12 weeks.  While I know friends would have been supportive and loving and wonderful if we had of told them early, I still remember the hurt and in order to protect myself I held my news close.  

I've had 3 other early miscarriages since this one and it was easier to heal, make peace with my loss and move on when only my husband and I knew.  I am an internal processor and need to deal with situations on my own before sharing with others.  It's the way I'm wired.  I admire those that are social processors and need to share their experience in order to cope, it's just not me.

I have found the good in all this.  I have an understanding of how precious and tenuous life is.  How one day it's here and the next, gone.  I am immensely thankful for all my children and love them deeply because I know the hurt of loosing four that I never even met and I can't imagine the pain of loosing an older child.  My heart breaks for parents that loose babies further in pregnancy, shortly after birth or anytime really.

I learned to have courage to try again.  I learned to be kind to others who find themselves in a similar situation.  I learned to forgive those that say hurtful things, although this took along time.  I learned that life goes on and hope is renewed and there is still good in the world.

I learned that what you say to a woman who has lost a baby, at any stage of pregnancy, has a lasting effect, good or bad.  I have strived to choose my words carefully, to validate the life, respect the hurt and loss, and reduce the sense of isolation.  

Experiencing miscarriage at a young age, one that everyone knew about, has enabled me to support other woman who walked that same path of loss.  There is not very much support for early miscarriage.  It isn't talked about too much.  I've never been uncomfortable talking about my experience once I took the time to process it.  Talking is therapeutic.  Sharing helps with healing.  I'll never forget how alone I felt when I lost my first and if there is a way that I can lessen that feeling for someone else I will.

I am sad for my little ones that were never born.  I'll never forget where I was or how I felt when I knew I had lost them.  I will always have a special spot in my heart for them.  But I can see the good.  God never gives us trials that don't have good in them.  We just have to find it.  Sometimes it takes years, but it's there.  There is good and hope even in the darkest times.  We just have to keep looking for the good.

 

 

Butterfly Release

IMG_0948Earlier this month, on Sunday June 7, 2015, I had the opportunity volunteer at the PAIL Network's (Parent And Infant Loss Network) annual family picnic and butterfly release.  This event is a chance for families to gather in rememberance of their babies that have passed away too soon.  

This year the weather was absolutely perfect!  The sun was shining, a gentle breeze was blowing, soft clouds floated high in the sky.  There couldn't be better conditions for the butterflies to released and take flight.

This was my first time attending an event like this.  I decided to volunteer after seeing a  I saw on facebook.  After a quick consultation with the giant family calendar that runs the house, I signed on.  I had no idea what I would be doing. I figured they would have something for me to do!

I wanted to serve at an event and with an organization that really validates and honour babies that have passed prenatally or shortly after birth.

A bit about the day:  This event is an opportunity for families that have lost a child prenatally or shortly after birth to take a moment with family and friends to remember and honour the little life that has passed away.  It is a chance to take a time out and remember.  To feel supported and less alone.  

IMG_0964My own experience with miscarriage was quite lonely.  It is something that is not often talked about and people rarely know what to say to help a grieving mother, or father or siblings.  Finding positive support in different forms, such as group counseling, one-on-one counseling, peer counseling, or private reflection, or quite often a combination of all, is very important to healing and being able to face another day.   The PAIL Network provides such resources for parents.

This event was great.  From a weather stand point it was perfect, not too hot, not too cool, and barely a cloud in the sky.  There were games and activities for the kids that came.  There was plenty of space for families to spread out a picnic blanket and enjoy the day.  There was a raffle and silent auction with the proceeds benefiting the PAIL Network so they can keep supporting families.  

But the most beautiful part of the day happen just past noon when everyone gathered at the top of the meadow, by the silver coloured windmill to release their butterflies.  There was a poem read by a mother in memory of her daughter, words shared by one of the organizers and a gentle rendition of Angel Eyes (by Jim Brickman) played on the guitar as families let their butterflies go.

The day was special to me as I had the opportunity to not only give back to my community and support families from across the province (there were families from Ottawa to London), I also was able to watch my girls give back too.  When I volunteered to help, the organizer asked if I knew anyone would would be able to help out with the kids' station.  Turns out I have 2 teeange daughters who would be great at that!  So they got signed up too.  I must say I am extremely proud of my young ladies for their willingness to serve and the gentle way they interacted with the children and parents.

11254222_10152787016801739_1843910427036502914_n11377110_10152787017716739_2126296125218879063_n

 

 

 

 

 

 

 

 

In addition to being awesome helpers, my girls did a very special thing for me, that makes me tear up as I write this.  They, without my knowing, got a butterfly from the organizer for me to release in memory of the four little angels I lost prenatally.  I was not planning on taking part in the release, I was there to help ensure that my small contribution was taken care of.  I had not even thought of joining in.  I have made peace with my loss.  My experience has allowed me to comfort other women and walk with them through one of the hardest parts of being a mother.  That being said, I feel blessed to have had the opportunity to let that little Monarch fly in memory of the little ones I only barely knew.  I am humbled by the thoughtfulness of my daughters.  I am truly glad I went. 

IMG_0953

Nothing compares to the loss of a child.  Nothing fills the hole left in your heart.  Nothing takes the memory away.  All we can do is focus on the good, remember the moments that filled us and treasure our little ones here on earth and in heaven.  One day I'll get to hold my angels in heaven, until then I am comforted that the first face they saw was Jesus'.  Which is what my insightful nephew told his parents when they suffered a loss prenatally.

One of the most important things I learned after my first miscarriage was that my husband grieved differently than me and that it was okay.  Seems like a simple thing now, but at the time I was angry and hurt that he didn't seem as upset as I was, that he wasn't a sobbing mess like me.  I learned that it didn't mean he wasn't sad, he just dealt in a different way and that it was important for me to let him.  

I have to say that this event was a mix of happy and sad.  Everyone who attended has been touched by a loss that hits you in the gut.  It's so hard to carry on, but carry on we must.  Events like this are beautiful, not only on the day of, to gather and feel like there are other people who understand, really the wealth of emotions and stages of grief that parents and family members go through, but also, because in the days, weeks and months after everytime you see a butterfly flutter through the air you remember your child with joy.

IMG_20150607_131841If you have lost a child you are not alone.  Miscarriage is more common than anyone wishes.  Infants pass away more often than we talk about because it's hurts so much.  Reach out, find a group or a friend or a therapist that is right for you.  It might not be the first place you try.  Group support might not be your thing, or it might not be your thing at that time.  Keep looking, don't go through it alone.  We are a village in good times and in hard times. 

For local (Markham) and on line resources for prenatal and infant loss support click here.