Postpartum Depression — with Dan Wickert

Janet Aucoin May 18, 2024

In this episode, we welcome special guest Dr. Dan Wickert to the podcast to discuss a highly requested topic, postpartum depression. Postpartum depression is a common experience of moms that is not always well-understood.

As an OBGYN doctor and certified biblical counselor, Dr. Wickert brings deep knowledge and experience as Janet and Jocelyn discuss this sensitive and complex issue from a medical and spiritual perspective.

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Episode Transcript

Resources

Books

The Gospel Primer - Milton Vincent

God’s Healing for Life’s Losses - Bob Kellemen

Trusting God - Jerry Bridges

Overcoming Fear, Worry, and Anxiety - Elyse Fitzpatrick

Christian Counselor’s Medical Desk Reference - Charles Hodges

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Read Through the Scripture Challenge 2024

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Faith Bible Seminary Masters of Arts in Biblical Counseling

Transcript

Jocelyn: I don't just need to feel better. I need the truth. And ultimately that will make me better.

Janet: I just want to make it as totally simple as possible for ladies to see that the Bible is really applicable to their everyday life.

Jocelyn: When they understand theology, the application flows out of it quickly with joy.

Janet: It is a journey, but even the journey itself is joyful when I'm doing it, holding the hand of my savior and trusting him all along the way. This is the joyful journey podcast, a podcast to inspire and equip women to passionately pursue beautiful biblical truth on their journey as women of God. When you choose truth, you're choosing joy.

Janet: Okay. Welcome back. This is Janet here once again with my trusty cohost, Jocelyn.

Jocelyn: Hey friends.

Janet: And also a friend of ours, Dr. Dan Wickert, has agreed to join us today and I'm incredibly excited that he was willing to do that with his time. Dr. Wickert is here, because he and Jocelyn together did a session at our recent biblical counseling training conference that was so helpful and so hopeful that I've asked him to come and so they could share that session with you again. So that means this will not be our typical structure. We're not interviewing them. I will just be listening along with the rest of you. But, I would like you to hear what they had to say on the topic of postpartum depression. And if you're thinking, I don't deal with that. The help and the hope that they give goes way beyond that, but is being specifically applied to that topic today. So if you could get us started, Dr. Wickert, by just letting us know, our listeners a little bit about who you are and how you and Jocelyn came to write on this.

Dan: Certainly thanks Janet and Jocelyn for the opportunity to be here and to be here with you and to be on this podcast. For me, my story is that I am, by profession, a physician and an obstetrician gynecologist. I practiced Medicine, practice obstetrics and gynecology, delivering babies, taking care of women, doing surgery for 30 years. And then about 9 years ago, actually 9 years ago in April, I transitioned out of clinical practice, no longer see patients in the office, and now serve in an administrative role at our local hospital here in Lafayette and in Crawfordsville and in Rensselaer. And serve as in essence, the chief medical officer, the liaison between the medical staff and administration at these three hospitals. So that's my role currently. I have been involved in counseling ministry here at Faith for over 20 years now. And I recall a time at that point, a number of years ago, we would counsel with individuals on Monday afternoon, and then pretty much at dinnertime we would kind of go over some with the other counselors collectively together and go over some of the cases we were struggling with or having problems with. And hey, how would you address this? Or what other hope and help could you give individuals? What do you think about this? And at one point, for some reason, we just mentioned this topic.

Jocelyn: I think that we were talking about adding this as a teaching session and we were like what should we do about this? We were just brainstorming about it.

Dan: How could we do this? And all of a sudden you said, well, remember I, and I'm like, no, I don't know anything about your story as we kind of walked in like, Whoa, Whoa. And so then it was like, okay, we really could do this. I remember sitting down in the community center at one time and saying, well, let's work through what an outline would look like. And then we kind of just developed it. And it has grown over the course of years that we've been doing this now for a number of years. And it's been interesting and kind of a great challenge for us. As you will see, as we talk about this, I'm involved in her care initially, as we talk about the delivery. My associate and I at that point were her physicians. And so we were involved. I didn't even, I didn't remember. And she tells some lines that I don't remember I ever said.

Janet: I hope they're good. Which is kind of what happens to many of us. Right. And we say things and we oftentimes don't remember them.

Jocelyn: And you don't even remember how your life story impacts someone else's life story significantly.

Janet: Right.

Jocelyn: But it is.

Janet: That's right.

Jocelyn: It is. Yeah.

Dan: The things you say really make a difference for people. They remember them even when you said it, but I don't remember I said that. And so that, that's kind of how this happened. The first time we did it together was very emotional, and it continues to be emotional for both of us as we have these memories and think back through and remember what happened.

Janet: Well, thank you. What I'm going to ask is that you just go through it as you did for the counseling training conference and let our listeners listen into all of it.

Jocelyn: All righty. Well, you guys know me, the listeners on this show know me, I'm Janet's cohost. And this topic is something that I teach about and we together write about because it's a private part of my life story. And this part of my life story began in April of 2002. So ,you know, 20 some years ago. My husband and I had weathered a few turbulent growing years in our early marriage and we were celebrating five years, which is, you know, that's huge five years. And without really having any concrete plan, we found ourselves pregnant because that's what you do when you've been married for five years and you love God. Like, you know, you have babies.

Janet: Five years. Here we go.

