Earlier in the week, I shared an expert’s perspective on the emotional and mental health impact of formula feeding. Megan’s story feels like the perfect corollary to the insight offered in that post; a raw, brave account of mental illness and how this illness influenced a truly informed decision not to breastfeed.
It is so incredibly humbling to get stories like the one below. The fact that you trust me and this space enough to share them here is not taken lightly… and while I hate that any of you even have to write these heartbreaking accounts, I can’t help but celebrate your resilience and willingness to speak your truths in the hopes of helping others feel less alone.
So thanks, Megan. And thanks to all of you who share and read and participate – you are all amazing.
Happy Friday, fearless ones,
During the summer of 2014, I spent two months separated from my husband. I took our 4 kids, packed up and went to another state to stay with my parents. Things were pretty tough. Traumatic would put it mildly. But there’s a happy ending. We both desperately wanted our marriage to succeed. With blood, sweat and tears on both sides, we reached a really good place by the end of the summer – a fantastic place, even! That fall, reunited both physically and emotionally, we finally made significant progress in so many areas of our lives that we had been struggling to move forward with over the decade of our marriage. We remodeled our house (which we bought bank owned and in need of repair). We instituted family rituals and routines that we had always wanted in place, but never quite could manage because we often couldn’t be in the same room with each other – hurt feelings make it hard to pretend that everything is fine. But mostly, we both felt very strongly that there was another child ready to come to our family. It was a very exciting, exhilarating time. And a very anxious time. Things were still so new. We had just demolished the foundation our entire lives had been built upon for the last 11 years, and our new foundation was yet to be truly tested. We were about to do just that – and how.
The day after my birthday in September, I started what would be my last menstrual cycle. We were so thrilled! This baby was figuratively and literally a symbol of our renewed and healing relationship. Hope for the future of our family. Evidence and a symbol of just how far we had come, of the new life we had brought to our union. I was basking in the glow of being pregnant again.
Eventually, however, elation began to give way to a gradual sinking… At first I just thought it was exhaustion from first trimester blahs’. But as the days began to grow shorter, and colder, we began to see that this was depression. Depression wasn’t something foreign to me. I had struggled with major postpartum depression with 3 of my 4 babies, with depression in-between postpartum periods as well. I had a history of childhood sexual abuse, though, so I mostly attributed my depressive episodes with my work to resolve the effects of that abuse. I kept figuring “once I get past this issue, I’ll be able to move on with a normal mood”. Grieving and untangling trauma can be very difficult, and often looks like depression. As we neared December, however, I hit a new low, even for me. I went from being just fine and functional in the morning, to being so low that afternoon that I began thinking not just suicidal thoughts, but even thinking that my children would be better off being spared the agony of living with such a mother. I thought to myself, “I can see how those mothers end up drowning their children in the bathtub. I can see how that would be merciful”. Then I wondered, as I brought up the image of the logistics in my mind, how you would drown multiple children, and what would you do with the bodies? If you did them one at a time, they would freak at seeing the bodies of their siblings…..” OH MY GOD!! Did I really just think that??? Right as I thought that, the very clear phrase came into my mind “I need medication”. That snapped me out of it, and gave me a surge of energy and forward momentum to act on a solution.
I reached out to my husband. I told him he needed to come home. I was shaken, I was ashamed, I was afraid. What was happening? That was NOT like me. What was going on? I couldn’t wrap my brain around it, but I knew that this couldn’t happen again, something had to change! Dealing with things in psychotherapy wasn’t addressing this issue. What else would?? Could medication really help?
Near the end of the two months I’d spent at my parents, when things began to calm down and my husband and I had a solid timeframe and plan for our reunification and going back home, my mother sat me down and had a talk with me. That summer she was finishing up her rigorous PhD program in psychology. She later said she was too close to the situation to be able to see it clearly for a time, but by the end of the summer, she finally had drawn a few conclusions that put the pieces together. She read me the DSM-V definition of Bipolar I. I was crushed. I fit the description to a t. I didn’t want to believe it. Bipolar meant something was wrong with me, and I didn’t want to own that. That was shameful. And it meant I had a part in the separation, and I wasn’t the innocent victim. I needed to be the innocent victim, and I needed him to be the perfect bad guy.
