Duet of Screams: PPD at the End of the Century

At PSI, we understand that storytelling has the power to save lives, and we are honored to provide a space for survivors to share their stories. This article is part of a subsection of the PSI blog dedicated to survivor stories. Please note that this story has not been edited, and caution is advised as distressing themes related to perinatal mental health may be present. If there are specific trigger warnings for an article, they will be listed below. Links to resources can be found at the bottom of this page.

By Kim Leisner Korevaar

In 1998, I was happily married to a kind, attentive man living in a well-to-do county in Northern California. As I aged deeper into my 30s, we turned the corner from romantic newlyweds to trying desperately to have a child. After two miscarriages, we finally conceived a healthy little girl. We were both thrilled. He attended most OB visits, videotaped my ultrasounds for later reviewing, and took videos of my tummy every Saturday. Labor came quickly. We rushed to the hospital, breaking every speed limit as I screamed in tremendous pain. I was at 8 cms 45 minutes later. An hour after the epidural, Hannah slid out. It was the highlight of my life…

The shock of new parenthood

When we got home, I quickly realized that my loving feelings of wanting a baby had nothing to do with actually knowing how to take care of one. Hannah cried. A lot. She spit up constantly and arched her back while drinking. She seemed in pain as if telling me she was unhappy with me as her mom and that I wasn’t doing it right. Lots of times she didn’t cry alone.

Insomnia

Her dad and I decided to tag-team night feedings. I took the 10 pm and 2 am shifts. He took the midnight and 4 am shifts. The problem was that after I nursed at 2 am I could not fall back to sleep. I worried about not being able to hear her cry (my head was next to the monitor), I worried that I would not be able to sleep, I dreaded being alone with her the next day, and I felt guilty (her dad told me I was wasting precious time when I had the time to sleep and didn’t use it). During the day I could not “sleep when the baby sleeps” ever. After three weeks of sleeping two hours per night, I seriously considered making a run for it. My mom tells me it was during this period that I called her up one night and asked her to adopt Hannah. My parents intuited something was very wrong, which set my dad on an investigation.

Effects on my marriage

The demands of new parenthood need no explanation. Like most new parents, we had no time together where we weren’t fighting fires. The changing, the crying, the feeding, the lack of sleep, and the disruption to our practiced routine went front and center. In our case, my crying jags, impatience, panic attacks, and “losing my vocabulary” made us argue more than ever before.

Before Hannah’s birth, I had been a writer and editor. And fairly articulate. Or, at least, adequately so. After her birth, I suddenly couldn’t remember the word for “fridge” or “shower” or “sandwich.” When I started to speak, words would elude me, leaving me grunting instead. The smallest decisions, like “grilled cheese” or “tuna,” would make me scream, “I can’t tell you that!!!”

Hating my new life

When I was alone with Hannah her crying made me anxious, sweaty, and full of rage – that I directed toward her. “Why are you crying?! What is wrong with you?” I would call my mother and sob, “I am a terrible mother! If I knew what I was doing she wouldn’t cry. She doesn’t like me. She knows that I am not her real mother!” I continued, “I don’t know how to be a mother!”, to which my wise mom responded, “Well, that’s OK. Hannah doesn’t know how to be a baby.”

I hated my new life. I was feeling things I never anticipated. These included:

Not wanting to be a mother; not liking it
Not sleeping
Feeling that Hannah’s dependency is so total I cannot care for my own basic needs of eating, drinking, or sleeping
Having no time for myself; feeling like I’m going out of my mind
Experiencing chest pains
Obsessively worrying that harm would come to the baby if I ever physically let go of the stroller or car seat in a public setting
Realizing to my horror that I’m not cut out for all this work
Constantly wondering why: Why don’t I want to take care of her? Why don’t I melt in love like the others? Why don’t I have a connection with this person? Why isn’t this fun?
Not knowing who I am anymore
Feeling duped by Hollywood into believing caring for a baby was one giant, easy lovefest – especially the scene in “Tootsie” where a gorgeously lit Jessica Lange smiles into her baby’s eyes as her daughter adoringly reaches up and touches her mother’s face
Believing without a doubt that my body – including my head, memories, personhood, brain, and spirit – had transformed into a giant feeding arm

Was a new baby group the answer?

I joined a new mother support group when Hannah was three weeks old. These new moms seemed to have it all together; some even wore make-up. They talked about how great new motherhood was. They described their deep intimacy with their husbands and how much joy nursing gave them. In place of these gushing and love-filled feelings for me was a crater of dread, fear, and shame. I felt that I had made the biggest mistake of my life and ruined everything by having this baby. I admitted to this group how awful and confused I felt. The facilitator told me that this was why Hannah cried so much, that she was “picking up on my stress.”

(The memory of this statement still makes me angry. What occurred to me when Hannah was just about a year old was this: Why did everyone say when she cried, “She’s picking up on your stress”, yet when she smiled, nobody said, “She’s picking up on your joy?”)

Soon we new moms “graduated” to meeting at one another’s homes. One time the moms asked me to take Hannah into another room because she was crying. Soon after, they told me not to come back.

PPD diagnosis

My postpartum behavior mystified my parents. My dad searched the Internet for explanations and snail-mailed me information about PPD. He located a therapist in my region who specialized in it.

