Alicia Cooley: My name is Alicia Cooley. I am 38 years old and I heard about the ďSpeak Up When You're DownĒ campaign while I was in the hospital after the birth of my first daughter.

Speaker: When did you first hear the term PPD?

Alicia: I had heard it years ago, in relation to other people or news stories, usually the most extreme cases, usually a psychosis. You hear about unfortunate incidents. I had heard about it but never thought it would apply to me.

Speaker: What was your pregnancy experience like?

Alicia: It was difficult. There were potential complications. I was 34 at the time. Since I was close to 35, they were treating me as high risk. There was always something with her pregnancy, back and forth, a potential blood clot in my leg, family history of heart disease, multiple ultrasounds. So the delivery went fine. I had to be induced, but she had no color, her body temperature was low so I held her for about a second and they took her in a warm room down the hall. That was pretty nerve-wracking at first. After that, she was fine. They thought she had a spinal issue. She has a tiny opening above her rectum so they were afraid the spinal cord didnít close, but she was fine. It was one red flag after another that there could be potential complications. I didnít have a great pregnancy. The delivery was as good as you can get when you are induced. It was vaginal, it was six hours of intense pain and then she was fine.

My recovery was really easy I would say. I was fine, I was elated, so excited she was born. We didnít know the sex so we were like, wow itís a girl! Wait, where are you taking her? And then they brought her back later and she was fine. When I asked about her Apgar scores, what was wrong? Why did you take her? She scored a 0 on color, she had no color. But she was term and everything leading up until that seemed fine. She just, she didnít come on the due date so thatís why I was induced. My pregnancy the second time was very difficult, the second time.

Speaker: Was that a planned pregnancy?

Alicia: It was planned. We did plan it. We knew we wanted two kids. It didnít happen right away so it was like the back burner, it will happen eventually. I didnít even know I was pregnant until I was three months along. We had just lost my father in-law so there was an intense period of time where he was in ICU, we were back and forth to the hospital. I got my period once then skipped it. I thought nothing of it, it was stress. I bought new scrubs and then all of a sudden they didnít fit and I had two different people ask me (if I was pregnant) and I was so offended, I thought I wasnít (pregnant).

After a week or so, I took a test and I was 11 weeks along at that point, so we didnít have as much time to prepare as we planned. And we were still grieving and it was bad timing. I hurt my knee. I was out of work so I was not getting paid. My husband hurt his knee and he was out, but he was getting paid. And we both had rehab and he had surgery and we were concerned about the recovery.

Megan was still in the nursery. We wanted to get the room ready before the new baby came. After Sarah was born, she was in our room for almost a year until we were able to get the other room ready.

Speaker: How was your pregnancy with Sarah? What was the experience like? Did you have anxiety at all about the pregnancy?

Alicia: I was concerned about how my husband was going to react. If it had been any other time in our lives I think it would have been fine, but I knew he wasnít going to be excited he wasnít going to be fine or want the baby. He would feel overwhelmed. That was my concern and the other was, I lost three months to get ready. I am a procrastinator by nature but I like to be prepared for children and have things taken care of so the stress level went up. And it was poor timing. We wanted a child, just the timing wasnít for us.

Speaker: Did you have any difficulties during delivery?

Alicia: We had another blood clot scare and we met with a cardiac specialist, a pediatric one, and they ran tests and they were ruling out a congenital heart defect and all looked well in the tests. And they could only test for 15 out of 40 conditions so it wasnít an all clear. So we said, OK, thatís all we can do. We crossed it off the list of things to worry about. I really wasnít sleeping well at all. I had really bad varicose veins that started and got worse with Sarah, my second. She was breach and wasnít turning so I was trying crazy home remedies trying to get her to turn. My OB/GYN said you seem anxious about the possibility of a C-section. I didnít want it. I donít want to have to go through a surgical recovery if I donít need to. We tried an external procedure where they give you painkillers and they push on your stomach and she started going but the heart rate dropped so that was an issue. The placenta was in the wrong spot, potentially, which could have made me bleed out. It was one thing after another. She was 75 percent of the way around, I didnít want to have to be cut, but her heart rate was at 70 and then 50 and it was time to go.

I had all these nightmares about two weeks prior and it was going to be a C-section and it always ended with them saying, we are losing her, and I died on the table. I was so convinced I was having a boy. The whole pregnancy felt different so I thought I must have testosterone in my system and in the dream it was me dying and it was a motherless child and my older daughter wouldnít have a mom. And it was terrifying, living that every night whenever I had it. It was so bad. I didnít want to tell my husband. I wasnít talking to anyone about it. I just got more and more anxious.