Fast forward again to that dismal and garish December. At this point, my mother’s conversation came back to me in vivid detail. Maybe she was right!! A sense of relief washed over me. This wasn’t my fault!! I can do something about this that would actually work! Exercise wasn’t cutting it, praying and reading my scriptures diligently wasn’t cutting it, having a close connection with my husband wasn’t cutting it, having good friends wasn’t cutting it… But if this is bipolar and not just me not “trying hard enough”, then I could see a light at the end of the tunnel.
So, at 20 weeks pregnant with my 5th child, I was officially diagnosed with bipolar I disorder, and began taking lamotrigine. It pulled me out of my depression! What elation, what relief! Of course, I obsessively looked up and read every scientific study I could get my hands on, and I was very worried about the effects on my baby, but most studies concluded that after the 1st trimester, baby was at relatively low risk. Then I began to notice a ramping up of anxiety. It started gradually, but I began to notice feeling really great, and very productive, but increasingly I began heading toward fully anxious, crawling out of my skin feelings. And then I realized, 3 weeks in a row, getting to the point where I was becoming paranoid again. That was enough. I went back in to my doctor and pretty much insisted he start me on lithium. I was 32 weeks pregnant. It helped! I was so excited, and the case studies on lithium said that as long as baby didn’t have any troubles eliminating or getting dehydrated, that as far as they could tell, lithium didn’t have any measurable side effects. Yes, they knew it was transferred to baby in breastmilk, but didn’t really see consistent harmful effects. I felt comfortable with those odds.
Then came the day, at 37.5 weeks, when I began to wonder how the hormones of breastfeeding would impact me postpartum. My biggest fear was having a major mood set back after birth, and for good reason. I had a very clear history of it. And, the medications were still helping, but I wasn’t actually feeling rock solid stable yet. I still was having some ups and downs, just not so extreme. All the research said that breastfeeding was protective against PPD, but nothing was said about bipolar. So I asked my psychiatrist and my OB what their clinical experiences were. They both said that almost universally, when moms are having postpartum mood issues, they fairly immediately improved after ceasing to breastfeed. Clinical experience has to account for something, doesn’t it?
I think the biggest reason I could see their point and trust it was that not even a week before these discussions, I had about 4 hours of “warmup” labor, and it put me into a manic place, followed a few days later by a depressive place. We increased the dosage of both my mood stabilizers, and that noticeably helped. So when both my providers agreed with each other about stability and breastfeeding in my situation, I whole heartedly could see their point of view. If I wasn’t even mood stable before birth, what would be the after birth chances when things really got screwy with my hormones? It also occurred to me that my psychotic episode the summer before happened while I was still breastfeeding my one year old. They were right. Breastfeeding was not the option for me if my main goal was emotional stability. I was crushed. And peaceful. And then obsessive about ordering just the right bottle feeding supplies. And then crushed. And then peaceful. And then obsessive about looking up research to tell me that my doctors were wrong and I could actually breastfeed and I would be able to stay mood stable at the same time….
And then my shipment of bottles, pacifiers and all things formula feeding came in. I could barely look at the unopened amazon box for a few hours. I placed it on my couch where it could torment me every time I passed it. Then I’d have a good cry, and busy myself with something to forget it. Then I finally screwed up enough courage to open the shipping box. Then I had a good cry, but left all the bottles and things in their original packaging – I wasn’t really going to use these, was I??? Eventually, after enough tears and grumpiness, I decided I would stop thinking about it. I invited my older daughters to help me open them. They were thrilled. They wanted to touch everything, suck on everything (of course) and figure out how everything worked. Bottles and pacifiers are definitely a novelty in our home. To this point, the only bottles I had ever owned always lived safely covered in thick dust in the cabinet above the fridge (you know, the useless one you can never get in and out of because it’s too high and you always have stuff on top of your fridge in front of it?). Boy is this a change. It did comfort me that the small size bottles, when I held them up and imagined feeding my baby from them, felt very close…. Like maybe I could bring baby really close to me like if I was breastfeeding. Bottles and pacifiers safely in the dishwasher and ready to be sanitized, I needed a good cry again.