Jocelyn: So on April 23rd, 2002, I found myself 27 weeks pregnant with our first baby, just about ready to enter the last 12 weeks of my pregnancy. And at that time I was working in a Christian ministry that was integrationist. I was running it and really trying to clean it up. I'd been working there for about five months and my first months were all about helping the ministry transform through the application of biblical counseling. I'd gone through the counseling training at my church and I was just on fire for the authoritative and sufficient word of God being applied to people's lives. So on that day, nearly by now, almost 22 years ago. I got up, went into work just like any other day. And that day at work was really hard because I was dealing with a woman who had a psychiatric diagnosis and she'd chosen to go off some meds, cold turkey. So she was having really out of control behavior and was threatening to kill herself. And by the end of that long day, I was just a really shaky mess. There were police involved. There was a trip to the psychiatric hospital. And on top of that, I just, after that initial crisis was, you know, blown over, I realized I really don't feel very good. My stomach hurt really, really bad. And I felt, I don't know how else to explain it, but I felt like a peanut butter and jelly sandwich whose peanut butter was on fire. And when the excruciating pain didn't get any better. I called my doctor's office, Dr. Wickert's office, and they advised me to get to the hospital immediately. So being the strong woman that I was, I drove myself to the hospital since my husband was at school, or at least I tried to, but I couldn't. So I stopped in a nearby town and had my friend drive me the rest of the way. And it's weird because I was a first time mom. We had not dreamt of having children. It wasn't like a big thing that we had planned. Like I felt like I was dying, but I was pretty sure that when I got to the hospital, they would Be like rolling their eyes and be like, Oh, you first time mothers just go home and go to sleep and everything's going to be fine. But what really happened was that in the next two hours, every definition of normal in our life became rewritten. And I went from being this obliviously and innocently excited about our first baby kind of first time mom to finding out from Dr. Wickert that I had 24 to 48 hours to live unless they got the baby out. And I didn't know what was going on. I didn't know what's happening, but I knew that I was really sick and we had never even been to one birthing class. Like we had never even toured the hospital. I had no clue that a 27 week baby could survive outside the womb, but Dr. Wickert was saying that that was the plan and they were going to give me steroids and make the baby's lungs mature more quickly and they were going to try to keep the baby in as long as possible. But according to the doctor, the baby had to come out within the next day or two. So the next 12 hours was just a blur of seeing my husband ushered out into the hallway and noticing his terrible reaction to the doctor's news, seeing the numbers on my blood pressure monitor and realizing they were really, really high, like high enough to have a stroke, throwing up repeatedly, just writhing in pain and calling my parents who were in North Carolina at the burial service for my mom's mom, who had just died two days before after a three year battle with colon cancer and telling them they should probably make the 13 hour trip to be with us as soon as possible. So all night long, as my mom drove 13 hours, she was a hospice nurse and she was getting updates from the nurses at the hospital about my blood counts and liver panels. And I knew she was freaking out because they were really bad. And she was worried that I might die before she got there to see me one last time. So they got me stabilized and the next day they wheeled me into the operating room where my doctor, Dr. Wickert's partner at the time, Dr. Miller, cut me open, and pulled out my tiny little one pound 13 ounce baby that was born 12 weeks early in order to save my life. There was a NICU team standing there waiting to put her on a ventilator. I felt like death warmed over and I just wanted to go back to two days ago when everything was innocent and fine. I was put in recovery and spent every ounce of energy I had trying to stay awake, desperately trying to wiggle my toes, which is how you get to get out of that room, wiggle your toes so you could leave that room. And I just wanted to see my baby. So they eventually wheeled me to the baby's side in the NICU. And I almost threw up as I looked at her and realized I didn't even recognize her to be human. She was so tiny and she was, I wasn't prepared for this, but she was lying under this see through plastic blanket that covered her whole entire body. Like even her head, like I was like, wow, how is she not suffocating? There was a machine breathing for her. And all I could think of was that she looked like a pound of a hamburger that you buy from the store on a styrofoam tray wrapped in saran wrap. And I just thought she looks like a ugly little red rat. And what kind of mother is revolted by the sight of her own baby? I just, I got wheeled into my room where I went through the motions in a big black fog. I visited her through pictures, and then finally I was allowed to leave my room and I went and saw her for the first time after that first really horrible post surgery visit. She was all hooked up to wires, laying under a plastic blanket and she would just scream and scream and scream. And I looked at her and told myself, don't you dare start loving her because when she dies, you will never be able to handle it. So I told Brian, my husband, I was going to hold her loosely in case God decided to take her. And he got angry at me and he said, no, we're not, we're going to fight for her. We're going to beg God to let her live. And all I could do was cry and cry and cry because I could not imagine letting myself love her and being able to handle that much grief when I lost her. It was easier just to not love her. And what kind of terrible, pathetic mother doesn't love her baby? Everyone says it. You look at your baby and you instantly feel a surge of love. That's baloney. I looked at my baby and I felt nothing but pity. Then all of my dreams that I'd had since being a tiny little girl were ruined. I wanted to have a wonderful pregnancy and look adorable in cute little maternity clothes. I wanted to have a tree huggy natural birthing experience where I embraced my true womanhood and pushed a baby out and then got up and washed the dishes without even a shot of pain relief. I wanted to nurse my baby with the wind blowing my long blonde hair as butterflies wafted in the distance through sunlit daisy fields. And this is where I was, in the middle of a neonatal intensive care unit where there were machines beeping all around me and alarms going off all the time and nurses rushing to babies and parents crying. I couldn't even comfort my own baby. Every time I touched her, she screamed. I wasn't a cute pregnant girl. I was monstrous and sick and puffy and my own parents didn't even recognize me when they saw me in the hospital. Breastfeeding wasn't a glorious spiritual experience. It was terrible. I was afraid of everything. I was afraid my baby was going to die. I was afraid I was going to pass out or throw up when I went to visit her. Cause literally it was just, it was so disgusting. And being in the NICU just made me nauseous. There's so many smells in a NICU that are just overwhelming. And on top of that, I still had a business to run. I took two weeks off to recover from the surgery, then I went back to work because I only had six weeks of maternity leave and I needed to save some of it for when she got out of the hospital. So for the next two months, my life became a flurry of driving 30 miles to work, 30 miles to the hospital, 30 miles to home, 30 miles to work, 30 miles to the hospital, 30 miles to home until finally I just moved into Lafayette and slept at a friend's house in their basement. We juggled work, driving, seeing each other, updating our parents with a baby's progress who was the first grandchild, dealing with baby's illnesses and setbacks, and simply trying to remember to eat. Until finally The doctors was like, Hey, it's time for her to come home. And I was like, what? I was so afraid to leave the hospital. We knew the nurses could do anything. We had actually seen one of them resuscitate one of the other babies while we were there visiting our baby. And we knew we would never ever be able to do that at home. So for three months, we took care of her at home and we managed and we got used to it. And then things began to get a little normal. So we decided to take our first big car ride that was 10 hours long. And on that ride, I realized I didn't feel well. In fact, I felt a lot like I did when I was in the hospital originally. I felt lightheaded and short of breath and panicky. And then while we were at our parents house, it became evident that their marriage was really, really, truly terribly broken after just years of warning signs and worrying. And while we were there, and I was worrying about my parents marriage, I had my first full blown panic attack, only I didn't know that's what it was. I just knew, I felt like I was going to die. And six months earlier when I had felt like that previously, I actually did almost die. So on the drive home for 10 hours, I just had panic attack after panic attack. And anyone who's experienced one knows they just, they have extreme physical results on your body. So the entire drive home, I was just on the phone with my doctor's office trying to figure out what was happening, not realizing it was just panic attacks, just thinking, Oh my word, here we go again. So we finally got home and I fell exhausted into months of horrible, overwhelming panic. I was just so, so sad. On top of all the things that I was physically feeling, I was starting to understand that my parents marriage, a pastor and his wife, was really, really broken and what was happening as a result was that I was questioning things to God that no good Christian girl should ever be questioning. And I couldn't handle that I was questioning what I was questioning, so my sadness was just really mixed with a lot of shame. My life became completely overwhelmed by darkness. I woke up sad and went to bed sad. I was so extremely tired all the time. The baby was up every two hours to eat and at six months she still only weighed eight pounds. I was worried that I couldn't even make enough milk for my baby. I couldn't do anything right. There was no joy in my life and I was a Christian. That's never supposed to happen. I was full of shame, shame that my life was falling apart and I didn't know how to get it back together. Guilt that I didn't know how to be a good mom or a daughter to a mom that was also falling apart. Inadequacy to know how to care for this special baby when I couldn't even take care of myself. My thoughts were constantly going to what if. What if she had cerebral palsy? What if she had a brain bleed? What if the baby's heart monitor went off in the middle of the night? What if I didn't hear it? What if she died? What if my baby died? Would I ever be able to handle that much grief? What if my baby died, and then on top of that, my husband died? What if my baby died and my husband died and then my mom died? What if I found myself completely and desperately alone? What if the rest of my life was this dark? What if it never got better? What if I had 50 or 60 or 70 more years of this panicky darkness always shrouding me? So I started to envision what my life would look like if all those what ifs happened. I could picture myself sitting in the front row of church with a tiny little baby casket in the background, holding my dead baby's body, grieving all by myself. I could see myself drowning in a grief that was so horrible and terrible that it almost killed me. I could picture the grief so terrorizing my life that I ended up committed, sitting curled up in the corner of a psych ward, sucking my thumb, rocking back and forth with no husband, no mother, completely and utterly alone. And eventually every fear, every what if question led me to that spot. I became so good at being afraid and sad that every fear eventually led to that picture in my head, sitting curled up in the corner of a psych ward, sucking my thumb, rocking back and forth completely and utterly alone for the rest of my miserable life. I would wake up in the morning, exhausted and scream out to God in my head, Why didn't you just let me die in my sleep last night? Aren't you merciful? Why won't you let me out of this terrible existence? And then I would get up and trudge through another miserable, panic filled day so full of crying that I couldn't even do anything but sit at my desk at work and stare. And every day was the same. My mind full of questions that I wasn't allowed to ask to a God who wasn't kind enough to just kill me. My brain felt like it was going to explode. I had so many questions in my head, so many problems, so much crisis, and God was very, very far away. And none of this should have been happening. I was a Christian. I was a biblical counselor for Pete's sake. I was a maverick, cleaning up a ministry and righting wrongs, fighting for justice for the oppressed. I was helping people change. This is not allowed to happen. Christians don't fall apart. Christians don't get depressed. Christians don't get so stressed out that they forget how to walk up the stairs. Christians don't start being afraid to use scissors around their baby because they have delusions that the scissors might fall onto the baby and cut the baby open, and they can picture the baby's guts falling out all over the place. Christians don't imagine their baby's funeral. Christians don't find hope in a little pill that promises to take their depression and anxiety away. Christians don't go to the emergency room for panic attacks. Christians don't doubt God. Christians don't beg God to kill them, so there must be no reason to live. My whole life was dedicated to being a Christian. Being a good one. I was strong. I was brave. I grew up as a missionary kid in a third world country. If this is how God treated strong, brave, courageous Christians, then what point was there in being alive? I knew my alternative to being alive with this much suffering. And that was being dead and waking up in heaven. I knew where I was going and it wasn't worth staying on earth and fighting this hard each day only to wake up the next day and have to do it all again. All I could think of was that I needed out. I needed God to just let it be okay for me to die, but he never let it happen. And I couldn't hurt my husband and my mom and my tiny little daughter by doing it myself. So I just kept on existing. Kept on waking up day after day for months and months and months, living panicky moment after panicky moment, begging God to just put me out of my misery. Why would he have saved my life in the hospital just to put me in this position where I was wishing I could die? And I never told anyone, especially the people at church. I never asked for weekly biblical counseling because Christians do not suffer this way. They don't bring trials on themselves like this. They are strong and brave and obedient and they smile and fight on and they do not let feelings run their lives. No one knew what was happening except for my husband and my mom. And even they didn't know how bad it was inside my head. They just knew it was bad and that I needed help and that we were never, ever, ever having another baby ever because we were never, ever going through this again.

