by Blaine H. Carr, Ph.D., father of preemie Ella
After a busy weekend and tour of the hospital maternity wing, I was making my pregnant wife a favorite Italian dinner. She called me from another room, and when I went to see, we found her water had broken. “But our daughter is not due for another month,” I was thinking. What did this mean? My wife was terrified. I was terrified. We didn’t even have a name picked out or a bag packed. We found ourselves heading back to the hospital half-expecting and hoping to be sent home. Hours later, my daughter was born and whisked to the NICU because of breathing difficulties. We learned in the early morning that her lung had collapsed, and thus began our NICU stay. At the time, we focused on doing the basics and surviving, but looking back on it five years later, it is much easier for us to see the long-lasting emotional effects this experience had on us and to think about how we’d support ourselves differently with what we know now.
Different Reactions to Trauma
Going through a traumatic experience of a difficult pregnancy, a loss, and/or having one or more babies in the Neonatal Intensive Care Unit can affect parents’ emotions in very different ways. No matter how short or long your baby’s stay is or what the complications are, your reaction may be mild or severe. It is completely normal to feel intense sadness, grief, guilt, shame, anger, disbelief and numbness going through this time, especially when your baby reaches milestones or suffers setbacks. In fact, your baby’s hospitalization may be one of the most stressful times you ever experience.1
It would probably then not surprise you to learn that childbirth experiences place parents at risk of developing Post-Traumatic Stress Disorder (PTSD).2 PTSD is classified as an anxiety disorder, and it is characterized by a collection of persistent, debilitating physical and emotional reactions to traumatic, scary or life-threatening experiences. To make matters more complicated, depression can co-occur with PTSD because of the powerful distress, grief and new caregiving routines that parents are thrust into in the midst of medical procedures, doctors and information overload.
When Is It PTSD?
It’s normal to have many of the symptoms of PTSD (listed below) for some time after any traumatic event. This can last for several days. Be watchful if you find you or your partner is becoming immobilized by these feelings or if they aren’t going away, particularly if they last longer than a month. Also, notice if it is interfering with your life, relationships, your ability to bond with and care for your child or your performance at work or school. Signs you should ask for help also include problems sleeping, considering the use of drugs or alcohol to cope, feeling hopeless about your life or having suicidal thoughts. Even if you’re just experiencing a few symptoms, treatment can go a long way to helping you heal and give you emotional relief. This is why it’s so important to be evaluated by a healthcare professional who can give you options for treatment.
In general there are three broad types of symptoms for PTSD: intrusive memories, avoidance/numbing and increased anxiety/emotional arousal.
| Intrusive Memories | Avoidance/Numbing | Anxiety/Emotional Arousal |
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Normal for Emotions to Resurface
Different experiences, even years afterwards, can trigger distress at unexpected times. Katrina Moline, mom of a 24-weeker, writes, “I guess the thing about PTSD is it can hit you anywhere, anytime. You might be perfectly happy and just enough distracted by this, that and the other that you don’t even see it coming. That’s how it happened to me this morning. Standing in line at Starbucks I recognized a glassy-eyed look on another woman’s face. I saw in her blank stare that while she was standing right next to me smiling politely she was all together somewhere else. My mind instantly and without my control went to the days that Bryce was his sickest and I’d escape the NICU for 10 or 15 minutes to walk to the nearby Starbucks. I was never where my body was, my mind was always with Bryce.” A child’s birthday or anniversary of NICU release, a television documentary, subsequent illnesses or diagnoses (even minor)–all may bring up unexpected, intense feelings.
Self-Care
Finding a Professional
- Hand to Hold’s Resource Directory
- Referral from your physician
- Your hospital social worker
- Your insurance company
- A peer mentor
- PsychologyToday.com
Because PTSD can develop from intense, life-threatening fear, having a child in the NICU or a loss is just as much a cause of PTSD as military combat, being a crime victim, or surviving a car accident. Mother of two preemies, Kelli Kelley shares her initial reaction to the possibility of having PTSD symptoms, “…It took some convincing in the beginning because I felt guilt for my emotions – as if I should be able to control them given my son lived. How could I be so sad and emotional knowing his successful outcome?” These emotions are a normal reaction to completely abnormal situations. Though your concern is focused on your precious child in the hospital, what you need to hear in the midst of this storm is that one of the most important ways of caring for your baby is to care for yourself.
Research has shown that these strategies can help you receive emotional support while your child is in the NICU and afterwards:3
- Consult with a psychologist, counselor or physician about therapy and/or medications that can help with PTSD. You can ask for an initial consultation to see if you and the person you choose are a good match for working together.
- Find peer-to-peer support4 through Hand to Hold.
- Seek out a support group within your hospital.
- Consider writing, journaling or blogging about your experience.
Creating a support system for yourself will go a long way toward helping you and your partner heal emotionally. And, you’ll find that taking care of your emotional health will have far-reaching benefits for coping as a parent, spouse and caregiver.
Sources:
1Miles, MS, et al. (1992). The stress response of mothers and fathers of preterm infants. Research in Nursing & Health. (15) 261-269.
2 See Ayers S and Pickering AD. (2001). Do women get posttraumatic stress disorder as a result of childbirth? A prospective study of incidence. Birth. 28(2): 111-118; Bailham D and Joseph S. (2003). Post-traumatic stress following childbirth: a review of the emerging literature and directions for future research . Psychology, Health, and Medicine. 8:159-168; and Olde E, et al. (2006). Posttraumatic stress following childbirth: a review. Clinical Psychology Review. 26(1) 1-16.
3 Shaw RJ, et al.(2009). The relationship between acute stress disorder and post traumatic stress disorder in the neonatal intensive care unit. Psychosomatics. 50(2):131-7
4 Marina N, Glazebrook C. (2008). Emotional support for families of sick neonates. Paediatrics and Child Health. 18(4): 196-199.
Dr. Blaine Carr, www.drblainecarr.com, is a Licensed Psychologist in Austin, Texas in independent practice. He works with children, families and adults providing counseling, testing and consultation. Dr. Carr earned his Doctoral and Master’s degrees from the University of Texas at Austin. He completed his undergraduate degree in psychology from Trinity University in San Antonio. He and his wife live in Austin with their daughter now five, born at 35 weeks.
