This update has been a long time in coming. Not because I have been avoiding it, but because this stage of life is really busy and this kind of writing takes my full attention. That, and I just don't know what to say or how to say it. I feel like I have enough to write to fill an entire book. The challenge is deciding which angle of this whole mental health thing would be the most helpful and encouraging to my readers.
I have been encouraged to hear many of you share your appreciation for sharing my mental health experience openly over the last year and a half. Several have been encouraged in their own struggles with depression and anxiety, others have thanked me for a better understanding of what their loved ones are going through, and still others just appreciate keeping tabs on me and knowing how to pray for us specifically.
My goal in this blog post is to share my full experience from the beginning to the present day. In the future, I have some other things I would like to share about what I have learned through the experience.
Without further ado, I will attempt to make a beginning. My story in the mental health department probably begins during my fourth pregnancy in January 2020. We had a lot going on during my first trimester, and toward the end of the trimester, I was feeling the blues. I just remember feeling sad quite a bit of the time. Once I got to the second trimester, I was feeling much better mentally and didn't really think much more of those previous hard weeks. In the outside world, COVID hit right around the twenty week mark of my pregnancy. It was one of the most relaxing, enjoyable second trimesters and stages of my life I've had. My mental health had no issues my second trimester.
My third trimester arrived in early summer, just when we were starting to get out in the world again. As thrilled as we were about being in church and with family and friends again, going back out in the world brought along a lot more challenges than anyone anticipated. My personality and upbringing combined with my pregnant condition were not a good fit for the transition. I have a very strong conscious, a strong inner obligation to do the right thing, a strong sense of duty and submission to those in authority, and a have a very sensitive spirit and intuition when it comes to how my actions and words are affecting others. In the past, these things all seemed to come together for good in my life. This time, these attributes simply did not work. No matter what I did, my actions were hurting and offending others. Even if I just tried to please the people around me, I didn't always feel like those actions were pleasing God who I ultimately wanted to serve. The inner turmoil added another level of spiritual isolation to my already physically-isolated COVID life. Most of you probably understand this battle, because I am guessing my struggles were not much different than the rest of you at that time on this troubled earth. But I do believe all these things helped pile up to my eventual downfall.
Looking back later at my third trimester, there were several nights, perhaps a couple weeks apart, where I could not shut down my mind to fall asleep at night. I would be up until the middle of the night just unable to turn off my thoughts and fall asleep. With what I know now, this is a symptom of anxiety. Obviously having trouble falling asleep a couple times a month is much less concerning than a more regular occurrence, but it is one of the earlier symptoms I noticed after the fact.
The next stressor toward the end of the pregnancy was that me and Matt had to be COVID and exposure and symptom-free when we got to the hospital to deliver, or I would be stuck in an isolated COVID room during labor with no husband. To add to the matter, it became standard procedure to test pregnant women for COVID at 38 weeks. At the time of everyone just getting back in the world and concern about the virus's rampant spread, this was stressful to me. I tried hard to let my family have a free social life after all the months of isolation, but I was anxious about COVID wreaking havoc on my upcoming labor. To be clear, I was taking very good care of myself health-wise and not at all concerned about how my body would react to the virus. The concern was having no husband at labor. I definitely started looking into home birth options, but felt like it was a little late in the game to get started down that road. Plus if I had COVID who would want to come to my house to birth my child anyway?!
As if pregnant women need one more thing to worry about, I thought a zillion times that month. I couldn't wait to get the baby into my arms and out of the hospital so we could go on with our lives and stop caring about COVID.
So, childbirth came and went, twelve days past my due date. We added our perfect little Keenan Duane to our family in August. He was an absolutely precious miracle. The labor started on its own and everything went well. It was the perfect natural birth experience I had always hoped for. We left the hospital the next day so we could bring our bundle home to share with his three older siblings.
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| Our first reunion as a family of six! |
Once the baby was born, I was ready to GO! Except obviously COVID stuff was dragging out and I still had my horrible strong conscious to deal with. And you know, the world wasn't getting out of its turmoil any time soon with the good ole' 2020 elections coming up and such. Church reopening and family gatherings were going great until COVID restrictions slammed back down again in November. Yuck. I hate reliving this as I write it again. But there isn't any sense in trying to block this wonderful year out of our memory because God did amazing things through all those tough times.
