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Spokane group works to get up for mom experiencing postpartum depression

Spokesman-Review - 8/24/2023

Aug. 23—Waking up her husband with their newborn in hand, Erin Skoog saw herself as entirely incompetent and incapable of taking care of their son. But as soon as the baby was placed in the arms of her sleepy spouse, she felt the "shame of it all come crashing down." Then she tried to take her child back.

Amid a severe mental health crisis brought on by postpartum depression, Erin Skoog ended that night in jail — having grabbed and punched her husband to get her baby back.

Accounting for symptoms ranging from the so-called "baby blues" to life-debilitating suicidal ideation, up to 1 in 7 of those who have given birth experience postpartum depression, said Providence Sacred Heart obstetrician Dr. Robin Messinger .

Unlike general depression, postpartum depression is specifically caused by the high levels of hormones precipitously falling in the hours and days after birth.

"In the first two weeks after delivery, there are so many hormonal changes that are going on. Because when you're pregnant, your estrogen levels and your progesterone levels are at a remarkably high level, and then you deliver and it's this immediate drop," MultiCare Rockwood clinic obstetrician Lacey Marks said in an interview.

In those first two weeks it is extremely common to have dramatic mood swings and feel emotional or tearful suddenly for no reason. But postpartum depression is often the cause if these symptoms do not subside two weeks following the birth.

"If you are still feeling depressed or are having thoughts of hurting yourself or your partner or your baby — those are all considered to be part of the postpartum depression continuum of diagnosis," Marks said. "Women often don't realize how common those symptoms really are."

Cloaked by her shame, Erin Skoog experienced intrusive thoughts often in the months after she gave birth.

"Sleep was becoming less and less. I was afraid of myself. My thoughts weren't coherent, and my physical body felt foreign to me," she said.

A transplant from the Midwest, Erin Skoog moved to Spokane to be with her husband in 2015 and the couple welcomed their first child in 2017. In her mid-20s away from her large family, she was in a stalled labor for four days at the hospital before she was suddenly taken for an unexpected C-section. Symptoms of her postpartum depression originated in part from her traumatic birth experience, she believes.

"I was stitched and brought to recovery, where I dry heaved over a pillow while the room spinned around me and the nurse and my husband held a pillow to my abdomen so the stitches wouldn't blow out," she said. "Skin to skin with my newborn was the only thing stopping the spinning, but the nurses would remove baby in case we fell asleep."

Discharged a day later, she was left "alone and healing physically" but "lost mentally." An all-consuming depression that followed was a "quiet beast" she tried to hide while pretending to be the "new mom who had it all together."

Erin Skoog felt unable to open up to her husband about her growing depression or pursue professional treatment. She felt like a bad mom and a bad person.

"At my postpartum checkups I couldn't say anything," she said. " Their questionnaires feel cold. And I know there is only so much they can do. But it feels almost shameful to be completely vulnerable and honest on these forms. Because you feel like you might just get called crazy and put in a room with the key thrown away."

Shortly before their son's birth, Erin and Ben Skoog started a roofing business together — leaving Ben away from his wife and newborn for long stretches while keeping the new business afloat. He did not know how much his wife was struggling.

"I was totally naïve. I had no idea how to be supportive. I guess you can't be prepared for a child. I wasn't. And it was hard for Erin especially. And I didn't know," he said.

The night of Erin's arrest, Ben slept on the living room couch — hoping not to wake his wife or baby when he left before sunrise for a roofing job in Pullman. Waking to his crying wife, she said he needed to take the baby away from her.

"I was hysterical, erratic," remembered Erin Skoog. "As soon as I said that just something washed over me that I was incapable. I wasn't able to do this."

But as he took the baby and stepped away, she felt an "inescapable need" to prove she could care for her baby.

"I needed to prove that I can be a good mom, I can take care of my baby. And it was just a big clash of knowing I needed help but feeling so much shame, even just getting help from my husband," she said.

Instead, she tried to take the baby back. He stepped away and she "grabbed" his arm and "hit his arm" with her fist, according to Erin Skoog's recollection.

"I had never been hit like that," Ben Skoog recalled — noting he "would not accept being hit or physically violated." Unsure of how to calm his wife, he called the police. Against his wishes she was arrested.

"I thought we would get mental health help. I definitely did not expect that. I was completely naïve. Once I realized they were trying to build a case, I just shut up. I did not expect jail, but I felt helpless," he said.

Erin Skoog spent a night in jail before charges were eventually dropped. But the rift in their marriage went much longer. She began therapy to work through her postpartum depression and latent PTSD from her childhood.

"I was raised in a violent abusive household where I left when I was 18 and I maintain minimal contact with the majority of them. It was a violent home where sexual, physical, verbal, mental and emotional abuse ran rampant," Erin said explaining the violent incident — while noting her past does not excuse her actions that night.

"Being raised in that environment brought up things that I could never have imagined or have been ready for when becoming a parent ... emotions, repressed memories, fears and anxieties to name a few," she said.

Those with pre-existing depression or other mental health diagnoses are at a much higher risk for postpartum depression, Marks said.

"More often than not, if a woman has a severe postpartum depression, typically, it's more likely to occur in somebody who already has a pre-existing diagnosis of some form of depressive disorder," Marks said.

