Dr. Chad and Kelly Swan: FACES of TriStar

One month after the birth of her first child, Kelly Swan couldn’t sleep or eat. Her anxiety was so intense that “irrational thoughts” and suicidal fantasies (“If a semi-truck swerved into my lane and took me out, it would be the best case scenario.”) consumed her. Eventually she just shut down; she felt paralyzed.

Her husband, Dr. Chad Swan, a vascular and thoracic surgeon with TriStar Hendersonville Medical Center, had no idea what to do until Kelly’s family in West Virginia prompted him to get his wife medical help. Doctors diagnosed Kelly with severe postpartum depression (PPD) and treated her with antidepressants and anxiolytics. Her therapist made house visits, and her mother (also known as Grammy) moved in for three months to help with baby Kathryn.

Though Kelly was scared to have another baby, she decided, with the help of her practitioners, to stay on medication when she got pregnant with her second daughter, Samantha. Aside from a bewildering and frightening liver issue that landed Kelly in the hospital for four days, she and husband Chad describe Kelly’s postpartum experience with Samantha as “smooth sailing.” So, why not try for a boy?

As our newest FACES of TriStar, patient Kelly Swan sat down with us at her Goodlettsville home, with husband Chad by her side, to talk about her latest and most severe bout with PPD. Now a happy and healthy momma to three beautiful girls (Kathryn, 7, Samantha, 4, and Charlotte, almost 1), Kelly hopes her survival story will spread awareness about this debilitating illness that affects one in eight women (according to the CDC).

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What happened when you had your third child, Charlotte?

I had high anxiety. I had constant worries. There are so many worries that you’re almost confused. I felt paralyzed again. I had to take a Xanax to even get out off the couch. I remember one day calling my mom bawling crying and saying, “I think I need you.”

Chad did not waste any time. He took me to TriStar Centennial Parthenon Pavilion (a psychiatric hospital in Nashville) to admit me. I was a deer in headlights. I didn’t know what to do. I just did what he told me to do. He told me, “Go pack your bag. Come with me. Get in the car, we’re going.” So, I just got in the car, leaving my kids behind because I knew it was happening again, and I knew that I had to get help.

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Chad, when did you realize Kelly might be suffering from postpartum depression again?

Charlotte was born on December 6, and it was fantastic. This was how that first month and baby’s first Christmas were supposed to go. We’d done everything we could possibly do. We had psychiatrists on board, her therapist was on board, she was on the right medicines, Dr. Riggan, the OB, had done a great job preparing us. Luckily, we had the resources to hire a full-time nanny. We had all this in place, and it still came on just like a storm, like a front.

In February, I’d planned to go back to Slidell, Louisiana, to my high school for a career day to talk about a program I do during the summer where high school students follow me around like an internship. I remember Kelly telling me, “I don’t want you to do that.” I thought, “Well, that’s strange, but OK if you need me here, I won’t go.” It felt like it was out of the blue, and that’s when things rapidly declined. We went from a Monday with her saying things like, “I don’t want you to go out of town a month from now,” to a Wednesday, when she was closed off and sitting in the fetal position, to Thursday, when we got Grammy to get down here, to that Friday, where finally it was just like, “This is code blue, this is the STEMI, this is the major trauma.”

She wasn’t able to do anything. She was frozen, walking by a crying baby to the point of almost being catatonic. That’s when I called the psychiatrist, and the psychiatrist started talking about increasing the medicine, and I literally said, “You don’t understand. I’ve got boots on the ground here. This is an emergency.”

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What happened when you got to TriStar Centennial Parthenon Pavilion?

Kelly: When we got there, Dr. Koumtchev explained to us that the quickest way to recovery is electroconvulsive therapy (ECT). He showed us a tutorial video on it and asked us if we were interested. I was in the fetal position, and I looked at Chad, and we both said, “Yes, if it’s the fastest way to recovery, we want to do it.” So, I got 10 sessions of ECT, where they put you under general anesthesia, and they induce seizures. Somehow they found that people who have seizures don’t have depression.

