Tuesday, July 1, 2014

Postpartum Depression After Twins

Megan contacted us recently and asked if she could share her postpartum experience.  She mentioned our scheduling posts make life with twins look rather easy and (very politely) reminded us that's not always the case.

She's exactly right.  Amber and I have each faced difficulties along the way, but neither of us experienced postpartum depression.  We knew it was common and a topic that needed to be addressed, but we weren't sure where to begin.  Fortunately, Megan's email came at the perfect time and she was able to beautifully capture a difficult time in her life that is now a distant memory.

We know you will find her post as inspiring as we did.  We're grateful she was willing to take such a personal experience and share it with Twin Talk readers with the hope it may help someone else.

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As most new moms would agree, life with a newborn is tough. Life with two newborns and a toddler is REALLY tough. I knew my world would be very different after we brought our two precious baby boys home from the hospital, but I didn’t realize how different it would be.

Rewind a bit to my twin pregnancy. It wasn’t exactly an exciting, wonderful time for me and my family. I had been diagnosed with an incompetent cervix in my first pregnancy and delivered my son Kaleb at 28 weeks. He spent 74 days in the NICU and I was willing to do whatever it took to ensure my twins did not meet the same fate. After taking every possible precaution with the twins, including a cerclage, pessary, and nearly 16 weeks of bedrest, I was able to make it to 35 weeks 2 days before my beautiful little guys were born.

The last selfie I took before the boys were born

Max Charles was born on November 29, 2013 at 4:12 pm weighing 4lbs 15oz and Mason Keith followed shortly after at 4:21 pm weighing 5lbs 3oz after nearly 24 hours of labor. They were born on Black Friday and we all joked that they were our Black Friday BOGO special! They were incredibly healthy and didn't need any respiratory support. We only spent six days in the NICU so the boys could learn to eat and receive some jaundice therapy.

First exhausted mama selfie with my boys - Mason (L) Max (R)

Mason Keith and Max Charles

Heading home from the hospital at 6 days old!


The day we brought the twins home, I realized I was walking into total chaos. I had been functioning on pure adrenaline for the entire week the boys were in the NICU, not really paying attention to my surroundings at home. As I looked around, it was apparent how unprepared we were for the boys. We didn't have a cute nursery, or organized dresser and closet space. We were so focused on getting through the pregnancy that we hadn't gotten anything together. During the four months I spent in bed, my house had fallen into ruin, my almost 3-year-old toddler had grown accustomed to months of limited discipline, I couldn't find a single item of clothing (aside from pajamas) that fit my new, saggy and HEAVY postpartum body and my muscles were highly uncoordinated from months of atrophy. Basically my life was a mess and now I had two new babies to figure out how to care for!

Baby Burritos


Kaleb meeting his brother Mason

The second day home with the twins, I woke up in the most horrific pain I had ever been in in my life. I rushed to the ER and begged for mercy, or at the very least some pain medicine. It was determined I had a uterine infection and I would have to be readmitted to the hospital for three days of heavy antibiotics. During our stay at the hospital, my boys were allowed to room with me, but I was unable to work on breastfeeding as I was barely able to sit up. I pumped as much as I could and my husband and I tag teamed bottle feeding. Despite being in the hospital, and doped up on copious amounts of drugs, it was kind of a nice respite to the chaos that was awaiting me at home - where real life would continue.  I had to just dive in and figure things out.

Pathetic hospital selfie

I was pretty proud of myself as I was able to manage my three kids for the first several weeks after my husband’s return to work. I started to get my house in somewhat working order. I was working on discipline with my toddler, and we were trying to find activities, other than the iPad, to occupy our days. After my stint in the hospital, breastfeeding had become impossible. I could not get either baby to latch and they would just SCREAM every time I tried. The thought of breastfeeding became so stressful that I just decided it wasn't worth it and began exclusively pumping. For about six weeks I carried on with a bit of a routine; pumping and feeding the babies and putting them back to sleep in their swings, playing with Kaleb, and doing a bit of housework when I could find time. This twin thing wasn't so hard! I was getting the hang of it! Then… the twins “woke up.”

One month old baby boys - Max and Mason

Handling all 3 with ease in the early days - a walk to the park

One day, when the boys were about two months, a switch seemed to flip. They wouldn't go right back to sleep after a bottle anymore. They started becoming aware of their surroundings and spending more time awake. In the evenings they began screaming endlessly. They always seemed so uncomfortable and sometimes their cries were so shrill it was obvious they were in pain. After about a week of our new reality, we took them to the doctor who determined the boys had reflux and colic. She recommended a different formula and probiotics to aid in digestion. We were also prescribed medicine for the reflux. Even with the changes, the boys would scream for hours on end. Days became unbelievably stressful as I could no longer count on the babies eating and going right back to sleep. They would spend a bit more time awake, but would then - probably because of their reflux - insist on being rocked to sleep. I started wearing one twin at a time in hopes of being able to still get some housework done or attend to Kaleb, and would pray the other twin would sleep for more than 20 minutes at a time.

