Happy birthday, sweet baby. Today, you are one. One full, beautiful, amazing, incredible, terrifying, sad, desolate, panicked year in which your life began and mine nearly ended. I carried you with me for exactly 40 weeks, loving you from the moment I knew you existed. You would complete our family, I knew. Mommy, Daddy, two big brothers and then there would be you. I reveled in the knowledge that for a third time, I had two hearts beating inside my body. I pressed your brothers’ hands to my enormous belly, showing them how you kicked and punched and flipped all around. I was utterly exhausted, caring for a two year old and a four year old fulltime and working part-time, but despite the physical and emotional exhaustion, I knew my life would be better with you in it. I eagerly awaited June, wondering if you would be different from your brothers and come on your own, or if I would have to evict you like I did the other two. I was prepared to wait, to carry you to 41 weeks, to birth a 10lb baby so that I could have the experience of going into labor on my own, but it wasn’t to be. Blood pressure went up, you got bigger and bigger, and Dr. Magee said we shouldn’t wait. I trusted her implicitly and so, at 4pm on Thursday, June 20, they broke my water and you began your process of becoming an outside baby. Only eight hours and a few pushes later, you entered the world, face-up, crying, all 9lbs 3oz, 10 fingers, 10 toes of perfect baby you.
At first, I marveled at the ease with which you blended into our family. You slept at night, you nursed beautifully, you barely cried, and I loved you with the same incredulous love as I had your brothers before you. Physically, I recovered so much faster after your birth than I did after I had your brothers. I felt incredible, better than I did at the end of my pregnancy, and I was elated that your brothers loved you, and you fit so seamlessly into our family. I took picture after picture of your chubby little body, your sweet nose and pouty baby lips, the way you curled up on my shoulder and slept after you nursed. I even bragged to friends about how much easier it was to have a third baby. It felt that way, after all, in the moment.
And then you got a rash. Yeast, the doctor said. We took you out of your cloth diapers and put you in disposables, we used over the counter creams and then moved to prescription creams. You stopped sleeping at night. You were so uncomfortable, itchy and pained, waking each time you wet your diapers because of your discomfort from the rash. You nursed all night, for comfort, and I pretended that everything was still easy because it had been easy, and sometimes, you fake it until you make it. But I was starting to struggle. I didn’t sleep at night because I was caring for you, and I didn’t sleep during the day because I was caring for you and occupying your older brothers. I wanted them to have a great summer, for life not to change so drastically just because we had another baby. I put you in a sling on my chest and went to the zoo, the park, the playground, the grocery store, birthday parties, playdates. Externally, my façade remained intact; internally, I was crumbling.
I sent messages to my friends: “My throat hurts and I don’t know if it’s from coughing or from yelling at my children,” and, “This is pretty brutal, not having the opportunity to nap after a bad night. We are feeling stuck and without help from family.” I flew home with you, leaving the big boys with Daddy, hoping that a break at Auntie Emmy’s house would be enough to get things back on track. She was phenomenally helpful, rocking you to sleep, making sure I got to nap, making sure I got to eat. Your rash had improved and I was hopeful that we were past the worst of it.
And then it got worse again. I remember the morning that I screamed at your Daddy, “What the fuck am I supposed to do all day with these kids? I’ve slept for two hours total, the last 3 days, and you just up and go to work and leave me with all this shit to deal with. How the fuck am I supposed to do this?!” All the while, I loved you. I wished that your big brothers would go away, that it could be just you and me, but I didn’t wish you away. If only the brothers could go somewhere else, I thought, I could get enough rest and be a better mommy to you.
I recognized the irrationality of my thoughts. I was, after all, a therapist. I sent a message to my friend, another therapist, who specialized in working with pregnant and postpartum moms: “With regard to postpartum mood disorders, are meds effective on their own or better to be paired with therapy? I am suddenly struggling with some pretty (irrational) severe anxiety. I’m a mess.” That was on Wednesday, July 31, 2013. On Saturday, someone took a picture of me with you and I thought, “Wow. I look so sad in that picture. So, so sad.” On Sunday, when you were just six weeks old, I started back at work, teaching a cloth diaper workshop. It was overwhelming, to say the least. On Monday, your Daddy went out of town for four days. I was alone for four days with you and your big brothers, ages 2 and 4. It broke me. My memory of those days is foggy, but I remember a friend, the same therapist friend, coming to help me for an afternoon. It was on that day that I admitted to her that I was having intrusive thoughts.
