Re: Postpartum mental health

[Wondering]

So, a mere six months later....

I have an appointment to see a postpartum counselor.

Why am I kinda scared?

[reboot]

So, a mere six months later....

I have an appointment to see a postpartum counselor.

Why am I kinda scared?

Because it is new and unknown and you fear something might be really, really wrong? So kind of normal *Jedi hugs on offer if wanted*

[Wondering]

Yeah, unknown. And partially, if I get some sort of official anxiety diagnosis, then I worry people won't take me seriously when I express concern about things. Like, "Oh, whatever, that's just your anxiety." Having my thoughts and emotions dismissed makes me really angry.

[Prajnaparamita]

Hey Wondering, I just wanted to say that I really understand where you're coming from here. I have an anxiety disorder, and I've had people in the past use it against me--for instance my ex boyfriend, whenever I came to him with a problem or a concern about his behavior, would tell me stuff like "oh it's all in your head, it's your anxiety disorder", which was really awful as it led me to blaming myself for everything and feeling voiceless, as everything I brought up got thrown back in my face with his gaslighting. But one of the things that I've realized is that friends and family who love me and are truly good people for me do not behave like that at all, and when I am anxious they don't dismiss me and say stuff like that. Even if I'm in a state where I'm wildly irrational, which sometimes happens as a result of my anxiety, they listen to me and ask how they can help improve the situation. Regardless of whether its a concern that comes from a real place or its a concern that comes from the warped worldview of anxiety, they still want to help me and make things easier for me, and in both cases they respond with empathy and listen and see what they can do to help. For example, I have a lot of irrational anxiety about being late for anything. My friends understand this, and don't make a big deal about it but when they're with me they'll try to find a way to make sure we show up for things earlier, as that makes it easier for me to be able to enjoy the experience. Whether it's a rational or irrational fear, they still want to help. The thing about shitty people who would try to gaslight you and invalidate you though is that they'll find a way to do it, diagnosis or no diagnosis--instead of anxiety they might dismiss you due to being a woman and thus overly emotional, or anything else they think they can latch onto. It's just the sorry truth about that kind of person.

Another thing that I found actually a benefit of having an official diagnosis (and I'm not saying I think you have one, just if you end up being told by a professional that you have one and that feels accurate to you) is that slowly it has helped me gain some distance from my anxious thoughts. Rather than having irrational anxiety fears all over the place and being like "AAAHHH I AM THINKING ALL THESE THOUGHTS AND THEY MUST ALL BE ABSOLUTELY TRUE BECAUSE I KEEP THINKING THEM" I was (slowly, gradually) able to start being like "Okay, I think these are anxious thoughts that I'm having, and even though right now they all feel super real and scary I know that they're probably not all real (because anxious thoughts generally aren't.) Now is there some way that I can recognize that they're probably not real and not helpful for me right and put them down for a bit so they're not constantly weighing me down?" For me, recognizing that I have an anxiety disorder which sometimes floods me with disturbing intrusive thoughts (which if I remember correctly is also something you've experienced, right?) is to identify those intrusive thoughts as what they are, validate them (because even though they're not real, they often originated from a place of real fear inside of me) and then that allows me to put them down and let them go for a bit. For example, when I went on vacation to California recently, I started to have incredibly disturbing intrusive thoughts about how the Big One was going to hit, any second now. Just randomly through the day I would become convinced that it was going to hit any day now, maybe even today, and I was going to die horribly. It was making me miserable and unable to enjoy anything about our vacation, because the more I tried to push it out of my head, the stronger it came back, making me convinced that I needed to panic, right now. But eventually I recognized it as my anxious thoughts, and I told my mom what was happening. By talking it through with her, I was able to validate the fact that I was scared of a big earthquake happening, and of course it's rational on a certain level for fear for the safety of the people of California who live in major cities along the coast that don't have adequate earthquake and tsunami prevention measures, there was nothing in that particular moment that I could do about it, and the panic that I felt like I needed to fear about the issue every time it came up in my thoughts wasn't actually going to help me or anyone else around. And eventually, that let me let go of the anxious thought.

