Postpartum depression

As a personal trainer, I was often hired right before or after a major event, such as a wedding, a high school reunion, a cruise, while planning for a baby and after baby was born.

Training women post-baby is great because their weight comes off usually so effortlessly that it makes exercising more rewarding to both the client and I.

I had this one client that lost weight so fast that it concerned me. I asked her to please go see a doctor because she shouldn't be losing five pounds a week, when she wasn't incredibly overweight to begin with. Turns out that even though her baby was only two months old, she was pregnant again! Her poor body was basically handling a lot with breast feeding, exercising and growing a new person, and was therefore eating away at the fat. A few months later this client gave birth to the most adorable and incredibly girlie girl, whose first word was "shoes."

Another client, whose exercise routine consisted of very high intensity training five days a week could not lose a pound.

She would cry every day. She would throw the hand weights on the floor, enraged. She would say she hated her baby and made such comments as, "Look what he did to me!" or "God must hate me!"

I would say mostly under my breath then vocally at first that her baby didn't do anything to her, that it was her choice to have it, anyway. When the sessions were over I would peak in the winter room, where her nanny held her baby like his mother should. He looked so beautiful and calm and helpless. I would leave her house angry and promising myself to never come back.

A few days later I would be back, however, still trying to figure out why she was so mad, so sad and seemed to me to be so cruel. I guess in my mind I just wanted to see if she was getting better and hadn't killed herself, since she mentioned often her wish to do so.

This was my first encounter with postpartum depression. I wasn't aware it was something real. Since I didn't know this woman pre-baby, I figured she just had an awful, selfish character.

I started researching about her condition after I read the book "The Female Brain" and how it changes throughout pregnancy and after. Once I realized what could be going on with this woman, I set her down one day, mid-session, after she said once again that she couldn't get close to her baby because he destroyed her body.

As I described to her what postpartum depression was, she surprised me by adopting a little girl expression on her face. I was sure she would attack me back, as she had in the past, so many times before, with any suggestion to become healthier that I made. Instead, this time she humbly listened to me and looked down at her hands. After I was finished, I handed her her cell phone, dialing her doctor's number beforehand.

I am happy to report that this woman is now one of the most loving and present parents I know. I often quote her as saying that every day she falls in love with her kid all over again. Oh, and she lost the weight, eventually.

Why the interest in it now?

A few weeks ago, someone at the prenatal yoga center handed me a pamphlet on postpartum depression. I tucked it deep inside of my purse, avoiding it and telling myself that that was for crazy people, and I am not crazy.

That is... until the prenatal blues hit me (read the post name "Blues (but not the music kind)").

In all honesty, my prenatal blues only hit me three or so times, lasting only one day, so it is nothing worth being overly concerned about.

However, when it hits, the feeling of sadness and helplessness is overwhelming. All energy is drained of me and I feel so sorry for myself that I can hardly move.

A few days ago, I was cleaning the house (a task I still force myself to do perfectly since I stopped working and want to feel productive) and as I pulled the paper towel from the closet, all the cleaning products came flying on my head.

I had been frustrated already with my lack of sleep, my back pains, my discomfort in every position, my constant tiredness, my inability to just be my energetic, normal self.

The mess I created now in the utility room brought from deep inside of me a surprisingly and reactive guttural cry, that left my husband staring at me hopeless as I set on the floor, weeping uncontrollably.

The scary thing about depression is that it really takes over the way you see the world and yourself and when it goes away, you can hardly recognize where that came from and feel shame for it.

Being a person who is often very positive and overall happy-go-lucky, it is specially scary to me when I fall on those valleys of sadness and despair, especially when they come and go so fast.

With that in mind, I had read that pamphlet and handed it over to my husband to become familiar with it.

I honestly don't think I will have a full on depression; maybe the baby blues, but you never know.

I am reading Brooke Shield's memoir on her experience with postpartum depression and she herself has never had anything like it beforehand.

In this book she mentions that risk factors for postpartum depression are extreme life changes, difficult labor, difficulty getting pregnant (especially when taking hormonal cocktails), and a history of either PMS, depression and bipolar disorder.

So let's see: I did move across the country, I did quit working, and have something close to PMDD during my cycles.

We shall see. I may come out serene on the other side. You never know. Stay tuned to find out... or not. I may hide in a rabbit hole.

Carbohydrates (and insulin and estrogen and progesterone and cortisol and serotonin)

Conversation over the phone with nurse from my doctor's office:

NURSE: I saw in our records that you called late last night with a blood pressure of 88 systolic and 49 diastolic. Did you go to the emergency room?

ME: No. I put some salt on my tongue and the blood pressure went back to normal. I figured I was having a hypoglycemic episode because I felt dizzy a few minutes after eating a few... hum... sweets...

NURSE: It could be hypoglycemia. Your body processes sugar differently when you are pregnant, do you know?

I know. When pregnant, the excess estrogen affects how fast and efficiently insulin is released and breaks down sugar, and also the body's retention of water. Insulin is the hormone responsible for taking sugar off the blood and carrying it into the cells. When there is not enough of it or the insulin is lazy (e.g. insulin resistance), the blood gets "sugary" and sugary blood will clog everything (hence why diabetes can be fatal and can cause blindness and loss of limbs) and when there is too much of it all at once, the body runs out of cells to feed and stores the excess as fat.

This discrepancy of the insulin's job during pregnancy causes some ladies to become diabetic, others to become hypoglycemic and for most of us to just become fat.

Since we are talking hormones, I'd like to mention that progesterone during pregnancy makes women loopy (as if I needed any more "loopiness"). To counterbalance this, the body releases an insurmountable quantity of cortisol; which usually is the stress hormone, but in this case it is the "alert hormone" to keep us ladies from running into walls.

Because there is this crazy amount of cortisol, serotonin, one of the sleep and mood hormones, has very little saying on anything, and this is one of the reasons why we get blue sometimes (and a tad moody) and can't sleep.

Once the baby arrives, estrogen and progesterone leave the body like they are busted from smoking crack, leaving cortisol and insulin like a couple of belligerent drunks in a party where poor serotonin has no chance of controlling. In non-scientific terms, this is called post-partum depression.

Anyway, back to my conversation with this nurse person, I want to impress her with my nerdy knowledge of hormones, so I ask, referring to her comment on carbohydrates being processed differently while pregnant:

ME: Is this why we gain so much weight so fast while pregnant?

NURSE: Hum. I think it has more to do with the fact that you are eating a few too many...hum... sweets?

ME: :o/