Prison: Bipolar and Postpartum Depression

Bipolar Disorder and Postpartum Depression
You do not love them enough. You are incapable of caring for them. They deserve a better mother. You should leave for their sake.
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My entire body shook as I sat in the corner of my closet, in the dark, listening to the cries of my newborn twins.  Each hungry wail was like a razor blade slitting into my skin and I wrapped my arms around my chest tighter and tighter, moaning in pain, desperate to hold myself together.  I visualized myself running out the front door and down my neighborhood street, with the lifesaving heat of the sun on my dying skin, and only the sounds of birds chirping and passing cars in my ears.   But, I remained in my corner with clothes hanging in my face, clinging to the last stubborn shreds of maternal instinct that held me in my place.

One baby’s wails became breathless, and I knew his cheeks would be turning red.  The other, the more patient one, whimpered in between cries, as if begging me to come to them.  It was the same pattern I had learned to dread over the past four weeks, and it was always followed by a new inner voice that haunted me, louder and louder with each passing day.

You do not love them enough.  You are incapable of caring for them.  They deserve a better mother.  You should leave for their sake.

It was the voice of exhaustion.  It was the voice of utter despair.  It was the voice of fear.  But, I was in my dark place of escape and somehow began to feel safer there.  And as I sat there in my self-fashioned cocoon, curled into myself, another, weaker inner voice emerged, and began to argue with the first one.

You are their mother.  They need you so much.  They are helpless.  You have to get up.

As I released my arms from around my chest, I tried so hard to listen to the new voice and let it get louder and louder, drowning out the voice of fear.  I pictured my tiny boys lying in their crib, side by side, stiff with their own desperation, innocent victims of my own terror.  As I tried to muster the strength to stand with my burning and exhausted muscles, their wails ceased.  The silence sent an immediate bolt of terror, not for myself, but for them, through me.  I ran to their room afraid of finding them dead. 

When I reached the nursery door, I saw my three year old daughter standing on a stool, leaning over the side of the crib.  She was still in her night gown, though it was two o’clock in the afternoon, thanks to my neglect. 

“Hi, babies.  It’s okay, babies,” she crooned in her little voice.  Angry sucking sounds came from the crib, and when I peered inside, I saw the pacifiers in their mouths.  A flood of feelings washed over me, reviving my brain, depositing it back into this world of the living.  I exhaled relief and love, but the ever-present ball of anxiety and resentment and guilt spun in my gut.  She smiled at me and touched my cheek, just like I had done to her many times before, and said,

“It’s okay, Mommy.  I know you’re tired.  I can be a helper.” 

My tears flowed and, though my body still screamed from exhaustion, I swallowed her in a hug.  I realized that I had done something right with her.  She loved me because I had loved her and cared for her the right way.  Maybe I could do the same for my new babies.

The babies lay in front of me with tightly clenched fists and groaned as they sucked on their pacifiers.  They were beautiful, sweet babies, but I cringed at the sight of them still.  Their need overwhelmed me.  But I told myself I could care for them.  I willed myself to.  So, I scooped them up, one in the crook of each arm, took them to my bedroom, and propped them on pillows.  I settled into the bed and nursed them simultaneously.  The sensation of their tiny fists holding my breasts was difficult to tolerate at first, but eventually I could feel my body relax into the rhythm of their sucking and the softness of their bodies.  I realized I loved them intensely and needed to get better for them.  I vowed at that moment to get professional help. 

My mother came to stay with us to help me and the first thing I did was to leave the children with her and visit a psychiatrist.   Not surprisingly, he diagnosed me with severe postpartum depression, and put me on Xanax for anxiety and Zoloft for depression.  I revealed to him that I had experienced bouts of depression as a teenager, and mild blue feelings after the births of my first two children.  He explained to me that postpartum depression can become more severe with subsequent births, and that I should feel better soon with the drugs.  I did for several months.  I was able to enjoy the scent of baby lotion on my babies’ skin after bath time, and enjoy watching them babble and learn to sit, and crawl, and walk.   Then the depression returned, again and again.  When I talked to my doctor about the severity of my feelings, he patronizingly upped my medications, and patted me on the hand.  The episodes continued.   Over a period of the next three years, the worsening depression would become punctuated by bursts of energetic or irritable moods.  I was unpredictable and impossible to live with.

When the twins began preschool, the mood swings swung like a pendulum faster and faster and I vacillated between energizing shopping sprees, days of suicidal feelings, and periods of anger and irritability with the world.  I subsisted on Starbucks coffee during the day and glasses of chardonnay at night.  Twenty-five pounds dissolved from my petite frame over a four month span.  Near the point of requesting hospitalization, I found a new psychiatrist.  This new psychiatrist did a comprehensive mental health history, both personal and familial, and treated me as more than just a moody woman.   He connected my condition with aunt’s bipolar disorder and my mother’s long term depression, and regarded me with dignity and respect.

My diagnosis was bipolar II disorder.  Unlike bipolar I, in which patients exhibit extreme mood switches that cause grandiose feelings when manic, and sink deep into depression during low periods, bipolar II disorder was a milder form of the disorder.  He explained to me my postpartum depression was possibly a precursor to my bipolar disorder, or that perhaps it just sparked more intense symptoms in an already existing condition. In either case, my condition needed to be addressed differently from simple depression. 

I stopped taking antidepressants and began taking Abilify, which was a drug specifically for my condition (bipolar depression).  I became hungry again.  I wanted to play Candyland with my children again.  Joy came to me from simple things like going to dinner with my husband, and winning a tennis match with my new tennis team.  I felt like I was transported to a new reality, where I was paddling my way across a calm ocean with the rest of the people I knew, instead of being whipped around in the waves while they watched me flail.

In the nine years since my diagnosis, I have still struggled with my disorder.  Periodically, I will experience weeks of hopelessness or anxiety, or unpredictable surges of giddiness or irritability with my children.  I have been through some of the most trying times any person can experience, and these times have indeed exacerbated my symptoms.  I have lost a parent, been on the verge of divorce, had a fifth baby, and filed bankruptcy.  But because of my doctor’s vigilance and my own self-awareness, we are able to adjust medications, and change coping strategies to get me through those times.

As a mother of five children, I have learned the value of taking care of myself so that I can take care of them.  The twins’ adolescent attitudes and constant fighting with one another exasperate me, and I do get overwhelmed with the stresses of raising a large family.  However, with the help of my doctor, I am in a good enough state of mental health where I can treasure the good times.  Because I know I am not just “crazy”, that my condition is a valid disorder with a name and a way to control it, I have let go of my guilt for how I felt about my twins when they were babies.  But, because I always have the shadow of my condition hovering over me, I will never forget it.  


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