SMP-05819

We were rushing out the door, scrambling to get big kids to the babysitter so that I could attend my six-week postpartum checkup. No one was listening. I had asked them repeatedly to follow instructions, but it hadn't seemed to register. I resorted to bellowing, adopting the distinct inflection that only a mother with overly gleeful, bouncing, distracted children does just right: "Will…you…Get in the CAR!"

As I buckled the new baby into her seat - the tiniest baby I'd ever held, mere weeks home from the NICU, our life together still so tenuous - my six-year-old did a fancy jumping dive toward her booster chair. As she leaped, her feet went up, and her pink sparkle sneaker missed the tiny baby's forehead by inches. Centimeters, maybe.

That tiny, fragile baby, the one we'd imagined might never come home. The one I worried about my ability to protect, the baby whose breaths I never stopped counting, almost kicked in the soft spot by a pink sparkle sneaker.

I lost it.

I grabbed my older daughter, pushed her forcefully into her booster, and buckled her seatbelt while yelling - screaming, really - about how she could have hurt the baby, could have killed her little sister. Her face was white; she was shocked at my reaction. In that moment I felt more anger towards her than I had ever felt towards anyone before.

When I tried to fasten my four-year-old's chest clip, my hands were still shaking. I was angry, and I was terrified.

I knew I hadn't hurt my eldest when I put her in her booster seat, at least not physically. What left me shaking was not just the adrenaline rush but the disturbing, painfully clear realization that I had wanted to hurt her, and that it had taken an alarming amount of restraint to not hit her. In some horrible, dark corner of my heart, I wanted her to suffer and feel ashamed.

We pulled out of the driveway in silence. Halfway down the road, I gave her a tentative rear view mirror apology in a quivering voice. She stared out the window.

I hated myself.

If you've never experienced postpartum rage, you might be appalled by this story. You might wonder if I'm fit to parent, or ask why somebody with such anger issues would choose to have children in the first place. That was the question I asked myself as we drove through town. And in all honesty, I'm still a little appalled myself, almost three years later.

But if you've felt the sinister tug of anxiety and rage after baby, if you can relate just a little too easily to the scenario above, you may well be nodding along.

Postpartum rage is a symptom of postpartum and depression and anxiety that no one talks about. Research done by the University of British Columbia states that one in seven mothers experiences postpartum depression, and that anger should one of the symptoms we are looking for in new mothers. The study took data for 24 different research projects over a 25 year period and found that most mothers with postpartum mental disorders like postpartum depression or anxiety exhibited feelings of anger. But anger is an understatement when it comes to postpartum rage. Many women described themselves exploding, almost immediately, at things that, in hindsight, seemed insignificant.

Women with postpartum rage react much as I did with my 6-year-old. Uncontrollable, explosive anger over small annoyances. Women like myself might see things like a dirty dishwasher and scream at the fact that no one thought to start it. They might see another dirty sock next to the laundry hamper and completely lose it. We aren't talking about the passive aggressive comments most of us make under our breath- we mean full on screaming, crying, and explosive anger.

Women who experience postpartum rage can't control it. It comes on in an instant, and even in the moment they can't seem to remove themselves and take a breath. It boils over and they are powerless to stop it. Some women have even reported thinking in the very moment they were turning into the Hulk that how they were reacting was not ok- but they couldn't stop.

But this symptom of postpartum depression and anxiety was never talked about when talking about what to look for as a new mom. So that day I felt like I was a terrible mother because only terrible moms get that angry at their child. Or so I thought.

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For weeks there was a handout sitting on my nightstand, a single purple page, mixed in with the stack of hospital discharge papers, keepsakes from our NICU stay, and guidelines for proper breast milk storage. The handout was a list of symptoms of postpartum anxiety. I had read it one day while pumping, and found it moderately interesting. It listed several thoughts and feelings I'd had before, after the older kids were born. Huh. So that explained it.