He (the doctor) was right. She was out in probably under five minutes. He asked my husband if he had a camera and told him to get it now, sheís coming. He called his mother and said, they are cutting now. When he came back in, she was on her way out. He had a really traumatic view of lots of blood and gore. Usually the father is behind the curtain but he walked into the thick of it. It was traumatic for both of us, but she was healthy and I survived to tell the tale.

Speaker: How were you feeling in the hospital after delivery?

Alicia: I had a few nightmares here and there. I was on a lot of drugs so you canít tell if itís hallucinating. I would wake up in a cold sweat and short of breath thinking something was wrong. Then I realized she was born, it was OK. I hurt like hell but I was OK. I started to have flashbacks and that continued for two weeks after. They were many times when I was sleeping, sometimes in midday if I was doing something else, I was on the table with that feeling of dread and I would shake and I felt like I couldnít breathe and I was going to pass out.

Speaker: Do you recall being tested before you left the hospital?

Alicia: Two young women came in together, maybe students, and my husband was there and they asked me if they could do the 10 questions, it would be quick. Snd I answered all the questions to the affirmative. Within the last week I had felt nervous or anxious or sad or cried Ö all of the above. I was scared of having the surgery and afraid. I had this feeling of dread all the time, that something bad was going to happen.

Speaker: When you completed the questionnaire did you get referred to a therapist?

Alicia: They recommended I speak to someone in the department. As far as, they run their own support group, and they would contact me at home and they did two weeks later. And I was home I guess about two weeks and I had said to my husband, I need to get to see one of these therapists. All I did was cry all day long. So we went over there and I met with a woman and I wish I remembered her name, she was very kind. I spent about 45 minutes with her crying and she said, this is common and itís not under your control. Donít feel bad, you can continue to come to the support group but then you will have to drive into the city and park and walk. You may want to go to the one that we hold that will be in the suburbs and you will feel more comfortable so I went to that, the TLC program.

Speaker: How did you know what you were going through was different then how you felt after you had your first daughter?

Alicia: I noticed even in the hospital I wanted to hold her and I asked someone if they wanted to hold her, almost pass her off, let her rest. I was so exhausted from the surgery and I was coming down with pneumonia at the time and then I was diagnosed with that so maybe I just felt so lethargic because of the pneumonia and I just had major surgery. I just wanted to sleep and I wanted to sleep for four years and wake up when things were easier. And I just felt like the whole pregnancy was exhausting and now this and I felt even worse. I had a 2-year-old also begging for attention and all the typical things that needed to be done. I donít have time for her or myself. I want to check out and go somewhere and sleep for a while. I wasnít interested.

And my husband is wonderful. He was so nurturing to her and to this day she still is daddyís little girl whereas Megan has always been my girl. So I guess itís good in that way, they got what they needed from one of us. I couldnít give to her at that time. I knew that wasnít normal.

Speaker: Did your husband approach you about it or did he just know because you were so open?

Alicia: He never brought it up but I knew he noticed how I was irritable. If I wasnít crying and if I wasnít irritable, I was trying to go to sleep, just leave me alone, very different than my typical personality. I lost interest, I didnít want to call people back, a huge amount of energy talking to people about why it was a C-section and how everything turned out and rehash all of that. I wanted to be alone and Iím a very social person by nature so I was very honest and I said to him, I think I am going crazy, there is something wrong with me. I look at Sarah and sheís just this alien baby to me. I donít feel like sheís mine. If I wasnít in the room I wouldnít have believed she was mine. And she was such a different baby then Megan. All the books say that will happen so you think, but really they were like night and day. Everything we thought we knew went out the window. She was colicky, which made it worse. He and I were sleep-deprived. I have to get to one of these meetings, I am literally going to lose my mind or run out of here. I couldnít take it anymore.

Speaker: Did you do individual therapy as well as the original support group?

Alicia: I did. She gave me a few recommendations of people to call in my area so I called and I found a wonderful therapist, a clinical social worker. I still see her to this day. It has been two years now and sheís been there the whole time, thatís wonderful. My psychiatrists and I took antidepressants and a sleep aid because I was an insomniac so that helped to an extent until I went back to work part time and the antidepressants werenít enough to get me through the day. I tried switching medications and I have a lot of drug sensitivities and allergies. There are drugs that work for many people, but I canít take them. I switched psychiatrists to someone I felt was more intuitive to that he listened to the experiences I have had before as far as sensitivities. He found the right cocktail for me and that has made a huge difference in my life.

Speaker: How long were you going before you noticed a change?

