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.

Avocado

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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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.

 

Quick Personal Update

Hello! I have always wanted to blog more regularly about maternal mental health, and after publishing my memoir in April, I actually started doing that. But I am now in the process of recording the audio version of my book. I’m not doing a fancy-schmancy audio book (hopefully someday!) but I am sharing it FOR FREE on my podcast.

Today I uploaded Chapters 6 and 7. I just finished recording Chapters 8 and 9 and will post those soon.

I have so many things I want to blog about, especially tips and tricks for writing your postpartum story, but sigh, one thing at a time. So this week and next, I’m focusing on the audio version of my book. In July, I’ll turn my attention back to blogging.

Adventures with Postpartum Depression: The Audio Version

My book is now available as an e-book and paperback on Amazon (or check out the link for your free book on the homepage!) But I’m a podcaster. It feels like there should be an audio version.

I’ve never created an audio book. I did some research online and concluded: this is not the right time in my life to make an audio book. To make an audio book, I would either have to (a) spend thousands on dollars on production or (b) do it all myself, which would involve a steep AF learning curve.

I don’t want to do Option A because I’d rather spend the money on different things. Sorry not sorry. I’m a writer and I’m writing my first fantasy novel, so my next major expenditure will be on an editor for that project.

Someday, after I have made money as a writer and podcaster, I will invest the money in a proper, formal audio book version of my memoir. But that day could easily be five years away.

So that leaves Option B, do it all myself, but I don’t have the time. Sorry not sorry. I have limited Me Time, and I need to use the time I have to do the things that fill me up. Right now, that means writing, lots and lots of writing, podcasting, exercise and the occasional pedicure or massage. Figuring out the logistics of creating an audio book? That would drain my energy, so I’m not going to spend my limited Me Time that way.

So that means no fancy-schmancy audio book, but hello, I have a podcast. So I have decided to record my book as a series of podcast episodes. Since it’s not a formal audio book, I’m just figuring it out as I go. I’m not rehearsing. I’m not re-recording any chapters if I stumble over the words. It’s just me reading my book out loud as best I can into my podcast mic. But I figure the podcast version is better than no audio version at all.

I have to admit that I spent months and months worrying about creating the audio version of my book. It’s so liberating to accept that the audio version is not in the cards for me (yet) but I can embrace imperfection and share the podcast version instead.

The Prologue and Chapters 1-3 are now available on the podcast, right after episode 72. Enjoy!

My Motherhood Superpowers

I love my book’s cover:

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The cover has a superhero vibe, but even though I named my podcast and book Adventures with Postpartum Depression, I must confess that I never thought about the superhero angle until my cover designer sent me this beauty. I know, weird. When I was writing my book, I always had in mind an adventure from a fantasy story like Lord of the Rings or Game of Thrones. But now that I have published my book with this cover, let’s pretend that I was always trying to evoke a superhero vibe.

I recently read the novel My Grandmother Asked Me To Tell You She’s Sorry by Frederik Backman. The protagonist is a little girl, and the little girl thinks about people in terms of superpowers. Like, so-and-so has a superpower of staying quiet when there’s nothing that can be said. Or, so-and-so has a superpower of giving hugs when hugs are most definitely needed. Ever since reading that book, I have thought about myself in terms of my superpowers.

Or, more accurately, I think about my non-superpowers.

Superheroes have powers, but they only ever have a few. Like Spiderman can climb up buildings but he can’t fly or make himself invisible. Iron Man has an ass-kicking suit and is ridiculously smart but he can’t breathe fire like a dragon. And the Hulk can use his rage to good effect but he’s probably not good at tasks that require a delicate touch.

I like to remember that as a mom, I’m a sort of superhero, but that does not mean I have unlimited powers. It means I have two or three strengths but otherwise, I’m just human.

These days, my superpowers are snuggling, reading books with my children, and hugging them when they are upset.