Dan: So, as you can imagine, at this moment, if there's even three or four people in the room as there are today, the emotions are quite high at this point. And so, they asked me to come in and to kind of settle the group a little bit and settle everyone down. So, I get to talk for a few minutes about, well, what do we think about medically when we think of postpartum depression? And really, we categorize postpartum depression into three categories. So we have to be careful about our terminology. So this condition, postpartum, we break it down into three categories medically. So we'll just spend a couple minutes walking through those three categories and explaining them and understanding that, yes, we do have medical definitions and what are they and what do they look like. So the first one is what we call the postpartum blues. which is defined as a very transient condition characterized by mild and often rapid mood swings from elation to sadness, some irritability, anxiety, decreased concentration, insomnia, tearfulness, and crying spells. And we would really define that statistically as probably maybe upwards to 40 to 80 percent of postpartum women develop these symptoms. Now, the interesting part is it usually starts within two to three days after delivery and peaks at about day five and resolves within two weeks. So, that really is our, the least difficult or the least,

Janet: Concerning.

Dan: Yeah, concerning.

Jocelyn: Problematic, yeah.

Dan: Because it goes up from there, it gets more significant from there, I guess. We always try and look at from a physician's standpoint, well, well, okay, great. Okay. If we define it this way, and that's really what we're trying to do is definitions in medicine. Well, what causes it? I mean there are changes that happen in pregnancy. We know that. Well, certainly there must be some reason. Well, unfortunately, as we look at causes, there's no conclusive data regarding the etiology, what causes postpartum blues. Although all women experience hormonal fluctuations, postpartum, some women may be more sensitive to these changes than others. We do look at risk factors. Now, what are some of the characteristics that we see in individuals who struggle with postpartum blues. And those are very interesting so that the risk factors really are if you've had a history of depression prior to pregnancy. If you had depressive symptoms during pregnancy. If there's a family history of depression. If you have challenges either premenstrually with a lot of hormonal and a lot of emotional changes. Or if you have significant mood changes when you would be on oral birth control pills. Or, distresses around child care are oftentimes listed as the risk factors for postpartum blues. So that's the first category. Probably we define it as the most mild category of the disorders that happen after delivery. The second category is called postpartum depression, which is kind of the definition of this topic today, but it really is one of the three categories. And again, usually that begins within the first month of delivery. The same criteria are used for postpartum depression as are used for non pregnancy related depression conditions. Clinically, there's changes in sleep and energy levels and appetite and weight and GI function and libido. There's anxiety, anger, irritability, guilt, feeling overwhelmed, feeling of failure, and potentially harming oneself or the baby. What's interesting as you look through this and read this information medically, this is often unrecognized and underreported. And hopefully as I walk through some of these characteristics of these three categories, you'll think back on Jocelyn's story and try and say, well, where did Jocelyn fit into these categories? And certainly some of the things that I've just mentioned are things that Jocelyn mentioned. Certainly, I'm not telling anybody, nobody knows about this. And so we would also, from a medical standpoint, say the prevalence or the number of individuals that struggle with this would be somewhere in the range of 5% to 9%. Again, as we look at causation, and that's very different than the postpartum blues, which is 40% to 80%. So, As these categories get more severe, more significant, the number of individuals that struggle with these categories will go down and will decrease. So again, as we look at causations or factors, well, Unfortunately, as we looked at that, there's, you say, well, well, certainly pregnant women have changes in hormones. Absolutely. And after delivery, those changes occur again after delivery, hormonally. The the challenge is, we do recognize they happen. The challenge is, well, what's different about those individuals who struggle with postpartum depression versus those who don't? And as we've looked at this, there's no hormonal factor that's consistently emerged as the real causation. Why? And we've looked at hormones such as estrogen, progesterone, thyroid hormone, testosterone, cholesterol, corticotropin releasing hormone, cortisol, some of the hormones that have been investigated, but we just have not been able to identify what's different between individuals who struggle with postpartum depression, versus those who don't after delivery. And again, if you look at the risk factors, which again are interesting, it's similar risk factors as for the postpartum blues. You have a personal history of depression prior to pregnancy, there's marital conflict, you have stressful life events, you have poor socioeconomic status or poor social support. So that's the second of the three categories. The third category is the most severe, the most significant, and the most concerning. And as I walk through this category, think of Jocelyn's story, and you'll hear some of these concerns and questions. So the third one's called postpartum psychosis, and it's a disturbance in an individual's perception of reality manifested by delusions, hallucinations, thought disorganization. And again, think back through Jocelyn's story that she just told. It most commonly presents within the first two weeks of delivery. And medically, at least in the statistics, it would say it really only occurs prevalence wise of about 0. 1 to 0. 2 percent of women after they deliver. So a very, very smaller, percentage of individuals struggling with postpartum psychosis as opposed to the postpartum blues. Again, as we look at causation, we really don't know. We don't know why this occurs and what's different to those individuals that struggle with this. Other than again, if you look at the risk factors, if you've had a previous history of psychosis or a previous history of bipolar disease or a family history of psychosis, or recently you stopped your lithium or your mood stabilizers, meaning you had a significant, mental health diagnosis that you're on those type of medications. So really you say, well why? Who cares what are the categories? And what's the significant component of that? Well, I think The point of discussing the categories is to remind us that medicine doesn't always understand and know the cause, the reason. And we want to define it. We want to say, well, there's something different. What's wrong with this person? Well, we really can't find those significant conditions and problems. We know changes occur, but nothing that's significantly different that we can identify medically. And as you think back through what I listed as risk factors, what's very interesting about the risk factors that they're all psychological or psychosocial issues. They're not really medical issues as risk factors, but they're psychological and social issues that really occur. The other component is, I mean, there must be something different medically. There must be something wrong. And that's the component of, well we really can't find a reason for Why this happened to Jocelyn versus why it maybe didn't happen to Janet. What could we look at? What could we analyze? What could we measure? What could we do from a blood stamp? There isn't anything that we can identify as causation or the reason why. So it just really helps us to understand some of those kinds of concerns as we walk through this and it from a standpoint when we teach about it, it takes the emotional notch down a little bit when I talk about the medical problems because there's like, oh, they're rolling their eyes at me because, talk about something important, but I think it really helps us understand medically. Yeah, we, we do define things and do have mechanisms to define things the issues that occur for women individually after they deliver.

