The clock reads 2 am.
A baby cries.
I startle awake, jack-knifing out of bed to run to the twins bedroom. Exhausted and overwhelmed once again.
This time, it’s Eva who needs her pacifier, a quick pat to soothe her back to sleep. I go through the motions, barely awake and yet totally wired. It is the 24th time I’ve woken since I fell asleep at 9 pm.
I fall back into bed, knowing it will be Mario’s turn to stir me soon. They are seven months old; what I don’t yet know is that this cyclical insomnia will continue until they are two years old.
Even after the babies finally began to sleep better; after I survived the teething period, I continue to wake every few hours. My brain hears babies crying all the time now, even when they are both fast asleep in their cribs.
Months of broken sleep leave me chronically anxious and depressed. My heart races when I arrive at daycare to pick them up in the afternoon, and again, when I’m awake in the early morning, trying to find one moment of peace, alone.
I didn’t have those months of postpartum bliss, snuggling two beautiful babies. When I was pregnant, I pictured myself rocking them to sleep each night and pushing them in the double stroller for our daily walks.
But the demands of caring for two tiny creatures around the clock were never-ending. I was always exhausted but also struggling with anxiety and insomnia. I woke up to two cups of coffee daily and tried to wind down with a glass of wine each night, but it felt like I never really woke up or relaxed.
And as my twins entered toddlerhood and I continued to struggle, I began to wonder: Will I always feel like this?
I thought I must not be up to the task of motherhood — let alone twin motherhood! — the way I expected I would be. In fact, I reached out to a handful of practitioners searching for help.
Some practitioners told me, I needed a longer svasana, or I need to pay $400 of dollars for a visit, but no one said, maybe you have postpartum depression (PPD), how can I help you?
Surviving my own PPD has inspired me to help others. If you’re struggling in the first year or two of having a baby and wondering if there’s a way to feel better, I hope you’ll keep reading.
Postpartum depression (PPD) is a potentially devastating mood disorder thought to affect approximately 15% but as many as 28% of new mothers, with an estimated 400,000 women suffering from this condition annually. ¹
And all too often, these women are dismissed, told they just have the “baby blues” and sent away with a pat on the back and maybe, a prescription. Few doctors have the time to sit down with their postpartum patients and ask the hard questions: What are you worrying about? How are you sleeping? Do you have someone who can help you with the baby?
And they are even less likely to make the kind of lifestyle recommendations that can make a big difference, whether that’s straightforward diet tweaks or botanical supplements.
You can have postpartum depression even if you’re getting out of bed every day and functioning fine on paper. It’s important to understand that while of course, new babies are tiring, that never-lifting fog of exhaustion and anxiety is not healthy. You don’t have to live that way.
When does Postpartum Depression start?
PPD can come on gradually anytime in the first year; you may notice symptoms as early as two weeks postpartum; however, it can occur at any time in the first year and may last up to a year or longer.
I particularly noticed insomnia began after I stopped breastfeeding the twins. The months of sleep deprivation led to anxiety, stress, and depression.
Why does postpartum depression occur?
There are lots of theories. One theory is the hormones shift that rapidly occur during the postpartum period, which can trigger a cascade of neurochemical effects. Thyroid function can go from hyperthyroid to hypothyroid in a matter of months.
Why is autoimmune thyroid disease so common after birth?
When the normal immunologic changes that kept you from rejecting your baby as an alien being while she or he was in your uterus start to revert back to normal after birth, they can play some nasty little tricks on your own body tissue leading to autoimmune disease that targets the thyroid, especially in women who are already genetically susceptible.- Aviva Romm
A second theory is sleep deprivation
“Some research suggests that in the first year postpartum, the average sleep debt of Mothers is 700 hours.” ~ Dr. Oscar Serrallach M.D.