What I meant to say when I started the last paragraph is that instead of life being busy during pregnancy and then slowing down to an almost standstill after having a baby, this time around it was kind of the opposite. We had so little of a social life and so much isolation before the baby came that once he popped out, I was ready to just get out and be with people. It was my fourth child, I was taking good care of myself, and I felt pretty good afterward, both physically and mentally. The first two months postpartum actually went really well, believe it or not. I do remember a few hormonal tears being shed the first couple weeks, but seriously, that's just postpartum for you. Unless I'm totally clueless to what a normal postpartum experience is like. There are two things I remember crying about: 1. Feeling like I couldn't spend enough time snuggling my newborn because too many other people needed me, and 2. Disappointment that very few people came to visit the baby because of COVID. But as I said, postpartum hormones are very easily shaken and I wouldn't say there was anything happening yet that was out of the ordinary.
Since starting to have babies, I have always known that my mood needed a little extra TLC. I for sure got the baby blues with my first one, though I didn't recognize it at the time. My second and third postpartum periods went seamlessly. At some point I started taking vitamin D and B to help with my postpartum mood and energy. The fourth time around, my mood and energy were doing well after two months postpartum when I ran out of these two vitamins. I planned to restock and start taking them again, but got busy and distracted and didn't rush since things were going well. I didn't realize what those vitamins were doing for me.
We are now caught up to the end of October 2020. This is when the real excitement started.
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| October 2020 |
First up, the baby blues. Within a week of stopping my vitamin D, I could tell my mood was down. Obviously we all have good days and bad days, or even good mornings followed by rough evenings. That's just how life works. But when the sadness and loneliness stick around and it becomes hard to find enjoyment and see the bright side of life, the baby blues have arrived.
As with any low point in life, I expected it to get better with a little time. But the blues just became deeper and within a week or two I had changed my self-diagnosis from "the baby blues" to "postpartum depression." The things I remember feeling at the time were loneliness, isolation, very little energy, and just being really sad and emotional most of the time. I did get restarted on my vitamins after a couple weeks off, but the spiral had already started. Looking back, perhaps taking five times the normal dose would have been more effective. But I was still completely clueless about mental health at that point.
"Clueless." That was me. And that's what I don't want for you if my experience can be at all helpful.
The first time a thought came to me that something was maybe actually wrong was during a well-timed training Matt and I had for our foster care license renewal. The topic was the impact of pandemics on mental health, or something to that effect. At some point during the slideshow, there was a list of symptoms and warning signs of depression and anxiety. And most of those symptoms described what I was experiencing. We were both like, oh, that's what I'm going through.
But still, I thought it was something that would pass on its own once my body was back together and I could get a little rest, get some fresh air, exercise, eat healthier, etc. I wasn't real fond of the idea of going on medicine to treat depression because I didn't feel like it had been going on long enough to actually be serious. It had only been going on a couple weeks, after all.
Two weeks into the mood change. 2.5 months postpartum, mid-November 2020. Keenan was my fussiest baby so far. I am convinced a mother's stress and anxiety level during and after pregnancy is a huge indicator of how fussy her baby will be. Anyway, he was getting more fussy because I was not eating or drinking as much due to my mood (because I am the cook in the house and didn't have the energy to keep myself fed). He was never a great sleeper from the beginning, but by mid-November he was consistently getting up to nurse every two hours during the night. Which leads me to the next danger zone for mental health: sleep loss.
I have always been under the impression as a mother that I can get up and take care of my baby during the night and "fake it till I make it" the next day. And most of the time, our attitude does go a long way in determining how exhausted we feel during the day after not getting much sleep at night. Most of the time, the season of life will pass and the baby will grow up into a big boy and you will catch up on sleep again. When I don't get much sleep at night, I just try to keep my day as low-key as possible and don't expect to get a lot done.
However, I started running into a problem. It's called, it started taking mama an hour to fall back asleep after the baby was sleeping again. Before long, that hour turned into two hours. If anyone is doing the math, that means I had barely fallen back asleep before baby was ready to eat again. Which does not equate to much total sleep at night. And with an additional 4, 3, and 2 year old under my care during the day, I didn't have a chance to ever "catch up" on sleep. This issue escalated very quickly and within a week I was only sleeping an hour or less at night.
Around the time when the sleep problems started happening, the depression symptoms seemed to turn more into anxiety. I couldn't shut my mind down. Sometimes I was worrying about things, other times I was solving "problems," and sometimes I was just thinking about anything and everything. Eventually, my brain was overworking itself so much that I was walking around in a fog during the day, unable to focus on my household tasks or take care of my children's needs. I was so fogged over that my kids would be calling my name and pulling on my leg for awhile before I would even notice they were there.
