2020年8月19日 星期三

The Unimaginable Hell of Postpartum Insomnia

Photo illustration by Slate. Photo by Image Source/DigitalVision via Getty Images Plus.

When my friends and acquaintances met my baby girl for the first time, there usually came a moment when they would lean toward me conspiratorially and lower their voice and ask, “But really, how are you doing?” This, I learned, was a question people pose to new moms to make sure they aren’t going to jump off a cliff. But I thought they were the ones who were out of their minds. I had never felt such intense joy in my life.

With an ectopic pregnancy and two unpublished novels behind me, I had a beautiful daughter and a book coming out at last. I had recently finished grad school in Iowa City, and my plan to stay home with my baby for a year and prepare for my book’s release felt like a dream come true. Sure, having the book coming out was a little stressful, and so was the fact that my husband and I were on the academic job market, but did these people not see the warm little ball of love strapped to my chest? I was ecstatic. After my daughter turned 4 months old, people stopped asking how I was, right when I got desperate for help.

What started as an innocent night of no sleep turned into an eight-month living hell that lasted until my daughter turned 1. One night in the early fall, I couldn’t get my brain to turn off as I prepared for my parents’ visit the next day. I kept thinking about how to work my folks into my daughter’s nursing and napping schedule, while the Imagine Dragons song “Thunder” played over and over in my head as I sweated through three nightgowns and got up to nurse every two hours. A second sleepless night came on the heels of the first one. After a month, I’d racked up a dozen. I was bewildered and terrified, and did a lot of things that I now see probably made it worse.

My heart pounded even more wildly when my daughter napped, so there was no chance I could “sleep when the baby sleeps” anymore. I used that time to Google sleep cures instead of writing. I harassed every friend and family member I knew for advice. I decided to sleep downstairs on a stiff couch, away from my family, and every 30 minutes when I failed to drift off, I marched up to my husband’s office to declare, “It’s happening, it’s happening again …”

I tried every tip I got from friends and the trusty internet: body scans, meditation, yoga, yoga nidra, standing on my head, journaling, puzzles, reading a boring book about high-frequency trading, reciting the name of every Bachelor contestant ever, counting forward and backward to 1,000, sleep apps, videos of sheep, sleeping with all the lights on, falling asleep to Don Lemon’s soothing voice, cuddling my daughter’s stuffed animals dressed in her dirty clothes so I felt less alone, not to mention the cocktail of melatonin, passionflower, valerian root, sleepy tea, magnesium, No Doz, and OB-prescribed hydroxyzine.

A monster had invaded my brain and wanted to kill me.

Most of the time, nothing worked. When I closed my eyes, I’d hear pop songs on repeat, but they took on an evil tone—think “Shape of You” sung by the devil instead of Ed Sheeran. Sometimes an eclectic mix of faces floated before my eyes like some kind of hideous bouquet: I’d hear I’m in love with the shape of you while seeing my daughter, my landlord, the academic job search committee members who interviewed me over Skype, ex-boyfriends, Post Malone, and the barista at the local coffee shop smiling at me menacingly. Add having to nurse every two-to-three hours plus the whirlwind of fears about becoming a terrible mother and wife on top of that and that was basically how my nights went. I was convinced I was losing my mind.

My daughter began sleeping through the night at 6 months, but I did not follow suit. As Iowa approached its polar vortex, I decided to get help. I began spending my “free time” visiting a therapist, psychiatrist, sleep doctor, and, on one occasion, even a hypnotist. The sleep doctor, my three visits to whom I later learned cost more than $1,000, told me to think of a relaxing place at night, like a beach. The psychiatrist suggested I try anti-anxiety medication, but I said I was “strong enough” to handle this without the meds. I’d never had insomnia or needed medication before. I thought that at worst, I would sleep when my novel came out and I had something else to focus on, though that was months away.

The therapist told me I was being hard on myself and got me some emergency Xanax to take as needed at night. I quickly ran out and got more. Though it didn’t always work, I began taking it several nights a week. Each time, I waited at least four or five hours to take it, convinced I’d feel better if I could only fall asleep “on my own.” I worried I would become addicted, that I would never fall asleep naturally again. I felt like I had been pushed out on an iceberg, spending most of my time either feeling worthless or obsessing over my sleep, feeling terror creep into soul when darkness fell. A monster had invaded my brain and wanted to kill me.

Don’t get me wrong, the insomnia was pure hell—there’s nothing lonelier than having your heart pound wildly while your family sleeps peacefully above you, like you’re the last person on Earth, knowing you have a full day of parenting ahead. But even worse were the destructive thoughts that had settled into my brain like an animal burrowing into a creaky old house. According to the “combating my negative thoughts” Word doc I made during that time at the suggestion of the self-help book Feeling Good, whose motto was, “It feels good to feel good!,” the loop went something like this:

Why can’t you handle being a mom? Everyone else can do it without going insane!