Pregnancy, childbirth, and breastfeeding can all leave your body depleted, as the baby takes the nourishment she needs. Postpartum women often have inadequate levels of essential fatty acids, B vitamins, zinc, and protein, all of which have been associated with PPD. ³
Iron is one of the most critical nutrients to replenish post-childbirth, especially if blood tests showed anemia during your pregnancy. The immense loss of blood during childbirth can dramatically deplete your iron stores and eat a healthy diet or take your prenatal vitamins may not be enough to make up the difference.
This is worrisome because anemia triggers the kind of fatigue commonly associated with depression.
And the lack of social and emotional support that most American mothers face also plays a critical role. The support from family members during the postpartum period allows for the greatest care of mother and baby, it places importance on bonding the new baby with the community.²
How does postpartum depression feel?
It is as if you are living outside of your world, looking in and you cannot recognize the woman you see. You may experience any or all of these:
- Chronic fatigue
- Difficulty relaxing
- Feeling inadequate
- Inability to cope or function with daily life
- Irrational concern for the baby’s well-being
- Loss of interest in normal activities
- Memory loss
- Poor concentration
- Thoughts of hurting oneself or the baby ·
Note: You should report all of these symptoms to your doctor, especially if you’re struggling with thoughts of hurting yourself or the baby. The vast majority of women with PPD will not harm their babies. But the fear that you might can be petrifying and all-consuming. Professional help is available. NYC health lists.
How can I manage postpartum depression?
There is no single magic solution. Postpartum depression is a multifactorial problem requiring attention on all different levels. Personal I’ve found a healthy diet, rest, self-care, art therapy, and adaptogens helped pull me out of postpartum depression.
What are adaptogens?
Adaptogens are a category of herbs that help us adapt to stress. Herbs like Panax Ginseng, Ashwagandha, Holy Basil, Astragalus, Licorice, and Rhodiola can reduce adrenal fatigue or this burnout we experience from sleep deprivation.
Essentially, the HPA Axis (or hypothalamic-pituitary-adrenal axis ) is how our brain and body communicate with each other — and when we’re stressed out, it sets in motion a series of hormonal and neuroendocrine responses that control our body’s primary alert system, known as the “fight or flight” response.
When you’re in fight or flight, you may experience increased heart rate, increase blood pressure, a sudden need to pee or dilated pupils. Sounds smells, and colors may all become more vivid because all of our senses go on high alert as well.
The problem is that many of us live in a chronic state of fight or flight, especially in the postpartum years when you’re being woken up at all times of the night, or constantly having to jump up every time a baby cries.
Over time, this can lead to dysfunction. The HPA Axis loses its ability to shut off and leaves us in fight or flight mode all day long. If you’re struggling with PPD, you’re probably stuck in this mode as well.
A category of herbs called adaptogens can help regulate this stress response. In traditional medicine systems, these are also known as “tonics” and their purpose is to help restore adrenal health, ease anxieties and reduce cortisol levels.
My favorite adaptogen to use with postpartum breastfeedding moms is Ashwagandha, known as the “strength of stallions” as it strengthens the immune system, reduces cortisol levels and balances thyroid hormones. (It’s considered a Level 1 category, in the herb/risk during lactation categories and considered safe to take when you’re breastfeeding.)
If you’re not breastfeeding ginseng (Panax ginseng), St. John’s wort, Schisandra and Kava Kava may help as well.
If you or someone you know is suffering from postpartum depression or postpartum anxiety, know that you are not alone. Diet, community support, and botanicals can help begin to nourish your body in conjunction with therapy and possibly medication.
The first and hardest step is to ask for help.
Your friends your loved ones and your community want to help you, all you have to do is ask.
My health consultations focus on diet, self-care techniques and botanicals to help restore your adrenals, reduce anxiety, insomnia and depression.
¹ Romm, Aviva; Botanical Medicine For Women’s Health. Pg. 418
² Adrews, Dr. Lia; 7 Times A woman; Ancients wisdom on health and beautify for every stage of your life
³Romm, Aviva Jill; The Natural Pregnancy Book