I knew I needed help, so a couple days I asked others to take the older three kids so I could get some sleep during the day. Matt was still working from home, so he would also help with children so I could try to sleep. But no matter how much I tried, I couldn't fall asleep for a nap, either. My mind was so out of control.
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| Little boy loved his quality time with Daddy! |
We are now in the third week of November. I would say that Sunday was the lowest of the anxiety and depression stage, and on Monday the turning point began where it turned into mania. Mania is something I had never heard of from a medical sense. I don't know how most people picture mania, but I guess I mostly had heard it referring to people driving or acting like a maniac. Like wild and reckless, maybe? So to me, when mania started coming on, it felt like everything was getting better. Things were coming together, all of my relationships were getting reconciled, I was solving all of my life's problems and eventually everyone else's problems and all the world's problems from my little abode in rural Iowa. I went from being depressed and anxious to being full of enthusiasm and confidence. It just felt like my whole life had come to the most wonderful climax. Like, every single day was a new higher climax than the day before. My sleepless nights hadn't improved at all, and were in fact worsening, but I no longer cared because who needs sleep when life is this wonderful? Life was feeling great again and I was so excited about it.
A medical list of mania symptoms well-describes my condition that week: abnormally upbeat; increased activity, energy, or irritation; exaggerated sense of well-being and self-confidence (euphoria); decreased need for sleep; unusual talkativeness; racing thoughts; and poor decision-making.
Since I was being over-confident and talkative and making out-of-character decisions, along with not sleeping at night, my parents and husband were thankfully getting very concerned. By God's grace, I didn't attempt or consider anything dangerous, destructive, or completely inappropriate, but my self-restraint was certainly lacking when it came to conversations I was having with people. The end of that week is somewhat of a fog. A lot happened in a short amount of time because... well, that's mania.
Sometime around Saturday, the mania turned the corner into psychosis. That day is my first recollection of actually becoming delusional. My parents offered to take the kids for the day, but by mid-afternoon I was so emotional that Matt and I went up to my parents' where I completely fell apart. I was definitely ready for serious help at that point, at least to get something to help me sleep again. They called the doctor for me and transported me to the ER where I was admitted to the behavioral health unit. Since I didn't have my own mental health doctor yet, it would be several weeks before I could get in to see a doctor and be put on medicine unless I admitted myself to the hospital. And things were pretty urgent at that point.
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| Saying our fond farewells for the week in the emergency room. |
Similar to mania, I had no clue what the medical definition of psychosis was until the whole experience was over. My interpretation of psychosis is mania (or sometimes depression) that reaches the extreme where you may become delusional, hallucinate, and/or have very confused and disturbed thoughts. I was definitely excessively talkative and my thoughts were hard for others to follow. After doing my research, I do not think I was actually hallucinating at any point but was rather extremely delusional throughout the next week or two. The basic definition of delusional is when you are completely convinced of something that is untrue. Delusions result in extreme highs and lows of euphoria and fear. The euphoric times I experienced most of the time felt absolutely wonderful, but usually at some point in the evenings I would become very fearful of some sort of terrible doom, and those moments were horrible. It was a fear more horrific than anything that felt earthly, like demons were surrounding me or something. I never actually "saw" or "heard" anything that wasn't there, which would have been classified as hallucinating, but was fully convinced that a lot of big and unearthly things were going on, and that I was at the center of it all.
The hospital stay lasted five nights. Because of COVID restrictions, I was not allowed to have anyone with me the entire time, including my husband or my nursing baby. Talk about an anxiety-healing place to be {sarcastic sigh}. Looking back, I think being alone at the hospital was probably worse than anything for my mental health, but God was gracious as always. With the help of some Benadryl, I was able to get a good night's rest the first two nights before the doctor arrived and got me started on medicine (Seroquel) on Monday night. How come the thought of taking a sleep aid didn't occur to me two weeks prior?! I guess with how fast things escalated, I probably didn't realize there was a need for some sort of sleep medicine until it was too late.
They increased my meds Tuesday and Wednesday nights. The side effects of going on Seroquel were absolutely awful the first week, and really weren't that great for the first several weeks. By this, I mean the fifteen minutes after taking my medicine at bedtime resulted in a really strange, scary feeling throughout my body. Along with healing the brain, it is also sedative, so it would knock me out for the night. Once I got home, anytime during the night that I would wake up (which was a few times a night with the baby) I would find it almost impossible to move my body, and my speech would be really slurred. It did go away after a couple weeks once my body got used to it.