And why was I crying? I had hope for stability. I was making choices that would not only benefit my new baby, but all my children and my marriage too. I was making a choice to skip the living hell that is the ups and downs of bipolar – a choice that would afford me the chance to be in the world of people, living in the moment and enjoying that living. Bipolar depression is completely exhausting and isolating, and bipolar mania is terrifying and crazy making because you can’t trust your gut or calm down enough to take in the moment. Why would I want that? Wouldn’t I want the best thing for everyone I love, including myself?
That night, my husband held me while great sobs wracked my frame. I didn’t want to grieve. I didn’t want to have to grieve. I didn’t want to need to grieve. I wanted to just treat this as a matter of fact, and then move on. Grieving is scary – what if I get going and can’t stop – what if it’s not actually grief but just that ugly old depression again? I felt broken, helpless, like a failure… Why did I have to be bipolar? Why couldn’t I be stable? Why did I need medications? Why weren’t they working better yet? Where was the line between a normal emotional response and a bipolar swing? In truth, I don’t think they can really be distinguished, after a point. The feelings are there either way. The options are learn to sit with it in a way that isn’t destructive, or adjust medications. After my intense crying session, I felt better. That was a good sign that this was grief! But grief usually comes in waves. I woke up the next morning after nightmares about having to bottle feed next to my breastfeeding friends. I felt so surreal, to be bottle feeding – and horrifying. I got up, sad and even angry. Angry that this is my situation. Angry at myself, angry that this is just part of living and having a body. I’m grateful for my body and the children I have been able to conceive and give birth to, and the four I was able to breastfeed, even if it was a great struggle for my mental health in every postpartum period. I’m grateful for this baby too – this little miracle child of the seaming back together of my marriage that was hanging by a thread only just one year ago. And I feel raw. I don’t want one more thing put on my plate that I don’t feel I have the capacity to do and do well. I don’t want to see anyone pregnant and brimming with excitement about breastfeeding. I don’t want to imagine them taking their brand new baby onto their chest, and having their baby root and suckle. I don’t want to imagine that and a hundred other images I have in my head from my own babies. I just want to fall down face first and sob until I have no strength left to sob. And I want to not have to sob, to be able to either breastfeed, or get over it.
So why is it so emotional? Why can’t I just “get over it”? I never realized how much of my self worth was wrapped up in my ability to breastfeed, and ultimately in my capacity for perfection. Good mothers feed their babies, but the best mothers know that “breast is best” right? Good mothers know that emotional stability and consistency are keys to raising well-adjusted children, but the best mothers are just born with that natural ability. Good mothers often sacrifice and put their children first, but the best mothers never have needs of their own and can endlessly give whatever their children require without resentment or burnout. Wow. What a load of distorted thoughts!!! Does any of this sound familiar to you?
The truth is – the best mothers recognize their limitations, and plan for them. The best mothers accept reality, get help, surround themselves with supportive people, and don’t try to brute force themselves into good mental health through sheer force of will and determination. The best mothers recognize that breastfeeding, while extremely biologically engineered to create bonding, is not the same as bonding. It’s a tool. Bonding is a choice – one that continues through the child’s entire life span, and has many stages and phases. You can’t breastfeed your teenager back into a close relationship with you if you haven’t stayed close through his earlier childhood and tween years….. The best mothers understand that our imperfections are gifts to ourselves and our children. Seeing that we aren’t perfectly put together all the time lets them know that it’s okay that they aren’t perfectly put together all the time either. It gifts us all a sense of “we’re in this together – I’m ok, you’re ok”. Which brings the sweetest sense of safety, connection and reassurance I’ve ever known.
The best mothers know that when we love ourselves, warts and all, we are providing the greatest example for our children we possibly can. An example of just showing up, being transparent, and having self-compassion and self-kindness.
And that’s why my bottles are currently sitting in my dishwasher sanitized and ready to be packed into my hospital bag. That’s why I have histamines and decongestants ready to go to dry up my milk supply. That’s why I have a list of friends and family who have agreed to help support me after birth. That’s why I’m still taking my mood stabilizers. That’s why I’m going to finish writing this, and then go enjoy the last precious days of being a family of only 6, before our world changes to welcome our new one. She’s precious no matter my weaknesses, and we will bond no matter how she is fed, because I will be emotionally stable enough to enjoy her.
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