Postpartum's Gaping Black Hole

My first struggle with Postpartum Depression occurred when I was still living in the United States, with my husband and three kids. I was 33 years old, and had for the previous six years been working on my Ph.D. A mere two weeks after submitting the final draft of my thesis, I gave birth to a healthy, eight-pound baby girl. She was born at home, by choice, and I was surrounded by friends and care-givers.

The period immediately following her birth was exhilarating. My Ph.D. came through during Sukkot, which added to an already festive Yom Tov. Life was normal and happy. I was busy with the kids, tending to my family's needs, the house, going back to aerobics classes – all the normal functions of daily living.

I was not prepared for the turmoil that awaited me some four months afterwards. I had not experienced any postpartum reaction with any of my three previous babies; I didn’t recognize it when it began.

A shroud of meaninglessness seemed to seep up from the depths of the earth and envelope my body.

At first, I simply felt ‘down.’ The feelings of my after-birth exhilaration faded and left me hanging somewhere between birth and life. Then I began to lose enthusiasm for my usual interests and found myself milling around the house with the sense of having nothing to do.

As the weeks progressed, this intensified into a deep and terrifying feeling that I had nothing to do with my days, nothing to do with my life. A shroud of meaninglessness seemed to seep up from the depths of the earth and envelope my body. A gaping black hole began somewhere in my throat and ballooned when it reached my stomach. It made me physically nauseous. Although I lost my appetite and could barely taste the food, I ate a lot, trying to fill the ever-widening void within.

My brain was very detached from all of this. It was aware that my situation was growing worse. But for once, there was nothing my intellect could do to help me. Whatever was happening to me was not cognitive.

My ability to cope with the kids and the house deteriorated, which led to panic and despair. I feared that this was a form of insanity.

In normal circumstances, we take coping for granted and we don’t realize the inner strength that goes into just coping. When Postnatal Depression descends like a black cloud, there’s no such thing as coping. The word itself drops out of one’s vocabulary as if it never existed.

The thought of shopping overwhelmed me with anxiety. The idea of juggling the demands of the kids threw me into a series of severe heart palpitations. I still had no idea what was happening to me. Had I not had a full-time nanny, I think I would have been out of my mind with fear.

The actual details of my life at that time are blurred. I remember more the feelings, the sensations and terrors. When I woke in the morning, the gnawing black hole inside almost devoured me. I could barely drag myself from the bed. Making a cup of coffee was unthinkable. Getting dressed was fraught with so many choices, I was torn apart by panic. Much better not to get dressed. Ever.

Every time a child asked for something as minor as an apple, it felt like he was asking for a 747 Jumbo Jet.

I was unable to perform the most minor tasks. Preparing a simple meal – toast and butter – was an enormous burden; I could not undertake for anything in the world. An hour or so before the kids would come back from school I would feel a surge of panic in my throat, making breathing difficult. Something inside kept on screaming, “You can’t cope with this! You’ll never manage the demands!” And I didn’t. Every time a child asked for something as minor as an apple, it felt like he was asking for a 747 Jumbo Jet.

The daily battles with the toddler about getting dressed made me feel as if I was in the middle of a war zone, as if I was about to be struck by a bomb. And indeed, I was far more terrified then than I have ever been during the situation here in Israel. I found the terror within much more devastating than the terror without; for I breathed it all the time; or rather, it breathed me. I was its desperate slave. And those inner sensations threatened to consume me completely.

I just left everything to the nanny. [We then lived in the United States and were luckily able to afford one.] She fed the kids, she bathed them, she put them to bed when my husband wasn’t at home. I don’t remember who did the shopping – for sure, it wasn’t me.

I still had no idea what was happening to me. I only knew that the worst thing in the world was to be conscious, because what I craved more than anything was the bliss of unconsciousness. I didn’t want to know I was alive because I was where Hell was and Hell was where I was, and we were as deformed in our bonds as Siamese Twins. If I wanted anyone at all in this purgatory, it was the baby, and the only thing I wanted to do was to coil myself around her in bed, go to sleep and never wake up.

THE TURNING POINT

The turning point happened one morning. I was sitting on my bed, rocking backwards and forwards, hugging a cushion to my chest as if it was a life-support machine. My husband came into the room, and I remember bursting out, “What is the matter with me?!”

"You need to see a doctor."

My husband's reply was in itself a great blessing. Many husbands are utterly confused by this sudden change in their wives and the idea of her seeing a psychiatrist or taking pills only intensifies their fear.

If there was a name to what I was experiencing, perhaps there was also a cure.

My doctor was a highly sensitive woman who specialized in women’s issues. She immediately diagnosed Postpartum Depression, and this gave me the light of hope. If there was a name to what I was experiencing, perhaps there was also a cure.

This light of hope enabled my husband to revolutionize. Before I was diagnosed, he felt completely helpless and unable to understand what I was experiencing. Once he knew that there was something clinically, medically the matter with me, he completely took over my ‘role,’ cooking and dealing with the needs of the kids.

I was again very blessed. What might have happened had he been bitter or resentful? What if he’d been angry at suddenly finding himself the captain of a sinking ship?

