I recently published my memoir Adventures with Postpartum Depression. You can buy the ebook and paperback now on Amazon – woot woot! I’m sharing several chapters on my blog. In this chapter, I describe the development of my postpartum obsessive compulsive disorder.
Two in the morning. I was lying in bed, Nathan sound asleep to my left, Pippa sound asleep in her yellow cradle to my right. The ceiling fan whirred overhead. I was wearing my headphones, and my headphones were plugged into my iPhone, which was playing the sound of a rushing river. Circumstances were perfect for sleep.
Except my wrists were throbbing. Lying in bed, I reprimanded myself. I really needed to stop clutching my smartphone during Pippa’s nocturnal feedings. Except scrolling through blogs was the only thing that kept me awake. If I just watched Frazier reruns, I fell asleep, and if I fell asleep, I might drop Pippa or, worse, lean forward and suffocate her with my own body.
I tried to put my wrists out of my mind. Thinking about the wrists just made me think about the ultrasound. I had gotten the blood test, and the results had shown elevated enzyme levels in my liver. The nurse said this was probably due to weight gain during pregnancy (you think?), but my obstetrician still wanted me to get an ultrasound of my liver before I could get physical therapy for the wrists.
I flipped from my left side to my right. The blood test had been an ordeal. My parents had watched Pippa, and the entire time I was gone, my anxiety spiked as if I were in the middle of a natural disaster. This made no sense. Pippa was safe and happy with my parents. I had pumped a bottle of breast milk in case she got hungry. The lab was only a few miles from our house so if there was an actual natural disaster, I could still get home.
Nevertheless, I suffered. My heart pounded, my skin crawled as if I were covered by hundreds of bugs, and I generally felt as if the world were about to end. It was not. There was absolutely no reason for the way I felt. At least, there was no logical reason, but there was a biological one.
Anxiety is a symptom of postpartum depression, a symptom I was experiencing with greater intensity and frequency. As I tried to get back to sleep, the thought of the ultrasound made my heart race. There were so many things that could go wrong. What if Nathan had to go to work and I had to bring Pippa to the appointment? What if I could not pump enough milk and Pippa got hungry? What if Nathan was annoyed that he had to go into work a little late because his fat wife needed an ultrasound?
These petty concerns were easier to ponder than the deeper fear: What if I had cancer? Rationally, I knew my doctor was being overly cautious. Just as she had wanted to rule out MS when I was constipated, now she wanted to rule out some serious liver condition when all I had were sore wrists. Yet I could not stop myself from worrying that I might have cancer and leave Pippa to grow up without a mother.
I flipped back to my left side. I could not get comfortable. At least Pippa seemed to be comfortable in her cradle.
Or was she?
I tiptoed over and leaned as close as I could to her face and listened for the sound of her breathing. Her chest moved up and down but the room was dark. Maybe my eyes had tricked me into thinking she was breathing but she was actually in distress.
I gently rested my hand on the soft spot on the top of her head where the skull had not fully closed. For a moment, I felt nothing. Trembling, I inched my hand to the left. My body relaxed as I found it: her pulse.
My baby was still alive.
I got back into bed and closed my eyes. My muscles relaxed, my breathing slowed, and the chatter in my brain faded—
Had I checked Pippa’s sleep sack?
At night, Pippa slept in a sleep sack, which was like a sleeping bag with armholes. The sleep sack kept her warm without the risk of smothering her the way a blanket might. Rationally, I knew she was safe and snug in her sleep sack and told myself to go to sleep.
What if I had inadvertently nudged the sleep sack out of place?
What if it was on top of Pippa’s mouth?
What if she was suffocating this very moment?
My eyes flew open.
I closed them and urged myself to go to sleep. I knew Pippa was fine. These fears were ridiculous. I needed to get some decent rest before Pippa wanted to breastfeed again.
Just as it seemed as if I could talk some sense into my anxiety, the guilt chimed in: Was I really placing my desire to sleep above my daughter’s safety? What sort of mother was I?
I got out of bed, crept toward Pippa, and examined the sleep sack’s position. It was several inches away from her mouth.
I went back to bed and closed my eyes. I took several deep breaths.
What if, while walking back to bed, I had caused a disturbance in the air that moved the sleep sack onto Pippa’s mouth?
It had not always been this way. In the maternity ward, whenever Pippa was swaddled and in her cradle, I knew she was safe. Or, more precisely, it never occurred to me to worry about her safety.
