Episode 55: Vivianne’s Continued Adventures With Bipolar Disorder

This week, Vivianne is back on the show to tell us more about her postpartum adventures with bipolar spectrum disorder. But first: if you haven’t already, check out episodes 45 and 45.5 to hear the first part of her story in greater detail. (Also, mea culpa. I just realized those show notes never made it online. You know what? That’s life. I’m a mom and I can only do so much. Sometimes show notes slip through the cracks!)

Vivianne’s story started when she was a teenager. She was highly sensitive, quiet, and introverted and had an eating disorder. But she also did well at school, went to college and got married.

In July 2014, after the birth of her daughter, she felt depressed and suicidal. This continued until Fall 2015 when it felt like a switch flipped. Suddenly, after months and months of questioning her decision to have a child, Vivianne was ready for another baby.

Two or three months after her son was born, Vivianne started to feel depressed and suicidal. She also experienced expansive moods. An expansive mood is when a person quickly moves through an entire range of emotions.

In early 2017, Vivianne started a very low dose of Zoloft. This worked until April 2017 when the depression returned. Her doctor increased her dose of Zoloft. Four days after starting 75 mg of Zoloft each day, Vivianne experienced hypomania. Hypomania is “mania light.” Vivianne felt extremely happy, talked quickly, and had lots of plans.

When we last spoke during episode 45, Vivianne’s doctors were still working on her diagnosis. During Summer 2017, the bipolar diagnosis floated to the top. That is her diagnosis to the present day.

Vivianne started taking Lamictal. The therapeutic dose (e.g. effective dose) is between 100-200 mg but Vivianne had to start lower than that and ramp up to the larger dose. During the ramping up period, she had a mixed episode. During the mixed episode, Vivianne experienced both severe depression and agitation and hyper-activity at the same time. This meant she was mopey and slow but getting hit by negative thoughts at a very fast pace. She became obsessed with a suicide plan. Fortunately, she had a prescription for Atavan to treat anxiety. She took a dose and slept for a few hours. After sleeping, she felt better.

The mixed episode showed Vivianne and her family just how high the stakes were. They realized sleep deprivation was a major trigger for her. Vivianne asked her husband to help with her sleep hygiene. It took her husband a little time to realize how important this was.

In Summer 2017, while all this was happening, Vivianne moved from D.C. to Nashville. For many moms, this would aggravate a maternal mood disorder. The move, however, was great for Vivianne. She know has a shorter commute and bigger house, two things that help her mental health.

Since September 2017, Vivianne has been taking 200 mg of Lamictal (aka Lamotrigine). Medication and therapy have helped her enormously. She has developed more insights about herself and can recognize when she is feeling more sensitive. On those days, she takes charge by doing something like taking a nap or going to the gym to burn off excess agitation.

Vivianne has been reading The Bipolar Disorder Survival Guide: What You and Your Family Need To Know by David J. Miklowitz. It discusses the different medications used to treat bipolar disorder. For example, lithium is still the gold standard but it works best to prevent mania. Lamictal has worked great for Vivianne. She has not experienced any side effect. Lamictal, however, does not work for everyone.

The Bipolar Disorder Guide has advice beyond medications. For example, it recommends establishing a routine. Persons with bipolar disorder are sensitive to things like sunlight but this is life. Chaos happens. If you have kids like Vivianne, then you are probably living with humans who have their own needs and agendas. Vivianne likes to have routines that are flexible. Meals and bedtime happen at generally the same time.

Vivianne had lots of excellent advice during this episode.

  1. In the beginning, your medication might not be working at its full force. Its important to control all the variables that you can while your medicine gets up to speed.
  2. Keeping a mood journal can help you understand your triggers. You can give it to your psychiatrist so they have all the information possible to treat your illness.
  3. It’s easy to over-identify with your disorder. Don’t become the disorder.
  4. Family-based therapy can be wonderful tool for coming to grips with a bipolar diagnosis.
  5. It’s important to talk to people with your experience but it’s also important to talk about your experience with the people most important to you.
  7. Have a hobby.

Vivianne is afraid of going back to the way she used to feel. Her psychiatrist good her that she is strong enough. It’s okay to feel emotions. She just need to be aware when her emotions leave the normal range. 

Another book Vivianne recently started reading is Quiet: The Power of An Introvert in a World That Can’t Stop Talking by Susan Cain. When she was a teenager, Vivianne assumed she was an extrovert because she enjoyed the performing arts like acting and dancing. Now she realizes she is an introvert and needs time alone to recharge. Vivianne has learned to embrace her introversion so that she can take care of her well-being rather than worrying about societal expectations. (Vivianne got me so excited about this book that I ordered a copy a few minutes after our interview was done.)

The bipolar disorder diagnosis has helped Vivianne really hone in on who she is and what makes her comfortable in her skin. Looking back at her life and talking to people who knew her as a child, she thinks things for more intense for her when she was about sixteen years old.

Don’t you think Vivianne should have her own podcast? Except I know she is busy so let’s just have her on this show as often as she likes!

Vivianne, it was wonderful having you back on the show. For those of you who listened to the audio, you know there was a bit of an adventure with gardeners in the background. Thank you, Vivianne, for being so gracious during that nonsense. And thank you for being so candid and open about your postpartum adventures.

