Episode 74: Tyra’s Struggle With Postpartum Depression and Anxiety

This week, I am so excited to share Tyra Fainstad’s interview on the podcast. Tyra is the mother of a two year old girl and baby boy, and as of July 2018, she is in the throes of postpartum depression.

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Tyra had a history of anxiety before she became a mother. As as child, she saw psychiatrists and was put on medication. She had a phobia of vomiting and engaged in OCD behaviors to prevent puking. Around the age of 12 or 13, Tyra’s anxiety around vomiting ended. She just grew out of it. But she was still an anxious person who worried about school and work.

She went to medical school and a year after finishing her residency, Tyra became pregnant with her daughter Madeline. This was a wanted pregnancy. Tyra had not always wanted kids, but her husband Brandon did, so she eventually decided that she did in fact want to be a mom and raise a family. Once they started trying for a baby, Tyra got pregnant right away.

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Keeping it real. Babies cry. A lot.

Tyra developed various concerns and worries about her pregnancy. When the baby was breach, she worried about that and tried acupuncture to get her daughter into the right position for a vaginal delivery. A c-section, however, was necessary and the surgery was easy. Recovery from the c-section was also physically easy.

But from the first night of motherhood, Tyra’s anxiety kicked into high gear.

When she was pregnant, Tyra thought that all her concerns would evaporate once she could see that her baby was healthy and fine. But that’s not how anxiety works. Once Tyra had her baby, she still could not convince herself that her baby was health and fine.

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Would you believe that a woman goofing off like this could be living in postpartum hell?

Tyra wanted to breastfeed. Her baby was angry, crying and hungry. Breastfeeding was tough. Baby Madeline also was colicky and cried all the time. She did not sleep unless she was snug in the Moby wrap. Tyra got the idea that if only her body could produce enough milk, then her baby would sleep and Tyra could sleep and everything would be fine.

By three weeks postpartum, Tyra was a mess. She knew she was a mess and her physician agreed that she had postpartum depression, postpartum anxiety, and a severe lack of sleep. Her doctor convinced her to take Ambien.

Slowly, breastfeeding improved. Baby Madeline started sleeping better. Tyra, however, was not getting better.

Tyra’s doctor prescribed Lexapro. Tyra obsessively researched all the medications but stopped taking Lexapro on the third day because she thought it was making her daughter fussier than usual.

Tyra went to see a therapist. She brought her baby to an appointment and was stressed that therapy would ruin the nap routine. Tyra spent therapy sessions with a baby screaming in the Moby wrap, which was suboptimal to say the least.

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Totally random caption: My daughter had those leggings! Why don’t they come in a grownup size?

Tyra would not let anyone help with the baby. Her daughter would not take a bottle and she worried if the baby didn’t eat, she wouldn’t sleep, and everything would be ruined.

As the weeks passed, Tyra came up with reasons to not be healthy. She isolated herself.

Around four or five months postpartum, Tyra started working with a life coach. They did phone therapy. The life coach taught Tyra about mindfulness and cognitive behavioral therapy techniques. This was very helpful.

When her daughter was eighteen months old, breastfeeding ended because Tyra got pregnant again. Once breastfeeding was removed from the equation, Tyra felt less anxious.

Tyra knew she was at risk for a second round of postpartum depression and anxiety, so she restarted therapy. She talked about the tools that would help her cope with Baby No. 2.

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Tyra did not take any medications during her second pregnancy. She’s a physician. She counsels patients all the time to stay on their SSRI while pregnant, but she could not do that for herself. She also could not convince herself to skip breastfeeding and only use formula for her second child. She can’t explain her resistance to formula. She just couldn’t give up on breastfeeding.

Tyra gave birth to her son Desmond in March 2018. The first month postpartum was great! Desmond was an easier baby and would sleep all by himself in the Rock ‘n Play. (Personal side note: the Fisher Price Rock n’ Play was a life saver when I had PPD with Pippa, and I wish I could wave a magic wand and make sure all of your babies slept beautifully in it as well, because holy crap, sleep is so essential.)

Breastfeeding was fine. Desmond latched and Tyra has become an over-producer of milk. Tyra seemed to have dodged postpartum depression.