I do not remember exactly when I started checking Pippa during the night—those first weeks are such a blur—but I do know it was not our first night home from the hospital. That first night, I was too busy figuring out a way to get Pippa to sleep in a place other than my arms. She had slept easily in the hospital cradle but screamed every time we put her in the travel crib in the master bedroom.
Nathan and I took turns holding her. Around 1:00 a.m., out of desperation, I checked a baby book the pediatrician had recommended specifically for sleep issues. The book said newborns could sleep in a car seat. I eased Pippa into her car seat and slowly withdrew my hands. She slept. I rejoiced and went to sleep myself. I was too exhausted to think about her breathing.
But eventually, probably when Pippa was a few weeks old, I started to worry. According to my baby books, sudden infant death syndrome claimed the lives of 1,500 infants every year in the United States. That is not actually that big a number when you consider the fact that in 2013, the year Pippa was born, there were 3.93 million births in the United States. That means for every hundred babies born in 2013, less than 0.04 percent of those babies died of SIDS.
SIDS still terrified me.
It was as if the Grim Reaper were hovering nearby, waiting to snatch Pippa while I had the audacity to slumber. I followed all the advice I could find. We kept the cradle in our bedroom, ran a fan all night, used the sleep sack. Pippa still seemed to be in imminent danger. And so I checked to make sure she was breathing, as if by checking I could ward off evil spirits or, at the very least, reassure my frazzled nerves.
The reassurance, though, never lasted more than a few seconds.
I got out of bed again, the fifth time in as many minutes. This time, after checking Pippa’s pulse and watching the fall and rise of her chest, I tucked the sleep sack into her pajamas to make sure it would not get loose during the night.
Now I could sleep.
Tucking the sleep sack had created a big fabric bulge near Pippa’s neck. Could that interfere with her windpipe?
No, I told myself, she was fine. I had pulled the fabric bulge several inches away from her neck.
But. How could I be sure the fabric bulge would stay in place?
I had to know.
* * *
A few weeks later, once again during the middle of the night, I put my hand on the knob of the front door and turned as hard as I could, twisting back and forth until I was sure it was locked. Then, I turned away to go back to bed.
But. Was it really locked or did it just seem to be locked?
I unlocked the door, relocked it, and then rattled the knob back and forth to make sure it was really, really, really locked.
I felt calm.
I removed my hand from the doorknob.
My heart immediately started to thump as if I were on the verge of a heart attack.
Was the door really locked?!?
After testing the lock’s integrity a dozen more times, I pulled myself away, like a spaceship escaping a tractor beam. At last, I could go back to sleep. I had finished breastfeeding Pippa almost an hour ago, but if I fell asleep right away, I could probably get into a REM cycle before she was awake for the day.
I took a deep breath. Sleep, please, let me sleep.
Was the back door locked?
I had checked the back door just five minutes ago, but maybe something had happened to unlock it.
I chided myself. I was being ridiculous.
But if the door was unlocked, and a kidnapper was prowling the neighborhood . . .
The risk was too high.
After checking the back door, I could not resist the urge to revisit the front door again because you never know.
On my way back to bed, I walked through the kitchen.
When was the last time I checked the stovetop burner?
* * *
If you place a frog in a pot of boiling water, it will leap to safety.
It is said that if you place the same frog in a pot of room-temperature water and flick on a flame, it will not notice the change in temperature. (This is not actually true. Still, I like the metaphor.) Even when the water has started to boil, the frog will stay in the pot, oblivious that it is being cooked alive.
I was the frog.
* * *
I staggered toward bed, half-assured that the doors were locked and stovetop burners lit.
What about the windows?
I started in the kitchen, yanking upward on each window. Then I moved to the living room. I could see with my eyes that the windows were in fact locked.
Or maybe they only looked that way.
I pulled as hard as I could on the first window. It did not budge.
I turned and considered the second. A huge thorny bougainvillea grew in front of that window. Not even Prince Charming could get through those tangles. The window was completely inaccessible.
Yet I could not resist. I had to check.
Next I went to the nursery and checked the windows by the changing table. Then it was time to survey the guest room.
There was a window in the nursery closet. The old owners had sealed that window shut and it was impossible to open. Besides, it was no bigger than a shoe box. No one could climb through it . . .
I had to know.
I opened the closet door, leaned over diaper boxes, and strained at the window as if the house were on fire and this window were the only way out. Only then could I convince myself to move on and check the guest room windows.
At last. We were safe. I could go back to bed.
I turned and started walking back to bed.
What if an intruder had broken into the house during the day?
My heart beat faster.
What if he was hiding under one of the beds?
My breathing accelerated.