Another thing about intrusive thoughts that I found helpful is my therapist's explanation of what causes them. According to her (and obviously I can't say this holds true for everyone but it seemed really accurate to me) is that they're a result of a chemical spike in the brain that causes the sensation of fear even though there was no stimuli that would result in fear. Because the brain feels afraid but isn't sure why it should be, it comes up with something to be afraid of--in my case, suddenly being convinced California is going to get that giant earthquake/that someone is secretly watching or filming me/that Slenderman is standing outside my window at night, ect ect... I know pregnancy and childbirth (and the aftereffects) release a shit ton of hormones into the body that can really confuse and destabilize things, and I imagine that could manifest as sudden spikes in fear, that your brain latches onto and turns into a paranoia that something could end up happening to your child. I don't know it if would be helpful at all to try and see your intrusive thoughts in that way, but perhaps understanding and identifying them might help take away some of their power?

I hope the appointment goes well and it provides you some relief at the very least

[Wondering]

Another thing about intrusive thoughts that I found helpful is my therapist's explanation of what causes them. According to her (and obviously I can't say this holds true for everyone but it seemed really accurate to me) is that they're a result of a chemical spike in the brain that causes the sensation of fear even though there was no stimuli that would result in fear. Because the brain feels afraid but isn't sure why it should be, it comes up with something to be afraid of--in my case, suddenly being convinced California is going to get that giant earthquake/that someone is secretly watching or filming me/that Slenderman is standing outside my window at night, ect ect... I know pregnancy and childbirth (and the aftereffects) release a shit ton of hormones into the body that can really confuse and destabilize things, and I imagine that could manifest as sudden spikes in fear, that your brain latches onto and turns into a paranoia that something could end up happening to your child. I don't know it if would be helpful at all to try and see your intrusive thoughts in that way, but perhaps understanding and identifying them might help take away some of their power?

That actually would make me feel terrible. Being told that there's nothing real at all behind my concern for my child's safety and well-being, that it's all just some chemical spike in my brain and I made it all up to deal with the chemical spike. That's the sort of thing I'm worried about being told. That would make me feel worse about myself.

My baby is safe and healthy, and maybe she would be even if I hadn't taken all the precautions I had about that, or maybe she wouldn't, but she's certainly not been harmed by any of them. And I really, really don't want to be told that I need to stop being so concerned about my child. Or ranting about anti-vaxxers. Or getting on my mom's case for her utter lack of food safety procedures when she makes food. "Yeah, sure, Mom, I'm perfectly okay eating and having you serve the baby that uncooked salad you chopped up with the same knife you used to cut the raw chicken."

Mostly, I just want someone to talk to. I have so many thoughts and feelings about all of this and it's all intertwined with other aspects of my life, and when I try to talk to real life people about them, it's basically disorganized word vomit, and it's either way too much for someone else to process, or they can't figure out what particular issues I do want to talk about because there are so many at once. So, having someone who I can dump all those thoughts on and start to organize them will be a huge benefit for me.

So, I guess I'm anxious about going to talk to someone about anxiety. LoL.

[Prajnaparamita]

Oh Wondering, I'm so sorry what I said made you feel invalidated, I didn't intend it that way at all. Let me try to rephrase it somewhat--the fear that you have for your child's safety is a rational fear. I believe that every good parent holds that fear within them, because that's what it means to love and care for your child--you want to protect them and ensure their health and safety. And right now you the caregiver to an infant--a tiny, helpless human being that needs your protection. That's just a fact. However, it is entirely possible to have a real and rational fear, AND also have a anxiety response to that fear that prevents you from productively dealing with that fear and impairs your quality of life. As a mother, you have every right to want people to practice good food safety while preparing food for your child, and be angry at people who put their child's and others' health at risk for refusing to vaccinate. However, from the posts you've written, it also sounds like you've been struggling with mental health symptoms that have impaired your quality of life and ability to function.  

