Marcie Le, one of the Ashtangis here in Charlotte, recently revealed her story of Postpartum Bi Polar disorder to the community. I was blown away. It never even crossed my mind that this calm, poised woman working diligently beside me had this story inside of her. Marcie told me that Ashtanga helped her with her Postpartum mood disorder. This is what I love about Ashtanga. Without even knowing what was going on, the practice was still doing it’s work.
I am so glad that Marcie did this interview. I am so glad she chose to share her words with us. It has opened my eyes to the courage of Marcie and women like her on the postpartum spectrum. Marcie wants women suffering with these disorders to know that they are not alone. That there is help and that they can climb out of darkness. She wants families to know what to look for and how to help their loved ones. This is Marcie’s story.
Marcie: I was not properly diagnosed until after my suicide attempt nearly a year after the birth of my daughter. My case is a good example of how lack of knowledge, denial, and embarrassment can get you into some hot waters. It began almost immediately after the birth of my daughter. I had a 36 hour labor after which I could not sleep. After she was born, I felt very energetic, but in a strange manner, almost like being wired on caffeine, but it was very intense (now we know this was likely the start of hypomania a symptom of the Postpartum Bipolar Disorder). We stayed only one night after my daughters birth and I never slept the entire time we were there, a total of 3 days. Coincidentally, stress and lack of sleep, and the shift in my hormones was brewing a perfect storm for the onset of my Postpartum Bipolar Disorder.
I had no idea that such a thing even existed and even less of an idea that I was susceptible because we had a family history of bipolar disorder. I just wanted to go home, and they screened me with the Edinburgh Postnatal Depression Scale, which unfortunately does not catch bipolar symptoms when you are hypomanic as I likely was. My daughter‘s bilirubin was elevated, but not enough to keep us so we were sent home. During that first night, my daughter became increasingly agitated, screaming, and was unable to sleep. I had breastfed her until I was bleeding (she cluster fed), I tried rocking her, walking with her, we tried every device we had been given from swings to slings. Nothing was making it better. I could feel how agitated I was getting, and at this point, I knew I had to get out of that house. I still to this day feel shameful for leaving my daughter that night, even though I just rode around the block a few times. I got caught in a license check, just my luck, and that poor police officer ran my tags and took my work badge as ID, because all I was wearing was a nursing gown then told me to ‘go straight home ma’am because you are in no shape to drive.’ I did.
The next few days were more of the same. We were sent back to the hospital for my daughter’s jaundice. More sleep deprivation, but I was still wired, anxious, and the night we got home, I again did not sleep even though my daughter and husband did. Instead I stayed up tossing, turning, and eventually just sitting on the bed afraid to move, because every little noise sounded like someone coming in the house every shadow cast in the hallway seemed to be alive and sinister. I was terrified out of my mind, but I just kept thinking if I could just sleep it would be ok. I told my husband, but there was no way I was going to tell anyone else they would think something was wrong with me, and it was just sleep deprivation right?
Things calmed down for a couple of weeks after that, I didn’t feel exactly right but I’d just gone through a lot, right? Two weeks later my daughter developed colic. I had heard the term, but I had no idea what colic really was. I had no idea she would scream nearly 18 hours a day. There would be 20 minutes of rest here and there but for the most part, she just screamed. I will be honest. There is not a whole lot that I remember of that time other than it felt dark, and cold, and never-ending. My husband was back to work (working the night shift) so I was often alone at night unable to console my screaming infant. I was exhausted from lack of sleep and my emotions terrified me. I knew I wasn’t feeling well at all, I had very little attachment to Anna even though I knew that she needed to be cared for and never harmed. Several times I had to call for help in the middle of the night when I felt like I was just unable to bear the screaming any longer. I was so sure that when the colic passed we would be ok, I would feel normal again.
The colic passed (when she was five months old) and while it was much more settled, and I even felt good enough to go back to work, I still felt that something just wasn’t right. I went to my psychiatrist who had treated me for depression in the past. I was devastated that I would not be able to breastfeed for the whole year which I took as another failure on my part, but I knew it was better for me to feel good and be there for her. Unfortunately, what we failed to recognize is that my depression was no longer just depression. It was Bipolar Disorder, that had been triggered by the birth of my daughter. He put me on the same antidepressant I had been on prior to my daughters birth. I thought we were out of the woods. What I did not know is that my brain had literally changed after the birth of my daughter. Anti-depressants given without mood stabilizers often shoot people with Bipolar straight into a manic state. So did I feel better? Yes! I felt so much better that I decided we should sell our home (that we hadn’t even been in for a year) and our townhome (which was rented out) and buy a piece of property outside of town near my parents. I wrote a page long email to our realtor and we were off! Symptoms of mania: continuous high energy, racing thoughts, little need for sleep, impulsiveness, grandiose thoughts, overconfidence. This went on for a few months I was completely goal directed and obsessed and relentless (symptoms of mania). I just thought “Hey I feel so good lets do this now before we have another kid so we can be closer to help!” Needless to say this put a large strain on our family physically, mentally, and financially, I started working more to cover all of the house payments.
