Depression & Anxiety in the NICU

As you’ve probably figured out, the NICU is a hard place to be.

Parents have to watch their babies grow in incubators and must leave them behind at the hospital every night.

That picture perfect idea they had during the pregnancy is shattered and replaced with nurses, doctors, specialists, medications, surgeries, tubes, wires, machines, monitors, and the very high possibility that depression and anxiety will take a firm hold on their lives.

It’s no wonder why parents get sucked into the pull of depression while in the NICU; my husband and I did.

I can’t speak for my husband and what exactly he felt, but he was the one that suggested the two of us went to counseling so we could deal with it (which I am forever grateful for).

I can, however, break down what was going on in my head.

Dealing with Depression & Anxiety in the NICU can be hard. If you're struggling, don't hesitate to seek help in whatever way you need it. I sought out professional help in the form of a therapist, and help from my peers in my hospital's NICU Support Group. Do what is best for you, and don't let your depression and anxiety get out of hand.

This blog post contains affiliate links, which means that at no additional cost to you, I will earn a commission off purchases made using said links.

When I went in to labor at 29 weeks and 2 days gestation with my son, I was in total denial. I’d had the picture perfect pregnancy up to that point, and I’d experienced absolutely no warning before labor began. By the time I got to the hospital, I was fully dilated and the physician could feel the descended water bag.

After my emergency c-section, my son was transported to a different hospital to be admitted to the NICU while I stayed behind to recover. That night, at around 4am, the shock slipped just enough for me to experience my first wave of grief, pain, and the beginnings of depression.

Since I couldn’t go see my son, the nurses marked his length on a paper tape measure and gave it to me. At 4am, I had to take some medication and while I lie in bed waiting for my nurse to come back, I opened the paper tape measure and saw how long he was. I broke down and started sobbing.

When I was finally discharged and able to see my son, I was in awe at how small he was (and he wasn’t even a micro preemie. He was 2 pounds 14 ounces, and 15.35 inches at birth). That’s when the guilt washed over and chipped away at my resolve. I felt like I had done something wrong to cause him to be born early. I got caught up in the whirlwind of “what if” and “if only” thinking.

Every lightning bolt of pain at my incision was a reminder of my son, and the fact that he was stuck in the NICU instead of settling in at home with me. Every pregnancy picture on Facebook reminded me that I was no longer pregnant, and that my baby should have been younger than theirs, but he was already born. Every day I slipped further into the dark place, where my son was the only light at the end of the tunnel, and even then it was a dim light.

Once I was able to hold my son for the first time, it was bittersweet. On the one hand, I was ecstatic to be able to snuggle him close like I should have been able to do after he was born, but on the other hand, I was devastated that I was limited on time because he wasn’t big enough to maintain his body temperature and he got cold easily. On the one hand, I got to hold him and kiss his tiny head, but on the other hand, I had to ask permission to do so.

When my son had complications with his PICC line, I was understandably distraught. Once he was in the clear, but still on pain medication, it hurt my heart to watch him lie still and lethargic under the daze of pain killers. He had just started showing his personality, and then it got drowned in pain killers.

This, I think, was where my anxiety started elevating. A PICC line is supposed to be a reliable way to administer medication, but Kaden’s caused problems. How was I supposed to allow then to insert another PICC line when his first one was so catastrophic?

Moving forward, I rode the roller coaster that is the Neonatal Intensive Care Unit, and my emotions were pulled in every direction.

As we drew closer to discharge, Kaden was starting to shed some of his tubes and medications. He started taking feeds from a bottle instead of an OG or NG tube. He was starting to act and look like a “normal”, term baby instead of a fragile, preemie. This was almost just as hard, if nor harder, than his admittance to the NICU. The more “normal” he looked, the more my heart ached to take him home with me, and the harder it became to leave him every night.

I sunk to a place where I didn’t want to do anything that didn’t revolve around the hospital. I didn’t want to go anywhere other than the NICU, and I didn’t want anyone to come visit me in the NICU if it meant I had to step out to allow more visitors (my NICU had a 3 visitor limit, which included parents. That meant that my husband or I could take 2 visitors back, or we could both go back with one visitor. I was often the one left in the waiting area because it was mostly my husband’s friends and family visiting, since mine are out of state).