My new life with twins and a toddler quickly became unmanageable. I would often have panic attacks as my husband left for work and beg him not to leave me alone with the babies. I would cry every time a baby woke up. I would lay awake at night anticipating a baby crying. I stopped napping because it was easier to stay awake than to start to fall asleep only to be awoken by a baby. No one had a schedule. Kaleb had returned to spending all day watching movies and playing on the iPad. My sanity was quickly waning. I was miserable and I hated being a twin mom. Any time I would see a pregnancy or birth announcement I would think, “Oh that poor woman.. why would anyone want more kids?” I started resenting my babies. Every time they needed something I would get angry.  I often thought, “Why did I decide to have more children? I was happy with the way things were.” I would cry and feel guilty for not being able to give Kaleb the time and attention he needed. I had missed him for four months on bedrest, and now I still couldn't spend the time with him I wanted. I would watch my sweet babies cry in pain after a feeding and feel guilty that I couldn't exclusively breastfeed. Suffice it to say, I was not handling things well and my mental state was very fragile.

After a particularly rough day - unshowered and still in my pajamas

Two months old - Mason and Max

As the days and weeks went by, things got worse. I was always angry. Not just a little angry.. I was ALL CAPS ALL THE TIME ANGRY. I determined it wasn't good for me to be alone with all three kids anymore and sought the help of my family. All of those who helped while I was on bedrest weren't too keen on spending more time helping out. They all reluctantly obliged me for a few weeks, but with two crying babies and an unruly toddler, the help started dwindling, along with my sanity. It was time to seek professional help - on all fronts.

I put in the call to my doctor who referred me to the clinic at the local hospital for women suffering from postpartum depression (PPD). I didn't think this is where I needed to go. I wasn't depressed. I was STRESSED and under so much pressure trying to run a household with two infants who cried all the time, a toddler who was unimpressed with mommy being spread so thin and taking advantage of limited supervision, and a husband who was spread just as thin as I was. Reluctantly, I decided to take the advice of my beloved doctor and go to a PPD clinic appointment. I met with a midwife who did an assessment and determined I was, in fact, suffering from postpartum depression. I mostly scored high in the “anxiety” portion of the assessment. I pretty much sat there and cried to the midwife and told her how stressed I was and how I thought I was failing my family. I was overwhelmed with guilt that I couldn't be a good mom to any of my kids. I hated pumping, but felt like I had to in order to give my babies the nutrition they needed. I was hardly sleeping because I was always worried someone would wake up if I closed my eyes. I stressed how much I loved my kids, because everything else I was saying seemed to contradict that. She assured me that everything I was telling her was right in line with a PPD diagnosis and that she was there to help. She knew first and foremost that I loved my babies and that was why I was seeking help.  I was so relieved. Someone who told me what I was going through was NORMAL -- especially for someone who had a less than easy pregnancy, babies in the NICU, and then re-hospitalized only to return to a less-than-prepared home.

I never felt like I was a normal twin mom. I saw so many twin moms effortlessly adjusting to life with two babies. Moms who were able to breastfeed without issue. Moms who were able to juggle their older children. I thought they were normal and I was just a failure. It felt good to hear that it was ok to feel overwhelmed and stressed and there was help available for moms like me. I was given names and numbers of people I could call if I needed to talk. I was given online tools and groups to join. I was also given a few prescription medications. I was asked if I would like to continue breastfeeding, and if so I could be given medication that was not transferred to my milk supply. Upon discussing it with the midwife, hashing out all my feelings of guilt and crying A LOT, we determined for the sake of my mental state it was better to stop pumping and to take medication for high anxiety. This was probably one of the hardest decisions I ever had to make. I breastfed my oldest and pumped until he was nine months old. To quit pumping before my boys were even 4 months old was brutal for me.

3 months old - Mason flashing a smile and Max was clearly unimpressed

Silly guys!

My husband took all three boys to my mom's for the night and let me have an evening to myself to process my appointment and mourn the end of my breastfeeding journey. I waded through a lot of the information the midwife had given me and decided that along with hanging up the pump, I had to get serious about getting full-time help with the boys until I was feeling better. I reached out to a really good friend of mine who gave me the name and number of her sister who had nanny experience. I called her immediately and she said she could come help for a few days a week in the mornings. Done. So with a few major decisions made, I slept through the night for the first time in four months, woke up and decided I CAN DO THIS - IT WILL GET EASIER - ONE DAY AT A TIME.