Meanwhile, I was starting to feel really bad again. Except for this time it was different. I had the energy of before, but with a confused mind that could not be directed. I was also starting to feel depressed. It took everything in my body to drudge myself out of bed in the mornings. This time, when I saw my psychiatrist, my husband was by my side. “I’ve never seen her like this” he told him. “She can’t even move she is anxious all the time, but exhausted at the same time. She can’t even talk well enough to come here by herself.” Some medications were added and my anti-depressant was increased but there was no talk of Bipolar.
I tried hard to hold on, but this time things just weren’t coming back together. I felt fundamentally broken. This is when the suicidal ideation started to take hold. “My family would be so much better without me.” I thought. “My husband is still young. He will find a wife who won’t be such a drag. My daughter will finally have the mom she deserves.” I didn’t intend to act on these, but they were obsessive. If we could just get the houses sold we would be fine, right?
Two weeks later, as the anti-depressants started kicking in, I entered what is known as a mixed mania. This is where the two extremes of Bipolar, mania and depression, marry into a very disastrous union, also the riskiest time for suicide. My “pull yourself up by the bootstraps” attitude was gone. The cracks were starting to show. At work, people were noticing my weight loss, and the change in my temperament. At home I was volatile. The effort it took to put on a front was crippling me. So the day after Thanksgiving, after so much energy expended in trying to put on a happy face, I figured my real happy face was never coming back. I went through with my suicide attempt.
I wound up in the psychiatric facility in Kings Mountain. Where at last, after extensive interviews and review of my history, I was diagnosed properly with Bipolar Disorder. I was placed on lithium a very old but reliable drug (it is essentially just a salt), and I felt more normal than I had in an entire year. I had never thought I’d be so happy to be in a psychiatric facility but to be honest, I was thrilled. I was alive, there was treatment that could help me, and I was going to be ok.
AYP: Do you still have Postpartum depression or Bipolar Disorder?
Marcie: No. I had both Postpartum Depression and Bipolar Disorder Postpartum Onset together at first. My detachment and lack of interest in my daughter during the first few weeks are linked to Postpartum Depression not Bipolar Disorder. The Postpartum Depression let up after about 3 months. Yet, the Bipolar Disorder will remain. It is currently in what they call remission. Some people can stay in remission for years. It is important to note that you can have just the Bipolar Disorder without experiencing Postpartum Depression.
AYP: What is Postpartum Depression?
Marcie: Postpartum Depression is one of the six postpartum mood disorders that a woman can develop either during or after pregnancy. The spectrum of mood disorders includes: Postpartum Depression, Postpartum Anxiety Disorder, Postpartum Obsessive-Compulsive Disorder, Postpartum Post-Traumatic Stress Disorder, Postpartum Psychosis and Bipolar Mood Disorders.
Postpartum Depression is probably the most well-known of the mood disorders, but taking account of the other five disorders paints a much broader and more inclusive picture of maternal mental health. This is especially important for proper identification and treatment of these distinct disorders. On one hand these disorders can be wildly different in the way they present on the other hand, there is often some overlapping of symptoms. This can muddy the waters for proper diagnosis, particularly since it is very difficult for a new mother to determine what is ‘outside of normal feeling and behavior’ given that everything is new to her. As more information becomes available to the public this will give women the tools and vocabulary they need to discuss what they are feeling with their healthcare provider. It is important to note that all of these disorders are treatable.
AYP: Do you feel that society ignores postpartum disorders? If so, why?
Marcie: I do not think that society intentionally ignores postpartum mood disorders, but I think sometimes people tend to dismiss the symptoms. Especially since having the ‘baby blues’ is not uncommon at all. Many times I was told by people, who were very well meaning, that it was probably just the baby blues and that it was ok, the feelings would pass. While that is likely the case for most people it was not for me. That often led me to doubt what I was feeling, and [I felt] like I was failing because I just couldn’t pull out of it on my own. I don’t think this was in anyway intended to minimize my feelings. I just feel like people aren’t very aware of the many different ways postpartum can manifest. That is one reason why I am so passionate about this cause.
AYP: Did your friends and family immediately accept your diagnosis?
That is a mixed bag. There were some (mostly the ones who were closest that also work in healthcare) that realized it immediately. One friend just couldn’t believe that we had missed it, but hindsight is 20/20. There was a lot going on that made this a difficult case to recognize. My dad still can’t talk about it, but I can feel his respect. I, myself, struggled with the diagnosis a bit and after a second opinion was confirmed at Duke, I began to accept it. Bipolar Disorder does not go away, but it can be managed very well with proper medication and stress management (ie. Meditation/Ashtanga). The disease will worsen progressively over time if not managed.
