Battles In My Mind (Part III): PTSD, PND, ASD, GAD Alphabet Soup and Black Dog Dancing

In Part II of this series, I started my battle story in the middle with the arrival of my second child. As brutal, protracted, and dehumanising as that series of events was, it paled in comparison with the acute trauma of my first birth. When we think about having a baby, it's all teddy bears and nappies, smiling exhausted parents, bottles and boobies, not near-death experiences. I'd heard of PTSD prior to my first pregnancy, but it was something I mistakenly only associated with soldiers returning from the battle fields or perhaps police officers or firefighters, never ever "the happiest day of your life".

I was physically and mentally prepared to give birth. I knew instinctively what my body needed to do, I was not afraid of the pain; my highly experienced midwife had more faith in my ability to birth my baby than any of her previous clients. But things didn't exactly go to plan. We'll never know exactly why my body didn't quite do what it was supposed to, but it's quite likely that a bike accident a decade earlier disrupted the communication along my spine just enough that part of my cervix simply didn't get the message to let go and my big-brained baby got stuck.

I had zero desire to go to hospital, ever. I have a massive phobia of them. The noise, the lights, the intrusive people, the lack of privacy, the GERMS; it's a fucking nightmare. My homebirth was going beautifully until I exhaustedly agreed to have my waters broken after eight hours of full labour. 

There's meconium. I no longer have any option but to go to hospital. More than six years later, I still feel the edges of the floorboards that I clung to, pleading not to be taken into the waiting ambulance, under my fingernails and bare body. I summon every ounce of resolve in my bull-headed self to keep my contractions going during the 25-minute ambulance ride to avoid an emergency Cesarian upon arrival in hell.

Four hours of battle later, with the aid of untold scores of midwives fighting along side me, I let out a tremendous roar (after being nearly silent for the preceding 12 hours) as the doctor unsheathes the scalpel and eject my daughter into the world unaided. The midwives are shocked to see a baby fly out that fast. It is over. She is placed on my belly and crawls to my breast. We lie there united at last. But the nightmare is just about to start…

After a few lovely moments, a couple of photos, a general reprieve, she is taken from me to be weighed and measured. I am stitched and stitched and stitched as well as the surgeon can muster before he mutters something about the rest he can't get to that will have to heal on its own… The happy congratulatory voices become hushed. Doctors sound concerned and new messages start zipping around the room. Something about her respiration, I can't understand, I'm cold, I know she is cold. "She'll be OK, we just need to monitor her resps… Do you want to get up and take a shower?" "Yeah, OK, that would be great…"

I get up, the room swims, there's a lot more blood under me than anyone anticipated. I reach out for the bed, a midwife catches me before I crash to the floor. Someone presses an alarm. The room seethes with strange faces. No one can find a pulse, a vein to pump fluids into, I'm poked full of holes in a futile exercise to find one that is not collapsed, "20 over 80" someone proclaims. My daughter is also slipping, she is plopped into an oxygen cot and my husband rushes manically back and forth between us but I tell him to stay with her because the terror in his eyes scares me too much. He goes to NICU and a steadfast midwife stares deeply into my pupils willing me to stay with her as I start to slip down a very easy slope. I am so incredibly cold. Nothing warms me. I am left completely alone.

I am supposed to be elated, but I am empty. My most precious little person is no longer inside of me and I can't even touch her anymore. I spend an hour listening to other women scream their heads off having short and highly medicated labours whilst I'm trapped alone not knowing where anyone is or how my baby is doing. I can't sleep.

When I can finally go to her, I can only just put my hand on her tiny relaxed body for a few moments. It's absolutely heartbreaking. I've been waiting to hold her in my arms and nuzzle that little neck for nine months and now I'm not even sure she knows I'm here. She has no needs now as the tubes have replaced me. I'm told to go get some sleep. But sleep doesn't come. I feel like I'm going crazy. After a few days they hesitantly discharge us because the doctor can see I'm too anxious in this place, but the midwife comes every day to check both of us. Less than 24 hours later we're re-admitted to emergency because my little one is fighting a lung infection. All focus is on her and no one worries about me.

Another week in hospital. I rage and scream when my roommate's visitors think it's cool to have a smoke prior to entering the maternity ward where I stew with my IV-antibiotic-fed newborn fighting for her life. I've earned massive cred with the midwives on this ward for what I fought through, so they quickly pull strings to get me a private room. I'm in pain, but trying to maintain a brave face. I'm still not sleeping, but neither is my baby, so it appears normal.

But the sleepless weeks turn into months. Even when someone else looks after her and tells me to sleep, I can't. I'm 100% on edge all the time. I cry nearly as much as she does. We travel a lot because it's so much easier to just keep moving.

