My doctor overlooked my postpartum symptoms. I started treating her with Ambien – and got hooked.

I am a recovering addict who published a paper about my addiction to alcohol and pills earlier this year. A few weeks ago I was interviewed on a podcast and the host asked me when I thought I became addicted – specifically why I first started taking Ambien, the pill I became addicted to.

I’ve been asked this question before, and I’ve come up with a kind of standard answer: I think I was born an addict and becoming dependent on a substance was inevitable for me. But this time the question hit me differently.

“To be honest,” I said after what must have been an uncomfortably long pause, “I think I’ve been treating undiagnosed postpartum anxiety with Ambien. I think if the postpartum period and other issues affecting women weren’t so stigmatized, I might not have treated myself the way I did and might have gotten a different outcome. “

On August 4th, the Food and Drug Administration approved Zurzuvae (a brand name for Zuranolone), the first oral medication specifically designed to treat postpartum depression. This pill is different from most other antidepressants because it works fast and is designed to be taken for a shorter period of time – just 14 days. Additionally, because Zuranolone is a pill, it is more convenient to take than the only other FDA-approved treatment for postpartum depression, intravenous infusion of brexanolone (the). costs $34,000).

Apparently, getting a treatment in pill form is groundbreaking. But just as importantly, I think this announcement has sparked much-needed conversations about a medical condition That affects 1 in 8 young mothers. Conversations that didn’t exist when my son was born almost 26 years ago.

“Do you think I could have postnatal depression?”

It was December 1999 and I was sitting in my obstetrician’s office in a scratchy paper gown that was making my nipples sore from nursing. I closed my eyes briefly and rocked uncomfortably after the words were out of my mouth. I hoped he would smile and say I was wrong. That someone who was as together, young and optimistic as I was, couldn’t possibly come after birth.

Although I worked up the courage to say those words, I had no idea what I would do if he said yes. Because if he said yes, that would mean it was true. And if it were true, then I was flawed.

Six weeks earlier I had given birth for the second time in two years. After the birth of my first son in 1998, I was emotionally overwhelmed but physically fine. I recovered quickly and immediately went back to exercising five days a week and having a heavily planned social life.

I really don’t understand what all the fuss is about. That was easy.

What I knew about the postpartum period was what I saw on the news. It was usually reported that women who killed themselves or their babies suffered. These women were typically white and visibly unstable. None of the new mothers in my life admitted to having experienced the postpartum period. And when it was discussed in our little group of black moms, it felt judgmental, like, ‘Have you heard from Liza? she has a really hard It’s been a long time since she had the baby, poor thing.”

The subtext was that we who didn’t “had a rough time” were somehow the better moms (and people).

My second pregnancy was a copy of my first, carefree and smooth. My contractions were short (three pulses) and almost painless. But a few days after I got home, the reality of my new situation began to make itself felt. I was the mother of a sweet newborn and an equally sweet (but very active) toddler, neither of whom slept more than a few hours at a time.

After a whole week without sleep, I became vaguely aware that an alarm bell was ringing somewhere in my head. And although I didn’t have the language for it, I was full of fear.

I knew I should sleep when my babies slept, but I just couldn’t. The anticipation of them moving in their beds kept me awake. I kept scanning the house with my ears, listening for the faintest whimper before waking.

At first it didn’t occur to me that I might be dealing with a postpartum birth. I didn’t feel flat or listless. And unlike the women in the news, I loved my babies and never considered harming them or myself. I had never heard of postpartum anxiety and had no idea affects up to 20% from new mothers.

I had my nails and hair done before my 6 week postpartum appointment. (I also got waxed before giving birth both times – just to show you guys where my head was.) I figured if I looked better I might feel better, and to be honest I wanted to impress my gynecologist. Throughout my pregnancy he had told me that I was his “easiest patient”. He’d even bragged to the nurses.

I gladly accepted this role. I trained to lose baby weight fast, made sure of it I was always together (no matter what) and never complained or played the victim. I didn’t want to lose that “better-than” status with my obstetrician.

But I really wanted the internal alarm bell to stop ringing.

“Why do you think you have a puerperal illness?”

“I don’t know. I can’t sleep when the babies are asleep and I can’t relax like I always do.”

“Have you lost your appetite? mood swings?”

“What about feelings of hopelessness or crying spells?”

“No, nothing like that.”

I felt relief spread through my body. I didn’t have these symptoms so I couldn’t come after the birth.

“You had two babies back to back,” he smiled. “Let’s just give your body a chance to recover and then see where you are, okay? If you can’t relax in the meantime, just try an evening glass of wine. It should be fine while you breastfeed.”

On the way home in the car, I scolded myself for not telling him about the alarm bell or my feeling of hypervigilance.

Is a gold star from your doctor more important than an improvement?

A few months later, my GP prescribed Ambien for the first time. I had told him that my babies were still not asleep and neither was I (which I had kept secret from everyone). What I didn’t mention was that the alarm bell was louder than ever and I was beginning to experience feelings of hopelessness.

The moment and I mean the moment, When the first Ambien hit my bloodstream, the alarm went off. I slipped under the covers and enjoyed a previously unknown, blissful, velvety stillness. The next morning I woke up invigorated, with no sign of a drug hangover. I felt like a superhero.

Everything will be fine, I thought. As long as I have these pills (forever), I can appear for my family.

My descent into addiction was like Hemingway’s quote about bankruptcy—”gradually and then suddenly.” I started treating my ailments with one Ambien a night. Six years later I was taking up to 10 Ambien every 24 hour period. In addition, my anxiety and insomnia were worse.

In July 2008 I went into treatment to get help. But despite being evaluated by several medical professionals, including therapists, it never occurred to anyone that my addiction to Ambien began when I started self-medicating after childbirth, without a diagnosis having been made.

Researchers have found that this is the case in women after childbirth a higher risk of substance abuse compared to postpartum women without depressive symptoms. Conversely, women with a history of substance abuse are more likely to show symptoms of postpartum depression.

I was ashamed to even say the word “postpartum” out loud – I thought it would make me a bad mother. When my doctor dismissed my symptoms, I ended up treating my postpartum anxiety with Ambien.

When I first read about Zurzuvae, I asked myself: What if this pill had been available after my babies were born? Would I have been a better mother? Would I still have become addicted?

Pregnancy and childbirth are considered risky times for depressive symptoms. Combine that with addiction and you have a recipe for tragedy. As long as we are afraid to talk about what we are experiencing, we will be more inclined to self-medicate with substances.

Hopefully, Zurzuvae is just the beginning of a long-overdue trend of drugs and talk aimed at giving young mothers and their children a chance at a better life.

Do you need help with a substance use disorder or mental health issue? In the US, call 800-662-HELP (4357). National SAMHSA Helpline.

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