Do I have PPD/PPA or am I sleep deprived?

My first (and only) baby will be 5 months old this weekend. I returned to work full-time as an associate attorney after 3 months. I enjoy working, although I am at a firm, I do litigation, and my job is high stress. Under no circumstances do I want to be a SAHM (I sort of became Jack Nicholson from The Shining toward the end of maternity leave #IYKYK). I mention this because I don't want to take a step back from my career, so that is not an option.

Baby is in daycare full time. We LOVE the daycare. They have the Procare app, so we get notifications all throughout the day of every diaper change, feeding, photos, etc. He's there from about 8:45-5:15 p.m. The one concern I have is that they don't seem to be pushing ounces throughout the day as much as I would like but our baby is a fussy eater and I know they have 10 babies to take care of. I have mentioned this to them and they said they would work on it.

With that background, I had a mental breakdown last week. We had three blissful weeks of my baby sleeping 7 p.m. until 4 or 5 p.m. when he was about 3 months old. Ever since July 23rd (he was 3.5 months), his sleep is a DISASTER!!!!!!! The best we can get is a six hour stretch but we frequently have 3 hour stretches. He's waking up to eat multiple times a night and eats 4-5 ounces each time. My husband and I alternate nights or if it is a really bad night, the person who is sleeping upstairs in the baby's nursery (there's a daybed next to the crib) can "tap out" around 2-4 a.m. and switch with the other person.

I don't think I've gotten a 6 hour stretch of sleep since my baby was born in April. Most nights I sleep 6 hours total. My main problem is that even if he is sleeping, once he wakes me up, I CANNOT go back to sleep. My mind is racing- I start thinking about work tasks, household tasks, etc. and panicking about how much time I have left to sleep (e.g., he wakes me up at 2, okay I have to be up at 7, so that gives me 4 hours by the time I put him down IF he sleeps that long). Last night, he went to bed at 7, woke up at 9:30 p.m. (ate 5 ounces), 3:30 a.m. (ate 5 ounces and was up from 3:30-5 a.m.), and 7:30 a.m.

I have a doctor's appointment tomorrow to discuss PPD/PPA. I messaged my provider through the portal last week after a particularly rough night where I had to go to work on 3 hours of sleep. I have never been on psychiatric medication but I'm at a loss. It's hard because I know for a fact if I could sleep 7-8 hours a night, I would be happy as a clam. But the sleep deprivation and anxiety around sleep is SO hard. Do I need medication? Will it help if my underlying issue is never sleeping?

I know this is a huge ramble. I'll accept any advice, solidarity, tough love, etc.
 
@iwantchristmore28 Honestly that sounds like he’s going through a sleep regression and it’s triggering your anxiety. My son (now almost 3) went through a ROUGH one when he was about 4 months old and it lasted like six weeks. It was awful. My husband and I would alternate who got up with him so it kind of helped but it was arguably worse than the newborn phase and we were convinced we would never sleep “normally” again.

I also had a lot of anxiety around sleep (and life in general lol) so I can totally empathize with your situation. You are absolutely doing the right thing by reaching out to your provider. My providers only screened for PPD so I was never formally diagnosed with PPA but looking back it was hilariously obvious I was suffering from it.

I started seeing a therapist when my son was about 9 months old and it’s been life-changing. I would definitely recommend one if you have the means to do so (many of them offer virtual appts now!). Stay strong
 
@iwantchristmore28 You will! It just might take some time to get there. And the subsequent regressions (yes, there are multiple!) will get shorter/easier to deal with. I feel like nobody ever told us about sleep regressions so we were def thrown for a loop when it happened the first time.

But the one cool thing is that they generally preface some pretty big developmental milestones! Our son started really rolling after his 4-month regression and then started walking shortly after his 12-month regression. As he’s gotten older, he’d have a week of bad nights and then all of a sudden was able to talk in full, more complex sentences. So the regressions are definitely crappy but they can lead to progress!
 