Alicia: About four months I saw a change. I went back to work when she was 3 months and work was good for me. It was an outlet, something I felt I was good at, something where I got a break to use the bathroom by myself, to be around adults and it was huge. I had felt like a prisoner in my own house until that point so I felt better when I went back into my old routines. As far as a real noticeable change, around month seven, when I was changing up my medication a little bit more and had more energy. She was beginning to sit up and talk and more interactive and I finally felt connected to her. I felt like this could be a good thing. She was getting to know me and I her and I liked it.

Speaker: When did you begin to feel the bond you should have had with her?

Alicia: At night, just sitting and rocking with her in the chair, once ... the colicky nights were very bad until then and then all of a sudden she calmed down. She would curl up against my shoulder. I would rock and she would stroke my cheek or hair and I would think this is my beautiful baby girl. I wish I had felt that all along but I couldnít and I have regret that I wasnít able to give to her the ways a mother usually would or could but I was doing the best I could. I did everything right according to the experts. Itís just, it took my body a while to readjust.

Speaker: Did you do any journaling, and what was your experience with the support group like?

Alicia: I enjoyed them. The TLC group was on Wednesdays during the day. I went for about two months before I went back to work and I was unable to attend, but I attended a different one where you could bring your children and they could play in a play center and that really helped a lot and I still go to that. Some days are better than others. I was supposed to be doing journaling but I was bad at it. I would sit and as soon as I would think about what I wanted to write I would get even more depressed if that makes sense to you. I didnít want to commit those words and thoughts to paper. God forbid someone else should see them. I should be grateful that I have this wonderful family and I felt anything but. I was really overwhelmed and I rather not put that down.

Speaker: How often did you go to the sessions?

Alicia: I saw my social worker once a week for several months and then we dropped down to twice a month. Now I see her once every three weeks to go back and check in. The whole postpartum was difficult to the marriage. We have other family issues that were stressful so my husband dealing with those and he and I in our interaction with each other. My therapist said, I think if you didnít have these issues going on that you and I would have been done a while ago. The depression has lifted. Some days are still hard but the good days outweigh the bad and now it's the anxiety that is an issue. I see a psychiatrist once a month for medication management and seeing what we can do about getting off the meds.

Speaker: Are you still on the medication?

Alicia: I am trying to wean off of Xanax. I take such a small dose but I take it between two and three times a day. I am trying to get down to twice a day and then not at all.

Speaker: Did your therapist ever diagnose you with anything specific outside of PPD?

Alicia: No, they said it was a mild case of major depression, a moderate or so. But I had some post-traumatic stress syndrome signs but I guess they disappeared fairly quickly. It wasnít separate in and of itself but I know many women have OCD tendencies or anxiety in addition. I had the anxiety but I would say not greater then you typically would with PPD. They usually go hand in hand.

Speaker: Did your sisters talk to you about this? Did they experience anything like this?

Alicia: My younger sister has two kids and she had the baby blues after her son was born and my mother was there helping her for about two weeks. She cried a lot the first two weeks and then she was OK and it all changes. After her daughter she was pretty all right after the fact.

My other sister was not able to have kids so they adopted two boys and that was a major adjustment. I know she had some depression and anxiety when they got the boys to the U.S. One was already starting to walk and you had to babyproof your whole house. You expect a baby and the process dragged on for so long, it was dealing with toddlers pretty much.

One of the things I found interesting my mom shared was that when my older sister was born they didnít have the technology they do now but they couldnít detect the heartbeat. She didnít know if it would be stillborn or not. And her mother died of a heart attack six weeks before my sister was born so she was grieving. And she said, I had a healthy baby girl but I just, I was so depressed. I thought I expected my mother to be there to help raise my child in the beginning like she had done with the sisters. Instead of going home to my house with my husband, I stayed with my sister and my father and I think that was a bad mistake. I was so surrounded my motherís things. All I could do was think of her so she said, I remember what that was like but had no idea what I was going through. I tried to keep it to myself but I eventually told my family and they never knew.

Speaker: Do you feel like they really understood?