Thursday morning, the doctor let me go home. I was so excited to see my family and baby again! And grass...and trees and buildings...and sunlight...and hear music again. The behavioral health unit is highly secure and very bland as far as outside stimulation goes. And having a ban on visitors just worsened the blow. But my hospital stay was a very wonderful experience, don't get me wrong. I got to interact with the other patients throughout the day, and the nurses were absolutely amazing at going the extra mile to fill in the gaps when I needed my family around. God worked in so many ways during my stay and I wouldn't change the experience if I had the chance.
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| The sunset that night and for the next several months seemed so extra-beautiful... |
It is also worthy of mention that Thursday, discharge day, also happened to be Thanksgiving Day! I was still delusional the next few days, which was very hard for my family to watch, but being with familiar people in a familiar environment was so comforting and helpful for me. While I was gone, Keenan had been staying with my parents and the other three were with Matt's parents. We brought Keenan home with us and the three older ones stayed with grandparents for a couple weeks where we would visit them in the afternoons or evenings. Our community of prayer warriors kept us going through the next month. I didn't have to cook for several weeks due to people supplying meals, and the holidays were so enjoyable and relaxing because people just took over every obligation I had. Matt's work gave him a lot of flexibility with FMLA time so it was a unique, special quiet time of being together with just a baby most of the time.
With the medicine forcing me to sleep and slowing down and healing my mind, the delusionary psychosis state waned over the next week or so at home. I couldn't handle very long periods of stimulation without getting mentally exhausted and needing to lay down. Everything affected me differently, but I was pretty good at figuring out and communicating what I needed to calm me down. The other thing I remember about those first couple weeks home is Matt having to wake up with Keenan during the night to give him a bottle because my medicine knocked me out so much I couldn't wake up at night to nurse. Over time I was gradually able to wake up for all of the night feedings again.
Our timeline at this point is one week into December 2020. The other three kids made their way back home around that time. Being back to a little more of a "normal" routine with my children home was really helpful in getting my mind slowed back down and focused on something productive. At that point I still got worn out easily, so people were helping out with the kids every day and we still had meals being supplied.
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| It was such a joy to bring the children home again! |
It took until the end of December before I remember the mania being gone. I had an abrupt end to all my help when we got COVID at Christmas and were quarantined the next two weeks (at that time the three kids who didn't get sick had to quarantine an additional ten days). It was a really tough time. I had felt so much support over the past month and had been getting so much help, but when quarantine hit I felt very overwhelmed to suddenly have the full responsibility of four children and a household back on my plate again. Thankfully my family also had COVID (our Massner family Christmas turned into a mini super-spreader event), so we did get some help and social interaction from them during those couple of weeks.
It was January of 2021 by the time I got out of quarantine. By then, the mania had passed and depression had settled in hard. Getting out of the house and being with others again helped, but the next two or three months were plagued by bouts of depression as my brain continued to heal and make its way back to where it was before.
What did depression feel like to me over those months?
Hopelessness. I felt very sad and hopeless most of the time. I did not find fulfilment or enjoyment in my daily life. I had little energy and my brain had trouble focusing and thinking clearly. I had no will to live. I never considered taking my life or hurting anyone because I did not want to forsake my God, but I spent a lot of time wishing He would let me die. As I drove down the road, I felt like I wouldn't have the will to survive if I did get in an accident. I wasn't convinced that my children and husband were better off with me alive.
Brain fog. Some days I would be struggling and know I needed help, but my brain would fog over and I wouldn't be able to think straight enough to know who to ask or how to ask or what I even needed help with. Everything just seemed so big and overwhelming and I couldn't think straight. And I would just sit there and cry in my helplessness.
Anxiety attacks. These kind of went along with the brain fog. Suddenly I couldn't think straight and would freeze up and panic about the pettiest things. I would just stand there shaking and eventually start crying and hyperventilating until someone (namely, Matt) came to my rescue to calm me down. The worst attack I remember was getting dressed to go to church one evening. As a busy mom of four, I normally put very little effort into my outfits, but this time the decision of what to wear got so overwhelming that I had a full blown anxiety attack right there in my closet. It sounded silly, but life could become quite a nightmare.
