I had an idea: I should publish my memoir Adventures With Postpartum Depression on my blog. So that is what I am doing. If you want to start at the beginning, start with The Prologue. If you want the actual book (yes you do!), it’s available now on Amazon, Barnes and Noble, Apple Books, Kobo, Scribd, Tolino, Baker & Taylor, Borrow Box and Overdrive.
“How are you doing?”
“Wonderful! I’m doing great.” I knew exactly what the obstetrician was doing. She was trying to sniff out a whiff of postpartum depression.
As if on cue, Pippa started to scream. She sounded like a siren portending the world’s end, but the obstetrician seemed unperturbed by the noise. Instead, she looked concerned for me. I willed myself to appear calm and collected.
“But how do you feel?” she pressed.
“I feel great.”
I was at my six-week postpartum appointment and given my history with hypochondria, did not want to say anything that would lead to a misdiagnosis of postpartum depression. Still, my doctor seemed to think I had it.
In hindsight, I realize my appearance might have tipped her off.
I usually got my long brown hair professionally cut and highlighted every two months. During pregnancy, my obstetrician had assured me that I could continue getting my hair highlighted, but I was not taking any chances. What if some chemicals seeped through my scalp, got into my bloodstream, and hurt my baby? If I was not getting my hair highlighted, I might as well skip the haircuts too. I had read about postpartum hair loss and reasoned it was better to have as much hair as possible in case half of it fell out.
By the time my water broke, my hair was straggly and a mix of greys and faded highlights. Three hours of active labor did nothing to improve my look: the ponytail holder fell out, and my hair got tangled into a sweaty, salty mess. During my first postpartum shower, I was too tired and defeated to drag a comb through the knots.
Six weeks later, I still felt too defeated to deal with the hair situation. Eventually, I would buy detangler and conquer the knots, but that was still several weeks away. My obstetrician must have been more than a little alarmed by my hairstyle.
“Are you happy? Getting enough rest?”
(My hair was truly frightening.)
“I am doing wonderfully. I didn’t even have the baby blues. I haven’t cried. I’ve been so happy since Pippa arrived.”
When I said I was happy, I was trying to convince myself as much as the doctor. The part about crying, though, was true. I had not cried since Pippa’s birth aside from the one time I started crying at one in the morning from pure exhaustion. That didn’t count. That was not the baby blues. I assumed that whether or not a new mother had the baby blues was the ultimate barometer of her mental health; that postpartum depression was an extension of the baby blues.
In a few months, I’d know better.
By the time of this six-week appointment, I had postpartum depression. I had not experienced any symptoms that would get me locked up in the mental ward (those would come soon enough), but looking back, I can see the red flags.
There was my new obsession with germs. Previously, my hypochondria had always been limited to symptoms I had, or thought I had, never extending into mysophobia, or fear of germs. Postpartum depression had helped me make the leap from hypochondria to mysophobia.
The first day of Pippa’s life, while my parents and grandma were visiting us in the maternity ward, I scrolled through the online options for face masks. I needed a cache of masks for visitors who might arrive at my house with coughs and sneezes.
“I can’t tell which one is good enough.”
“I’m sure they are all fine.” That was my mom, a woman who was always vigilant about her children’s health. When everyone, including the pediatrician, insisted my sister simply had the flu, my mom was the one who piled everyone into the car to go to the hospital. Three hours later, the nurses were prepping Katherine for an emergency appendectomy. Now that her first grandchild was here, you could be sure my mom was not going to let anything endanger Pippa’s health.
“But even the ones that are supposed to be good enough for surgery are not 100 percent effective.”
“Courtney, if it’s good enough for surgery, it will keep Pippa safe.”
“You don’t know that.” I spent another hour agonizing over the options before settling on the best bad choice. Then I fixated on my next fear: unwanted visitors.
“What if someone wants to visit and they are sick?”
My mom had Pippa stretched across her legs, facedown, and was patting her back. This seemed to help her burp. “Courtney, no one is going to visit when they are sick.”
“But what if someone wants to visit and they are already sick and contagious but they don’t have any symptoms yet? Or they think it’s allergies? A cold can kill a newborn.”
I was imagining droves of Hennings, aunts, uncles and cousins from my dad’s side of the family, descending upon our house unannounced.
“If the Hennings ask, do you want me to tell them you don’t want visitors?”