And it listed rage. This symptom was news to me. I had never known anyone with anger issues after having a baby, but then again why would I? No one talks much about postpartum depression or anxiety much less a symptom that is as pearl-clutching as rage. I tucked that interesting tidbit into the back of my mind and went about our post-NICU life, ignoring the nagging whispers of anxiety, the intrusive thoughts trying to worm their way in. We were holding steady, this time. We had this, I would tell myself on repeat.

All of that seemed to be working fine for me until the day I realized how badly wanted to punch a six-year-old with pink sparkle sneakers. The pamphlet I had read while pumping popped into my mind, and I realized I was exhibiting one of the most common but least discussed symptoms of postpartum anxiety and depression.

I called my husband at a stop light. "I'm going to ask the midwife for a referral to a counselor. I'm telling you so you'll hold me accountable." If I didn't tell him, I would have shrugged off the stress, turned on my have-it-all-together façade for the midwives like I did for everyone else. But if I told him, he'd follow up with me and make sure I'd asked. He already knew about the anxiety, because I'd been feeling it since mid-pregnancy. I think he was relieved I was finally planning to talk to someone else about it.

At the appointment, my midwives gave me a handout for area resources. The points of contact were the same providers with whom I'd sat around a conference table and discussed ways to support new moms experiencing, well, everything I was fighting currently. These were professional women who knew me as a childbirth educator and nursing student, not a mom who couldn't handle her postpartum moods.

How fortunate for me that these same providers had been open and honest about their own postpartum struggles, and had broken down the barriers between patient and practitioner. How fortunate that I never felt seeking counseling meant I was unfit to educate and support others.

And so I made that dreaded appointment, the phone call that says, This is not me. I am not okay. Help. The phone call that shatters the façade.

It felt good, being so transparent. Scary, but good.

Research has found that postpartum rage often occurs because mothers feel overwhelmed or underappreciated. Their rage spikes when they see another dirty dish that someone left for them to clean up. They see their husband sitting on the couch, and they lose it. When their dog walks across the hardwood floors, their nails tip-tapping, they start to scream.

Over time, my counselor helped me to recognize the way my anger and rage were tied to other elements of my anxiety. As I developed a better understanding of myself, it became obvious the way the various, fragmented elements of my personality connected to one another. The last two years of my life, with changes in several close relationships and a premature baby as the cherry on top, had left me feeling entirely out of control. The nagging whispers slowly forming into conscious thoughts reminded me often: You have no control. This is all out of your hands. This could all fall to pieces any moment now.

A truth that was undeniable, painful, and infuriating.

And so I tightened my grip on each tiny piece I could, and raged at every reminder that it was a pointless endeavor.

My counselor used an exercise with meditation balls to illustrate my struggle. I held silver metal balls in the palm of my hand, too large for me to hold tightly, and practiced keeping them steady. If I squeezed, I dropped them. If I relaxed my hand completely, they tumbled to the floor. The only way to keep them all in play was to soften my grip, to maintain just enough. The pieces of my life were like silver meditation balls, better left to rest.

At home, I began to work on releasing my vice-like grip on the life happening around me. It wasn't easy; when your fists are clenched for years, they don't simply undo on command. But slowly, they softened. I learned to breathe more deeply, and gave myself permission for time outs when I started feeling anxious. I brushed up on the everyday mindfulness techniques I'd learned from yoga. I got back into a consistent exercise routine, running out any pent up energy and frustration. I cut down on coffee.

Most importantly, I stopped thinking of my needs and my kids' needs as being in conflict with one another. I had heard it, but I didn't believe it until I put it into practice: Taking care of my own emotional needs was essential if I was to take care of theirs. If I expected them to listen on the way to the car, to keep their own wild energy in check when it became necessary, I needed to be able to show them what self control looked like.

We were on the same side, after all, that girl in the pink sparkle sneakers and I.

Every parent's experience is different. While I was able to manage my PPA with mindfulness techniques and counseling, many parents have found that other solutions, including medication, are most effective. If you or someone you love is experiencing postpartum depression or postpartum anxiety, including rage, please use the resources below to connect with help in your area.

Postpartum Progress: http://www.postpartumprogress.com/

Postpartum Support International: http://www.postpartum.net/

 

Photo credit - Just a Minute: Moments in Motherhood