I'm going to write about a lot of different things here. Things that make me happy, things that inspire me, things that are on my mind. Although I've abandoned the Cranky Pumpkin, I imagine I will talk about pumpkins at some point. (I really like pumpkins.) (So much.) But for now, I want to talk about postpartum depression.
I suppose I could start at the beginning but the beginning is over three years ago when I gave birth to my daughter Pippa. Actually, the beginning is probably somewhere back in January 1998 when my cousin Kim died unexpectedly. Something shifted inside me the moment I learned of her death. That was the start of my anxiety. For years, I was an anxious but highly functional person: I went to an Ivy League college; I went to law school; I practiced law for several years. Then I had Pippa. My hormones went nuts and my anxiety bumped up to a new level and in a matter of days, I went from "anxious but highly functional" to "incredibly anxious and only moderately functional." Four months postpartum, I was "ridiculously fucking anxious and no longer able to function." I wanted to die except I didn't want the mess of killing myself. So instead, I entertained very elaborate daydreams in which I admitted myself to the hospital and doctors put me in a coma and I stayed in that coma until someone figured out how to fix me.
But I'm not going to start at the beginning of my story because that's just too long for a blog post. I need to write an entire book if I want to start at the beginning (and hey, that's what I'm actually doing). So instead, I'm going to start with today.
Today I am a stay-at-home mom of two: Pippa, 3 years old; and Julian, five and a half months old. Pippa loves art, especially painting and stickers and anything that makes a huge mess; she is getting better at eating her vegetables; and she would go to the zoo every day if I let her. Julian is the happiest person in the world. He rolls from room to room and is trying so hard to crawl.
When I was first diagnosed with postpartum depression, my doctor prescribed Zoloft. That worked great and I was still taking it when I learned I was pregnant with Julian. My doctor took me off Zoloft and switched me to Buspirone. I had some scary Zoloft-withdrawal (lots of hysterical crying) but the Buspirone worked fine.
Then I broke up with my first psychiatrist (long fucking story, that is) and started working with someone new. She kept me on the Buspirone. We talked a lot about what I should do after giving birth and finally decided I should get back on Zoloft as soon as possible. Three days after Julian was born, that is what I did. I also kept taking the Buspirone.
My husband Nathan took a month-long paternity leave, and we also hired a night nurse for that first month. It was so wonderful to sleep that first month. The night nurse cost about the same as a week long trip to Maui. I consider it some of the best money we have ever spent.
I breastfed Pippa until I was diagnosed with postpartum depression. That's another long story, but after lots of soul searching, I decided that breastfeeding aggravated my depression. I knew that if I breastfed Julian, I would probably sink back into depression. So this time around, I skipped breastfeeding entirely. I consider it one of the best decisions I have ever made.
For three months after Julian was born, I felt great. Tired, but great. Then, about three months postpartum, I tanked. I had three nights of insomnia and could feel myself unraveling. My body felt wrong. I felt physically agitated. It was as if the depression was reaching up from hell and started to coil its tendrils around me.
I sensed something was wrong, but then denial kicked in. I started telling myself that I did not need to call my doctor, that I could wait until my next appointment, that I just had to tough it out and wait for my hormones adjust. But after three nights of insomnia, something inside me said, "Enough," and I repeated, "Enough" and I called my psychiatrist. She increased my Zoloft dose from 100 to 150 mg each morning, pulled me off the Buspirone, and prescribed Mirtazipane to help me sleep. She thought I might need 30 mg of Mirtazipane but 15 mg has actually been the magical dose. I felt a little out of sorts for about two weeks, but then the tendrils of depression lost their hold on me and slipped away.
Now I'm nearly six months postpartum and I feel fantastic. I'm still taking 150 mg of Zoloft every morning and 15 mg of Mirtazipane at night. Some people experience an increase in appetite from Mirtazipane. I have not had that problem and have in fact lost over ten pounds since starting it.
A month ago, I also started working with a new therapist. During my first round of postpartum depression, I worked with a cognitive behavioral psychologist for seven months. I had developed a lot of OCD rituals and he helped me dismantle them. This time around, I have not suffered from any OCD rituatls but a lot of emotional flotsam and jetsam floated to the surface. I decided it was time to work with a new therapist for some fresh perspective. So far, she has been enormously helpful.
I saw my psychiatrist a week ago and we decided to keep me on the same medications. I am doing so well, my next appointment is in three months. (But if I need to, I can always see her sooner.)
So that is where I am at: 150 mg of Zoloft in the morning; 15 mg of Mirtazipane at bedtime; and weekly talk therapy with my new therapist. Well, that's not it. I do a lot of other things to stay healthy - walk 10,000 steps every day; write in my journal; paint; avoid caffeine at all costs; stay connected with friends and family; indulge in plenty of massages and pedicures; and play and cuddle with my children as much as possible. It's a lot of work to keep my soul in tip-top shape!
Okay, I think that's enough for this inaugural post. I'm too tired to think of a clever ending so I will just bid you good night, good morning, or good afternoon, whatever suits you best.
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