Shoshana Bennett of Postpartum Support International called me and she spoke (I sobbed) for a short time. She assessed me, asked me to come see her immediately, and encouraged me to attend bi-monthly support groups at her office. In my very first group, I heard vulnerable moms express their despair, exhaustion, and sad thoughts for the future, validating everything I had felt.

A small window opens

Eventually, the groups, individual sessions, and medication (Zoloft for depression, Ambien for sleep, and Buspar for anxiety) helped me scratch my way out of the blackest hole. Shoshana had promised me tiny “windows” where I would feel like myself again – for me these would be quite short and maybe only happen once a day at first. Eventually, there would be more and they would last longer.

I went back to work part-time where I was surrounded by verbal and rarely crying colleagues and by work that I understood, could do, and could see results from. It was a reminder of the old, competent me. It also gave me a chance to “miss” Hannah, talk about her, and fall in love with her through the eyes of the people I spoke to about her.

Daily, I read my affirmations out loud that Shoshana wrote for me with my participation. When I didn’t feel like saying them or when I didn’t feel they did any good, I did it anyway, sometimes sobbing.

It’s essential that I take care of myself!
I’m taking good steps to get myself well!
It’s a strength to ask for help when we need it!
This is not a character flaw or a personality weakness!
This is more than a 2-person job!
I’m doing the best I can!
It’s important that I throw the guilt out! This is NOT my fault!
I’m looking forward to being able to enjoy my life!
I’m looking forward to reclaiming my body!
This is biochemical and it will go away!

What I didn’t do was read books about PPD in the first six months due to good advice from Shoshana. She said, “If you have the energy, time, and interest in reading, read something FUN. A good mystery, good trash. Use this time to escape.” Baby books made me feel guilty so she told me it was OK not to read those. I also watched “Friends” reruns painstakingly recorded onto VHS cassettes by my worried sister across the country.

It didn’t have to be this way

Another of Shoshana’s promises was that I might one day want to have another child. I thought she was out of her mind. But she wasn’t. Eventually and almost four years later, I delivered my son – this time thankfully avoiding PPD by following Shoshanna’s instructions to the letter. Once Jeremy was out of the toddler period and Hannah was in school full-time, I became brave enough to look back on Hannah’s newborn period with clear, rested eyes. From 20/20 hindsight, the writing was on the wall: I was at high risk for PPD before I ever conceived. All the risk factors were there:

Previous history of depression and anxiety: Check
Previous history of depression that needed medication: Check
Family history of depression: Check
Family history of PPD (my mother, upon seeing my despair, was reminded that that was how she felt when my brother was born in 1960, but she never knew there was a name for it): Check
Previous history of one or more pregnancy losses: Check
Lack of local family support: Check
Lack of babysitting support: Check
Lack of experience caring for a young baby: Check
History of perfectionism: Check
Previous reactions to sleep debt, including weepiness, hallucination, and inability to cope: Check
Lack of education about risk factors for PPD: Check

True, I thought there was a chance I could get a mild case of it because of past episodes of depression. But, because this child was something I wanted more than anything in the world, I thought that that certainty and love would somehow prevent PPD for me. My OB never discussed PPD except for an offhand comment to my baby’s father during a late pregnancy visit, “If she tries to put the baby into the toilet, give me a call.” I’m not kidding.

A pre-birth depression screening could have prepared me. When I look back, I am appalled that I wasn’t given a screening or survey. It wouldn’t have had to be complicated: just a few questions about history of depression, whether there was local family support, babysitting lined up, and a referral to a local psychiatrist and PPD specialist, just in case. Maybe there could have been points attached to each answer and the total would give my PPD risk.

My high score would have told me to prepare for this, so that I wasn’t left stranded, screaming and feeling like I should have never become a mom.

Twenty-five years later

As the kids grew up, I continued to find my way – writing, copy editing, planning vacations, and making plans. Eventually, their dad and I discontinued our marriage, which brought a whole new set of challenges and exciting choices. I am still profoundly affected by my PPD experience, which lends me compassion to new moms and less new moms. I try to do the little things, like opening doors to tired moms wheeling strollers and looking into eyes to tell new moms I don’t know, “You’re doing a great job. This is hard,” whenever I can.

That toxic new baby group? It was there that I met one of my best friends. After I was unceremoniously escorted out of the group, Lisa and I started getting together (with and without children) for the next seven years until I moved to Colorado. Today we are still very, very close; the stories we tell each other do involve the college-aged and young adult antics of our children, peppered among conversations about our parents aging and then dying, ourselves aging, the world at large, our marriages, travel, and the rich tapestry that is our lives.

Today I am the mom of Hannah, 25, and Jeremy, 21. They are thriving young adults who are finding their place in the world. Losing both my parents recently somehow deepened my relationship with my two siblings and lent a sweet and profound expanse to the joy I have found with my new husband.

Experiencing PPD, too, taught me about the other side of grief. The grief that comes with loss – of dreams, of how I thought it would be, my first marriage, my parents, my worries about my kids’ happiness (these never go away, I am told) – brings with it a sweetness of gratitude, of wisdom, the sweet that comes with the bittersweet.

And I have forgiven myself.