Jocelyn: So I'm gonna pick up and just share a couple of tips for Anyone who might love someone who is suffering with postpartum depression or if you are yourself are suffering with this here are just Some things that we think are important for you to think about. First of all, it's important to recognize that there really is real suffering happening. And so as you can tell, like this is a difficult part of my life, but it's 22 years ago by this time. And so I mean, I've been through a lot of suffering in the last 22 years. This was one of the major sufferings of my life. But at the time, what would have really been helpful is if someone had said, what you're going through is valid and you are suffering and this is worth us working through and talking through and understanding well. Cause I really was suffering. It was so scary to go through that situation and to not know what was going to happen and to really, truly to be on the brink of death and then to have a baby that was, you know, in the NICU for so many months. So, there really was real suffering. Another thing that I would encourage you to do is listen to the emotions that are coming out. And we've talked about this on other episodes about emotional health. If you think about emotions as a vocabulary that speaks to reality, It's what's actually going on. And then we have the job of looking at what's going on and saying, is it valid for this emotion to be tied to that reality? And then you say, how does God want you to deal with this reality? Like, listen to the emotions. So there was one time when I could not handle another panic attack and something happened that was very, very scary to me. And I started flipping out. And Brian happened to be home and I was like, I have to talk to someone, I have to get help. And so he drove me to the church and we talked to whatever pastor was available. And we sat down across from the pastor's desk and I didn't give him all the information. I just shared the thing that was really scaring me. And we talked about it. And he was writing stuff down on his yellow legal pad as we were talking. And when I finally took a breath, he like slid it across the desk to me and said, Jocelyn, this is how many times you have said the word afraid. You're a biblical counselor. You know what to do with fear. What do you do with fear? And so think about the emotions that you are experiencing, or think about the emotions that you're hearing from the people that you love and help them think through the emotions in bite sized chunks. And then I would also say, think about how you will walk through the valley of the shadow of death, or how you'll help someone that you love walk through the valley of the shadow of death. Because the truth is we are embodied souls and our bodies were never meant to separate from our souls. And that process of separation at death is abnormal and inappropriate. It's a product of the curse. And walking through the valley of the shadow of death is scary. And it should freak us out. And so when you have a near death experience or death is something that you have to think through, it is helpful to have other people to walk through that with you and to know biblically, how does God help you to deal with the impending reality of death? It's not something that we don't have instruction and help from scripture.

Dan: I think as we walk through some of these tips that we're talking about, many times we think, well, I've got to help somebody, which means I've got to tell them something. And one of the things that we're encouraging you to think about is listening to them. And listening with intent, listening with a purpose, listening with a, well, what do I want to know about? What do I want to hear from them? I think it really just communicates a message I care about you when I'm willing to listen to you, when I'm willing to hear you and even when it's challenging, even when it's really hard. One of the things that we talk about is listening, what are their expectations and desires? You know, as people are pregnant, they have many, many different expectations related to their pregnancy, both in the, what they want and what they expect and what the pregnancy will be like, look like, what the delivery will be like and look like. So the question has become, are their expectations reasonable? Or, Are they biblical? Or do they consider the sovereignty of God? As you're just thinking through what are they telling you? And remember from Jocelyn's story, as she related that story, some of the components of her story. She wanted to be the, not that she wasn't, not that she couldn't be, but,

Jocelyn: but I wasn't, Dan.

Dan: Maybe not. Maybe not the real end. She wanted to be the cutest pregnant person. She wanted the perfect pregnancy, the perfect baby, the, and these are all things people want. It's worthwhile just to kind of get them out in the open.

Jocelyn: Yeah.

Dan: The, the no complications for some only a vaginal delivery. You know, remember she wanted the wind blowing in her blonde hair while she walked the through a field of flowers. And I mean, these are the kind of expectations that people build up during their pregnancy,

Jocelyn: especially in the Instagram age. Let me just say that there are so many unrealistic expectations foisted on people

Dan: Oh, for sure. Or for some, it's just that because of the pregnancy, the relationship between the husband and the wife is going to get better. It's going to flourish. It's really going to be a great thing. Or the desire, I want everyone to compliment me. Or the pregnancy and the delivery will go a certain way and everyone around me will respond in a certain way. So it's just an element about listening to their expectations about, well, what did they think about this whole element? Another key point would be to say, well, what's their view of their body? If you think about it, because is it right to have pain and discomfort? You know, biblically, do we understand the curse of sin on every person? My body not functioning perfectly is the curse of sin, which all of us experience to different degrees to different elements at different times. But what's their view about themselves? Is it all about me and my time and about what I want to do? What's the I component? Me, me, me, me, me, me, me. The other thing that I have seen as I have had 30 years experience taking care of women deal with deliveries and then seeing them afterwards, Is, I would encourage you to think through as you help people or think yourself, these are some of the recurrent themes, the things that I've seen both in the counseling world and in the medical world about ideas that just kind of keep coming up over and over and over again. So one of them has to do with the element of fear and you heard that from Jocelyn and it could be the fear of failure, the fear of failure as a mother. Or the fear of failure as a wife now after delivery. The component of just being overwhelmed. There's just too much to do. I need 30 hours in every day and there's not 30 hours in every day. Or how do I take care of the baby, the house, my husband, my relationship with God, my church, serving? I'm just overwhelmed. And on Jocelyn's case, we added the component of a baby in NICU for an extended period of time. All the challenges that go along with that and the decisions that have to be made over and over and over again with infants that are in the NICU. The third one of just some recurrent themes is listening to them and asking them about how they are doing sleep wise. What do you mean? She delivered a baby. She's not sleeping. Well, that's a huge issue and something that we need to think about. For how long during the night is she sleeping and during the day? And does she ever, ever, ever, given the circumstances, feel rested? And for many individuals, the answer is no, I never feel rested. Or as Jocelyn mentioned, the pressure to work. And this is a really issue that is increasing in our society today as we move forward. Just the pressure that she is one of the individuals in the family that's a breadwinner. Now it's a husband. Yes. But her salary, her work is important, not only just for her, but financially for the family. And this, by the way, this pressure from work can come from all kinds of different arenas. She may have it herself, like, I've got to go back. That's, you know, this is my ministry. This is my job. This is my, and I really want to go back. Could come from her. Could come from her husband really pushing her to go back because, well, we need the money. We need for you to be working. Or it could come from the boss or even other other people that she works with. So this whole pressure to work can come from so many different sides to, you gotta go back, you gotta go back, you gotta go back and how quickly you go back is really critical also. And just what kind of ties into this pressure to work is a whole element of finances. And you can imagine the increased financial pressures that occurred in Jocelyn's life and for anyone's life who has a baby that's in neonatal intensive care unit. Let's be honest.