Oh, intrusive thoughts, the beginning of my end. At first, I imagined life without your big brothers. I imagined that they went to live with your grandparents, or that I left the family with you and never returned. Escape fantasies, that’s what they were. I couldn’t cope with my life as it was so I began to fantasize about escaping from the challenges of my life. Rapidly, the intrusive thoughts became more… disturbing. Violent. Utterly and completely terrifying. I imagined that I choked your brother to death with my bare hands while he slept in his bed. I imagined that I suffocated your other brother with a pillow while he slept. These were more than just passing thoughts, they were as they are called, intrusive. I would be playing with your brothers, nursing you, and the thoughts of murdering my own children, my hearts, would insert themselves into my head. Over and over again, I saw the murders take place in vibrant, terrifying detail, like horror movies that only I could see. The thoughts were so disturbing to me that I couldn’t think about anything else. They became obsessive, as intrusive thoughts often do.
And then I began to have thoughts about hurting you. I imagined that as you slept on the futon in your room, I turned on the light and slit your throat with the butcher knife from the kitchen. I watched as blood poured from your neck. I could see everything in your room, the clothes piled in the closet, your crib, the glider behind me in perfect, crystal clear detail. I saw your face, the color draining from it as the blood poured from the wound that I inflicted on you. Over and over and over again, I murdered you and your brothers in cold blood. Over and over and over again, I choked and smothered and sliced the life from the three of you. And each time, I died a little more inside.
Until you have children of your own, you won’t understand the way that I feel about you, how I love you. Even in the darkest times after you were born, you and your brothers were my world, my heart-outside-my-body. Even now, I can hardly articulate how I love you. I loved you three with everything I had, everything I would ever have, and I couldn’t stop thinking about murdering all of you. MURDERING YOU. MURDERING YOU.
Intrusive thoughts, obsessive thoughts, intrusive thoughts, obsessive thoughts, intrusive thoughts, obsessive thoughts, became my life. For days, I told no one but my friend that I was having those thoughts, not even your daddy. How could I? How could I, a proud and dedicated mom with an I-can-do-anything-this-is-easy-for-me façade, a mental health professional, admit that I was in such a bad place psychologically that I spent 99% of my time imagining the murders of my own children? Not that you disappeared, not that something bad happened to you accidentally, but that I murdered you. The thing is, I knew what an intrusive thought was. I knew that if I just could stop obsessing about the thoughts, stop giving them so much weight and power, then they would go away. I even knew that lots of moms experience intrusive thoughts during the postpartum period. So, while I panicked internally about them because they were so graphic and disturbing, I didn’t panic to anyone else. I didn’t even tell your daddy. Partly, I was terrified of what he would think, but partly, I just thought that if I could get on medication, on a good SSRI, they would go away.
On Wednesday, I had an appointment with my OB. It had been scheduled for weeks, and I was just holding out for that appointment, knowing that I could tell him what was going on and he would help me fix it. He would up the dose on my anti-depressant and maybe give me an anti-anxiety medication that I could take as needed to help with the intrusive thoughts, and then I would be fine. So I went to my appointment on Wednesday with all three of you boys in tow. He took one look at me and knew something was very, very wrong. He walked right back out of that room, grabbed 2 nurses, and they whisked you and your brothers out of the room so that we could speak privately. I told him everything, about how the lack of sleep triggered things to get so bad for me, that I couldn’t think about going to work without breaking down in tears, and that I had been imagining all of your murders for days on end. He didn’t overreact, he remained so calm, as he told me that while he wasn’t at all worried about the safety or welfare of my children, it was clear that I needed some pretty immediate help. He called a partial-hospitalization program at the local Women & Infants Hospital and had me complete an intake over the phone from the desk in his office. He sat with me while I described the unspeakable things I imagined doing to you and your brothers, and he held my hand when I cried. They couldn’t get me into the program until Monday – there were only 8 spaces total and they were all full – and so they recommended that I go to the local psychiatric hospital for an evaluation for more immediate treatment. I agreed; after all, I knew that medication was going to fix it for me, and the sooner I got on it, the better.