Either way, it does sound like being able to talk to a trained person about this would be helpful for you, and I hope that appointment goes well.

[Wondering]

Hey, Prajna, no worries. I'm not feeling invalidated by what you said. You're a stranger on the internet sharing your experiences. What I'm worried about is the official therapist making me officially feel officially invalidated by the sorts of things I said. So, hopefully that won't happen, and I'll see how it goes.

For those of you who have done this therapy thing before, what's to be expected at an intake appointment? Is it mostly just talking about what my issues are that bring me to therapy? An hour seems like a long time for just that. I wasn't asked anything about this at all on the phone when I called. Just: "Did you have your baby less than three years ago, Do you have any other health issues being treated by a doctor, Is there domestic violence in your home, Are you having thoughts of self-harm or harming the baby?" And lots of stuff about my insurance.

[eselle28]

I haven't done postpartum therapy, but I've seen therapists for other reasons. You'll probably fill out some forms, and you'll probably also talk about things like past and current mental and physical health issues and medications you're currently taking. How long that conversation is depends on whether there's much in your case to talk about.

Beyond going over the issues that brought you to therapy, it wouldn't be uncommon in an hour long first appointment to ask more specifically about what your triggers might be, who your support people are, if you've found anything that helps even a little, and that sort of thing. I think everyone I've been to has at least asked some basic details about my life, like what I do for a living, who I live with, and other basic details. In your case, I suspect they might ask some practical details about the history of your pregnancy, parenting obstacles you might have faced, your baby's health, and so on, so they at least have an inkling how you might be different from other people who have similar issues. This is sort of style dependent, but I've been asked to talk about myself free form - like generally what my story in life is - sometimes. I always assumed that was the person trying to get a bit of a read on who I am, how I communicate, and that sort of thing. Also depending on style, you may be given a short homework assignment at the end of the session.

[Wondering]

Homework? Gah!

[eselle28]

Sorry, I didn't mean to drop a scary revelation! This is a technique some therapists use. I was just surprised the first time I ran into it, so I wanted to mention the possibility of it. An assignment might be something like, "What are three goals you'd like to achieve from this counseling?" or, "Count the number of times you were anxious about your baby since the last session," or, "Describe one time you were anxious since our last session, and what happened between feeling like that and feeling more at ease."

Again, this is just some therapists. I actually tend to like ones who use techniques like that and seek them out, so I have no clue how prevalent they are generally.* Once I got asked to look over some online reading material and if I could come back with some thoughts with it. It might also be just, "Come next week/month!" It sounds like you've been assigned someone, so it's not really clear what will happen. I'd say in general just expect some bits that are like the beginning of seeing a new doctor, some that are focused on getting at least a bit of a sense of who you are as a person, and some sort of talk of follow up.

*I've also primarily seen therapists for ED and comorbid depression. Techniques may differ, and my approximations about what you might be asked may be very far off. (I mostly figured replications of my own homework might be a bit out of place here and even less helpful.)

[Wondering]

Ah, okay. More mental exercise than task-doing. I can handle that.

We get homework from the baby's music class (download these songs and sing them at bathtime, for one), and I never do them. Because I don't need more things to do! But mental exercises I can deal with.

[Wondering]

So, I had my first therapy session yesterday. I like the therapist, although it's really weird to talk to someone who doesn't react to things you say the way you expect people to since she's being professional and stuff.

And, you were right, eselle. I have homework! One, I'm supposed to track my sleep patterns over the time until my next session. And two, she wants me to figure out what I want from therapy. And that's the hard one for me, because I don't really know. I mostly want someone to talk to about all the stuff that happened. But I don't really know what I want from therapy going forward, other than just an understanding of what happened to me and may still be happening to me. And that seems kind of vague. So, at this point, I'm a little stumped on this one.