Jocelyn: Yeah.

Dan: That is not cheap.

Jocelyn: 22 years ago, she was our quarter of a million dollar baby. I don't even know what it would be now.

Dan: Wow. More than that, far more than that. And again, you know, maybe they had a budget, but guess what?

Jocelyn: That got blown.

Dan: This baby blew the budget apart, right? And how do they deal with that? And how do they feel about that? Not only just for the wife, but also just for the couple as together, they're struggling with some of these financial issues that occur. Along with that is what about the extended family? In other words, what about the parents of the, of like Jocelyn and Brian's parents? What do they think? What's the impact on them? For some, they're really excited because you're pregnant. For others, maybe they weren't very excited that you got pregnant. Maybe they didn't think the timing was right. Or it was a bad choice on your, I mean, how are they influenced? And they do influence how people see the pregnancy, respond to it. That has an impact. It also may be the other way that they just don't have any extended family to help and celebrate with, in our culture today. In years past, you pretty much lived, you know, probably in a family unit for a long period of time. Today, that's not the case. Today people have moved out, have gone way far distances. And the family may be miles and miles and miles away. Now, yes, we have zoom and teams and

Jocelyn: It's not the same.

Dan: It's not the same as being there in person. So I think those are the kinds of things of just recognizing recurrent themes as you think about what happened and talking to people, you'll see these elements that come up over and over and over again. I think the next point we want to talk about is that recognize this whole element of listening to a person and trying to help them or thinking about what you're going through. That can be just an incredibly difficult experience. And you're like, whoa, this was harder than I ever thought it was going to be. Even listening to Jocelyn story as we've taught about this over the course of years. As you look at the audience, you'll see many of them squirming in their seats. This I, I don't like to hear, this is just not fun to hear.

Janet: Uncomfortable. Yes.

Dan: They just get uncomfortable and recognize you gotta be willing to listen and sit through these emotions without saying, Oh wow, this person's really off. This is really bad. And just listening to them.

Jocelyn: Which could be true, but you know, that's,

Janet: or making the goal, how do I fix it quickly? Cause this is uncomfortable.

Jocelyn: Yeah. How to make it better.

Janet: How do I tell them? No, no, no, no. That's not true. Cause I don't really want to hear it anymore.

Jocelyn: Like seeing that someone is off comes out in a deluge of really difficult emotions. Like you just can't discount it.

Dan: Just don't be freaked out.

Jocelyn: Yeah.

Dan: Sometimes again, as we heard the story of Jocelyn, you say, well, some of that was really ugly.

Jocelyn: Yeah.

Dan: Yeah, it's real and it can be ugly, but you got to listen to it.

Jocelyn: Yeah. So here are a couple of things that you can do with someone who is suffering and really going through a difficult time with postpartum depression. And the first thing I would encourage you to do is pray with them, and pray for them. And there were times when I really, really was struggling with how far away God felt. I was not even thinking clearly. The last thing I could imagine doing was formulating a prayer that made any sense. And so one thing that I've really appreciated, especially in my relationship with people like Janet or some of my other friends is just like stopping what we're doing in the moment and praying right then, that has really been a helpful practice. So I would encourage you, if you are struggling to pray, find someone who can pray the words that you should be praying, but you can't put words to. And if you are loving someone who's suffering, just voluntarily begin to pray for them.

Dan: We also talk about encouraging them with hopeful passages and thinking about, well, what would be, and the Bible is chock full of hopeful passages. So we're going to just outline a couple, but not saying that these are the only ones. This issue of, you know, there's no hope well, Romans 15:13 says now may the God of hope. So that's who he is. He's a God of hope. Fill you with all joy and peace and believing that you may abound in hope by the power of the Holy Spirit. So this whole element about is there hope in the midst of what the struggle was with severe postpartum depression, postpartum psychosis? The answer is yeah, there's still, there's hope. There's hope that comes from God. Or Isaiah 26:3 and 4, the steadfast in mind thou wilt keep in perfect peace because he trusts in thee. Trust in the Lord forever. For in God, Lord, we have an everlasting rock. Isaiah 41: 10, do not fear for I am with you. Do not anxiously look about, for I am your God. I will strengthen you. Surely, surely, I will help you. Surely, I will uphold you by my righteous right hand. We walk through Romans 8:31-39, talking about who can separate us from the love of God. Now, the interesting part is, even Jocelyn will say, It felt like I was separated from the love of God. But the reality is we never can be, never will be, because that's the promise of God. Will not be separated. May feel like it, but we won't be. Overwhelmed. 1 Corinthians 10:13 talking to people about the pressure to work. In Colossians 3 talking about doing our work heartily as for the Lord. And even the element of finance is talking about that. Hebrews 13:5 and 6 talk about let your character be free from the love of money, being content with what you have. So many of the Psalms. Just walking through many of the Psalms talking about what David and the other Psalmists talk about. Psalm 23. I love the first verse. The Lord is my shepherd. I shall not want. Wow, if we could ever get there for minutes at a time that I shall not want.

Janet: Yes.

Jocelyn: I think it's also helpful to share that there's hope to handle life in a biblical fashion. I think one thing that complicated this was that I was a first time mom with zero experience and I had no idea what I was doing and it would have been really helpful for someone to say, you're going to get through this and there's hope that things will get better. That would have been so helpful.

Dan: We also talk about helping individuals, helping all of us to see life and the struggles of life in light of the gospel. I'm like, well, of course we know the gospel. That's how we're saved. Agreed. Agree. Agree. But seeing all the daily events of life through the lens of the gospel. One of the resources that we use quite often is the Gospel Primer or Primer by Milton Vincent. And we really think this is a great reminder for us as we walk through challenges and say, well, how do I change the way I think? What would that look like? So he says in this Gospel Primer, he says, the gospel is a gift. I love that. We like to get gifts. All of us do. Is a gift that keeps on giving to us everything we need for life and godliness. We extract these benefits by being absorbed in the gospel. Boy, I love that phraseology, that turn of words, to be absorbed in the gospel, speaking it to ourselves when necessary and by daring to reckon it true in all we do. He goes on to say, I've also found that when I am absorbed in the gospel, everything else I am supposed to be towards God and others seem to flow out of me more naturally and passionately. In his book, he lists 32, 33 reasons of why we should rehearse the Gospel and then lists a way to do it in either prose form or poetry form. So depending upon your like or dislike, it's just a way to walk through the gospel and to remember it so that when I'm challenged to think differently, no, I can remember and think through this in a way that honors and glorifies God.

