Sleepless Nights

When her first child was born, Dini Djalal faced the usual problems adjusting that most young mothers confront. But then she was hit with something else she had not expected.


When my son was five months old, I stopped sleeping. I do not mean that I woke up every few hours to nurse, though nurse I certainly did, around the clock. No, it was not interrupted sleep that I suffered. For a few unbearable weeks, my body forgot how to sleep.

Days and evenings were indistinguishable, made all the more interchangeable by a perpetual headache. I was so desperate for sleep that I gave up all caffeine, even chocolate. Our kitchen cabinets stocked only sleep-inducing herbal teas: chamomile, lemon balm, valerian. Still I could not sleep.

I was a first-time mom, living in the United States with my family far away in Indonesia and my husband traveling a lot. My life had become a haze of nursing, diaper changes and infant naps. You may think that nap time translates into some mommy shut-eye. Alas, my sleep-averse son would nap only in a moving vehicle or carried in a sling. So every day I would walk through the neighborhood, rain or shine, snow or sleet, rocking our budding insomniac to dreamland. I could not lie down until evening, when my son would finally sleep in a bed – mine.

I was a basket case. Yet my son thrived through my insomnia. His arms and thighs rippled with fat borne of breast milk.

In my second week of not sleeping, my mood worsened. I begged for help. Some friends suggested nighttime cold tablets or allergy medicine. Still I did not sleep. I raided health-food stores for herbal insomnia remedies. I scoured the pharmacy for melatonin. I attended meditation classes. Still I lay awake. I even called a hypnotist who promised salvation, but she was a two-hour drive away and I didn’t want to risk falling asleep while driving down the highway. I cried every evening, dreading the impossibility of slumber.

I did have one bit of success: A yoga instructor bored me to sleep. I lay flat on my back as she described how every muscle in my body was relaxing, including my brain. I listened, and slept for all of 20 minutes.

But at $50 an hour, it was an expensive recharge.

So I wound up in the emergency room. You cannot appreciate just how precious sleep is until you aren’t getting any. I had already visited my general practitioner who prescribed the potent sleeping pill Ambien. I took one. Hours later, I remained awake. The next evening I took two Ambien. Counting sheep was never less fun.

At the emergency room the next day, the doctor asked, “Are you depressed?”

My doctor had asked the same question. So had friends and family.

I answered, “I don’t think so.” I had read about depression and felt that I did not fit the bill. I still enjoyed music, films, shopping. A depressed person no longer enjoys her hobbies, right?

The doctor smiled and wrote a prescription for Halcion, a strong hallucinogenic with a shelf life of only a few hours.

That night, I swallowed a tab. I slept! But after two hours, I woke up. I swallowed another. This time I did not sleep.

I feared becoming a pill-popper, so I knocked on my doctor’s door once more. She asked again, “Are you depressed?”

I was indignant. Here I was, trying so hard to survive each day without throwing pots and pans out the window, and everyone was trying to pass off my ordeal as depression. Couldn’t they see that I still relished French fries and strawberry milkshakes? Must everything be attributed to post-partum depression?

My doctor nodded and wrote another prescription, for Trazodone.

“Call me if it doesn’t work,” she added. It turned out that Trazodone is an anti-depressant that helps as a sleep aid. Did I not just explain to her that I was not depressed?

Yet I was beyond desperate. That night, my bedside table replete with unused sleeping pills, I took my first anti-depressant. I woke up five hours later.

I had not slept for five consecutive hours in more than seven months (I did not sleep much in my last months of pregnancy either).

My doctor advised me to stay on the medication for three months, as my insomnia would return if I suddenly stopped taking the drug.

She then continued refilling my prescription for the next year, until I became pregnant with my second child.

I had made a few mommy friends during my son’s first year. Some complained of the “baby blues”, a benign term used to describe a mother’s mood swings after birth. But post-partum depression – that was another matter altogether, spoken about with hushed tones and raised brows, and suffered only by women nobody seemed to know firsthand.

As for anti-depressants – well, they were for crazy people. This environment convinced me that, indeed, I could not have been depressed.

But I was. I suffered from mild post-partum depression, or PPD, a condition caused by a drastic drop in estrogen and progesterone and experienced by an estimated 10 percent of women following childbirth. This hormonal imbalance can become severe when sleep deprivation takes place. It is a vicious cycle. Sleep deprivation intensifies
the depression, which then intensifies the insomnia. Untreated severe post-partum depression can lead to post-partum psychosis, which can prompt its sufferers to become suicidal or homicidal.

As soon as I started taking medication and sleeping more, I stopped crying.

Conventional sleeping pills such as Ambien were not effective because they did not target the chemicals that anti-depressants do.

Recognizing the need to seek non-chemical treatment as well, I also saw a therapist during this period. She too concluded that I suffered from post-partum anxiety and depression.

With our second child, we were blessed with a baby who loves to sleep, so I discarded the Trazodone (PPD often recurs with consecutive pregnancies). But I would not hesitate to take medication if necessary.

Just as you should put on your oxygen mask before tending to your child, caring for your family starts with caring for yourself.

Recently, when I returned home to Indonesia for a visit, a friend admitted that she was taking anti-depressants as her baby passed the six-month mark. She told her story smiling nonchalantly, over dinner with friends. It struck me as a remarkable admission, and one that I would not have been brave enough to make four years ago. But today,

Hollywood stars the likes of Brooke Shields, Courtney Cox and Gwyneth Paltrow – celebrities with hired help at their disposal – freely admit that they too suffered from PPD; some admitted taking medication.

Can the stigma of post-partum depression be subsiding? For the sake of our families, our children and ourselves, let us all hope so.

 

 

Illustration by Lucynda Gunadi