Common symptoms of postpartum depression include exhaustion, sadness, a lack of bonding, decreased interest in doing normal activities, irritability, excessive anger, a desire to isolate yourself and thoughts of wanting to hurt yourself or others or the baby. Often early signs of these symptoms can be difficult to spot because they overlap with the normal exhaustion someone has after giving birth.

"Postpartum depression is a significantly worse exhaustion. It's exhaustion where you just do not feel as if you can motivate yourself to get out of bed as opposed to an exhaustion from not sleeping well," Marks said.

It took several years for Erin Skoog to fully recover from giving birth and her postpartum depression. The same symptoms reappeared after her second child was born a few years later. But this time she had support and a name for her condition.

"It felt like it was happening all over again. But I was able to call in my support team, my friends, my in-laws, and they were all able to be there to just surround me and help me. I was in constant contact with my therapist, and we got on the route to healing together sooner," Skoog said of her second son's birth. "It was something I was expecting, but I did not expect it to happen so intensely again the second time."

In recent years, Erin Skoog started working with local group Spokane Mama — in part to raise awareness around postpartum depression. The nonprofit is aimed at providing social opportunities and resources to Moms who may feel the "insecurity and isolation often found in motherhood," according to its website.

Kristen Rataezyk is another member of Spokane Mama who struggled after the birth of her child. The 28-year-old mother of a now 2-year-old daughter is reticent to describe what she experienced as post-partum depression — symptoms of her depression dissipated a few weeks following the birth. But many of these "baby blues" symptoms are characterized in the diagnosis of postpartum depression as well.

"I would be fine through the day, but every single night it would hit me like a ton of bricks. I would be horribly depressed," she said in an interview. "I just wanted to die. It was horrible. I felt nothing. I didn't feel a connection to her. I felt empty. And I don't think I've ever felt that depressed in my entire life. Every single day for a few weeks I was like that."

But for Rataezyk the larger impact on her life has been the crippling anxiety she felt shortly after her daughter's birth — symptoms she still experiences.

"Ever since she was born, I have had this horrible anxiety that something was going to happen to her. And that anxiety convinced me of unrealistic things," she said. These fears left her unable to leave her daughter's side or to leave the house.

Messinger, of Sacred Heart, called postpartum anxiety "along the spectrum" of postpartum depression.

"Postpartum anxiety is associated with a feeling of being overwhelmed or a hyper-vigilance with care of the baby and not being able to relax," she described.

Over time, Rataezyk was able to distinguish warranted fears and those that were unrealistic, but she still suffers from extremely high anxiety regarding her daughter more than 2 1/2 years after her birth.

"I still have such bad anxiety, even just taking her to the park. I'm constantly looking over my shoulder and it is difficult never allowing myself to ever take my guard down for a second," she said.

Like Erin Skoog, Rataezyk did not confide these fears for a long time, even to her husband, and experienced much shame over her symptoms.

"Struggling as a mother is such a stigmatized thing. It shouldn't be but people don't understand, and people can be nasty," Rataezyk said. "My husband is my best friend, and I didn't go to him. If I had, I know he could have helped me. There would have been no judgment at all. But I had judgment for myself. I felt ashamed to feel these things and I was embarrassed."

Having joined Spokane Mama in the past year, Rataezyk said the community she found in the group has been helpful.

"I really want other moms to know that it's OK to feel that way. And it's normal, and you don't have to be ashamed of it. You don't have to be embarrassed. And it's OK to find the community where you can relate your feelings and your struggle. Its hard but it gets better," she said.

Now Spokane Mama's vice president, Erin Skoog realizes many mothers feel shame around any difficulty they may have as a parent, especially those that result from postpartum depression.

"Unless someone hears another mom speaking out about it, they might think something is wrong with them. I'm not alone. I'm not the only one. I'm not bad. I'm not shameful. I just need help. I need support. And I don't think there's enough of that," she said. "The more women are open and vulnerable about what they've gone through, the more other women who are suffering in silence will recognize their symptoms. Because it's more commonplace than we think."

In her practice, Dr. Lacey Marks has seen many women who are "afraid to come forward and discuss" their symptoms of postpartum depression.

"These patients are afraid they are going to be labeled as 'crazy' or there is a problem with them as a human being, as opposed to having a recognized medical diagnosis based upon a hormonal imbalance."

But her patients with postpartum depression have been some of the most impactful in her career, Marks added. Often these individuals begin treatment believing it is "not possible to go back to how they were before they gave birth." But those same women can make a turnaround with treatment.

"Treating women with postpartum depression is incredibly rewarding because specifically with treatment, with medication and with counseling, these women often do remarkably well and find there is life after giving birth."

Both Rataezyk and Erin Skoog described the joy they feel as mothers — how their children have made their life better in uncountable ways.

"Being a mother changes you on a cellular level. Many of those changes bring hardships, but there is also joy. And that was difficult to see at the time," Erin Skoog said.

"When you have a kid, its like your heart is walking outside your body," Rataezyk said. "Being able to see this amazing little piece of me to grow and talk and learn things, and find excitement and everything — I mean, a leaf falls on the ground and she's the most excited she's ever been. She helps get back to being a kid."


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