Postpartum Depression and Type 1 Diabetes

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I have debated whether or not I should write a blog post on this topic.  It’s such a personal topic that I feel like I am really exposing myself, but I also feel like the issue isn’t really discussed as much as it should be.  Even though it’s something that can’t be controlled or prevented, I feel like there is still a stigma with having it or talking about it.  It isn’t all like the way it’s portrayed on the TV show Nashville, although it’s nice the show is getting the conversation started and huge props to the actress, Hayden Panettiere, who has come forward saying she has it as well.

Fellow moms will tell you about the sleepless nights they get or about the teething pains but from my experience, admitting that you are struggling with being a new mommy isn’t really conversation for a playdate.  Throw in Type 1 diabetes to the mix, which is pretty much an invisible illness, there is even less conversation happening on how tough it can be dealing with both postpartum depression and Type 1 diabetes.

Diabetes and depression (not postpartum depression) often go hand in hand. So it’s not surprising that one study I read online from the Journal of the American Medical Association stated that women with diabetes are twice as likely to suffer postpartum depression (although diabetes wasn’t necessarily the cause of the PPD, the study just showed their was a correlation between the two).  In researching PPD, I didn’t see much information out there, and I couldn’t find any material on PPD and T1D so I thought I’d share my story.  I will preface this to say I’m not sure if I technically had PPD but from things I’ve read I was definitely somewhere on the spectrum.

The first 6 weeks or so weren’t too bad.  I was completely exhausted but my son and I just slept a lot.  I had my husband helping out a lot with my son and in general (meals, house chores, errands, etc.).  My son was also born in November so we had the holidays as a distraction (Thanksgiving, Christmas, New Year’s) and family visiting from out of town.  I didn’t notice feeling down at all those first weeks.  I was exhausted so any baby blues I was feeling, I figured it was just the exhaustion.  I had my 6-week appointment with my OB, where she asked how I was doing but I smiled and said I was doing fine so she didn’t think anything was up (neither did I).

Then my husband went back to work, the holidays were over and family stopped visiting.  I was feeling exhausted and down.  I thought it was just baby blues but I read that baby blues usually passes around the 6-week mark.

I was a basket full of emotions.  I was stressed all the time about my baby’s sleeping and eating schedule. I was feeling guilty that I wasn’t talking to him enough (I was talking to him a lot but I thought it wasn’t enough).  I had days where I felt like a dark cloud was over my head and I couldn’t shake it.  I had days where I just wanted to lay in bed all day and days where I wanted to cry.

The first 8 months of my son’s life, he wasn’t a very good sleeper.  I was extremely overtired and my blood sugars were erratic as a result.  I remember going to my endocrinologist and she looked at how my blood sugars would spike overnight, likely due to the dawn phenomenon starting early because my son would wake up so much overnight.  She told me that all I needed to do was get him to sleep through the night then I wouldn’t have highs overnight.  I wish it were that easy!  The lack of sleep was really accumulating and taking its toll.

One particularly bad episode is when my husband’s sister came to visit us around my son’s 4-month mark. I was so excited she came to visit and hang out that I was on a very high high from the visit. She was only in town for two days so I was looking forward to making the most of it.  On the first day, we had a lot of fun, doing tourisy stuff around Richmond and going out to eat.  The second day we were also having a lot of fun but then in the afternoon she went to go lay down for a few (probably exhausted because I had us on the constant move!) and my husband took our baby to try to get him to sleep so then I was all alone with my emotions. I think being so happy to be hanging out with her left me really, really low when she wasn’t hanging out anymore.  Being all alone, the emotions really got to me and I started crying and couldn’t stop. I ended up going to my husband and I got really angry with him that no one was hanging out with me.  Even reading this now, I realize how ridiculous it sounds but I just couldn’t control my emotions. I felt like I had this huge dark cloud above me and I was so emotional.   My husband had no idea how to deal with me.  I don’t think he really understood what I was going through.  He was also living off of the few hours of sleep as well so he was probably more emotional than usual.  He didn’t know why I was so upset and instead of realizing it was the hormones, he felt attacked and fought back which of course only made things worse.  This is an extreme example and luckily “episodes” like this didn’t happen very often but I was constantly feeling tired and down.

So, I started to do research on postpartum depression to see if what I was feeling was normal, if there was something I could do to shake the blues or if I needed to see someone for help.