And these are some areas where I am decidedly human and non-superpower-y:

  • Laundry. Always amassing. Never conquering.
  • Tidying. No matter how many times I clear off the kitchen island, nature truly does abhor a vacuum.
  • Remembering what to pack for outings. I only survive with checklists. Checklists are my equivalent of the Batmobile.
  • Getting knots out of Pippa’s hair. This job requires magic provided by a special brush and detangler that my mom hunted down.
  • Managing sibling fights. I often hear them starting to get aggrieved but I rarely intervene in time. Oh well, they are learning about the art of social interactions.

I could go on, but I think you get the point.

The next time I’m beating myself up for being a lousy mom, I’m going to try to remember that even Batman has limited powers.

Anatomy of a Mother

Becoming a mother of two has changed my anatomy in some serious ways.

I used to have one stomach to feed. Now I have three. Except my brain only has a direct line to one of the stomachs, so I have to speculate as to the hunger status of the other two.

I used to have two feet. Now I have six, four of which are rather mutinous and like to run in all sorts of directions, especially if there’s a parking lot involved.

Let’s not talk about the miles and miles of intestines I have acquired. But we can talk about my three bladders, which all together, seem to have the capacity of a walnut.

I have three tongues, each with its own set of taste buds. My first tongue is an omnivore that loves all sorts of cuisine. My second tongue is an herbivore that subsists almost entirely on strawberries and crackers. My third tongue is a carnivore that comes running if there’s even a rumor of hot dogs.

I have six hands. It’s incredibly how I’ll be using two hands to clean up Mess #1 while the other four are making Messes #2-999.

I only have one third of a brain.

During the summer, I have enough skin to cover an American football field.

And my heart? I still only have the one, but it has doubled-tripled-quadrupled in size and feels love more infinite than infinity.

Despite its strangeness, I would not change one detail of my bizarre anatomy.

Courtney vs. The Chainsaw

Hello! As I write this, I’m at my parents’ house while my kids are at home with the babysitter. I thought I was going to record a new podcast episode and then start recording the audio version of my book. But no, the neighbors across the street are having their trees trimmed and a noisy chainsaw has interrupted my plans.

Seriously, every time I come to my parents’ house, there is either a chainsaw or lawnmower or some other mechanical monstrosity ruining my sanctuary of silence.

There’s a lesson in that, right? Right!

Life is uncertain. We can plan and plan and prepare until we think we have managed every variable, but still, we cannot control the universe.

I have a choice today. Choice A: I can let the tree trimmers’ chainsaw ruin my day. I can throw tantrums and call my husband and whine about the cruelty of life. Or, Choice B: I can be flexible, take a deep breath, and do something else. There’s a lot of things on my To Do list, so it’s not like the entire day is lost.

I have to be honest. For about ten minutes, I went with Choice A. I didn’t call my husband, but I did rant in my journal and then text my dad about the noisy tree trimmers.

Then I realized I was clinging to the river bank. Last year, when I was in weekly therapy, my therapist and I often used the metaphor of a river to talk about life. I realized that when I cling to the river bank, and resist the flow of the river, my energy clogs up and I feel generally miserable. When I let go of the river bank and surrender to the river’s flow, I enjoy my life and discover that things that seemed like catastrophes – e.g. the tree trimmers across the street – are actually little serendipitous blessings in disguise.

So now I am on Team Choice B. I am no longer clinging to the river bank and have instead climbed into a sturdy inner tube to enjoy the journey. Who knows what will happen today? I didn’t plan for it, but the journey is much more exciting when I let the river show the way.

 

Gift Ideas For A Mama With Postpartum Depression

Postpartum depression is the most common complication of childbirth. Even if you yourself feel great after giving birth, chances are very high that you know someone who will experience a maternal mood disorder.

Let me be frank: as a human being on Planet Earth, you already know tons of women who had postpartum depression, anxiety, OCD or some other fun maternal mental illness. Thanks to the stigma of mental illnesses, most of these women will conceal their diagnosis. Many of them will also never seek help and never receive a former diagnosis.