Jocelyn: Another thing that really helps too is to help someone who is suffering from postpartum understand and live out their purpose for life in Christ. Like it's possible to glorify God bearing his image as I care for a baby even if that baby dies. It's possible for me to represent Christ accurately to my husband while we are both sad. So it's possible for me to grow in the likeness of Christ as I get better from a major illness and as I learn how to balance a life with a baby. So just understanding what my purpose is, that purpose doesn't change depending on my circumstances. It's still the same purpose. It just needs to be applied in the context of those specific circumstances. And then something that really helped me was just developing a biblical view of trials and suffering. Learning like God's not shocked when we go through suffering. He's not thrown off by it. And I can be honest with God in the middle of how hard it is. I can talk to him about what's really going on. And I can even complain to him. I can cry out to him and say, God, you promised that you were sovereign. You promise that you're providentially unfolding the events of my life for my good. And this doesn't feel good. Help me know how this is good. So there's a really great book that we love called God's Healing for Life's Losses by Bob Kellerman. That's a great little book. It talks about some just six steps for understanding how to View trials and how to live in them. We'll link that in the show notes. But having a robust understanding of trials and suffering biblically will be important. And if you don't have one, it will be demonstrated in times when life is really tough and you don't know how to handle it.

Dan: I think it's important as we think through this topic and many others is to look for practical ways, because we all need practical ways, to demonstrate grace. What does that really look like in the middle of this challenge postpartum depression? What does it look like? How could we lighten their load practically? And I think this is where the church family can really come in to provide assistance and to provide really a way to help individuals as they struggle with this. And there's lots of different ways to ask the church family to assist: in meals, in childcare. Because some individuals will go home with this and they've got two other ones at home plus a baby. And they're trying to do all of that sometimes with not as much help as they would like to have at home. So, with child care help, what about housework? What about household chores? We're not talking about taking all the responsibilities away, but how can I help? How can we help and lighten the load? The other component becomes, we talked about this sleep issue is, you know, could we give her One night of just uninterrupted sleep where someone else takes care of the baby. That would make a huge difference to have one whole night of uninterrupted sleep. Just what does it look like to show grace in the middle of these kind of challenges. And I think this is a really where a coordinated effort by the church could really be very, very helpful and really, really impactful. The other thing that we've talked about and thought through is it would be wise because of our culture and because of oftentimes not having family members, not having a mother that's necessarily close to have a mentor mom, who has been through this, who understands biblical principles, who can really help them as they walk through this and someone they can talk to about, is this normal? Is this normal? Is this not? How do I do this? How all these things, how those work together? A mentor mom would certainly be very, very valuable at this point. I also want to just talk about ministering to the husband. Oh no, no, no, no, no, no, no. Wait a minute. This is postpartum depression and we're only talking about this one. But well, just remember there's some data that's very significant. Some of the medical statistics say that from birth to three months of age about 8 percent of fathers are depressed. From three to six months, 26 percent are depressed and from six to 12 months, 9 percent are depressed. So again,

Jocelyn: a quarter of dads.

Dan: One out of four. Yeah. I mean, that's amazing. And if you think about it from a father's standpoint or a husband's standpoint, he maybe, maybe he has quote, tried everything unquote that he can think of and she's no better. And maybe he's lost hope that life will be any better. And he doesn't know how to deal with her depression and sometimes the way, which is really counterintuitive and counterproductive, but he's tried, it's not working. And it's really frustrating him. So what does he do? He spends more time at work. He gets out of the house and, and that just adds to her challenges because now she has more and more responsibility on her own. So all we're saying is, listen, yes, we need to minister to the mom who's experiencing postpartum depression. Don't forget about the dad. Because he's involved in this also.

Jocelyn: And that definitely definitely happened to Brian. He had a period of depression That was significant before I had my significant period of depression and it shocked me I was like, what is he upset about? He has a baby. Like we're good. I was just not prepared for the reality of it.

Dan: Yeah.

Jocelyn: His whole life changed too.

Dan: Yeah, absolutely.

Jocelyn: You know, in more ways than one. I got a baby. He had the risk of losing his wife and having a baby. Like there was two things that was depressing.

Dan: And he had this different person that was not the same person before the pregnancy.

Jocelyn: And many thousands of dollars of doctor bills.

Dan: And also just, we just need to say that sometimes we develop attitudes that, Oh, this will be okay in a couple of days. Yeah. It's not the case. That many times this will take a significant amount of time. And be willing to invest-- because that's what you're doing. You're investing your life into other people and it takes time.