I called Daddy and told him that John, my OB, wanted me to go to Butler for an evaluation. We’d known John for almost 10 years, he and I shared God children, so we trusted him without question. Daddy was devastated. I told him about the intrusive thoughts that I’d been having, and of course, he asked why I didn’t tell him. I didn’t know what to say. I thought I could handle them myself? I was horrified and embarrassed that they were happening and I thought that if I pretended they weren’t happening, then they would go away? I called Rose, my college roommate and dear friend, and asked her to come to my house to watch you and your brothers while I went for an evaluation. I drove home with all of you and Daddy met us there. When Rose got to our house, we left the big boys with her and Daddy drove us to Butler Hospital so that I could be evaluated. All the way there, I messaged back and forth with my friend, who reassured me that I was experiencing Postpartum Obsessive Compulsive Disorder, that it could be treated, and that I was not experiencing Postpartum Psychosis. I took comfort in this and never doubted her diagnosis; it was the same conclusion to which I had come.
When we got to the hospital, they wouldn’t let you come in with me to the waiting area. I cried for having to be separated from you, for not being able to nurse you when you needed to be nurse, for being left alone at a hospital where I was to be a patient, instead of a therapist. Daddy took you home and I waited to meet with a doctor. I spoke to him of my current symptoms, my psychiatric history, my family’s psychiatric history. The first doctor with whom I spoke said not to worry, that likely, they wouldn’t keep me and that they would call your Daddy to speak with him and let him know that he could come to pick me up. Daddy left you at home with Rose, and told your big brothers that he was going to pick me up and I would be home with him in time for dinner.
But I wasn’t. They kept me. The second doctor who participated in my evaluation was concerned that I would harm you, that I would harm you and your brothers. Daddy insisted that we could safety plan, that he could keep all of us safe. My job, after all, was to maintain children in the home with their families despite incredible risk of hospitalization or out of home placement. I knew that you would be safe, that I would never, ever harm you or your brothers. The doctor asked your daddy if he would be able to make sure I was supervised all night, was he certain that he would be awake if I was in the middle of the night? Your daddy didn’t understand what he was asking, but I did. He thought that I would kill you in your sleep while your daddy was sleeping. HE THOUGHT THAT I HAD THE POTENTIAL TO KILL YOU. In an instant, with that question, everything changed. I had a new intrusive and obsessive thought: what if he was right? What if I developed psychosis? What if I actually hurt you or your brothers? Utter fear took over me.
Daddy wanted me to come home. He didn’t understand why the doctor had changed his mind. The problem was that I had admitted to an intrusive thought that I’d had for nearly five years, since your biggest brother was born. I admitted that I never slept with the windows open because I was afraid someone would steal your brother while he was sleeping. For this thought, I was deemed paranoid. And the paranoia was a bright flashing warning light for psychosis, for being out of touch with reality. And so we weighed our options. Against medical advice, I could go home with Daddy and begin the partial-hospitalization program on Monday. But I knew the system. This doctor legitimately believed that I was a risk to you and your brothers. I knew that he was obligated to call the Department of Youth, Children and Families to report risk of harm. I also knew that if I said this to the doctor, he would put another check in the paranoia column. And so, your daddy and I decided that I would stay. I would stay to get my medications figured out and to catch up on precious lost hours of sleep.
Daddy went with me to the unit. We sat together while I cried, while I spoke of fear and sadness and missing you and your brothers so much. Daddy was so strong with me, promising me that this was for the best and that he would take care of you boys. He said that I should just focus on getting sleep and taking care of myself so that I could get better and come home. Still, I cried. I needed to nurse you and we were apart, I couldn’t get to you even if you needed me. I, the proud and dedicated mom with an I-can-do-anything-this-is-easy-for-me façade, a mental health professional, couldn’t take care of my children because I was locked up in a psychiatric hospital because the doctors were afraid I would kill all of you. Words will never, ever, never be enough to express how I felt in that moment. Heartache, heartbreak, terror, fear like I’ve never known, guilt, sorrow… I’ll never properly be able to articulate how the why of being away from you, destroyed me.