We didn't even get halfway through all the things I wanted to talk about, which she said is normal and that it usually takes two sessions as introduction. And funny thing is, I didn't even talk about the actual postpartum anxiety or waking nightmares or anything. We talked mostly about my physical health during and after the pregnancy, and how it got so much worse after. And we talked a lot about my diabetes which is such a major factor in every waking moment of my life, and especially this pregnancy, and informs who I am and helped form my personality.

So, next time, I need to remember to actually talk about the PP anxiety stuff. Duh.

[Wondering]

I'm seeing reports that Hayden Panettiere has gone into a treatment facility for postpartum depression. She's been open about having PP depression in the media. Her character on Nashville has it, so it's getting press that way, too.

Here's hoping she gets the help she needs and has a speedy recovery. I can't even imagine having to go away from my baby to get treatment for after-effects of having my baby.

[eselle28]

And, you were right, eselle. I have homework! One, I'm supposed to track my sleep patterns over the time until my next session. And two, she wants me to figure out what I want from therapy. And that's the hard one for me, because I don't really know. I mostly want someone to talk to about all the stuff that happened. But I don't really know what I want from therapy going forward, other than just an understanding of what happened to me and may still be happening to me. And that seems kind of vague. So, at this point, I'm a little stumped on this one.

We didn't even get halfway through all the things I wanted to talk about, which she said is normal and that it usually takes two sessions as introduction. And funny thing is, I didn't even talk about the actual postpartum anxiety or waking nightmares or anything. We talked mostly about my physical health during and after the pregnancy, and how it got so much worse after. And we talked a lot about my diabetes which is such a major factor in every waking moment of my life, and especially this pregnancy, and informs who I am and helped form my personality.

So, next time, I need to remember to actually talk about the PP anxiety stuff. Duh.

Sounds like you had a pretty good first session - at least you were warned ahead of time about the homework! As for that question, I think the answer you wrote down here is a perfectly valid answer to it. Your therapist might want to tease out why understanding what's happening is valuable to you or how you think you'd feel after having more understanding, but while that seems like an answer that's vague, it probably isn't the answer everyone has. (I only have my own experience, but my first time seeking therapy was when I felt I was transitioning from being a highly functional person-with-my-problems to a not-very-functional one and wanted some harm reduction assistance ASAP so that things didn't totally fall apart. I suspect some women seeking postpartum counseling may also have an immediate focus, and there are probably others who want different things than you do.)

I'm seeing reports that Hayden Panettiere has gone into a treatment facility for postpartum depression. She's been open about having PP depression in the media. Her character on Nashville has it, so it's getting press that way, too.

Here's hoping she gets the help she needs and has a speedy recovery. I can't even imagine having to go away from my baby to get treatment for after-effects of having my baby.

I read about that too. Although sharing or not sharing these experiences is something that should be left to everyone individually, I think it may end up being very helpful to other people for her to share her experience. Hopefully she's on her way to recovery. It's good she has access to the kind of help she needs, though I imagine being away from her daughter is wrenching.

[Wondering]

As for that question, I think the answer you wrote down here is a perfectly valid answer to it. Your therapist might want to tease out why understanding what's happening is valuable to you or how you think you'd feel after having more understanding

Because I am a person to who likes to organize and categorize, and having experiences that I can't yet do that with (as in, was this anxiety or not? was this OCD or not?) makes me feel...adrift? I've got answers if she's got questions.

but while that seems like an answer that's vague, it probably isn't the answer everyone has.

True. And giving my answer says something about me.

I have been ruminating about it over the past week, too, and now know that one things I do want that's a bit more concrete is help determining what's a reasonable thing to be worried about vs what's anxiety talking. That doesn't mean I'm going to stop being anxious, but knowing what is or isn't "reasonable" is important for me.

[Wondering]

I think my therapist broke up with me.

Even if she didn't, I'm not too keen on a therapist that makes me think she ghosted on me.

[eselle28]

Oh. Yikes. I'm so sorry. That sounds like, at absolute best, a confusing experience. I think your sentiment in your second sentence is very much the right one. I've never been unfortunate enough to have a ghosting or flaky therapist, though I know some people who've had the second type. To me, a therapist should be something of a rock, like a family doctor or a lawyer who has an ongoing relationship with a client. Part of the package is knowing they're there for you, and at least willing to let you know if the relationship has to end. I'd suggest severing ties and finding someone else as soon as any applicable insurance allows.