Jocelyn: It's not tidy and neat. Yeah. So for the rest of our episode, I'm going to share what happens when God changes a life. The remainder of the story of my journey through postpartum depression can be summed up in these two verses from Deuteronomy 8:2 and 3, and you shall remember all the way which the Lord your God has led you in the wilderness these 40 years that he might humble you, testing you to know what was in your heart, whether you would keep his commandments or not. And he humbled you and let you be hungry and fed you with manna, which you did not know. Nor did your fathers know that he might make you understand that man does not live by bread alone, but man lives by everything that proceeds out of the mouth of the Lord. And before postpartum depression, I would have never told you that good could come from anything this hard. And that in all cases you should avoid things that were this hard. The conclusion though, is that my walk through this devastating experience is that really It's the best thing I could have ever gone through. Like that passage in Deuteronomy says, I was humbled and I was tested. I had the opportunity to see what was in my heart and I found out whether I was really going to follow God. And what I found out in the middle of this trial, when it was really the ugliest was that when I was tested and I looked inside of my heart, what I often saw was ugly, disgusting sin, not righteousness. I also learned that only a small percentage of my total problems were because of real innocent suffering or simply living in a sin cursed world like health problems. Living through the physical effects of my sinful thinking, desiring and acting was actually what led to my depression more than any physical cause. And the majority of the problems I faced were the direct results of my choices. And most of my choices at that point in life were Self protectionary, self centered, and fearful. God absolutely delivered on 2 Corinthians 9:8, when he promised he would give me enough grace to handle every trial he sent my way. But like Jonah 2:8 says, when I clung to my worthless idols, I forfeited a lot of the grace that could have been mine. Looking back, the medical problems were actually Not that complicated. The problems that were a result of my spiritual struggle and the theological fallacies were devastating. And every single problem I experienced there was the result of me having invested in that consequence sometimes for my whole life up until that point. So while I was silently suffering through all of this, I learned a couple of major life lessons. And this is the big one. First of all, I learned that God is not freaked out when I ask him honest questions. I found out that He is a big God who has answered lots of people's hard questions all through history. And questions about my existence and my purpose and His sovereignty don't make Him mad at me. I also realized when I was afraid to look at the shepherd square in the face, because I was nervous I wouldn't be able to trust Him to be big enough to handle my problems or good enough to care about my suffering. And what I found in Psalm 118:68. It says he is good and he only does good. Even if that meant a preemie baby, a difficult problem with my health and the decision to let me suffer with postpartum depression. I also learned that he is great and powerful and was sovereignly and providentially unfolding the events of my life for his glory, and my good. I read this book called Trusting God by Jerry Bridges at this point of life over and over and over. My book is so marked up. I learned in this book, something that made me so mad. God could have actually prevented me from suffering with this postpartum depression and he had chosen not to. What he does allow Is for the purpose of me understanding and knowing him better. And if God could have prevented it, but didn't, that didn't make God unkind. It proved his supremacy and wisdom. I also found out that unless I know why I'm alive, I really don't have any reason to live. And once I did know why God had created me, I could not imagine being dead. On days that I woke up screaming at God that I couldn't believe he hadn't let me die in my sleep the night before, the only reason I was able to get up was because at some point, and I don't even know when, I had memorized the first confession of the Westminster catechism. What is the chief end of man? The chief end of man is to glorify God and enjoy him forever. I realized that I didn't even have any idea what that really meant, but if God was going to force me to stay alive, then I guess I would spend the rest of my life figuring out how to do that well. And there were times when my mom and I were both really having a hard time at the same time. Like we got through the day by quoting that Westminster catechism, first confession to each other. Another big thing I learned was that there's a big difference between doing Christianity and being a Christian. I was super active doing many righteous things as a believer before this happened. And I learned that when push came to shove, if it's just me looking into Jesus's face, all of the things I do for him are not as important as knowing who I am because of my union with him. I just learned that I have to be in Christ before I can really know how to do anything because of Christ. I also learned during this time that the bible is not just a tool, although it is a tool. I learned that the Bible is God's love letter to me, describing how He's going to continue to pour out His loving, kind, faithfulness on me, His beloved child, forever and ever. And how He wants me to return that love by my obedient and loyal choices, even when it's hard. As the maker of my body, he wrote the Bible as his description and instruction of how even in a body that's cursed by sin, I can know how to live in a way that leads to my best happiness and satisfaction. I also identified a couple of big false gods that I was worshiping on a regular basis: not being afraid, being satisfied and upholding an image. And they are cruel masters. So let me just talk about each of those idols that I saw in myself, and they're not going to be the same for everyone. Your heart will be revealed in suffering. And this is what was revealed in my heart. You'll have to just look for yourself at what's going on inside of you. The first idol was not being afraid. I realized that in almost every facet of my life, I was crippled by fear because I was sure I would not be able to handle what God had decided to make me walk through. So I really learned to trust 1 Corinthians 10:13. And I read and studied the book Overcoming Fear, Worry, and Anxiety by Elise Fitzpatrick. It was just essential in retraining my brain and body to know how to handle fear and anxiety. I also learned using passages in Ephesians 4 and Philippians 4:8 really how to think. And I look at this now and realize like, I really didn't know how to think before this happened. And, and this experience made me relearn how to think as a human being. I realized eventually that just because something is potentially true or even possibly true, that doesn't make it really true. And my energy should be focused only on dealing with the truth that God actually had asked me to handle, not all the made up stuff inside of my head. And like half of my battles that I thought I had to face weren't even real. They were like potential battles that I might maybe have to face. And what was happening was I was sucking the energy God had given me to fight battles he hadn't assigned me to fight. And I had no grace for those situations. One of the biggest fears I realized I had was the fear of loving because I might get hurt. And that the delusion that love is easy and natural. I think that's pretty hard to overcome and to conquer. Choosing to love a daughter that could die was a decision to learn to love the way God describes in the Bible, giving passionately of myself to invest in someone other than me meant being willing to love at great cost. Those 22 years since my daughter Haley's birth and now have resulted in a love for her that I cannot imagine. I just barely can explain other, I'm sure other moms can understand the same thing. We've had real struggles, real heartache, real really difficult parent child relationship since then. But I've never loved anyone else in my whole entire life the way that I love her because I chose to love her even if she died. I've invested in her. I've poured so many hours into learning her and helping her figure out how to handle some of the unique challenges that have come along with being a preemie. I've given up so much of my comfort to deal with her biblically. I can't imagine ever being willing to be okay with not loving her in order to protect myself. The return on that investment has far outweighed the investment. The second idolatry that I saw was being satisfied. I learned that my life was filled with a string of ridiculous expectations and dreams and fantasies in my head that I was pretty sure we're going to satisfy me. And I learned as some of those dreams were ripped away from me one by one, that the only thing that would ever really satisfy me was God. Psalm 145:16 says this, you open your hand and satisfy the desire of every living thing. That verse became the promise that I balanced my life upon. I was willing to stake the continuation of my life upon the promise that I would to be satisfied, even if it had nothing to do with being a cute pregnant girl, having a dream of a delivery and nursing my baby like a fairy tale. Since then, all sorts of other dreams have flitted away as I've consistently come back to that promise. Perfectly obedient children will never satisfy. A drama free job, never satisfy. A boss and coworkers who always understand me and are passionate about working with me will never satisfy. I learned that I wasn't put on this earth to be satisfied. And honestly, many of the longings of my heart are incapable of being satisfied on this earth. I realized that many of the things I long for were actually my heart longing for home. And there was probably going to be 50 or 60 or 70 more years of delayed satisfaction about some of those things. But 50 or 60 or 70 years of delayed satisfaction is not the same thing as 50 or 60 or 70 years of depression that makes me want to kill myself. Unfortunately, on this topic of being satisfied, I realized that when it got hard and I wasn't getting what I thought I needed, I wanted to escape. And what's terrible was that I was using fantasizing about dying and going to heaven as a tool of an unbiblical escape from those hard things. In the years since this terrible depression, I've begun to long for heaven in a whole different and much more biblically informed way. I can barely wait to get there. I literally think about Jesus coming back all the time. But instead of thinking about how I'm going to get out of the life that God has given me by going there, I've come to learn to think about heaven as the place where my shepherd dwells, whose kingdom is going to be established forever, where I'm going to get to finally experience his real comfort in a way that I have as yet only experienced in the shadow lands. Heaven is not a tool I use to comfort myself and fantasize about escape in a way that serves me. Heaven is a place I will soon be living for all of eternity, from which I will be serving my King. And the last idolatry that I saw, I'm sure there was more, but these are my top three was upholding an image. One of the images that I didn't even realize I was upholding was the image of Christianity as an emotionless, feelingless existence, where by the force of your will, you conjure up the personal strength to do what is right simply because it is right. So Christianity is not also just simply an emotional feeling driven experience, but God did give me feelings and emotions, and he wants me to use them in my experience of loving him and others. One of the images I held up in my mind was that Christianity should not take time or effort. I should know the right thing to do and I should simply do it immediately without thinking about it. I learned that yes, obedience needs to be immediate and complete, but that sometimes as you figure out what that looks like, it takes time and that's okay. Some of the things I've learned since this time have taken me years to figure out, but I didn't stop obeying in the process. I just told God, I have remaining questions, and if you could please help me figure them out, that would be super awesome. There are some things that I did not learn until 4 or 5 years later, or 20 years later. But, I trusted that if God wanted me to have answers to my humble, but real questions, he would help me find the answers. And then finally, I had invested in this level of depression by cutting myself off from real relationships and living this image of a strong and courageous Christian woman. I did what I did because I was naturally strong, not because I was connected to the source of strength or had honest help from my family of believers. Some of my best and most godly friendships now were formed during that period of intense trial, as I eventually learned to open up and ask people to be a part of my life. One of the best things that those relationships did for me was to become a sounding board for the truth and a means of loving accountability. I can't get too far off track with what is true and end up thinking like Crazy fantastical delusions when someone is asking me what I'm thinking, and then I'm letting them honestly help me evaluate it. Like one of the biggest things was after struggling with that crazy delusion of being afraid to use scissors around Haley, I mentioned it to my sister and I said, don't use scissors around her. They might fall on her guts and cut her open and her guts will fall out. She was like, that is crazy. You should stop thinking that. And I was like. That's helpful. It's helpful for someone to get in my crazy head and be like, that's dumb. Stop thinking

Janet: That’s not rational.