When we were finally discharged, I was excited, but I was also a nervous wreck. A lot of my anxieties were normal first time parent anxieties, I think, but they were worse than a typical first time parent.

I had monitors to rely on for almost 2 months, and then suddenly, I had nothing.

I had a medical professional there to make sure my son was alright, and then suddenly, I had no one.

I had expert help to get Kaden through the day, and then suddenly, I was alone.

Many NICU parents that don’t come home on monitors invest in the Owlet Smart Sock Baby Monitor to help them feel more confident and at ease at home. I’ve heard many parents (of both NICU and non-NICU babies) swear by the Owlet Sock. I had one on my Amazon Registry, but we never ended up getting one, so I can’t give a review on them from personal experience.

I have never been so afraid that a human would spontaneously stop breathing as I was (and still am, to an extent) when I first brought my son home. Any time he was sleeping in his bed, I had my eyes glued to his chest to make sure he was breathing. I was happy that he snores a little bit, because I knew he was alive! I was terrified to sleep, because I was afraid he would stop breathing, or his heart rate would drop, or his temperature would plummet, or his oxygen level would drop while I slept.

Of course, the NICU would not have discharged him if he wasn’t ready to come home, and they would have sent him home on oxygen or other monitors if he needed them still, but my anxiety wouldn’t let me rest.

Part of me hates to admit it, because my husband is a wonderful father, but I was even anxious about leaving my son with my husband; not because he wasn’t capable or because I was so much more qualified than him (because I definitely wasn’t then, and still am not), but because I already had a bit of a controlling tendency before my son was born, and that compulsion was intensified after he came home and the need to be in control was painfully overwhelming.

I couldn’t keep my son from being born, I couldn’t control what happened in the NICU, I couldn’t produce enough breastmilk to feed him, but I could control his environment and watch to make sure he kept breathing!

Now that I am back at work, I can’t control what happens at daycare and I can’t prevent him from catching colds, but as my son starts his ventures into the world of solid foods, that controlling part of me wants to home-make his baby food, partially because I’ll know exactly what’s in it and it’s cheaper and all of that, but also because it’s something I can control.

All of this, to say that NICU parents have been through the ringer, and it doesn’t stop when you get home.

Kaden has been home from the NICU for about four and a half months, and while my episodes of depression aren’t quite as intense, they are still prevalent. My anxieties are still just as strong now as they were when he had his chest tubes from the PICC line in the NICU.

When we took Kaden to the Emergency Room in September, I immediately panicked and thought they would readmit him and send him to the PICU.

From his 4 month checkup to his 6 month checkup, he gained a grand total of four ounces. I immediately began worrying that he would be labeled as failure to thrive. He had been so sick for the entire month of September, that his body had been focused on beating the various illnesses and not worried about growing. Luckily, his pediatrician was happy with his cognitive milestones and changed his formula to give him some help growing, but I still carry some worry in the back of my mind about his size.

Preemies are small, and typically register as being in the 0 percentile as compared to other babies their age, but I’m trying not to stress about his small stature until his pediatrician tells me I have something to worry about. It’s easier said than done though, because the idea of being sent back to the hospital is just too much for a NICU parent’s heart to handle.

So, if you are a NICU parent, please know that your depression and anxieties are unfortunately, not uncommon. According to an article posted by Children’s National Health System:

45 percent of parents experience depression, anxiety and stress when newborns leave NICU.

Almost half of parents whose children were admitted to Children’s National Health System’s neonatal intensive care unit (NICU) experienced postpartum depressive symptoms, anxiety and stress when their newborns were discharged from the hospital. And parents who were the most anxious also were the most depressed, according to research presented during the 2017 American Academy of Pediatrics (AAP) national conference.

If you feel your depression and anxiety is not getting better, don’t be embarrassed to seek professional help. You’ve gone through something traumatic, and should not be expected to deal on your own. Seeing a therapist and finding new ways to cope can work wonders. Your baby needs you to take care of yourself, including your mental health.

Joining a NICU Support Group can also help, if you have one available.

Do what is best for you, so you can best take care of your bundle of joy.

Remember, you are not alone. You are part of a tribe of NICU Parents, and we all want you and your baby to thrive.


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