But then, when Desmond was six weeks old, he developed a minor health issue and started refusing feeds. This was a huge trigger for Tyra. During nursing sessions, he arched his body away from Tyra and was not soothed by the prospect of breastfeeding. As of the time of Tyra’s interview, he was also refusing the bottle.

When Desmond was eight weeks old, Tyra learned he was not gaining weight and had dropped down in the percentiles. The doctor was reassuring. Maybe Desmond was having trouble with dairy. Tyra’s anxiety went into high gear. She felt like something about her baby was wrong for her baby.

It turns out that Desmond does have a dairy intolerance – and issues with soy, eggs, night shade (tomatoes!), nuts, and so on. Tyra basically survives on avocados.

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Desmond also stop being the baby dreaming in the sleep department. Now he will not sleep unless he is on top of a human.

Logically, Tyra knows her baby is fine. She knows they are going to get through this. But she’s spiraling out of control and everything in her life feels like a crisis.

Tyra has lots of resources to get through this second hellish round of postpartum depression, like a nanny and helpful family. But still, she is struggling. Even during our interview, when her voice sounded calm and in control, she felt like she was having a panic attack. 

Tyra has a bottle of Zoloft. She took it for a couple of days but felt nauseous and light-headed. She reduced her dose to a tiny, tiny amount.

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She is terrified of losing her milk supply even though she is over-producing. Zoloft rarely reduces a milk supply, but in Tyra’s case, a reduction would actually be helpful. Still, she is terrified of what might happen.

Tyra and I talked about bonding. Going into her first pregnancy, she knew a lot about mood disorders and the possibility of not bonding right away. She can see that she did not bond right away with her daughter. When her daughter was a baby, she thought that she wanted to go back to her life before she got pregnant. When Desmond was born, Tyra felt like she bonded with him much more right away than she did with Madeline. But now, she is having regrets about having Baby No. 2.

I had a really tough time ending my interview with Tyra. I wanted to keep her on the phone and keep talking and talking until she felt better and had some sort of magical epiphany that resolved all her anxious feelings. I wanted so desperately to use my words to cast some sort of magical spell that ended Tyra’s depression and anxiety. But in the end, I had to end the call, knowing that the best thing I can do is listen and share Tyra’s story.

Thank you, Tyra, for sharing your story. I could not have done what you did when I was in the depths of my postpartum hell.

Mirtazipane Weaning, Take Two!

Last year, I sloooooowly weaned off Zoloft. I have been off that anti-depressant since Christmas 2017. I also used to take Mirtazipane a.k.a. Remeron to help me sleep at night. I weaned off Mirtazipane in Fall 2017, no issues.

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But my anxiety flared up in February 2018 when I cut sugar from my diet. I ended up going back on Mirtazipane in March 2018 and have been taking 15 mg at bedtime ever since. (I also ended up returning to sugar because meh. That’s another blog post!)

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Today, I saw my psychiatrist and we decided I’m ready to try weaning off Mirtazipane again. Here’s the plan:

  • I take 7.5 milligrams at bedtime (half my usual dose) for two weeks.
  • Then, I take 7.5 milligrams at bedtime every other night for one week.
  • Finally, I take 7.5 milligrams at bedtime every third night for a week.

And if all goes well, I’m done and off Mirtazipane.

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Here’s the thing: if I need medication to sleep, then so be it, I will keep taking Mirtazipane or whatever medication helps me get the sleep I need. Sleep is essential. For me, it’s non-negotiable.

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But if I don’t need Mirtazipane to sleep, then I don’t want to take an unnecessary medication. My gut tells me that I don’t need Mirtazipane. Also, my psychiatrist says Mirtazipane should knock me out right away, but I can take my dose at 8 p.m. and not go to bed until 10. The drug is probably just having a placebo effect on me.

A placebo effect, though, is still an effect.

So, we’ll see how this weaning goes! It’s another step in the constantly unfolding adventure that is my mental health.

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Episode 73: Rita’s Story

Hello! The podcast is back with another interview. I’m glad I did the audio version of my memoir, but whew, it feels good to be back to interviews.