The first thing I found was a list of who was more susceptible to PPD.  According to my research, if you have any of the following you are more likely to suffer from PPD:

  • Bouts of intense anxiety or depression while you were pregnant, particularly in the third trimester
  • Prior history of depression or anxiety
  • Family history of depression or anxiety
  • Marital difficulties
  • Stressful life events such as financial problems or the loss of a job
  • Childcare stress
  • Inadequate social support
  • Having to care for a child with a difficult temperament
  • Low self-esteem
  • Unplanned or unwanted pregnancy
  • Being single
  • Lower socioeconomic status

To be honest, none of those really applied to me.  My marriage is solid.  I haven’t had any stressful life events (recently that I can recall at least, although owning your own business is a constant stressor!).  I don’t think I have low self-esteem.   If I had to pick one that applied to me, I would say that I had an inadequate social support.  My husband and I moved from Northern Virginia to Richmond, Virginia (90 miles south) to be closer to family but we moved away from our friends.  My husband and I work from home so it’s been hard to meet people and my family is pretty busy so they weren’t really around to help out either.  My hubby and I really felt alone with taking care of this baby and not having anyone to talk to or get help from (although we did get some nice dinners from neighbors in the beginning which was great!).  I’ve discovered that the phrase “It takes a village” is so true! Besides the inadequate support system, I’d say my diabetes might be the single other factor contributing to my PPD.

While not many of the above applied to me, the symptoms sure did jump out at me.  Here are some of the symptoms for postpartum depression:

  • Irritability or hypersensitivity
  • Difficulty concentrating
  • Anxiety and worry
  • Crying or tearfulness
  • Anger
  • Negative feelings such as sadness, hopelessness, helplessness, or guilt
  • Loss of interest in activities you usually enjoy
  • Difficulty sleeping (especially returning to sleep)
  • Fatigue or exhaustion
  • Changes in appetite or eating habits
  • Headaches, stomachaches, muscle or backaches
  • Some women with PPD believe they can’t adequately care for their baby or may harm their baby.

Reading over that list, a few really spoke to me.  I was definitely super sensitive (my husband can attest to this!).  I definitely had difficulty concentrating, which was pretty unusual for me.   I normally enjoy reading books but I was finding it so hard to read even a few pages.  I also couldn’t concentrate on TV shows or movies.   I was definitely having anxiety and worrying and had negative feelings of sadness and guilt.  I also shed some tears over the months.  I was exhausted but figured it was waking up every two hours (which was probably most of it!). However, I didn’t have any headaches or stomachaches and I never thought I would harm my baby (other than not talking to him enough!).  But I think enough of the symptoms applied to me.

One website I found Postpartum Progress (awesome resource!) had an article describing the postpartum symptoms that really hit home with me.  She expands on the symptoms more but a few that really spoke to me were the following:

  • You feel overwhelmed. (Yes times 100!)
  • You feel guilty because you believe you should be handling new motherhood better than this.  (YES!)
  • You don’t feel bonded to your baby.  (I felt this way at first)
  • You can’t understand why this is happening.  You are very confused and scared. (In terms of my emotions, yes)
  • You feel irritated or angry. (Somewhat but not really)
  • You feel nothing. Emptiness and numbness. You are just going through the motions. (At times)
  • You feel sadness to the depths of your soul. (I had my moments)
  • You feel hopeless, like this situation will never ever get better. (Yep)
  • You can’t bring yourself to eat, or perhaps the only thing that makes you feel better is eating. (Well this didn’t affect me, I love to eat haha)
  • You can’t sleep when the baby sleeps, nor can you sleep at any other time. Or maybe you can fall asleep, but you wake up in the middle of the night and can’t go back to sleep no matter how tired you are.  Or maybe all you can do is sleep and you can’t seem to stay awake to get the most basic things done.  Whichever it is, your sleeping is completely screwed up and it’s not just because you have a newborn.
  • You can’t concentrate. You can’t focus. You can’t think of the words you want to say. You can’t remember what you were supposed to do. You can’t make a decision. You feel like you’re in a fog. (YES!!!!!!!)
  • You feel disconnected. You feel strangely apart from everyone for some reason, like there’s an invisible wall between you and the rest of the world. (Yep, I felt this from time to time)
  • Maybe you’re doing everything right. You are exercising. You are taking your vitamins. You have a healthy spirituality.  You do yoga. You’re thinking “Why can’t I just get over this?”  You feel like you should be able to snap out of it, but you can’t. (True)

Reviewing the above lists, it really became evident that I had some degree of postpartum depression.  Besides my husband, I really kept it to myself.  It wasn’t until I was talking with a friend who had her child shortly after I did that I realized I wasn’t alone.  She was going through very similar emotions and when we were texting one day asking about how our babies were and she mentioned something about how she was feeling and I thought I’m not alone!  We met for lunch and completely unloaded on each other and it was so therapeutic. I’m still so grateful that I had her to confide in.