I have little memory of the time during and following my hospitalization. I slept at least 16 hours each day in the hospital. I cried tears of joy and sorrow when your daddy would bring you to visit me twice a day so that I could nurse you. I cried each time that I pumped my breasts for milk for you, every 3 hours, on the dot, so that I could still nourish you when I couldn’t be with you. I cried when I talked to your brothers on the phone. I cried when I heard how many of our incredible friends went above and beyond to care for you and your brothers so that your daddy could visit me and have a break every once in a while. I cried, and I cried, and I cried.
Self portrait of a good day with Postpartum Depression. Self portrait of a good day with Postpartum Depression
Truly, I cried for the next 7 months. It took me seven months to recover. Seven months of medications, bi-weekly and tri-weekly therapy appointments, almost four weeks of partial-hospitalization in several different stints, three different therapists (I had to find the right one. I knew that the research indicated that the relationship with the therapist was more important to effective treatment than the method of treatment. I found her, thank God.).
And where am I now? I am at home with you and your brothers, full time. My depression is fully in remittance, along with my anxiety, panic disorder and OCD. I haven’t hallucinated in months. Yes, I had hallucinations. Auditory – a voice yelled, “DIE!” – among several others (mostly, I heard my twin sister calling my name), and two visual hallucinations. Still, I was not psychotic. My primary diagnosis was Major Depressive Disorder, recurrent, with postpartum onset with psychotic features. I, my therapist and psychiatrist remain confident that at no point did I experience postpartum psychosis. Beyond that, I don’t really remember what I did experience.
I remember so many moments, so clearly, until I went into the hospital. I remember how you looked, how you felt, how you breathed, how you slept, and then, there’s this gap that I can’t seem to fill, no matter what I do. I don’t know who watched you and your brothers when I couldn’t get out of bed for weeks at a time. I don’t remember when you rolled over for the first time, when you sat up for the first time, when you crawled for the first time, when you said your first word. I don’t remember when I stopped nursing you. I don’t remember your first Christmas. I don’t remember what you looked like when you were six months old. I don’t remember when your hair started to curl. In so many ways, I feel like I was robbed completely of your first year of life. I just don’t remember, and that breaks my heart.
Because I don’t remember, I have to focus on what I know. I know that you were 24lbs by the time you were 9 months old. Your daddy says I nursed you for 9 months, so I know that I nursed you on demand for that time because you were big and strong and healthy. I have pictures of myself nursing you, and the love that I feel for you is evident in the way I looked at you, held you, fed you, touched you. I have pictures of you in a sling on my chest, peacefully sleeping, so I know that I kept you close despite all that I was going through. I know that you spent most of your time with your head on my heart, close enough so that I could kiss you at any moment. Every morning, I walk with you in the stroller while your big brother rides his plasma car next to me and your biggest brother rides all over the park, even out of my sight every once in a while. I know that I WORKED MY ASS OFF to beat my anxiety because now, I can let him out of my sight without panicking. I trust your daddy with my whole existence and love him as much as a mommy has ever loved a daddy, so I know that he took care of me and you and your brothers selflessly and exceptionally, while I was unable to care for us at all.
There is so much more to this story, but this is the part that I want to share. I want other moms to know that postpartum mood disorders like Depression and Anxiety and Obsessive Compulsive Disorder are real, and that they can happen to anyone. I feel pride – SO MUCH PRIDE – at surviving the last year and all that I’ve overcome. I want other moms to know that they should feel no shame if they experience depression or anxiety or intrusive thoughts. There is no shame in truth and honesty, and especially, there is no shame in treatment. This is our story, baby boy. This is the story of your first year of life. Having you nearly killed me, but more importantly, having you utterly and completely saved my life. I love you sweetheart, my littlest baby boy.