By Jessica Park
“For as long as I can remember, I’ve wanted to be a mom,” says Missy Nichols of Columbia, Mo. When she and her husband, Spencer, learned they were expecting their first baby in 2014, they were overjoyed.
But on a routine checkup, Melissa was diagnosed with severe pre-eclampsia. She was rushed to Boone Hospital Center and put on bed rest. Her daughter Scarlett was born a few days shy of 35 weeks’ gestation.
“I was able to touch her long enough for one photograph, then she was rushed to the NICU,” Missy recalls. “So many emotions flooded over me then – instant love for this beautiful little girl, overwhelming fear about what having a preemie would mean for our family long-term, and somewhere, the strength to keep myself together for her.”
While Scarlett was in the NICU, Missy was visited by a social worker who explained that postpartum depression, or PPD, was common in mothers of premature babies. But Missy didn’t think that applied to her.
“I thought I was too strong to be affected by depression,” she says. “To be honest, before I had depression, I never understood it was a real medical condition. I did not understand how overwhelming and crippling it is.”
Missy was no stranger to adversity; she’d grown up in foster homes and overcome many obstacles, but relied upon her drive, resolve and resourcefulness. She also drew strength from her faith; she and Spencer are active members of their Assemblies of God church.
“Life has not necessarily been kind to me, but I’ve never been one to sit and wallow in a situation,” she says.
When Scarlett came home, after three weeks in the NICU, Missy says, “I thought I was home free.”
But the relief and happiness Missy had expected to feel didn’t come. She worried constantly about Scarlett’s health and woke up frequently at night to check on the child. She felt guilty and blamed herself for the premature birth, even though her doctor told her she hadn’t caused the pre-eclampsia.
Missy was also sad that Scarlett’s birth did not go as she had wanted – she missed out on pictures and visits from friends -- and mourned the time when she’d been separated from her baby.
“Going home and leaving Scarlett in the hospital that first night was so hard,” Missy says. Over the next year, she would wake up with vivid, painful memories of that event.
“The experience of having your baby in the NICU is emotional, and it does take a toll.
Patti Blanchard, MSW, a social worker with Boone Family Birthplace has one thing she wants everyone to know about post-partum depression: “It can affect anyone.”
Parents of premature babies are at higher risk. New mothers at Boone Family Birthplace are provided with information about perinatal mood disorders, which include PPD, and resources for follow-up. Social workers also check in regularly with parents of NICU babies.
“When you have a baby who has to stay in the NICU or has a specific diagnosis, the stress of that situation increases the risk of depression in both parents. Dads can get it, too,” Patti says. About 1 in 7 fathers in the United States experiences post-natal depression in the year after a baby is born.
Perinatal mood disorders can start during pregnancy and up to a year after the baby is born. The most common is called the “baby blues.” Up to 80% of mothers experience mood swings or crying spells the first week after childbirth, but they fade within 2 or 3 weeks.
PPD, however, lasts more than 2 weeks and symptoms may include loss of energy and motivation, feelings of guilt or worthlessness, changes in appetite and sleep, loss of pleasure in activities you enjoy, lack of interest or negative feelings towards your baby, and recurring thoughts of death or suicide.
When Missy tried talking about her feelings of fear, guilt, and sadness, her friends assured her. It was just the baby blues -- and totally normal. As a first-time mother, Missy didn’t know what she felt wasn’t normal.
“Over the months, there were definitely changes that I see now were NOT normal, but clear signs of postpartum depression,” Missy says.
Her anxieties about Scarlett’s health and safety intensified. Her emotions felt hard to control. She was prone to sudden crying or angry outbursts. She also felt guilty about how bad she felt, knowing she had much to be thankful for.
Missy experienced physical symptoms, including loss of appetite, weight gain, insomnia, fatigue and physical pain. She found it hard to do simple things like showering. Her motivation was gone.
And Missy found it hard to enjoy the experience she had looked forward to all her life:
“I had difficulty adjusting to my role as a mom. Many days I felt like I was just an empty machine changing diapers and churning out nourishment for my child. It was difficult to even enjoy holding my baby.”
Missy knew something wasn’t right, but had difficulty expressing her feelings to her husband or friends.
By Scarlett’s first birthday, Missy’s depression had become unbearable. She felt like she was losing her will to live.
One Sunday evening at church, while leading worship, she couldn’t hold back anymore and broke down. Before everyone, she shared the painful feelings she’d struggled with. Her church family immediately responded with a show of support and love.
“They reminded me there was hope. If nothing else, I knew I wanted to live for my daughter and my husband. I was reminded that God had a purpose for me and that alone was worth fighting for.”
Missy made small, gradual goals towards self-care, trying to accomplish one or two things each day at first. She then focused on getting more nutrition and regular rest, taking walks, and letting her husband know when she wasn’t feeling well.
Missy also attended counseling sessions through Lutheran & Children Family Services in Columbia. Being able to talk about her experience to someone who understood made a difference. Still, it took several months before Missy felt like herself again.
Missy experienced PPD again recently, following the birth of her 5-month-old son, Thatcher, but having a support system in place, knowing the symptoms, and taking time for self-care made it easier to manage. She says, “I’ve felt really good the last few weeks.”
“If you’ve had PPD before, your risk is higher,” social worker Patti Blanchard explains. “But every pregnancy is different so not having a history doesn’t mean you’re not at risk. Again, it can happen to anyone.”
“Postpartum depression was the worst experience of my life,” Missy says. “I have always been so strong but this thing completely broke me into pieces. I felt like I’d lost myself.”
But as Missy’s drive and strength returned, she saw an opportunity to help other mothers. She has shared her story with several local groups and has made informing more people about PPD – health care providers and parents alike – part of her life’s work. She also praises the support she and others have received from Lutheran Family & Children’s Services.
Missy says, “I want the world to know PPD is a real and legitimate medical problem that can be treated. I want us all to collectively understand the intense impact that pregnancy and motherhood has on a woman’s mind, body and spirit… We can all make sure that no one suffers through depression alone.”
If you have symptoms of post-partum depression that interfere with daily functioning and last longer than two weeks, talk to your physician or a mental health professional. You may also find help and local resources through Postpartum Support International’s website (www.postpartum.net) or their helpline, 800-944-4PPD. Depression is a treatable health condition, not a weakness or personal failing.