While it was so nice to talk to my friend, she doesn’t have T1D so she couldn’t quite understand everything I was going through.  Days when I was the most exhausted, when the emotions really got to me, I also had high blood sugars to fight.  It always seemed like my worst days emotionally also happened to be my worst blood sugar days.  It really exacerbated the issue.  Not only did I feel like I was failing at motherhood but I was also failing with my diabetes care, which I had exceled at when I was pregnant. It was pretty tough and I didn’t really find many resources on T1D and PPD, which is why I decided to share my story.  I don’t really have any answers but knowing that someone else with T1D is also suffering from PPD might help someone to not feel alone.  It’s been so tough to manage my diabetes and feel burdened with all these emotions, while still trying to take care of a newborn baby!

Luckily, I feel like I am finally coming out of my fog.  Looking back, I wonder if it was just that I was extremely exhausted or if I really was suffering from PPD.  My son was an awful sleeper so sometimes I think it was just exhaustion but when I review the symptoms, so many of them did apply to me so I think I was dealing with PPD at least on some level.

Around the 8-month mark things started to get better.  We hired a sleep consultant and after about a month, we finally got on a nice schedule and my son has been a pretty good sleeper every since!  I don’t want to jinx myself but nowadays he goes to bed around 7 and sleeps until 7-12 hours! It’s so amazing to finally catch up on sleep.  Around that same time, I decided my son was getting more playful and we needed to get out more.  I joined a couple of Mommy and Me playgroups and we started going to the library for story time and music classes at a local church.  Between the improved sleep schedule and getting out of the house, I was finally starting to feel more like myself.  My blood sugars also started to improve, especially overnight since I was no longer having to get up 5 times in the middle of the night!

My OB told me that PPD can usually come back following subsequent births.  When times were really bad, my husband and I decided we didn’t want to have any more kids because this was so difficult.  I had always wanted at least two kids so this was hard to admit.  Luckily, things have gotten better (we finally caught up on sleep!) so we are considering a second kid.  If we do have another kid and I begin to feel the blues again I wanted to make sure I have some tips for my future self (and others-not medical advice just some tips I want to remember!):

  • Tell yourself “It will get better!”
  • Don’t wait too long to get on a good sleep schedule.
  • Get outside more!
  • Really try hard to wear the CGM as much as possible-it can really help with blood glucose management when times get too exhausting.
  • Make sure and take care of yourself because if you aren’t, it’s much harder to take care of others.
  • Don’t beat yourself up too badly about poor blood glucose control but don’t let it get too far from a top priority either
  • Talk to fellow moms (and the DOC!) more!  Maybe someone else is going through something similar and sometimes it just helps to know you aren’t the only one going through this! And don’t be afraid to talk about it.

10 thoughts on “Postpartum Depression and Type 1 Diabetes

  1. I’m glad you wrote this. I was feeling the very same emotions. I’m not a first time mom but so much was happening all at once that I felt overwhelmed and alone. I didn’t feel very bonded to my son at first and felt guilty for wishing for simpler days before him. I just didn’t know how to handle two kids. My husband was helping as much as he could but I felt like it wasn’t enough. This past, almost, year has been so rough. I contemplated not even thinking about diabetes so I could focus more on the kids. I found myself crying every night over nothing and everything. Barely now am I starting to feel normal again. Whatever that means. Haha. And now I wish I could have a do over because I wasted so much time feeling lost that I feel like I missed my sons whole first year. This is such a real issue. One I wish got more support.

    • Yes! Exactly! I see new moms with like 2 month old babies and I feel like I miss that so much because I didn’t really enjoy it at the time because I was just trying to survive. It has definitely been one of the toughest years of my life. I really wish there was more support too! And it’s crazy because our hospital had PPD classes but my husband and I talked about it and we were always like “No, I’m good I don’t need to go to that”, kind of more denial even though I knew I was going through it.