I marched back to the guest room. A small part of me protested. No one could be hiding beneath this bed. The frame was barely six inches off the ground and besides, I had crammed all sorts of junk down there.
What if there was a snake?
My heart started to pound even harder. I knelt down at the edge of the bed convinced that something terrible was hiding just behind the bed skirt. If I looked, it would surely kill me; but if I did not look, it might kill Pippa instead.
I took a deep breath and lifted the bed skirt.
No snakes, no fantastical creatures from horror movies.
I finally crawled back into bed, terrified of waking Pippa or Nathan. Neither stirred. Utterly exhausted, I fell asleep before my thoughts could rouse me out of bed.
* * *
Fourteen, fifteen, sixteen, oh no, seventeen.
There were seventeen steps.
Not sixteen, a beautiful number that could be divided into two halves of eight steps each or, bliss, four quarters of four steps each.
And not eighteen, which at least had the decency to be an even number.
But seventeen. Seventeen odd-numbered steps.
How could my parents have possibly thought this was a good place to live?
I was nineteen years old, home from college on spring break. My parents had bought a townhouse in a gated community. It was built on top of a hill, so the ground floor was also the top floor. A flight of stairs descended to the second floor, where my siblings and I would sleep.
A flight of stairs with seventeen impossibly odd steps that would torment me every time I needed to go to a different floor.
I experimented with ways to make the seventeen-step staircase feel like an even number. I tried skipping a step, but no matter what step I skipped, I knew the seventeenth step was there. Stepping on the same stair twice also felt wrong. I tried rushing down the stairs without counting, but not counting felt even worse than counting an odd number.
Counting stairs was one of my quirks. I had a few others—turning jumbles of letters on license plates into words, folding laundry in certain ways, counting how many cars I passed when I was in the faster-moving lane of traffic—but they were just innocuous mind games that made me smile. I freely told friends and family about my little games with a sense of pride. They were proof that I was unique and marching to my own beat.
It never occurred to me that these quirks were more than just games; that they were actually a way of exerting control over my world.
It never occurred to me that I was flirting with obsessive compulsive disorder. Or that my quirks could turn into something sinister if given the right circumstances.
* * *
“I’m going to bed.”
Nathan glanced up from his laptop. He likes to piddle with various sports-themed games while watching television. “Good night, sweetheart.”
It was not even nine o’clock, but at two and a half months postpartum, I felt like a shell of my former self. The sooner I got to bed, the better chance I had of getting a full night’s rest and feeling like an actual human being.
I tiptoed into the bedroom, careful not to disturb Pippa. I got into bed and closed my eyes.
Were the doors locked?
My eyes popped back open.
I listened. Nathan was still in the next room watching television and playing games on his computer. I had to check the locks, but he would think it was weird if I started locking and unlocking the doors.
I’d have to start with the front door, which was on the other side of the house. The television volume would drown out the sound effects.
It took me a few minutes to convince myself the front door was locked.
Now it was time for the back door.
I sauntered into the den. Nathan’s eyes were on the television. I sidled a few steps toward the back door. The back door was technically in the same room as the television, but thanks to the position of the couch, it felt like the back door was part of a separate little mud room. Nathan was not looking at me. I sidled closer and felt a thrill, as if I were riding a bike down a steep hill. I was there, close enough to touch the back door, and he had not noticed me.
I started to lock and relock the doors surreptitiously. Nathan kept watching television. My secret was safe.
Or so I thought.
Long after my postpartum depression was diagnosed and treated, Nathan and I talked about the way I locked and relocked the doors. He’d been aware of what I was doing, but he thought it was a result of normal new-mommy fears. Where he grew up, doors were often left unlocked. No one worried about burglars, and they would have thought you were bonkers if you’d inquired about local serial killers. But I was a city girl. In my world, doors needed to be locked.
At least, that was what he told himself. Maybe he was also in denial. It would have been much easier to think his wife was being a bit silly than to confront the possibility that she was swimming in dark psychological waters.
Besides, Nathan knew only that I was checking the doors before bed. He did not know I was checking Pippa’s breathing throughout the night; or that I checked the stovetop burners, windows, closets, under the beds, and sometimes even inside the washing machine; or that I rechecked the doors—and everything else—after every breastfeeding session. Those things happened only when he was fast asleep.
My anxiety sometimes seemed to have a mind of its own. Like, my anxiety knew that it had to be surreptitious and not arouse my husband’s suspicion. Otherwise he might have taken me to a doctor, and the doctor might have helped me, and my suffering might not have lasted as long as it did.