Things gradually improved - the intensity of the depression, the length of episodes, and the length of time between episodes. I remember my last bout of depressive symptoms happening around the beginning of March. I had observed that it usually let up for a few days to a week before returning, so a week later I was bracing myself for the next rough spell. But, praise be to God, it didn't come back. That is, not in an obvious way that I could distinguish from normal hormones and mood swings.
From there, the next phase of my journey was weaning from my medicine. Since the event seemed to be a postpartum experience, and not a permanent mental health issue, the plan from the beginning was to be on medicine until around one year postpartum. I was doing well in April and May, so we went forward with weaning in June and July. I did not notice any changes when we initially cut the meds in half. After the first week of July, we stopped completely. I felt a little shaky mentally for the first three weeks - some mild blues and anxiety - which made me worry I wasn't going to be able to stay mentally stable without medicine. But by early August, at one year postpartum, I was feeling more steady and "normal."
And I was also pregnant again, ready or not. I didn't know it until late July after I had finished weaning from my medicine. So, it was again difficult to distinguish hormones from mood problems! Obviously by this point, I was (and still am) on high alert for any signs or symptoms coming from the mental health department. It seems since then, things have remained manageable and stable for the most part, so I do think we are doing well.
Along with a whole world of new knowledge and experience, I do have a few tools under my belt that I didn't have before. For one, high doses of vitamin D help get me back on track if I start having issues with sleep or anxiety. It seems like vitamin D takes a few days or perhaps a week or more to start having a major effect, but does seem to be the best long-term solution. Second, since weaning from my medicine I have also kept a natural sleep spray on hand for nights when my mind seems to be racing and it is taking me longer to fall asleep. With everything I've been through, I don't let myself lay in bed for much more than 45 minutes before pulling out the sleep spray. I think the main active ingredient is melatonin. Between being pregnant and not wanting to become dependent on anything, I am pretty conservative with using it very frequently, but it has been helpful. Third, I have a CBD oil rub on hand that I have used a few times when I am getting really stressed or anxious. Again, the pregnancy unknowns with this solution makes me hesitant to use it very often, but I do feel pretty confident in its safety and the promise it holds for helping those with mental health conditions.
I have been seeing a mental health doctor regularly since getting home from the hospital last November. The checkups probably would have become much less regular once I finished my medicine, but by then we had begun another pregnancy, so we have continued having monthly appointments. This way we can monitor my pregnancy and prepare a plan for this upcoming postpartum season.
What does the prognosis look like for me after having postpartum psychosis? Mainly, I am at very high risk of another episode with my future postpartum periods. According to my research, each time I have a baby in the future there is a 1 in 2 chance that I will experience postpartum psychosis. Thus, both my mental health doctor and midwives are taking it seriously. They plan to start me on medicine again towards the end of my pregnancy and keep me on it for a few months postpartum to help prevent psychosis from happening again. This time we are going to try a different medicine that hopefully won't have the sedative side effects of Seroquel like last time, so I am optimistic about that.
I will say that it has been difficult for my natural-method-preferring-self to accept going on medicine again. Taking medicine just felt like a curse last time around, so when the doctor first mentioned going back on medicine, Matt and I were both very turned off by the idea. But we have been prayerful about it and we are feeling more peaceful. Maybe in another pregnancy in another stage of life where I don't have five children aged six and under, and can actually think about taking care of myself once in awhile, it may be a better time to consider trying to use more natural methods of keeping psychosis away. But for now, medicine is seeming like the safest and wisest option so that I can focus on being here for my children and husband and keep up with the increasing demands of a growing household. Our prayer request now is for a smooth postpartum experience with no mental health issues, and that we will feel peaceful about our decisions! (While you're at it, we of course are praying for a healthy, happy baby and a smooth delivery!)
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| Baby number five...coming soon! |
And that brings you all up to speed with where we are standing on the subject today. I wrote all of this with the risk of over-sharing, but have felt led to share my story for a long time. I share in hopes that my experience will encourage others - whether it helps someone who is heading down the same path to seek help early, or those of you who know you are struggling and just need to know you are not alone, or if I can help enlighten the rest of the population about what is going on when people are struggling with their mental health. If nothing else, perhaps it gave you something to do for an hour while you were waiting for your pot of soup to finish simmering on the stove (what am I saying...are there really people out there who have a calm house for the hour before supper?!).
As I mentioned at the beginning, I do have plenty of other thoughts to share regarding the things I have learned in the past year and a half, but they will have to wait for another day.
Thank you for reading and caring! It means so much to have each of you in our lives and God has blessed us so richly with your love and support!