You will never be normal again. No one will ever hire you because you’re terrified of going to bed. Even if you get a job, you’ll have to quit because you won’t be able to sleep. And forget ever having a second kid.

Nobody needs you. You’re only a burden to your family and friends and they’ll all be better off without you. You don’t deserve anybody’s love.

What is so wrong with you that having a baby and book coming out isn’t meeting your needs? This was supposed to be the best year of your life.

What are you going to do to try to fall asleep tonight? It won’t work. Nothing will. 

These thoughts played on a relentless loop in my head, as reliable as my daughter’s white noise machine or my recitation from memory of Goodnight Moon. I went from being pretty confident to feeling like a psychopath with a secret as bad as a serial killer’s. Any time I spoke about “normal” things, whether I was interviewing for a job or talking about my book or gossiping with friends, I felt that I was just faking it, hiding that I was an awful, ungrateful person who was so fucked up that she couldn’t sleep on her own.

When I closed my eyes, I’d hear pop songs on repeat, but they took on an evil tone—think “Shape of You” sung by the devil.

It’s funny, because I’m a fiction writer, and fiction is supposed to let you enter the inner psyche of complex, misunderstood characters. And yet, before the insomnia, when I studied other people, I always thought the gap between how they felt and how they acted was a neat little stream filled with quirky secrets and grudges that I could access with the right questions. I did not know it could be as wide and impenetrable as an ocean.

“Do you have hope for the future?” the psychiatrist asked me once, as I stared at my snow-covered boots. I burst into laughter, a cruel laugh that reminded me I hadn’t authentically laughed for months. “How can I have hope when I’m terrified of sleep?” I said, and she looked concerned and jotted something down. “It” would never, ever end. I was sure of it. I left the hospital through the wrong exit and found myself miles from my car. It was so cold it should have been illegal. I looked up at the sturdy building where I was treated for my ectopic pregnancy and later gave birth to my daughter and couldn’t believe it was the same place or that I was the same person. I kicked at the dirty snow and screamed.

Though my sleep slowly improved as winter ceded to spring (instead of pulling an “all nighter” several times a week, I could sometimes go one or even two weeks without one, though never more), the thoughts did not. When my novel came out, my book tour was my last hope. When I read at Prairie Lights, every Iowa City writer’s dream, I was baffled when I faced a crowd of strangers and friends. “What are you all doing here?” I asked them. Everyone laughed, but I wasn’t joking. I didn’t understand why anyone would come to cheer me on. After that, I began taking anti-anxiety medication for the first time in my life.

I began to feel human again by early summer. Though my job search was fruitless, my husband got a job in Alabama and we moved there just after my daughter turned 1. Though my sleep isn’t perfect, I haven’t had a night like the ones I had in Iowa again. The sleep got better, but more importantly, I got my mind back. My thoughts are still punctuated by anxiety, sure, but not in a self-destructive way. I’m focused on my next book, my friends, art projects with my daughter. Also, I went back to work part time and sent my daughter to day care, which helped.

Now that I’m not in panic mode, I can see how irrational my thoughts were—I had equated my self-worth with my ability to fall asleep!—but I couldn’t question my logic at the time, as the specialists told me to do. I can also understand what my therapist meant about having self-compassion and gratitude. Now I can appreciate how kind so many people were to me that year and how lucky I am to have a published book and an energetic 2-year-old, and to be able to do ordinary things like watch a movie with my husband without being terrified that I won’t sleep afterward. I can laugh again, not in the cruel way I had laughed at the poor psychiatrist, but for real. I can say I had a pretty bad case of postpartum depression and anxiety, instead of calling it “the year I went insane.”

When my daughter’s day care shut down, I was terrified that having her home full time would prove I was a selfish person who fell apart without my own independence and that this would drive me to sleeplessness again. It didn’t take long to overcome my fear. In fact, within the course of a single week, my cat got fleas, I found a lump in my breast, my grandmother died from the coronavirus, and my house flooded, and even then I was able to laugh as my husband and I scooped out buckets of water with trash cans to save our home. The truth is I don’t feel 1 percent as bad as I felt during my first year as a new mom. I have never been in the same room as that feeling before or since—not even on the same planet, really.

Today, I’m thinking of all the new moms who aren’t feeling so good, especially when child care is on hold—I’m willing to bet there are more of them than ever. Some of them may not feel good for far longer than they’d hoped. They may think this is their new normal. But in most cases, it will pass. Of course, therapy and meditation work wonders on some people; they just weren’t enough for me, and I wish I had seen that much sooner. As for those people who asked how I was doing those first few months—keep asking the moms around you how they’re doing long after that “fourth trimester,” even if their smiles suggest they are doing fine.



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