“Yes. Be nice about it. But if anyone asks, discourage visitors.”
The message must have been effectively delivered, because almost no one visited. Just my parents, Nathan’s parents, my siblings, my grandma, and one cousin. I have a lot of aunts, uncles, and cousins in Los Angeles who would have loved to meet Pippa, but they steered clear.
So the mysophobia created another red-flag behavior: isolation.
***
“Sorry, my hands are cold.” The obstetrician had opened my gown and was gently touching my abdomen.
“It’s okay,” I said.
I had dozens of questions about my abdomen. Various nurses had shown me how to check my uterus and make sure it was shrinking, but their instructions made no sense. I could never tell what part of my body was stomach, what part was uterus, and what part was flab. I wanted to ask my doctor if my uterus had shrunk back to its regular size, but talking seemed like too much work.
I like people, I like talking, and lately, my life had been lacking in the conversation department. I chatted with Pippa throughout the day, but so far, she was a lousy conversationalist. I usually enjoyed talking with my obstetrician and should have been looking for ways to prolong the interaction. Instead I could not wait to be alone again.
When my parents and grandma visited, I usually retreated to my bedroom to sleep. I was exhausted from breastfeeding Pippa in the middle of the night, and sleep is essential to health, physical, mental, and spiritual; but even when I emerged to feed Pippa, I hated talking. It seemed like an unnecessary burden. In reality, I was turning into a people-hating hermit.
Postpartum depression had changed my personality.
Just the previous week, my parents, sister, and grandma had wanted to visit during the weekend. I protested. Four visitors? At the same time? That was too much stimulation for Pippa. On the phone, I told my mom that anything more than two was unreasonable.
“Okay.” I imagine my mom must have taken a deep breath at this point. “Just your father and sister will come.”
“Thank you.” I felt so relieved. “Thank you. I have to look out for Pippa.”
A couple of days later, my mom called again. “Would it be all right if your grandma also comes to visit this weekend?”
“What? Grandma?”
“She’s going back to New York in a week and she’d like to see as much of Pippa as she possibly can before she goes.”
I gritted my teeth. “Fine.”
When Nathan got home from work, I exploded. “This is ridiculous! They turn the house into a circus. It’s too noisy and crowded with all of them here. My mom is being so manipulative.”
Less than two years earlier, the morning after our wedding, we had about thirty people over to our house for bagels and donuts. The house had not seemed too crowded or noisy then. One newborn later, I could not tolerate the idea of being visited by three of my favorite people in the world at the same time. People who bathed the baby, trimmed her fingernails, and brought groceries. People who whisked away the dirty laundry and brought it back clean and folded.
It was not my mom who was being manipulative. It was the postpartum depression. It had manipulated me into a new person.
***
“Are you still breastfeeding?” The obstetrician gently examined my chest. Over in her stroller, Pippa was still wailing.
“Yes, exclusively.”
I spent hours every day with Pippa suckling at my breast. The experts said a baby should be fed on demand, so every time she whined, I offered her a meal. Then once she had latched on, I could never tell if she was actually eating or just using me as a pacifier, so I let her linger as long as she liked. Each meal lasted at least an hour, and since she seemed hungry every other hour, I spent approximately half the day anchored to my chair.
I thought good mothers exclusively breastfed their babies. I was wrong (more on that later) but at the time of my six week checkup, that was what I believed. That explains why when my obstetrician asked if I was breastfeeding Pippa, and I said “exclusively,” my stomach heaved from guilt and anxiety. I still felt bad that we had supplemented Pippa’s meals with a little formula when she was diagnosed with jaundice. I remember the sucker punch of guilt that I felt in my gut when the pediatrician reported the jaundice on day two of Pippa’s life. The pediatrician mentioned that we needed to supplement with formula because I was not producing milk yet, and I immediately (and incorrectly) blamed myself. It was my fault that Pippa had jaundice.
Pippa’s jaundice was not my fault, but I had always had a propensity to feel guilty about things that were out of my control. In the second grade, when my vision started to fail, I assumed I had sinned and was being punished by God. My hippie parents were not at all religious, but after becoming less than enamored with the local public school, they had sent me to Catholic school. Impressed by an Old Testament God who sent floods and leveled cities, I hid my shoddy vision for two years. Every time I had to take an eyesight exam at school or the doctor’s office, I cheated. I got close to the Snellen chart, memorized the lower rows of letters, and bluffed my way toward twenty-twenty vision. By the fourth grade, though, no amount of squinting could help me decipher the blurry smudges on the chalkboard. When I finally confessed my poor vision to my mom, and she laughed and said I had inherited my dad’s vision, I felt as if I had escaped damnation.