I mentioned a couple of things during the show intro:

  1. In September 2018, Graeme Seabrook will be leading a coaching program for moms called Recovering from Recovery. It’s limited to ten women, so if you are interested, grab your spot now!
  2. I have just started reading Birth of a New Brain: Healing from Postpartum Bipolar Disorder, by Dyane Harwood.  I’m interviewing Dyane in a couple of weeks and after less than ten pages, I’m already in love with her book.

This week, Rita shares her story on the podcast. Her son is two years old. Right now, she is feeling pretty good, but she experienced some intense postpartum depression after her son’s birth.

Rita experienced depression before she got pregnant. During her pregnancy, she wondered how she could bring a child into the world if she was depressed. She felt anxious during her entire pregnancy.

After giving birth, postpartum depression hit Rita immediately. She had warned her obstetrician that she was worried about PPD, but her doctor did not go into any detail about what she should expect.

During her first months of motherhood, Rita experienced many symptoms, including:

  • constant crying,
  • thinking she had made a mistake,
  • not knowing how to care for her son,
  • thinking she should have a magic touch with her baby,
  • fear about leaving the house,
  • feeling nervous if she was with the baby alone,
  • and loss of appetite.

Rita did not know anxiety can be part of postpartum depression. She did not even know that her experience could be called “anxiety.”

Rita would wonder how she would feel if she did not have her son. She did not think she would miss him that much. She thought she would be okay without her baby. She also thought about abandoning him. Now she feels guilty for having those thoughts.

Rita went back to work after twelve weeks of maternity leave. Returning to work was a relief.

She started taking medication seven months postpartum when she ended breastfeeding. Her last pumping session, she felt bittersweet because she was no longer providing nutrients for her son.

Rita felt irritable. She didn’t like the way she felt. She looked forward to going back on the pill and feeling regulated.

After watching the documentary When the Bough Breaks, Rita wanted to help other moms. She started an occasional weekend support group in Arcadia, California. Attendance has been spotty, but still, I think it’s amazing that Rita is doing something to help women feel seen and supported.

Rita can be reached at wearestrongmoms@gmail.com. Thanks, Rita, for sharing your story!

Five Easy Ways To Be A Maternal Mental Health Advocate

You do not need any credentials or special training in order to be a maternal mental health advocate. If you want to volunteer for a specific agency or attend a program to learn more, that’s great! But if you want to fight the stigma of maternal mental illnesses, then you already have everything you need to be an advocate.

But where do you start?

If you have an idea of something you want to do, by all means, do it. Your voice and ideas are valuable and necessary.

But when I first started out on my journal as a maternal mental health advocate, I did not know where to begin. I just knew I had to do something. If you have the desire to be an advocate, but don’t know where to start, don’t beat yourself up. You are not alone. I had no idea what I was doing when I started! I had to fumble around and experiment and try lots of things before I realized I wanted to start a podcast and run a mom-to-mom postpartum support group. And even now, over four years into my advocacy, I still don’t always know what I’m doing. I just try different things to see what works.

In case you don’t know where to start, here are some easy ways to start your advocacy adventures:

  1. Hop on to social media and search relevant hashtags like #postpartumdepression. Hit the like button to show your support for the post. I love posting on Instagram about my postpartum experiences, and those hearts mean a lot. They inspire me to keep posting.
  2. Have you read any books that helped your recovery? Write a review! That helps boost the book’s visibility which in turn helps moms in the darkness find the resources they need.
  3. If and when you are ready, tell your social media followers that you had or have a maternal mood disorder.
  4. Tell your child’s pediatrician about your maternal mood disorder. Pediatricians see new moms regularly, but it’s not easy to bring up the subject of anxiety and depression. If you talk about your experiences with a pediatrician, you are helping them rehearse for their next encounter with a mom in the darkness.
  5. The next time someone you know has a baby, send her a private message and tell her you hope she is feeling well, but if she is ever struggling, you are there to talk.

But remember: only you know you, and your intuition already knows what you need to be doing. Listen to your gut and do what feels right for you. That is the best thing for your advocacy journey.