Alicia: I think they did. I think when it happens to someone you know it takes you by surprise, you never expect that. But we do have a family history of depression so I always had in the back of my mind itís a potential in some point of my life I could be depressed. I was hoping it would never happen but with my two sisters having kids I knew what it was like, oh I know when there are some days like that, not days on end, days that felt like they were never going to end and they were supportive of me going to therapy and seeing specialists and my husband was extremely supportive. He just wanted the real me back, I wanted you to be healthy, the way you have always been, this is not your personality, this is scary Ö

I remember vividly, I canít recall how old she was, but it was when Sarah was colicky and she would usually scream for about three hours a day and eventually settle down. And this day was so much worse, it was six hours and I tried everything I could think of, in the stroller, in the bouncy chair, laying her down, letting her scream it out, and my nerves couldnít handle that. I didnít want to take her in the car. I knew that would make her sleep, but I was so sleep-deprived I was afraid to drive. So I did do that, I put her in the car and I drove around the local streets and pulled into a CVS and called my husband and I said, you need to get home right away or I am going to drive her somewhere and drop her off and I donít know where I am going after that. He said, give me 45 minutes I will be home. So he left work and I said, I canít do this, itís too hard and I just, I donít know ... it was like having a small, angry boss in your face screaming at you all day and you canít do anything. The more she screamed, the more I cried and the more I cried, the more she screamed. We fed off each other. She was always slightly different around Dale, she was more relaxed because he was more relaxed. I was always tense, which made it difficult for both of us.

Speaker: Would you say you enjoy her now that you have been through everything to get you back to where you want to be?

Alicia: Things are much better now. I would say we have a good relationship. Sheís sweet, funny, smart. She makes me laugh and she comes over and she can say I love you and gives me a hug and she does that to Dale too. And she will give me a kiss. She is funny, a handful. When she turned 1, she really started to get more independent and, not that itís less work because itís still the same amount of work, itís a child, but it became more enjoyable for me to interact with her, the worst of it was over. I was feeling so much better I planned a big first birthday party for her that I would not have been able to plan a few months prior. I had fun, I had a good time at the party. I thought, I was proud, this is my little girl and sheís growing up and everybody loves her and she and her sister get along and sometimes they fight. I am a much better mom because of the therapy and the medication.

They say PPD will lift eventually on its own even without (medication), but that wasnít even an option in my case. Something drastic had to be done and I would have done whatever it took to feel better. I felt so alone even though I was surrounded by people who loved me. I felt lonely and very helpless all the time. And the therapist that I work with helped me see that I have a lot of strengths and I had just lost faith in myself and had to find those qualities again to understand.

Speaker: At the support group, did you find yourself bonding with other women who openly had PPD?

Alicia: Everyone there was having some kind of an adjustment issue, whether it was going from a couple to their first child or from one or two to all of a sudden four, another child and you donít know if you can financially or emotionally handle it. Most of us had PPD and that was the reason we were there. We heard about the group, we wanted to find other people who were going through the same thing. It was an instantaneous bond. We clung to each other through this.

You know, my friend Nicole that I met, she was my life ring. I just reached out to her and I remember meeting her and she looked so together and she didnít have a spit up-stained T-shirt and sweats like I did. She looked like she was really over the hurdles and she was like, oh no, I havenít slept in five hours and longer than five hours here and there. I am just kind of faking it until I make it, trying to get through each day as best we can. We would call each other because we all had insomnia. I could talk to her at 11 and she was wide awake.

Itís, you can, I guess have this connection with other people who truly understand what itís like instead of the typical new mother who is excited and everything is wonderful and oh my baby spit up, it was great. Thatís not my reality right now. I am just grossed out and thatís just on top of everything else not what I want to deal with right now. It was good to have a group of friends that I could really be real about my feelings and thoughts and we became good friends and some of them have thought about suicide. While I was pregnant, I thought about giving away the baby after he or she was born. You canít say that to someone who hasnít been through it without judgment or thinking they need to intervene on your behalf and call someone. Those are thoughts, not actions. Itís very frightening when you know your mind is not rational, you canít trust the things that are running through your head and I had some very angry thoughts and things were not in my nature to feel and I just thought, this is not, something is not connecting in my brain the way that it should.

Speaker: Did the nightmares stop once you began therapy? Did the episodes, cold sweats and things like that, did they end after you got home?

Alicia: Within two weeks and I started on an antidepressant right away but they donít take effect until six weeks or so. I think it was the combination of the talk therapy with the social worker but also I was on antibiotics dealing with pneumonia so when I was better with that they also coincidentally just stopped. Thank God they stopped. I never knew when they would happen

Speaker: Would you say that the hard days were some of the worst you ever had, the day she cried for six hours?

Alicia: Yes that was the worst. There were other days when it was hard but that was the worst. They were earth shattering, they werenít the worst ever, my mindset was everything was so difficult, every waking moment was hard and some days were torture and sleeping wasnít much better. So it was just this cycle of unhappiness and feeling terrible about myself as a mom. I knew I could do better but I wasnít. I was a bad mom. I felt I was withholding from my daughter. Why canít you give to her the same way you gave to your first daughter? I physically had nothing in the tank, I was wiped out.

Speaker: What was your relationship like with your oldest during this time?