Guilt, though, is its own sort of damnation, and six weeks postpartum, I was in guilt hell.
After Pippa’s jaundice, guilt hijacked my body. I felt guilty when Nathan got up with Pippa during the night so I could sleep a little more. Surely he needed his sleep more than I did. I felt guilty when my smartphone died and I had to race out on a Saturday to buy a new one. Surely I should have anticipated that and procured a new phone when I was pregnant. I even felt guilty when, after holding Pippa for hours in the evening (she liked to cluster-feed), I passed her to Nathan so I could go to the bathroom. My bladder should have been stronger.
At six weeks postpartum, I had no idea that the guilt I felt was extreme or that feeling guilty is a symptom of postpartum depression.
***
“Everything looks like it has healed nicely.”
The obstetrician was talking about my vagina.
“So it’s okay to have sex again?”
“Yes, all activities are fine, including sex.”
My vagina had been cleared for takeoff, but I still felt sore and tender in my pelvic region. I assumed I was supposed to be excited to rejoin the ranks of the sexually active, but my vagina felt differently. After the trauma of childbirth and second-degree tears, it was going to take more than six weeks for my body to be ready for sex.
When Nathan and I did have sex, it was painful. It became another source of anxiety. Most of the time, I worried we were not having enough sex. Then, when we were having sex, I worried the doctor had sewn me up a little too vigorously. Would I feel like a virgin forever?
My poor body just needed more than six weeks to heal.
To be more precise: my vagina needed eight months to heal.
I’m not trying to be lurid or sensational, but my thoughts on sex were another red flag. My doctor did not know how I felt. All she could see was the way my wounds had healed. Based on what she could see, my vagina was indeed ready for sex. Based on what I could feel, though, the only thing my vagina was ready for was hibernation.
A very extended hibernation.
I did not tell my doctor that everything was still sore in the pelvic region. That felt . . . inappropriate. Remember: this was not just any doctor. This was my obstetrician. A professional trained to take care of vaginas. Yet I felt too embarrassed to talk about my vagina with my vagina doctor.
This was new. I had never been ashamed of my female anatomy. When I needed a box of tampons and bar of chocolate from the pharmacy and nothing else, I had no problem making those purchases from a male cashier. When I needed a box of Monistat 3 and ice cream and nothing else, I had no problem purchasing those from a male cashier either. A urinary tract infection and a male doctor at the ER? I could not care less.
Shame is a symptom of postpartum depression, and I was most definitely ashamed of myself. I was ashamed that my vagina had not bounced back from delivery. I was ashamed about the physical pain I felt in a very feminine part of my body, the portal through which my daughter had entered the world. This was not rational shame. This shame did not arise from something I had done wrong. It originated from the very source of my femininity.
There was nothing rational about this shame, but as I would eventually learn, there is nothing rational about postpartum depression.
The appointment was almost over.
The doctor asked, “So are you sure you have been feeling well?”
Lovely. We were back on the subject of my mental health.
“Oh yes, I feel fantastic.”
“Have you noticed any personality changes?”
“Nope. I feel like me.”
Pippa was still crying. Why did the doctor think my mental health was so important? Obviously I was doing fine. I just had a couple of pesky issues I wanted to address before I could stage my escape and comfort my baby.
“I did want to ask you about stool softeners.”
“Yes?”
“I’ve been taking the stool softener that the gastroenterologist recommended ever since I gave birth. Do you think I need to keep taking it?”
“You should keep taking the stool softener for as long as you feel like it is necessary, but at this point, I think you can safely reduce the dose. Does that make sense?”
“Yes, yes it does.”
“Do you have any other questions about constipation?”
Six weeks postpartum, I still worried about constipation every day. I did not ask my doctor if my concerns were a problem. Of course, they were a problem. My preoccupation with constipation was a symptom of my increasing anxiety, but I did not see it that way.