My doctor advised me to see a psychiatrist who prescribed anti-depressant medication, which he said would take a few weeks to kick in. I was deathly afraid of pills, having no idea what this kind of drug would do to me. I was terrified of being out of control. But I was so terribly out of control, anyway, that I simply had no choice.

This medication was the difference between heaven and hell. I felt like an entirely new person.

ALIYAH AND MORE KIDS

When my fifth child was born three years later, there was no recurrence whatsoever of post-natal depression, and I truly believed I was free forever of what I thought had been a one-time occurrence.

Almost two years after making aliyah, I gave birth to a perfectly healthy baby – but who weighed just over three pounds. Unlike the uneventful pregnancy of my previous postpartum baby, this pregnancy had been fraught with anxieties. There had been questions about the health of the baby from early on, and I didn’t know what would be with her.

The birth was traumatic and she was separated from me. I was barely allowed to hold her, and I was certainly not allowed to nurse her. She was placed in an incubator for about two weeks in a hospital in the greater Tel Aviv area, and the daily trips to see her from Jerusalem involved a three-hour excursion.

During those weeks I was expressing milk at two hourly intervals, round the clock, in a desperate attempt to keep my milk and be able to nurse her. By the time we brought home this tiny little baby, I was completely exhausted, and utterly overwhelmed.

To my absolute horror, I began to experience those same old, terrible feelings. The same nausea, the same feelings of emptiness and panic, the gaping black hole, and the desperate imaginings of how I was ever going to cope.

But this time, there was no nanny. No one to take the kids, no one to make supper, no one to hold the baby – NO ONE.

My husband had professional commitments. He couldn’t simply stay home and nurse me, which was exactly what I needed. This time, it didn’t help him to know the name and condition of what I was going through. This time there was no nanny.

My husband’s initial reaction expressed the stark difference between my Postpartum Depression in America and this new, Israeli experience. Fraught with anxiety, he told me that he never wanted to have more children because he couldn’t cope with what I go through when I have a baby. And this from someone who always said he could manage with ten children. The sense of isolation and aloneness made him feel that now everything was on his shoulders and he felt completely overburdened and unable to face that task.

But this time there was NITZA, a non-profit support network for women experiencing Pospartum Depression, which I had heard about through a friend who had been helped by them. I cannot over-emphasize the importance of quality support after birth. Hormones are in an uproar, sometimes causing extreme outbursts of anger or tears. Because a new baby brings so much excitement and joy, the fact that women may also be very vulnerable at this time is something often not understood. From the moment I heard Chana’s voice on the phone, I knew that I wasn’t alone. I was almost light-headed with relief knowing that she understood, that she had a network of support people in various roles pulling together to help me in the way that I needed help.

I was struck by the selflessness underlying the organization. Nothing was imposed upon me; I didn’t have to do anything I didn’t want to do or didn’t feel was right for me. NITZA’s only concern was to address my needs.

Because I had been through Postnatal Depression before, I was very aware of my needs. NITZA's director of client services phoned me twice a day, every day. I have no recollection of what we spoke about, but the fact that she cared enough just to phone allowed me to integrate the emotional support I so desperately needed. A NITZA volunteer counselor was in constant contact, listening to me, sharing my pain and allowing me to feel normal and human within my desolation. And always, there was the knowledge of professionals behind the scenes, liasing, thinking, advising, cushioning.

As per my request, NITZA organized natural medication through a homeopathic practitioner, which helped enormously to calm my anxiety. Meals were organized on an extended basis, to remove the pressure of taking care of my family. Young girls were brought in to look after the other children when I needed to rest, and others were recruited to hold the baby when I needed to spend time with the older kids. And eventually, NITZA found in-house help for as long as I needed it. They had taken care of my needs, preventing me from plunging again into the pit of Postpartum Depression.

If women experience trauma that is overwhelmingly intense, as I had in my first confrontation with this syndrome, conventional medication may well be a matter of life and death. The gentle effects of my homeopaths’ remedies may not be sufficiently aggressive to deal with a condition that is marriage-threatening, kids-threatening and life-threatening.

In His great kindness, the Almighty brought NITZA to me, to my husband and to my children. I was amazed by the lengths to which these women were prepared to go, just to help. With the personal emotional support and the practical help in the house that they organized, my spirits began to lift almost immediately, for I knew I was not alone and didn’t have to cope on my own. Together, we had weathered an ominous storm.

NITZA - the Jerusalem Postpartum Support Network was founded in 1997 to provide support to women and their families suffering from Postpartum Illness, including Postpartum Depression, Psychosis, and Mania. NITZA is currently the only organization in Israel, providing a full spectrum of services meeting the unique needs of those suffering Postpartum Illness. Our privately run organization reaches out to women who would otherwise not seek help due to fear, shame, ignorance and financial limitations. NITZA works closely with leading health-care professionals in order to provide the most comprehensive services and safety-net possible.

Many of NITZA’s families are in great financial straits without adequate funds for basic necessities. NITZA provides financial subsidies toward treatment and recovery, including psychiatric care, individual and marital counseling, medical treatment, as well as instrumental support, all of which are very costly.

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P.E.F. Israel Endowment Funds, Inc.,
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NITZA-The Jerusalem Postpartum Support Network,
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