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PMADs: Intrusive Thoughts and the Healing through Exposing Them.

Updated: Jul 24, 2020

The social worker said, "The 4th trimester is all about survival....Intrusive thoughts are normal.... If things don't get better in 2 months, check back in and we will go from there."

That was the message I received roughly 2 weeks after our son Henry was born. As I'm nodding my head, smiling and feeling some relief, I'm also thinking, "Okay, but do you really know what I'm thinking? And, if you did, would you take my child away from me? Also, Why is it normal for me to think such awful things about my baby?" I walked out of that appointment returning to my 2 week old son and husband with a feeling of validation for my experience and hope I would get better and the thoughts would just go away. That night as I put my son to bed, I fell asleep with a sense of relaxation I hadn't felt since his birth (meaning, I checked on Henry's chest rising and falling 5 times versus the normal 15). Two hours later as I woke up to feed him, the thoughts came back. Sigh, I wasn't better and they didn't just go away.

I remember the day I told my husband about the thoughts... it wasn't until 3 months later when my depression, anxiety and intrusive thoughts were so intense I couldn't do life without help. I was so scared to tell him, scared he would judge me, scared he would leave me and scared he would take our son. "What if I drop our son off of the back porch?!?, What if I take this knife and hurt him? What if I take this pillow and press it upon his face? Why does he love my husband more than me? What if he stops breathing?". These were just some of the thoughts I experienced.

Postpartum Support International talks about how "thoughts are not action" and intrusive thoughts, while super scary, do not equate with the mother's intent to bring harm to herself or her child. Karen Kleiman and Amy Wenzel state, "...intrusive thoughts are part of the human condition. Most people have them. Typically, we compartmentalize and protect ourselves from them. Motherhood, however is one circumstance during which our ability to filter them becomes compromised" (Karen Kleiman and Amy Wenzel, 2011).

Have you ever had a secret so strong, so deep and so shameful that the thought of exposing it would bring upon ruin to your self, yet the experience of keeping it weighed so heavy and damaging to your soul that if it stayed inside of you, you felt you would crumble into a heap and fail to exist? I felt shame of being unable to be the mother I thought I would be, unable to be the image of the happy mommy carrying around my son all day with no sleep and still able to do everything for everyone. At the same time, I felt so overwhelmed with fear, isolation and sadness, the only option for me was to voice it.

Thankfully, my perceived risk of the realization of my fears was less important to me than saving my self. Verbalizing my thoughts and my experiences was primal, releasing, scary and absolutely necessary for me to recover.

When we are in the midst of PMADs (Perinatal Mood and Anxiety Disorders), everything seems harder and it is. When we reach out and engage in recovery, it gets better. The thoughts don't just go away, but they become less and when they do pop up, you are able to understand them in the way you would understand them outside of PMADs; they are fleeting and typically in response to a trigger (in my case, lack of sufficient sleep and self-care).

Intrusive thoughts are just one symptom of PMADs. I wanted to highlight them because for me, they felt like the worst of the symptoms and the hardest to talk about. Knowing this is true for most moms, I hope my acknowledgement of them allows you to be able to acknowledge them too. Being a therapist, I thought I could just deal with them. Being a mom, I thought I was just supposed to figure it out. Being a person who tends to like control and dislike vulnerability, they tossed me into a tornado and spit me out, leaving me out of control and extremely exposed.

Each of our experiences with PMADs is unique and deserves to be treated with understanding, acceptance and hope. We do not choose to experience these unwanted aspects of motherhood. My image of myself as a mom was me walking barefoot in a field of wildflowers with my baby snugly nestled into a Moby wrap. My reality was not; he hated the wrap and I would rather hide in the field and sob.

I'm good now. Mind you, I'm still figuring out the whole sleep thing - Henry is a rapid grower and each time he finds his way towards sleep, another developmental milestone or sleep regression ensues and we're back to square one.

The first year of Henry's life is such a fog and at times I wish I could get it all back; heck, I wish I could also get my pregnancy back - that's a blog for another day. I can see the fog now through lens of beauty instead of through a lens of sadness, anxiety and fear. I'm thankful to have exposed myself and come out on the other end. You can too.

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