IT HAPPENED TO ME: I Had Postpartum Depression And It Triggered Bipolar Disorder

When a woman has a genetic predisposition for mood disorders, childbirth frequently triggers the onset of PPD and accompanying mental illnesses.
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Jessica Azar
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When a woman has a genetic predisposition for mood disorders, childbirth frequently triggers the onset of PPD and accompanying mental illnesses.
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At 22, I was newly but very happily married when I found out I was pregnant. My husband and I were thrilled and began dreaming the dreams and planning the plans in which parents-to-be immerse themselves. 

We nervously hoped that we were as ready for the baby as the nursery that we had prepared for him. Hopeful, romantic visions of bringing my child into the world and baby-powder-scented daydreams of cuddling a sleeping baby filled my mind. I relished the world of prenatal bliss that had overtaken our little house.

Blissfully naive, I happily waddled into the hospital believing I would leave it in a couple days as a new mother, with my baby in my arms.

Then reality stepped in, and those fluffy, lullaby thoughts were ripped to shreds.

There were multiple medical fumbles throughout my delivery experience that unfortunately (and uncomfortably) resulted in a 27-hour-long labor. 

When the doctor finally brought my son, Zack, out of the quiet darkness of my body, he was blue. Zack wasn’t breathing. A squad of NICU nurses burst into the delivery room to assist the Labor and Delivery nurses who were frantically trying to coax oxygen into my son's lungs. 

As my doctor stitched up my postpartum body, I strained to see my baby over his shoulder as a myriad of frantic thoughts flooded my mind: 

“Is he okay?! Is he breathing yet?! Why are there so many people in this room?!”

I never heard the long-awaited "first cry," but the team finally managed to jumpstart his breathing. A nurse swaddled him, placed him in my arms for a few fleeting seconds, then whisked him away to the NICU. 

Gradually, all of the medical personnel in the room left. My husband, who was as bewildered and shell-shocked as I was, offered to get me some food, as it had been well over a day since I had eaten. 

After he left, I was alone. Painfully, I waited for a call from the NICU saying that my son had been stabilized, but that call wouldn't come for four more hours. The silence was deafening.

My traumatic birth experience, coupled with my already delicate nervous system, pushed me down the stairwell of PPD.

I was crumbling to pieces. I hadn't planned on breastfeeding, but when the NICU doctor told me that breast milk would help my baby, I began using the pump in my hospital room. 

As I mourned the absence of my baby and my lack of access to him, I turned away all visitors. I pumped like a madwoman, determined to do the one thing I could contribute to his wellbeing while being apart from him. I wound up overstimulating my milk supply. This strain exacerbated my hormone imbalance, which tightened the noose on my already fragile emotional state.

My son's health began to improve in the NICU, but he was not allowed to be discharged from the hospital when I was released. As I was wheeled away in the mandatory wheelchair exit from the postpartum wing, I felt myself being ripped away from the one thing that would've eased my pain. 

I knew I was lucky my son was alive and would be home in a short amount of time compared to what some other mothers experience. But still, as I climbed into our car with the empty car seat in the back, I felt devastated.  I started to weep as we drove away. I cried for three days, barely stopping to sleep.

Extreme emotions, sleep deprivation, and the hormonal hurricane coursing through my postpartum body resulted in a breakdown. I was pumping milk for the baby around the clock, yet I refused to eat. 

My husband tried to comfort me, as he grappled with his own disappointment and confusion over how to navigate this unprecedented situation. In desperation, he convinced me to call my OB doctor about my inconsolable crying. 

Thankfully, the doctor realized the depth of my despair and prescribed a hefty dose of an antidepressant. Within hours of taking it, I was able to eat and had stopped crying, but the emotionally charged cloud still enveloped me. I continued to pray for and obsess over the moment I would be able to bring my son home.

At last we got the phone call that we’d been waiting for, and my husband and I went to pick up our new baby from the hospital. 

We packed away the little things that had been hung on his crib by the nurses, and attempted to change his diaper before leaving. We gingerly loaded him into his car seat then buckled him into the car. 

After arriving at our house, we sat down with him and tried to figure out what to do next. The moment I had built up and idealized in my mind was actually here. Finally, the rosy picture of new motherhood I'd envisioned could begin. 

Then the evil bastard known as colic decided to show up. My husband was starting a new job that next morning, so I tried to quiet my son that first night on my own, ignoring the importance of my own rest. 

The baby, whose absence I had so deeply grieved, screamed from midnight to four in the morning, until I was wondering why I had ever decided to have a child. 

“Please stop crying! I’m doing the best I can! Why don’t you like me?!” I would alternately plead and demand with him. 

I sank deeper into the murky pit of despair and came to believe that I would never be happy again. These middle-of-the-night marathons of screaming lasted for about three months, but he was a difficult baby around the clock. 

It seemed impossible that this living hell was something that I had longed for. It felt like it would never end. I honestly didn’t know how I would make it out alive. 

While most mothers endure the misery and sleep-deprived conditions of newborn-land, they have adorable baby smiles and sweet little moments that sustain them. My embattled efforts went unrewarded, and my affection was rarely returned.

Self-loathing reigned supreme. I blamed myself for Zack's difficult disposition and constantly wondered if I was doing everything “wrong”; whether someone else would be a better mother to him. 