Alicia: Still good, but I had a short fuse. I am usually patient in most respects but I found myself very short tempered. If she was persistent on something, if she gets a no she doesnít settle, Ö try and keep going at you. And I would just snap and say, enough you are going to time out. I would overreact to little things. She would get this shocked looked in her eyes and I would feel so bad and say, Mommy is just grumpy today, Mommy isnít feeling well. Letís play a quiet game of something instead of running around the house like she typically wanted to. I felt like I maintained a good relationship but she was on edge. What kind of mood is Mom in today? And it hurts to think of that.

Speaker: Would you like to share a memory when you look back and were really happy that you have two little girls and they are growing up and you are in a better place where you feel better, maybe a party or something?

Alicia: There was just one the other day. It was cute, we got these dance recital dresses at a yard sale and just to get them something to dress up in and you would think that we gave them a million dollars. They were so excited, they wanted to run home and put them on and I put them on and they came out and did a little recital for my husband and I and my mother in-law and they were just hamming it up and having a good time. And I thought, this is fun, this is what it should be like. They were just enjoying the attention and I felt like I could give 100 percent and give them what they needed. I wanted them to be happy and you know play with them and spoil them a little bit, give them all the excitement and attention they wanted.

We had a great family vacation. We went to DisneyWorld and seeing them really in a childís element, the most exciting place they could possibly go and Megan had been there before but she was small so she didnít remember some things that she had seen but for Sarah, it was a first for everything. She was so excited. She kept pulling my hand, look at this, letís do this. And so I thought, she chose me over my husband, but normally she goes to him first. She wanted me to experience that with her. That was a good feeling, that she wanted to bond with me over this new experience.

Speaker: Looking back, would you change anything about how you handled the situation?

Alicia: I think the only thing I could have done differently and I wish I knew more was to seek out counseling while I was still pregnant. But I wasnít sure what I was experiencing was depression, I thought it was grief. How do you separate the two? A lot of that was tied into, yes I have the grief but also these unresolved feelings of not feeling prepared for the pregnancy this time around, issues with being hurt, my husbandís surgery, we had financial difficulties with that. There was a lot of stress I wish I had dealt with earlier on and I always heard of PPD but not perinatal mood disorders. I didnít consider treatment. I just thought I have to get through this. I am grieving. It will be better when the baby is born.

Speaker: Would you, say someone said it could be depression you should talk to someone, would you have, just to see?

Alicia: Yeah, I think I needed to talk but I wasnít and, like I said earlier with a family history of depression, I donít want to end up in a hospital. I had a job years ago I worked in a psychiatric hospital. It was one of the saddest places I have ever been and it made me avoid that kind of situation. I would have gone but nobody mentioned it healthcare-wise.

Speaker: Did you have a fear of being institutionalized? Did you think you were that bad?

Alicia: I didnít think I was bad enough to have to go to a hospital. I didnít have fears that I would kill myself or hurt the baby or kill her, something like that. My thoughts were more of leaving, getting away, that I was incompetent and that anybody else could do a better job, but I didnít feel like I needed to be in a hospital 24/7. I didnít think I was a danger to anyone.

Speaker: Do you find yourself trying to reach out to new members of the support group?

Alicia:I try but itís not always easy. Itís not always the best day. I bring both girls with me. How in the world do you get out of the house with two girls? But we are here and it is possible to get better. It is doable. A lot of the women I meet, this is their first and they are scared to have another. I would be too. Two was the number I wanted. I am happy with two, not planning on having three but I would be scared too if I found out I was pregnant again to think this could happen again, the depression, anxiety, insomnia can come back. I try and let the newer moms know it gets better. You have to make yourself a priority but a lot of women donít get the treatment. Itís OK to ask for help. They say, oh you have a baby what can I do? Watch her for an hour while I go to therapy. Come cook for me. I donít have the energy or just let me shower and nap while you babysit. Those are all constructive things people can do but a lot of times people are afraid to ask for that time for themselves but they need it.

Speaker: What would your advice be to women who are experiencing this?

Alicia: I would say. reach out for help. Tell your partner or your close friend or family that what I am feeling, I donít think is normal. I need professional help and I need you to help me get it. I need your support on this. A lot of families are not supportive or they donít want you to talk about it. It might be embarrassing to them, itís not about them, itís about you and what she needs. And they can always call the state 800 number to get immediate help if you feel like you are in danger or you are in doubt you go to the emergency room. Something is wrong. Call and they will find you someone in your area to talk to. You have to let someone know that this is a problem because women do a very good job of hiding it. I know I did for a long time so you have to ask for help.

Alicia's Video | Alicia's story