Jocelyn: That's not rational. So it's been 22 years. You could be asking what's happened since then. And there were some instances where some really, really bad things happened in our family. One of them was so terrible, I don't think I stopped crying for like three months straight. But working through these giant theological issues during this period of postpartum depression made it happen that even when there was difficult things later in my life, I never fell apart again, ever again. I never became unglued or delusional or incapable of action like I did after Haley was born. Not even when we decided that the only thing worse than going through this a second time Would be to have an only child. And we decided to take this huge leap of faith that God would be able to sustain us all to have a second baby. Even if that meant I went through all of this again. And we decided that we would try it again. And if I got sick a second time, there would never be a third time. So. There will never be a third time. So this experience was revolutionary in the way that I think about a lot of things, especially how I help other people change or how I be friends with other people. And I think one of the biggest takeaways I got from this was walking through this kind of suffering helped me to learn how to walk through suffering with someone else well. Like I'm not just helping them change or helping them to pull themselves up by their bootstraps. I'm walking through difficult trials with someone else. I probably say a lot of the same things, but I do them entirely different because I understand that God is a jealous God. He doesn't share his glory with anyone, even if it's you stealing the glory inside of your own head or working through things on your own. And he loves us. He's working through what he's asked us to walk through because it will conform us into the image of his beloved, perfectly thinking, perfectly desiring and perfectly functioning son. And I don't want to just be helping people have you know, like how to change quickly or how to get out of this pain. I want to be real with them. I want to walk through real suffering with my friends and be compassionate when people are really suffering. So I can't believe-- at the time I would have never been like, yeah, this is going to happen. But I can't believe about all the things that I learned through 18 months of really difficult postpartum depression. I really think it was a dividing point in my life. It's the difference between when I really understood what it meant to follow Jesus and what I thought I understood about that. Psalm 119:65 through 72 is a really amazing passage, but it says this, you have dealt well with your servant, oh Lord. It is good for me that I was afflicted, that I might learn your statutes. I think what I needed when life was the worst was hope, hope that I would ever be able to get through what I was facing. I never imagined I would look back and tell God that what he did to me and what he taught me about himself was good. There is this quote that I love. It says this. Oh, hope of every contrite heart. Oh, joy of all the meek. To those who fall, how kind thou art. How good to those who seek. Psalm 34 says, I sought the Lord and he answered me and delivered me from all my fears. They looked to him and were radiant. Their faces will never be ashamed. Taste and see that the Lord is good. How blessed is the man who takes refuge in him. The eyes of the Lord are toward the righteous and his ears are open to their cry. The Lord is near to the brokenhearted and saves those who are crushed in spirit. The Lord redeems the soul of his servants and none of those who take refuge in him will be condemned. Isaiah 49:23 says, those who hope in me will not be disappointed. So I encourage you if you are struggling with postpartum depression or if you love someone who is, help them to be courageous to seek, courageous to seek answers from the Lord, to courageous to trust in the Lord, courageous to work through the actual thoughts and questions that are inside of their head.

Janet: Thank you, Jocelyn. And thank you, Dr. Wickert for just walking us through that. And I love that you ended it on hope. Because that's, I think, the one thing that we would like people to take away from this is whatever they're walking through, your willingness to be transparent. There are many people listening that are like, I don't know that I would have wanted to say that, but I've thought those things. And now we can take those things out of the shadows. We can bring them into the light and know that God's people can help us, God can help us, and that there is incredible hope.

Jocelyn: It's really interesting. We taught this session in track two, which is men and women, like several hundred people. We taught in track two for maybe 12 or 13 years, something-- a long time. Every single time we spoke, every time, there was a line from the front of the room to the back door of people waiting to talk to us. And it was people from all walks of life who had experienced this level of depression, but connected to different kinds of topics. So pastors,

Janet: not always postpartum

Jocelyn: Not always postpartum. Pastors who had struggled through something significant in their church, parents who had lost a child. So one of the things that I think is, It's helpful to know is that the experience of depression at this level where you're having delusions and not thinking in reality, that experience is connected to many different topics and that what we've shared with you can be applied across the board in many different ways. And in all situations our summary to anyone who's ever asked us to talk to them is never ever be afraid to talk to Jesus about the questions inside of your head.

Janet: Yes.

Jocelyn: They're not going to throw him off. He's not going to be upset with you. He loves you. He wants your experience of following him to be authentic.

Janet: Yes.

Dan: And we are just thankful for the opportunity that we have to speak about this. For some, it's like, wow, this is good that we're finally talking about some of these things are happening. Sometimes these things can be kind of pushed to the side, like, Ooh, that's, we don't talk about that or do that. So to talk about it and to give people hope in the midst of these challenges that they do happen, that they're real and they do happen. We also recently, a year ago, actually a year ago February 23, the second edition of counseling of the Christian counselor's medical desk reference came out and we have a chapter in there that we both did similar to what we're doing today on postpartum depression. So it's a little different. When you write something, it's always totally different. It's a little bit different.

Jocelyn: Same content, same ideas, but yeah, it's in that book and we'll link it in our reference in our show

Janet: Yeah. We'll link that in our show notes for sure.

Dan: Yeah, the last one that I would add to is, this has occurred a number of years ago, and hopefully I can do this without being emotional and probably can't, but that's okay. We are walking through Psalm 139 in our Adult Bible Fellowship Sunday School class. And Psalm 139 says, you have enclosed me behind and before and laid your hand upon me. So that's God saying, listen, what I'm doing for you is, well, how I'm caring for you at this point is I've got you. And I've got you. Your head and behind and my hands on top of you and your back and Jocelyn with his story.

Jocelyn: Right. We were, so Dr. Wickert is actually my ABF leader. And so in ABF we were just kind of like digesting it and someone said, what does that even mean? And it was just, it just got really quiet in the room and I was like, well, I can tell you how I learned what that verse means for me. And I shared the story of in the NICU when Haley was just newborn and I was going to visit her and I would put my hand on and like rub her back like you would do for any baby. And it is so agitating to her because she had no fat pad. She was just skin and nerves. And so when I was rubbing her, it was actually, irritating her and it would cause her to be in distress. So Dr. Chua, my amazing neonatologist, watched me doing what I was doing and she's like, stop, you're hurting her. Stop. If you want to comfort her, put your hand on her head and your other hand on her bottom, and push in. Help her to feel like she's still inside of your uterus. Give her the boundaries of safety. And so I did that. I laid my hands on her head and on her butt and I just pushed in like I was her safety and she stopped screaming.

Janet: Wow.

Jocelyn: And it was just such a, I was studying Psalm 139 at that time. It was so vivid. Like that is what God does for us.

Janet: Yes.

Jocelyn: He hems us in. Before and behind, he lays his hands on us and he gives us safety.

Janet: That's beautiful. That's beautiful. So with that note, let's end on the safety of God who is right there. And thank you for sharing.

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Host Janet and her husband, Brent, also speak at a variety of conferences as a way to raise money for the seminary. If you want to look at what they offer or book them for a conference, go to their website.

Janet Aucoin

Bio

Janet is the Director of Women's Ministry at Faith Church (Lafayette, IN); Host of the Joyful Journey Podcast (helping women learn that when you choose truth you choose joy); ACBC certified; teacher in Faith Community Institute; Coordinator of FBS seminary wives fellowship, retreat and conference speaker; B.S. Human Resources, University of South Florida.