There were times that I cried because I felt like I didn’t deserve such a difficult baby, and then I’d cry even harder because he didn’t deserve a mother that was ungrateful to have him. 

My outlook and countenance improved slightly when he outgrew the midnight tirades, but I remained depressed and apathetic. When Zack was 6 months old, I got a huge surprise: I discovered I was pregnant again. 

Part of me was excited, but another overwhelming part of me wondered how in the hell I would manage two children when I couldn't handle the one I already had. 

All I could do was trudge bravely forward, with an ever-growing belly and a screaming infant on my hip. 

Mercifully, pregnancy was kind to me emotionally, so some of the depression symptoms lessened temporarily. Things like insomnia and a lack of appetite were overridden by the exhaustion and need for more cookies that my pregnancy hormones demanded. 

Thankfully, when my second child Ben was born, the delivery went well and he was healthy. I finally got the "rooming-in" experience I had desired with Zack's delivery, and the bonding was amazing. 

Ben was a more relaxed baby with a sunnier disposition, but that didn’t stop PPD from floating back into our lives. Dealing with two little boys who were only 14 months apart in age would be demanding for anyone, and for me it was like climbing Mt. Everest… every day. 

The boys were my world, and all of the shreds of energy that depression didn’t steal from me were used to care for them. My husband did his best to support me, but it’s hard to help someone who doesn’t know how to help herself. He was learning to be a dad, just as I was wading through the muck and mire of early motherhood.

Although I continued to take the antidepressant that was prescribed to me before I was pregnant with Ben throughout that pregnancy and into my postpartum days, the benefits were minimal. 

My OBGYN decided to prescribe a different antidepressant, and it worked very well for a short period of time, only to stop working altogether. After experiencing this phenomenon with three different medicines in a row, he referred me to a psychiatrist. 

“Jessica, I’m obviously not handling your symptoms effectively… This is outside the scope of my specialty, and I want you to see a psychiatrist," he explained.

What my depressed brain heard was that he didn't want to deal with me anymore. Who could blame him?! I didn’t like being around myself and I felt like my babies and husband were only tolerating me. I was desperate.

I made the appointment with the psychiatrist. After hearing my symptoms and that multiple antidepressants had abruptly stopped working for me, she promptly diagnosed me with Bipolar Disorder, Type II, which had been triggered by the PPD. 

My OBGYN had not picked up on my hypomanic symptoms, like severe irritability, pressured/rapid speech, and going 24 hours without sleeping on a regular basis. 

She explained that when a woman, like myself, has a genetic predisposition for mood disorders, childbirth frequently triggers the onset of PPD and accompanying disorders. 

Dealing with the extreme sleep disturbances that come with caring for a newborn exacerbate those symptoms and trigger mood cycling, which repeatedly took me from the frantic frenzy of hypomania to the pits of hell depression. It all made so much sense, for the first time. 

I felt extreme relief at having a diagnosis, and that there was a now a new plan of action to help me feel better, but at the same time, the diagnosis was a blow to my self-identity. Aside from adding a mood stabilizer and an anxiety medication to my antidepressant, the doctor told me that I shouldn’t have any more children, because going through those hormonal changes again would be so difficult for me.

Even though motherhood had been stressful and hellish at this point, I still planned on having more children, so her words stung and made me question my capabilities. 

After leaving her office in the mental fog to which I’d grown accustomed, prescriptions in hand, I remembered that I’d spent my life proving people wrong and challenging myself to surpass the expectations of others, including my own. My brain chemistry was a cross to bear, but I didn’t have to let it bring me to the ground.

I’ve learned that a medical diagnosis can only provide limited information, and it doesn’t take into account the details of a patient’s desires and willpower to see them come to reality. 

I began researching ways to improve my health beyond my pharmaceutical regimen and found that exercise, running in particular, and dietary changes, like cutting out gluten, helped to keep my moods from cycling. 

I’ve gone on to have two more children since my diagnosis, and while it’s never been easy, it’s been remarkably “worth it." 

With the knowledge of my diagnosis, I was able to prevent the ultimate lows of PPD after my third and fourth deliveries by continuing my antidepressant throughout the pregnancy and quickly returning to my pregnancy-prohibited medications soon after their births. 

This prevented me from nursing my children, but they had a sane, capable mother and I believe that trumps breastfeeding, at least in my case.

While I wouldn’t wish the hell of PPD and mental illness on anyone, it’s taught me that I can achieve more than I ever thought possible, like running a Half Marathon when I was 32 weeks pregnant with my fourth child (I continued running during that pregnancy because it helped stabilize my moods). 

I hope that other moms can see hope through my story, knowing that their lows can lead to amazing triumphs. Realistically, I know that there will continue to be dark times, and that mental illness can never truly be “beaten,” but now I know I can make it through the darkness, and that there just might be a silver lining. 

Together with Alyson Herzig, another writer, I recently published a book to connect those suffering in silence with PPD, Bipolar Disorder, and other mental illnesses entitled Surviving Mental Illness Through Humor

By shattering stigma and creating a more open dialogue about mental illnesses like Bipolar and PPD, we can help so many. 

For a time, I thought the birth of my son led to the death of the “old me” and my happiness, never to be the same again. While this is true in part, a “new me” was born from those ashes and I’ve soared to new heights, knowing that I can conquer other trials that come my way.