  2. I have so many thoughts/reactions to this I don’t even know where to start. I am 3mpp and while I don’t think I have PPD/PPA, I have SO OFTEN wished for a support group of women going through postpartum with T1D. No one gets it and how could they? For me the first 3 weeks were absolute hell on earth. I was recovering from a c-section (breech baby), baby had tongue tie, couldn’t nurse, I developed mastitis and thrush…honestly, the list goes on and on. After three 3 weeks I committed to exclusively pumping for which I STILL feel guilt and sadness over because nursing did not work. I seriously questioned why we even had a child in the first place and had extreme anxiety for pretty much 3 weeks. I actually said to my mom at one point, “I feel nothing. Like, I am dead inside. I am not happy, I am not sad, I am numb.” I also told my husband that if I were to leave the house for the day I wouldn’t miss my baby. We all agreed that if I didn’t feel differently by the end of that week I would call my doctor, but strangely enough, by the end of the 3rd week I did feel differently.

    Anyway, fast forward 3 months and on so many levels we are all doing much, much better, but I still have so many moments where I am just tired of having to do all things “mother” while also having Type 1. I think a huge part for me has also been trying to process the fact that I a) got pregnant, b) got through pregnancy, c) had a c-section and didn’t die in the process <—-I was truly scared of this, d) baby was not stillbirth <—also a huge fear I would not share outloud.

    We carry all of these HUGE, SCARY thoughts in our head because of our diabetes, but if you're like me, don't say them outloud because it will just terrify your loved ones. When you finally make it to the other side and you're just a "normal mother" trying to figure it out what you really want to scream from the mountain tops is "HOLY FUCKING SHIT, I'M ALIVE AND I'M KICKING ASS RIGHT NOW!!!!"

    I feel you 1,000,000,000%, Kelley. Thanks for writing this post.

    • Yes! Yes, I completely agree with those scary thoughts! I was so scared of the c-csetion and having a stillbirth! I still don’t know how I got through the pregnancy haha. Thanks for your comments! It’s so nice to hear that I’m not the only one. I was really unsure about sharing this post but it’s just so hard to deal with all these emotions all on your own with no one that can really understand! I wish there was some sort of T1D and PPD support group because it would have really helped these last few months.

  3. Hi Kelley – thanks so much for writing this very brave and honest post. I love your blog (this is the first time I have commented but I have been reading it for about a year now) and can relate to so much of what you write. I live in London, England and am a type 1 diabetic mum of two and have had type 1 for 25+ years. I also had c-sections with both babies (my son was breech and obstetrician thought having a VBAC was too risky with my daughter). I don’t think I suffered from PPD after either birth but I think being massively sleep deprived after each extremely stressful pregnancy (testing obsessively, freaking out whenever I was a bit too high, being terrified of stillbirth etc.) on top of having type 1 is sooo tough. What is weird is that when I am really tired, I feel like my blood sugar is really low all day long, even when it isn’t. UGGHHH, Anyway, I felt so frustrated that no one could really understand what I was going through that I have started a mini-support group with other type 1 ladies who attend the same hospital in London as I do. It is very early days and there are only a few of us – some pregnant, some who have one or two kids- but meeting these ladies has been really lovely. We have met for coffee and lunch a few times and sometimes just email or text. I was hoping to take things up a notch but in between looking after two kids, going back to work part time from January and trying to look after myself (and be a decent wife!), I am not sure how much time I will have to do so. I don’t know whether it would be possible for you to set up something like that locally where you are? It might be a great source of support especially as you said you are planning another pregnancy. I also wanted to say that your son is so adorable and it is so great that he is in a good routine – being well-rested makes everything, including diabetes management, so much easier. Thanks again for your fantastic blog 🙂

    • Aw, thanks 🙂 The group that you have started sounds really nice. I would love to have something like that but I don’t even know where I would begin! I don’t know too many T1Ds in my city but I should try to look into it. Good to hear from you!

  4. Hi Kelley – could your doctor/clinic help you with setting up a group? My doctor and the diabetes specialist nurse actually put me in touch with other type1 ladies who were trying to conceive, pregnant or had recently had babies. I set up a gmail account and they give the email address to anyone who they see who think might be interested.

  5. Thank you so much. I have constant anxiety and panic attacks because I’m worried I will be too high or low to take care of my child (this started when he was 6 months old). I was so proud to have a healthy baby while I had t1 diabetes, but I had no idea how hard diabetes would make it afterwards as well. Thank you so much for sharing!

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