One night, several months later, when she has finally started sleeping for at least a few hours at a time, my husband and I decide to watch a movie. It's a light-hearted comedy about four couples having babies. It's silly and ridiculous and we laugh a lot. Until suddenly, it's not. One of the mothers has a problem in labour and the doctors hit the Code Blue alarm. The same one I had. My smile instantly dissolves, my head spins, and I feel like I'm going to vomit. I try to get out of the room but collapse on the floor and feel like I'm dying. My whole body seizes up. I have no idea what's happening. I'm terrified. I'm heaving and sobbing. I can't make it stop. My husband holds me, lets me cry, is completely baffled with me; I have to get up to feed the baby.

Shortly thereafter I read an article in a breastfeeding magazine about the 1% of births that lead to PTSD. The description and explanation make everything click. I start to get some help and counselling. The regular counsellor is at a loss of what to do to help me so she sends me to someone who teaches me a tapping and eye tracking technique to use whenever I have a trigger. It works a treat, but doesn't stop the insomnia. I'm also severely depressed, but ardently refuse to fill the prescription for SSRIs the doctor implores me to take.

Looking back on my life, I know I've suffered multiple severe depressive episodes. I have contemplated suicide more times than I like to admit. Now, understanding myself through the lens of Autism, I see the patterns of sensory overload, people overload, new environments/experiences, anxiety, and insufficient time for my special interests that built up to each. Had I known then what I know now, I would have advocated for my own needs, removed the forks and conserved the spoons. I wouldn't have felt so ridiculous about my need for quieter spaces, fewer smells, a particular piece of fabric to rub.

Arriving on the scene wholly unprepared for parenthood unravels a lot of people. It is a triggering event for many ND women that suddenly sets them on a path toward self-awareness and/or diagnosis. But I crash landed into it with the triple threat of zero experience around children under 10, undiagnosed ASD, and PTSD. It has taken a long time, but I'm learning to forgive myself for being so completely fucked up those first two years of my daughter's life.

Learning to see depression and anxiety through a kinder, softer lens finds its corollary in the Black Dog Project. I came across this beautiful endeavour to break the stigma around adopting black dogs, who are perceived as more aggressive, as I was searching for images for this post. I love what they're doing and it reminds me to be kinder and more compassionate to myself when I'm fighting poor mental health.

Depression in all its forms is crushing. There is so much stigma, so many misconceptions, so little compassion that it takes a lot to even write anonymously about it. My mother once told my older brother I was being treated for depression, to which he scoffed, "what does she have to be unhappy about?" Depression is NOT about just being unhappy or dissatisfied (although those are some of the symptoms). For me, it comes from being out of my depth, pushing myself too hard, insomnia, isolation, sensory/people overwhelm, and the anxiety that ensues. I genuinely NEED time to self regulate, let my mind wander, control my environment, move, move, and move. When these needs are not met for whatever unfortunate combination of reasons, my mind goes into hyperdrive, it WILL NOT STOP. Yes, there are drugs that help, but they have unpleasant side effects and we still don't have any controlled long-term human studies to know if they're safe for continued use. I prefer to at least attempt to manage this brutal condition via non-chemical means because I do not want to be a living lab experiment.

There are so many people out there suffering in silence about their depression and anxiety. You can show you support them by brandishing a Black Dog logo or posting a sign in your office/shop/classroom. Dancing With the Black Dog is a registered charity.

Battles in My Mind (Part II): Depression, Anxiety, PND, and All That Jazz…

I've talked a lot about my mental health struggles with pretty well anyone who could be bothered to listen, but I've never really written about them in any purposeful, meaningful, or public way. I've often turned to my journal in times of extreme distress, trying to scratch the madness out of my mind onto paper, usually to no avail. What I ended up with was a long and painful record of my lowest, most vulnerable moments. Eventually I stopped because I was afraid if anyone ever came across them and read the whole tome I would be bundled off to an asylum and never heard from again.

I originally started this blog (oh, so many lifetimes ago) in an attempt to turn my writing into a positive way forward from those incredibly dark places. In so doing, I glossed over the agonising struggles leading me to that point and completely abandoned the blog altogether during the years in which it could have soothed traumatic wounds and drained the poison from within me. I realised recently, upon receiving the highest compliment that my writing had helped someone else in their moment of need, that I actually have a lot of value to offer those in the trenches with the Black Dog.

I have gained incredible perspective on my mental health challenges in the past year, moving from a head space wherein the only thing keeping me from stepping in front of a bus was my children's dependence on me, to a place where I'm allowing myself to dream and create and open up to curiosity and possibility. I've taken active steps to put self care at the top of my priority list, let go of toxic things holding me back, ask for help, say 'no' to that which I don't really need, and conserve my spoons as much as possible. Discovering my Autistic identity has played a central role in this metamorphosis.