Back episodes are slowly migrating to Patreon.com/PPDadventures. Support the show for just $2/month and you will have access to all the adventures. Once I have enough supporters for the show, I am going to get some professional transcripts for each interview. I think it’s important to have these stories available in as many ways as possible for moms who are suffering and think they are alone.


Episode 54: The Conclusion of My Personal Adventures With Postpartum Depression

Hello! This is my first episode of 2018 and I’m so excited to report that my personal adventures with postpartum depression are OVER. I am not done with postpartum depression. There is still a lot of awareness to raise and stories to tell. I don’t know if I’ll ever be done with postpartum depression as an advocate. But I myself am no longer a patient being treated for postpartum depression and that feels soooooo gooooood.

I took my last dose of Zoloft shortly before Christmas. I have felt great since then. Weaning off Zoloft was quite the journey. I talked about it during several podcast episodes, including Episodes 31, 37, 46, and 52. I started at a daily dose of 150 mg of Zoloft. Weaning from 150 to 75 mg sucked. But once I hit the 75 mg mark, it was easy peasy. Going from 25 mg to 0 was no big deal.

A couple weeks ago, I had my first “normal” period. The last time I had a normal period would have been in June 2012. In early July 2012, I got pregnant with Pippa. She was born March 2013 and my period made its triumphant return in July 2013 when I was about 3.5 months postpartum. I actually assumed that all my symptoms for postpartum depression were just a wicked case of PMS. (Spoiler alert: Nope.)

I started Zoloft in late July 2013 before I got my next period. So since June 2012, I have either been pregnant or on Zoloft. (That first postpartum period in July 2013 doesn’t count because the first postpartum months are WEIRD.)

My periods have been super ridiculously intense since I had Pippa. Like there are not enough tampons in the world to manage the hemorrhaging that happened. Every cycle, I lost at least one pair of undies. Gross? Yes. But should I feel ashamed of that fact and pretend it didn’t happen? Hell no!

To celebrate, I made myself a little something for Instagram:

I kicked PPD in the ass!

Oh hey, if you want to follow me on Instagram, I’m @Courtney.Novak.

I talked a lot about The Mom Center during this episode. I swear, Graeme is not paying me to promote her work. I just love what she is doing and think her work will help and inspire a lot of you. Check out the Mom Center right here or learn more about Graeme’s work at her personal website right here. Graeme shared her personal story and talked about self-care on Episode 35. If you haven’t listened to that episode yet, what are you doing here? Go, listen, Graeme is amazing!

In other news, I am so excited to be leading Team Los Angeles for the 2018 Climb Out of the Darkness on June 23, 2018. If you live in the area, I would just swoon with joy if you joined the L.A. climb! You can register for a climb here or register for Team L.A. specifically right here.  So far, I am the only climber on the team, but that’s okay. I know someone out there wants to join me!

Want to learn more about the Climb? Check out Episode 39 for my interview with Emily Newtown about the 2017 Climb. You can also read about it right here on the Postpartum Support International website.

Whew. My fingers are exhausted! Do I talk to much? Never! You can never talk too much about postpartum depression! I was reminded of this fact when a friend sent me a link to this Facebook post. This is what happens when doctors don’t understand maternal mood disorders. And you know what? That’s UNACCEPTABLE. Maternal mood disorders are common, more common than gestational diabetes, and any doctor who treats women should at least have a basic knowledge of symptoms, treatments and when to hit the panic button.

The End of An Era

I have been off Zoloft for about six weeks now and feeling great. Today, I touched base with my psychiatrist. After our usual talk about my life and mental health, the psychiatrist asked if I wanted to schedule a followup appointment or if I was ready to bravely go forward to conquer the world and call her if I ever needed a booster session.

(Those were not her exact words. I’m paraphrasing.)

I said that I was ready to conquer the world!

(Not my exact words either.)

We shook hands, I promised to get her a copy of my book when it’s published, and then I left.

Stepping into the hallway, I felt as if I was having a cinematic moment. Like I was about to fall to my knees and weep with joy. I did it! I did it! I kicked postpartum depression in the ass, did everything I needed to do to protect my mental health, and lived to tell the tale. And now, I am such a mental health boss, I’ve got this.

But instead of getting dramatic and weeping on the floor, I called Nathan to share the exciting news. He said we needed to get a cake to celebrate. Marrying that man was one of the best decisions I ever made. He gets it! He gets just how freaking important this milestone is to me.

We’ll probably just get takeout dinner tonight because we just had cake for my birthday, but still, I like the sentiment.

Folks, my mental health is all on me. I don’t need a psychiatrist to tell me that I’m doing well. I am so excited to be in charge!

Quick Update

  1. I have several podcast interviews scheduled over the next few weeks. Hooray for postpartum stories! Two are the continued adventures of former guests. Two are new stories from new guests. I am excited for all of them.
  2. Revisions are coming along on my book, and I hired a book cover designer two days ago. Yesterday I sent her the current version of my manuscript. I think we are going to work well together. She is working to finish the cover by the end of March so folks, it’s happening. My book will be published early April.
  3. I’m at Olympic Day Spa as I write this, a woman’s only spa in Los Angeles. I have already sweated extensively in the steam room and soaked in the mugworts tub (doesn’t that sound like a Harry Potter potion?) Coming up: more time in the tubs, a scrub and then the Nirvana massage. But I felt the call the write for a bit and enjoy a cup of coffee, so that’s why I’m checking in.
  4. I have lots more to share, but it’s time to get back to the spa experience!