With my history of hypochondria, I saw my preoccupation with constipation as proof positive that I was what I had always been: a hypochondriac. I did not want my doctor to think I was a hypochondriac, so I was not about to dwell too long on the subject. I would just have to wean myself off the stool softeners and move on with my life. Besides, I had a question about something even more important than constipation.
“Can I ask you about my wrists?”
“Of course.”
“My wrists have been in agony. Could I possibly get a prescription for physical therapy?”
“Let me take a look.” My obstetrician gently touched my wrists. “Does this hurt?”
“A little.”
“Can you describe the pain?”
“If I move my wrists, it hurts. I’ve been using cold packs and heating pads but it hurts to even hold a book.”
The doctor said that my wrists might be hurting because I had arthritis.
This is where my memory gets murky. I remember clearly that she used the word “arthritis,” but I don’t remember if she said the arthritis was related to childbirth or not.
Pippa had been crying for ten minutes now. The sound of her cries made me very uncomfortable. I’m not alone in this. Pretty much any mother will tell you that the sound of her baby’s cries is impossible to ignore. Scientific studies support this. But since I was at my six-week appointment and needed to lie back on a table for the examination, I felt obligated to ignore Pippa. Besides, if I soothed her and then put her back down to finish the exam, that would just piss her off more.
By the time my doctor mentioned the possibility of arthritis in my wrists, I was so agitated from ignoring Pippa’s cries that I could not process any more information. The postpartum depression had also muddled my brain. Sleep deprivation was not helping either. Also, I had already asked Dr. Google about the pain in my wrists, and the internet was happy to provide stories from women who ignored the postpartum pain in their wrists and eventually needed surgery. The word “arthritis,” coming from my doctor’s mouth, confirmed my worst fears. The pain in my wrists was never going to improve.
My brain started to shut down.
My obstetrician took several minutes to explain what might be happening with my wrists, but this was all I gleaned: it could be arthritis; physical therapy might help; but first, I needed to get a full blood work done at the lab.
“Do you understand?”
The obstetrician had stopped explaining the wrist situation. It was my turn to talk. Apparently I was now in possession of enough information to understand why I needed a blood test for pain in my wrists, but I was too overwhelmed to understand anything. The blood seemed to be rushing extra fast in my arteries; my lungs hurt; the room seemed smaller than ever; Pippa’s screams were certainly louder; and my skin seemed to be losing elasticity and having trouble stretching over all my bones.
I did not understand why my wrists hurt. I thought I had just strained some muscles lifting Pippa’s infant car seat. It had never occurred to me there might be something more serious at work.
I did not understand why I needed a blood test.
I did not understand why breastfeeding seemed more difficult now than it had the day Pippa was born.
I did not understand why other moms were able to go places with their newborns and I had so much trouble going to one doctor’s appointment.
I did not understand why the doctor had asked me so many questions about my mental health.
The doctor was waiting for an answer.
“Yes.” I smiled. “Yes, I understand.”
Okay, that’s the end of Chapter 6. I am rereading these chapters as I post them and damn, this chapter gave me so many feelings. Part of me is thinking, “Sweet baby Jesus, couldn’t my obstetrician see that I was suffering? And why did she think a blood test for my wrists was a good idea?” But another part of me is thinking how tough it is to help a mom with postpartum depression. I was not ready to see that I was suffering from a mental illness, and there was nothing my doctor could have said that would have made me see it before I was ready.
Also, rereading this, I feel an urge to go back in time and tell 2013 Courtney, “Pick up your baby! Don’t worry about what the doctor thinks! Get off the exam table and cuddle Pippa!” The doctor must have thought I was having trouble bonding with my baby. Then again: I must have been having trouble bonding with my baby because I was lost in a depression fog.
Another thought from 2021 Courtney: is guilt really a symptom of PPD? Or was it a sign that I had internalized some toxic beliefs about motherhood? And those beliefs were causing me so much pain, they manifested as a mental illness? Should we even call it a mental illness? Or does society have this idea of what it means to be The Perfect Mother and if we don’t fit in that box, we must be ill? Okay, that’s enough philosophical ramblings for a Thursday afternoon.
Ready for Chapter 7? Or just get your own copy of Adventures With Postpartum Depression. It is available now on Amazon, Barnes and Noble, Apple Books, Kobo, Scribd, Tolino, Baker & Taylor, Borrow Box and Overdrive. You deserve it!