[Wondering]

So...I'm back/still with my therapist. I should probably get a new one, but I don't have the energy to look for one now or to tell my whole story again to someone new. It's different with new friends; there's a return on emotional investment in telling your story to friends. But not with a therapist.

Plus, if my husband can't find a new job, we'll have to move, and I'll need to find a new therapist then anyway. So I guess I'm in an exhausted/lazy/uncertain holding pattern now. Sigh.

[reboot]

So...I'm back/still with my therapist. I should probably get a new one, but I don't have the energy to look for one now or to tell my whole story again to someone new. It's different with new friends; there's a return on emotional investment in telling your story to friends. But not with a therapist.

Plus, if my husband can't find a new job, we'll have to move, and I'll need to find a new therapist then anyway. So I guess I'm in an exhausted/lazy/uncertain holding pattern now. Sigh.

Take care of yourself, Wondering. You have enough on your plate to break even the strongest person. You will get through it, but know that it would stretch anyone to the breaking point. Hugs on offer if wanted

[Prajnaparamita]

So...I'm back/still with my therapist. I should probably get a new one, but I don't have the energy to look for one now or to tell my whole story again to someone new. It's different with new friends; there's a return on emotional investment in telling your story to friends. But not with a therapist.

Plus, if my husband can't find a new job, we'll have to move, and I'll need to find a new therapist then anyway. So I guess I'm in an exhausted/lazy/uncertain holding pattern now. Sigh.

Hey Wondering, I just wanted to validate just how goddamn exhausting and draining finding a new therapist can be, and you're not lazy at all for not feeling up for doing it at the moment. Even after all this time, I still find intakes to be one of the most difficult and stressful parts of mental health care, even though I've gone through them dozens of times in my life. Telling your story, as simple as that might sound, is surprisingly difficult in the sterile, unfamiliar context of the intake. After all, what you're expected to do is sit down across from this complete stranger who you neither know nor trust yet and give a succinct yet thorough account of all of your suffering, struggles, traumas, worries and fears in 45 minutes or under, things that you would often struggle to say to even those close to you who you've known for a long time, while not receiving in return any validation or support from this stranger across from you, just more promptings to continue spilling every last thing. And I mean, the process being as terrible as it is isn't entirely the fault of therapists--they're forced to do much of this sterile interrogation for insurance purposes, but there are some who do it better than others. There are some therapists that will do the cold "Tell me everything now while I stare blankly at you and take notes" interrogation that leave you feeling totally naked and vulnerable and wrung out, but there are also some who do the intake process with kindness and compassion and a focus on consent (like my therapist did) where you don't feel like you're being forced to divulge but rather having someone gently enquire about the key details that they need to know, using simple yes-no questions and making it clear you don't have to go into anything you're not comfortable talking about. The problem is, going in you just don't know, and so it can be really terrifying and overwhelming! Given all the uncertainties and potential for major change happening (job uncertainty, potential move) you might just not have the emotional energy to look for a new therapist at the moment, at least not until you know more about what's going to be happening in regards to your husband's job. You might be in a holding pattern at the moment, but that's reasonable, because there's a lot of things up in the air with you at the moment that make it hard to tell where you're going to be landing until they get sorted out. You're not going to be in this place forever, so it's okay to be kind to yourself and understanding if finding a new therapist is something that needs to wait until other life things get sorted out.

[Wondering]

Thanks guys. Hugs are nice.

Who knew having a toddler would be so exhausting? Oh, that's right. Everyone. Including me. Living it is different from knowing it, though.

And I definitely need to talk to my therapist about my lack of friends thing. Making friends as a 40-something, feminist, work-from-home mom to a toddler with a husband who does his equal share is so much harder than I ever thought it would be. Sigh.

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