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.
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.
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.
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.
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.
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.
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.
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.