@iwantchristmore28 I have a 4 year old and I still have to remind myself with every frustrating change in behavior that it is temporary. They go through all sorts of phases. Some are so well predetermined (you have zero control) that I can talk to moms with a child born around the same couple months, and they are going through the exact same thing. Whenever you feel overwhelmed with changes in sleep, clinginess, or whatever behavior, remind yourself that this is temporary. It will pass.

I also benefited a little from Zoloft but when I was done breastfeeding, I switched to a different anti depressant/ anti anxiety that worked so much better. So if you decide to go the pharmaceutical route, keep in mind that the first thing you try might not be the best.
 
@katty3333i I second the first sentence here. I feel a little hopeless every time my 4yo starts going through a frustrating phase. But it really has all been temporary and I have to remind myself of that.
 
@iwantchristmore28 I’ve have three kids, they are now 14, 9, and 4, my favorite saying has become “the nights are long, but the days are short”. It does get easier. There is an app that tells you about sleep regression and is personalized to your little one based on date of birth. Their minds are making big leaps in the first two years and advancing so quickly, i found it encouraging to look for the new things they were doing when I picked them up from daycare instead of thinking about how tired we both were. Also, when I have severe anxiety and am trying to sleep, I start counting back from 100. Anytime thoughts start creeping in I refocus on my counting. Sometimes I have to do it 2 or 3 times before I finally fall asleep.
 
@iwantchristmore28 Had PPA exactly the same way. Don’t hesitate, take Zoloft, and hopefully it’s a good fit for you. It was for me. I also had to take Ambien for sleep.

You can also sleep train, you know, if you are not opposed to it. Because it sounds like your kid wakes up after each sleep cycle and can’t put himself back to sleep without food.
 
@dekta09 How long did it take for you to see a positive change with the Zoloft? And what did a positive change look like for you?

I’m so hesitant to sleep train because he’s eating at wakeups. If he were not hungry I think I’d feel differently but it’s hard for me to fathom letting him cry it out when he’s genuinely hungry?
 
@iwantchristmore28 Part of sleep training is teaching them to eat more during the day and less at night. The more calories they get at night the less they eat during the day which turns into a vicious cycle. Sounds like baby went through the 4 month ish sleep regression and got used to eating more at night. I recommend the book precious little sleep… it helps slowly wean them off eating at night and closing the ‘breasteraunt’ during sleep.
 
@iwantchristmore28 It took a few weeks for Zoloft to work, but I noticed reduction in anxiety relatively quickly. Sleep took much longer to restore for me.

As far as sleep training, you do what you are comfortable with. But our ped told us that most kids can sleep through the night (well, 6-8 hrs) at two months, so for us just waiting for him to settle for 5-10 mins instead of jumping to feed at the first whimper, basically made him sleep through almost immediately.
 
@iwantchristmore28 My daughter continued to eat around 4 am for three months after sleep training and eventually just dropped it herself. It's not about ending the night feeds it's about consolidating the sleep cycles. He will still wake up to eat!
 
@iwantchristmore28 I was on Zoloft before I was pregnant and still continue now PP.

Everyone is different, but be aware starting any anti-depressant can give you mad nausea, I cried it was so bad. It went away after like 2 weeks. My dr. Recommended taking it during a meal to help ease the nausea when you start it.

Good luck!
 
@iwantchristmore28 My baby ate during the night till he was 9 months old and I decided enough. Two nights of night weaning and we've never looked back. He was just doing it out of habit. Next baby will be night weaned much earlier.
 
@iwantchristmore28 So for sure check with your pediatrician, but mine told me this … breast milk is digested very quickly so bf babies really do get hungry more often. But formula takes longer to break down, so they can go longer between feeds. Knowing that, I would guess your LO can go a little longer and you can sleep train with peace of mind. The folks on r/sleeptrain are absolute angels and there are other sleep training methods that aren’t cry it out!
 
@hester708 Here's a sneak peek of /r/sleeptrain using the top posts of the year!

#1: So freaking sick of social media pushing the idea that sleep training is child abuse.

#2: Some babies are just bad sleepers, and there's nothing you can do about it.

#3: My 2 cents (a rant)

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