Asking for help doesn't make you weak

This may be a sensitive topic for some people, but it needs to be spoken about because the lack of support and attention to mental health is part of what is wrong with our society.

This was a big topic when I was in practice, not only because I was in Internal Medicine, but because the doctor I worked with had a big psychiatric following. Not only did we specialize in hormone replacement and endocrine disorders, but he worked very closely with halfway houses and rehabilitation centers for those with a history of addiction. I’m only mentioning this so that I can give you my background and understanding as to why this is, and will forever be, an important aspect of care for me.

While in practice, I worked with anxiety and depression patients daily. I would say that about 75-80% of my patients had some sort of history of depression or anxiety, whether it was in their past (and they weren’t affected by it anymore) or it was still something they struggled with daily. I think that the stigma associated with anxiety and depression affects some people’s willingness to open up about the struggles they may have. I wish that wasn’t the case, because talking about either condition is such an important step in the management of them both.

Based on my experience, most of the time depression and anxiety go hand-in-hand. Those with anxiety become depressed about being anxious, and those that are depressed become anxious about their depression. I’m not saying it’s always the case, but it was more common for me to see patients with both conditions than with one or the other.

While I was in PA school, my anxiety and stress levels were at their absolute peak. I felt like I was at my breaking point and that my anxiety was literally consuming me. It was at this point that I decided I needed help. I started a low dose of esitalopram (Lexapro), a selective serotonin re-uptake inhibitor (SSRI). Why am I telling you this? Because I’m not ashamed of that. I am actually proud of myself for realizing that I was at the point where I needed help controlling my anxiety. The nice part about SSRIs is that they can be used short-term and they are non-addictive. I think I was on it for a total of 3-4 months before I started slowly weaning myself off. They were definitely my drug class of choice when I was treating my own patients. Not only because of my own experience, but because on my rotations, the providers I shadowed agreed that they saw the best outcome from them in their patients. For me, it felt like my battery was dying, and I needed a jump start. That’s exactly what the medication did for me.

Do I have my moments where I’m anxious? Absolutely. Do I still feel down from time to time? 100%. But I haven’t gotten back to the point where I was during PA school. I will say that after giving birth, there was a time when I thought I would need to go back on medication. If I’m going to diagnose myself, which I shouldn’t, but I will - I would say that I had the baby blues. There were literally days where I would just cry for absolutely no reason. I would look at Anthony and just feel so overwhelmed with love that I would start crying. The thought of him getting bigger would make me cry. The thought of him going off to school made me cry. Honestly, his hiccups, smiles, and burps would make me cry. If you haven’t caught onto the pattern here, let me sum it up. I CRIED AT FREAKING EVERYTHING. This is not uncommon. Most women experience feelings like this immediately after childbirth and it can last for a few weeks.

Do I think that a lot, if not most, of the emotional roller coaster women go through after delivery is hormones? Sure. That, and the fact that your life just drastically changed, you’re sleep deprived, and sometimes, becoming a new mom can feel really lonely. You now have this huge responsibility of taking care of a child. Your independence just shifted and most of what you do now involves a little human. You aren’t free to just do what you want when you want to do it. It’s a big change for most of us. But the important thing to remember is, it’s okay to talk about this. It is important to talk about this. A lot of women experience these feelings. Again, it’s not something that is spoken about often, and I think it’s so important that the topic begins to become more prominent, especially during postpartum check-ups.

This brings me to another important topic: postpartum checkups. Why the hell is no one checking up on the person that just spewed out a child? The newborn gets a check-up at the pediatrician after 3 days, 7-10 days, and then a month after being born… mom doesn’t get one for 6 weeks. And then after the 6-week check-up, what happens? “See you in a year.” Umm… am I the only person that sees something significantly wrong with that? Your body just went through A LOT and needs attention, too. Your body wasn’t just affected physically, but mentally as well.

It is extremely important to talk about these feelings with your healthcare provider. There is a difference between baby blues and postpartum depression. Postpartum depression is more severe. Those suffering from this may start to withdraw from their partners, may feel that they are unable to bond with their baby or even have some suicidal ideation. If you are feeling like this, please reach out to your medical provider. You are not alone. It is a topic that is just now starting to get some spotlight, in part because female celebrities are coming out and talking about their own experiences.

I’ve included a screening tool here for you: The Edinburgh Postnatal Depression Scale. This is just a guide. Your results and how you are feeling should be discussed with your healthcare provider, even if that means you need it before the 6-week mark, or sometime after. You have the ability, and you should use it, to schedule an appointment when you feel it is necessary.

Overall, the point of this post is to remind women that we are too hard on ourselves. It is okay to seek help. Especially if that means you will end up a better version of yourself. Not only for you, but for your child. Remember, your baby doesn’t know what is going on - they are relying on you for their care. You also have to care for yourself. Remember when you’re on an airplane and they’re going over the safety instructions, they state that you have to put the oxygen mask on yourself before helping others. The same works for having a child. How are you supposed to care for a tiny helpless human if you feel like you’re running out of air? Asking for help doesn’t make you weak; it shows how strong you are that you can see and admit you need it. There is help out there, and you shouldn’t be ashamed to ask for it.