AYP: What drew you to Ashtanga Yoga?
Marcie: I came to yoga through rock climbing. I was much younger and going through a rough breakup. I saw that the climbing gym had a yoga program at the time, and I thought I would give it a try. The instructor was Pip Cullipher (who I did not know until much later was also a fellow Ashtangi). I recognized immediately the benefits of yoga and I continued to practice on and off through the years. In my early days postpartum, I took a class at Y2 where Johnna explained a good bit about the lineage and philosophy behind Ashtanga. “This could really help me”, I thought, but we were sucked into the whirlwind that was Bipolar.
Once the storm calmed, I felt more settled, but I realized that I had been out of touch with my body for a very long time. My life, as I knew it before the Bipolar, was completely gone. I needed a way to process what had happened and to learn acceptance for the present. So in December I began, every morning, in the studio. What I had known as my athletic body before was also much different, and shaky (partly because of the lithium). None the less, I came and prostrated myself to the process. And breath by breath my mind and my body were melded back together. I’ve heard stories about how the Japanese fix their broken pottery by melding the shards together with gold in a process called Kintsugi, and the end result is beautiful. Some may say that the pottery melded together with gold is more beautiful than the original. I can relate to that piece of pottery who was smashed, but instead of gold I have Ashtanga. Some days still are difficult and in the words of Rumi, my “house is violently swept” with emotion, but they are much easier to sit with now.
I also love how Ashtanga has a community of people struggling together. In life we all have our struggles, but when you struggle together you breed understanding.
It is also inspiring to be taught by some of the best Ashtanga teachers, who exhibit a yogic lifestyle on and off the mat, and who also lovingly remind me that all is coming.
Since stress is a potent trigger for Bipolar flare ups, Ashtanga is incredibly helpful with managing my stress.
AYP: What other treatments, if any, did you use?
Intensive therapy: Davidson has a Behavioral Health Program that is dedicated to maternal mental health. I was able to do group therapy with women who were in very much the same place. It was incredibly helpful. That is also where I was introduced to Postpartum Support International.
Meditation: I took the Mindfulness Based Stress Reduction course with Dr. Lindsay Bridges. That is where I was first introduced to meditation. Ashtanga is very much a form of moving meditation
Medication: I choose to take medication for my Bipolar Disorder. I have experienced the damage this disease can do to my family and I would never want to risk that again.
AYP: Please share words of encouragement for those who are suffering.
Marcie: You are not alone and you should not suffer alone
This is NOT your fault
There is help (your OB is a good place to start)
This is treatable
This does not make you a bad person/mother
AYP : How can loved ones help someone who is dealing with postpartum depression?
Become educated on the signs and symptoms before the birth if possible. As I mentioned earlier, there are different signs and symptoms for each of the six types of postpartum mood disorders. This becomes a helpful tool if you begin to see these signs in your loved one. You may be the first to recognize this change in your partner. New mother’s especially have a lot of new emotions that they may or may not think are normal. This also gives you a way to talk to your doctor, print off the symptom list, call the OB office let them know what symptoms your loved one is experiencing. If they are cleared by the doctor, but you continue to feel that something is wrong, do NOT be afraid to contact the doctor again, call another physician, or contact Postpartum Support International. Postpartum Support International has services that can connect you to help or even just a hotline where you can call with your concerns.
Additionally, you should help your loved one identify if they have risk factors that predispose them to developing a disorder. There are more than 12 risk factors for Postpartum Depression alone. If you take a look at these for each of the disorders, and identify that your loved one is at risk, speak with the obstetrician about it during your next visit.
For more information on Postpostpartum disorders and how you can help yourself and others, please visit Postpartum Support International
When we first spoke on this, you were telling me about Climb Out of Darkness. What is it and how can we get involved?
Climb Out of the Darkness is the world’s largest event raising awareness of maternal mental illnesses like postpartum depression, postpartum anxiety and OCD, postpartum post-traumatic stress, postpartum psychosis, perinatal bipolar mood disorders, and pregnancy depression and anxiety.
All funds raised go toward our North Carolina State Chapter and are used to promote awareness, prevention and treatment of mental health issues related to childbearing in North Carolina.
It is the vision of PSI that every woman and family worldwide will have access to information, social support, and informed professional care to deal with mental health issues related to childbearing. PSI promotes this vision through advocacy and collaboration, and by educating and training the professional community and the public.
You can help by sharing our cause with others who may want to help, donating if you are able, or donation of time/talents! Donations accepted through June 24, 2018.