Brothers - priceless

After receiving my PPD diagnosis, it was like a weight was lifted off my shoulders. The more research I did, the more I realized SO many women face the same negative emotions and thoughts I had been battling. While it was normal to experience anger, frustration, and guilt, it was important to deal with those emotions and move on. Sometimes when I would feel some of those things begin to creep in my mind, I would stop and just breathe. Other times I would comfort eat. Yes, I was given permission by my doctor to comfort eat. It helped relieve the stress and I was able to tackle the next few hours. For me, quitting breastfeeding was one of the best decisions I made. My hormones almost immediately began to stabilize and it was like a cloud lifted off my tired brain and I started seeing things more clearly. The boys began to turn a corner as well. Maybe their tummies were upset by getting both breast milk and formula, but as soon as they became exclusively formula fed, they began to thrive. The colic episodes became fewer and farther between, their sleep patterns started to regulate, and they started smiling and laughing all the time.

Seeking help with my kids was also one of the best decisions I made. Not only did I have an extra pair of hands to rock a crying baby to sleep or help Kaleb with his latest play dough creation, I also had an adult in the house to talk to for a few hours a day. Just chatting about monotonous day-to-day things was unbelievably therapeutic. Getting outside when I could and trying to exercise also helped return me to a better emotional state. Reaching out and chatting with other moms who have been through similar circumstances also helped me a great deal. As the boys got older, things inevitably got easier. The stress became less and less as we fell into a better routine. My family and I were on the mend. I thank God everyday that I made that call to my OB and asked for help.

 "Things are looking up, huh Mom?" Mason and Max

"Yes, boys. Better every day!" 4 months old - Max and Mason

My 3 beautiful sons on Easter Sunday - Mason, Kaleb and Max

My twin boys are now seven months old. I am happy to say I have successfully been alone during the day with all three of my kids for two months now. Max and Mason are on a really good daytime routine. They are daily tackling new skills and growing so big! They are beautiful and just so much fun. My sweet Kaleb is now potty trained and has started going to preschool. We are all sleeping better. The babies have not had a single crying episode in months. We spend a lot of time taking long walks outside, shopping, going to the park, playing and just enjoying life as a family of five. PPD and the really tough first months with the twins is starting to become a distant memory. Life is good. I feel so blessed and am so in love with all these sweet boys I get to share my life with. They are an incredible joy and I am just privileged to be their mommy.

5 months old - Mason and Max

6 months old - so happy and so silly! Max and Mason

I wanted to share my story, not to focus on the negative or gain sympathy for what I went through, but to shed some light on the subject of PPD. 1 in 8 new mothers will experience symptoms of PPD.  Mothers of multiples and mothers who have had a baby or babies in the NICU are at a greater risk of PPD. If you are experiencing any of the symptoms I was, please know that it’s ok to ask for help. You don’t have to go through it alone.

I love this blog and read so many wonderful stories of moms making smooth transitions into twin mommyhood and getting into good routines early on. But every journey is different, and not all of them are easy. My story had a lot of bumps in the road, but I asked for help and was able to find my way back to smoother pavement. I wanted to share my journey in hopes that it would help someone who may be trying to navigate a path like mine.

If you think you may be struggling with PPD, ask yourself if any of these apply to you:

Feelings of anger or irritability
Lack of interest in the baby or resentment
Appetite and sleep disturbance
Crying and sadness
Feelings of guilt, shame or hopelessness
Loss of interest, joy or pleasure in the things you used to enjoy
Possible thoughts of harming baby or yourself
(Source: www.postpartum.net)

If you could identify with any of the items on this list, it could be time to ask for help. I started by contacting my OB and was referred to a clinic that saw mothers experiencing postpartum depression or anxiety, post traumatic stress disorder, or any other emotional changes that can occur during the antepartum or postpartum phases. I can’t stress enough that it is OK to ask for help. It was one of the best things I ever did for myself and my children.

If you are looking for online resources with information on PPD, support groups, local clinics etc, head to www.postpartum.net. This is a one stop shop for all things PPD and the site is amazing. Feel free to reach out to me if you need someone to talk to as well. I’m a twin mommy who has suffered PPD and I would be happy to help.

Little Brother Max, Big Brother Kaleb, Little Brother Mason

7 months old - Max and Mason

Mommy with Max and Mason - my sweet baby boys!

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If you have a question for Megan or simply want to send her a word of encouragement, CLICK HERE to email her.

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1 comment:

  1. Thanks for sharing your story. Your boys are all adorable! I also had PPD and ended up on medication. Once I got help, I asked myself why in the world I waited so long. My breaking point was one midnight with both babies awake. Neither would go back to sleep and I had to be at work the next morning. I called in sick and called my OB's office. They told me my dr was out and I told them this is an emergency, I will see anyone. Thankfully, my appointment ended up being with the dr that delivered my first baby. I sat and cried about all that was wrong and he just listened and agreed that I had a lot to be overwhelmed with. He prescribed me some meds and referred me to counseling. My twins are almost 2 now and I am no longer on the medication. It can still be overwhelming at times but I think I have learned to cope with it better and I try (i stress the word try) to be proactive by having a schedule and just being more organized in general. Plus all of those hormones are finally gone.

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