I have an impulsive urge to start all stories at the beginning, but I think this one is better told asynchronously. Let's begin at the bottom…

I'm in a mental ward with my five-month old baby. She's my second child, so the guilt of leaving my 3.5-year old behind weighs mightily but Anxiety is crushing every fibre of my being. I'm afraid of harming myself or my children, so I've come here of my own volition. I knew I was at high risk for developing PND again, so I sought help and built up my safety nets before my little one arrived, but it wasn't enough to fight the tide. Sleepless months, a colicky/tongue-tied/perpetual motion baby, an uncomfortable visit, election of the orange idiot, and an unrelenting fear that my new job would bring an early end to breastfeeding piled upon me and has now dropped me to my knees. The psychiatrist is pushing hard for SSRIs. I'm pushing back with the futility of kelp against the tide and crying desperately on the phone with the kind man with the answers before swallowing my first pill. I can't get my baby to sleep so the nurses push me out into the long, narrow hallway and tell me they'll watch her while she screams. I scream too. I'm incoherent, spitting mad, seeing red, screeching down the hallway past the doors of all the other sleeping babies and mothers that this isn't why I came here, I'm not here for them to "train" my baby to sleep, but they won't listen so I try to punch my hand through a solid brick wall.

The SSRIs kick in and make me think every previous anxiety attack was a gentle joke. I cannot pull myself out of the foetal position except to meet my baby's most intense needs. The walls are closing in on me; the air is crushing the life out of me; I cannot breathe. I want to die more than anything. If the kind man on the phone hadn't prepared me for this and the place wasn't designed to eliminate any possibility for self harm, I wouldn't make it through the night. But just to add insult to injury, I contract gastro while this is going on and have to be quarantined. I'm given two choices: send my exclusively breastfed baby home for my husband to sort out along with our other child and give up any hope of continuing to breastfeed her while I am transferred to the regular hospital unit, or go home. I hate this place so much, but the regular hospital ward is my worst nightmare. I call my husband and implore him to pick me up as soon as possible. My dearest friend drives an hour to watch our daughter while he comes to collect me and our baby. Due to my rapid and unexpected discharge, I have no further access to the prescribing psychiatrist and have to manage my meds on my own.

The following months blur, but I'm managing better. Meanwhile, my husband pulls away and we inhabit two separate worlds: Mine wholly centred around the joyfully beguiling little soul rapidly fermenting in our baby; His revolving around an overwhelming workload and our older daughter. My headspace improves with the medication and job satisfaction, while he recedes deeper into his own pit of depression, resentment, and rejection. Our family effectively splits in two.

I begin to find joy again through my work and friends, go off the meds, but by our little one's first birthday my marriage is toxic house of cards and salted wounds. We're so busy and exhausted all the time we have little energy to even fight, but when we do it frightens our daughter. Her behaviour, which has always challenged us, becomes increasingly difficult and we can't agree on how to deal with it. We escape into our own fantasy worlds and cannot meet in the real world at all. Threats of divorce are thrown around with increasing frequency. Then in waltzes a soothsayer.

It starts innocently enough, as most things do, with a flippant remark online to an old acquaintance about the definition of a "happy marriage". I suddenly find the trust, humour, shared interests, and common ground so completely lacking at home streaming through my screen. As my partner becomes ever more dismissive and uninterested, my new "friend" is quick to fill the gaps. To my mind, the case is closed by my husband's demand for a divorce on our dinner date. I stalk off without him and then we scream at each other from across the street. It's ugly. We try to keep up appearances for the sake of our kids and family at Christmas, but the rift is deep.

Over the next few months my anxiety skyrockets as I empty my bucket into my online "relationship". My husband and I separate. I try unsuccessfully to find full-time employment, getting nowhere with two jobs for which I'm incredibly well qualified. I'm gutted and feel my tenuous grip on things slipping. I go to my doctor begging for help to manage the anxiety that physically rips me apart at night and keeps me perpetually on edge during the day. I go back on the SSRIs and into therapy.

My husband starts counselling and taking antidepressants in parallel. Somehow in the shit storm of our separation, we discover our confounding neurodivergence and the pennies begin to drop. I'm an Aspie; he has ADHD; neither one of us is actually an asshole.

I realise he's been hurting for a long time. It's so outside of my nature to be able to give him what he needs or recognise how much he has sacrificed for so many years to try to meet mine. With help from more emotionally intelligent arbiters, we start to remove the distortion of our own lenses and reinterpret each other. He lays himself out to fight for what matters most to him: his family.

All this chaos, all this pain could have been avoided had I been identified as an Aspie earlier in life. There are so many episodes like this (although none quite so awful) throughout my life, all of which I contend would have been ameliorated, if not altogether skipped, had I known, had my family known, had my friends known. I know our struggles make us who we are, but I'm so scarred from this lifetime of brutal internal battles, I feel I hardly have the strength left to enjoy the life I have left.

The Delphic maxim resonates for every human today as it did in the ancient world, but sometimes we don't have an opportunity to truly know ourselves until we are on the brink of loosing everything we love. I have met so many late-diagnosed Spectrumites who were never able to fully grasp their true self through decades of mental health issues, relationship breakdowns, personal crises, and suicide attempts because their Self was buried and maligned from a lifetime of trying to be the square peg in a world of round holes. So I add my voice to the crescendoing chorus of adult Autistics calling for better diagnosis, especially of girls on the spectrum, and acceptance of our differences to improve life-long mental health outcomes for everyone on the spectrum and those who love them.