But let’s say you know a mom and she tells you that she has postpartum depression. Or, you hear it through the grapevine. and it’s public knowledge. And let’s say you want to do something nice for said mom. If you live near said mom, then there are lots of things you can do to help: bring a meal; take the baby out for a walk; or take mom to get a cup of coffee so she gets out of the house.

If you live far away, though, you might want to send a gift as a token of your support. But what?

  1. Flowers. Simple, beautiful, and touching. After I was hospitalized for postpartum depression, my Aunt Nancy visited and brought me flowers. The visit and flowers both meant a lot. I knew I was loved and knew someone was rooting for my recovery.
  2. Art supplies! When I was hospitalized, I discovered that art therapy energized me. My husband Nathan bought me crayons and coloring books so that I could continue the art therapy after my discharge. The fact that he bought the art supplies showed that he wanted me to continue doing things that helped me feel like my best self. Coloring books and pencils probably work best. No need to overwhelm mom with something elaborate or messy.
  3. A book about postpartum depression, such as Postpartum Depression for Dummies or my memoir Adventures with Postpartum Depression. Moms with postpartum depression often feel guilty about spending money on themselves, but they need information and stories to make a full recovery.
  4. A gift card for a local meal delivery service. Or, if you know what her favorite restaurant is, a gift card from there. Cooking dinner is overwhelming with a newborn. Throw in a bout of postpartum depression, and it can feel impossible.
  5. A notebook and pen for journaling. Writing is so therapeutic.
  6. A fancy fun To Do list, like this one. Postpartum depression zaps mama’s brain. Keeping lists helped me stay sane. I also felt an enormous wave of satisfaction every time I crossed something off my list.

Does a gift sound like too much work? Send a card! The cards I received when I had postpartum depression were very encouraging and helped me get through the darkest months of my life.

Ten Lessons Learned From Two Years of Podcasting

My podcast recently celebrated its second birthday! Looking back over the past two years and seventy-one episodes, these are a few things I have learned since starting my podcast about postpartum depression and maternal mood disorders:

  1. People from around the world are interested in postpartum depression. I have had listeners on every continent (except Antartica). (Penguins don’t listen to podcasts.]
  2. Dads want to learn about postpartum depression as well. I’ve only had one male guest so far (Tyler, Kaleena’s husband, way back on Episode 17), but I have been contacted by several male listeners. Guys, I know you are out there and I know you are listening. Whether dad has postpartum depression himself, or his loved one is struggling, the men need our help as well.
  3. Our stories are of vital importance!
  4. Everyone has a unique adventure.
  5. And yet, there are so many similarities between our stories. We truly are not alone!
  6. Don’t record interviews on your front porch at night, unless you want a cricket to be the star of that episode.
  7. What works today may not work tomorrow. My schedule is constantly evolving. I keep changing the way I do the podcast. It’s a work in progress.
  8. If you feel the call to do something, just start. Don’t wait until you are certain that you will be a perfect success. You will learn from your mistakes.
  9. Tangents are magical.
  10. It’s okay to take breaks. There’s this idea in our modern world that once you start building a following, you have to relentlessly keep going. Blog every day. Produce  two podcast episodes every week. Don’t take a break from Instagram or you will become irrelevant. But this is real life. If you need a break, honor that need and take a break. The people really interested in your work will still be there when you return. I’ve been doing this show for two years, which means I should be at Episode 104 or so, but I’m “only” at 71. That’s okay! The listeners are still there! And I’m still doing the work for all the future moms who will one day stumble on this show at two in the morning during yet another breastfeeding session.

And that’s ten lessons, but I have to share one more: I love all of you! It’s true, I really do.  Every time I put a new episode into the world, I feel a deep sense of love for everyone who might need to hear stories about maternal mood disorders. I know I have helped lots of people by starting this show, but you have helped me become a more loving person by listening. Thank you.

So now that I have been doing the show for two years, will I continue this adventure for two more? Hell, yes! Next up on the show: I’ll be doing the audio version of my memoir. Because why release an expensive audio book when I can just share it on the podcast?