Chad: I think they noticed that with patients who were undergoing acute phases of epilepsy, there was a very low rate of those patients having depression. I don’t know the science behind it, but somebody figured out that if we have a patient who has a major depressive episode, and the medicines aren’t working, if we can do ECT and induce seizures, we can break them out of this pattern to where it gives them a long enough time to allow the medicines to kick in and work. With postpartum depression like this, Dr.Koumtchev quoted us that 85 percent of women are going to get better a lot quicker and break this cycle, so that was why we went with the ECT because of how fast it can work and how effective it can be.

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Are you glad you went that route?

Chad: Yes, but it was hard because when he said ECT, the first thing I thought was, “I’m taking you out of here and going to a real hospital,” because I imagined Jack Nicholson. It really took Dr. Koumtchev’s incredible professionalism, and obviously he knew that’s how we would react. Well, Kelly didn’t react. She was almost in a coma, but I was like, “What are you talking about? We’re not going to do One Flew Over the Cuckoo’s Nest here.”

Kelly: One of the side effects is memory loss, so I have virtually no memory for about five weeks during the time I was receiving the treatment. That’s what actually made me quit because they wanted me to do another three sessions, and I was feeling well enough to where I said, “This memory loss is driving me crazy. I’m not going anymore.” My psychiatrist said that’s a good sign when you have someone feeling well enough to say, “I don’t like these side effects.” I also knew I was feeling better because I wanted everyone to get out of my house! I couldn’t drive, and I was basically on house arrest for five weeks because with this treatment, there’s a chance you might have a spontaneous seizure.

How did postpartum depression impact your marriage?

Kelly: After my first bout of PPD, our marriage suffered in part because I was angry with my husband regarding how he handled it and treated me. We did a lot of marriage counseling, not specifically always about that, but there was an underlying anger and unforgiveness on my part.

When I had PPD this last time with Charlotte, my husband acted swiftly to get me help, and he treated me with kindness and understanding. He said we would get through this together. This particular instance healed my anger and unforgiveness that I was holding onto all those years. I was finally able to let go of how PPD went the first time and focus on how loving he was through this third time.

Chad: I still beat myself up about being oblivious [the first time]. At the point where we are sitting today, it’s obvious that there was a huge problem, but as I look back on it, I did not know what was going on. We’d been married for three years, and this was our first child. We were living here six hours removed from any family. I just remember after the first month, thinking, “This just doesn’t seem like the way it’s supposed to be. Aren’t we supposed to be happy baby, smiles and rainbows?”

Now that I think about my side of things with medicine and surgery versus this kind of problem, my mentality is I’ve got to know what’s going on so I can figure out a plan to fix it or make it better. If you don’t even have the knowledge to know what the problem is, you don’t even know that there’s a problem. So, when we went to West Virginia and her family looked at me like, “What did you do to her?” I’m like, “I don’t know what’s going on.” I had no idea who to talk to or what we were supposed to do.

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Kelly, why are you sharing your story?

If I can save one woman or one family or one couple from having to go down the lane that we did, it’s worth it. I think awareness is the biggest thing. Postpartum depression can end in tragedy, and I can see how. But it doesn’t have to. It’s treatable.

Do you feel like there is a stigma surrounding postpartum depression? What misconceptions might people have about it?

I think women think it might show some weakness, but now that I look back on it, I have to treat it as a physical illness. It was an illness that I needed help with, and it was very treatable.

What advice can you give women who may be experiencing similar symptoms and are wondering whether they have postpartum depression?

If you think you have symptoms when you have the baby, get help. Tell somebody. Have a designated person you can call, like your mom. Bring that person in, and contact your healthcare professional. Don’t wait. You can always go to your OB first if you’re not sure, and your OB should be skilled enough to know whether you need to follow up with a specialist.

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How did you want to be treated when you were in recovery? If someone has a friend going through this, what should they do?

Kelly: Just text, “I’m thinking about you.” I didn’t want a whole lot of chit chat and being around people. Meals are great, too. But just don’t be afraid to text or pick up the phone and say, “I’m not going to engage in a lengthy conversation, but I just want to check on you.” When I started going to church again, I just wanted people to smile and say, “Hey, I’m thinking about you. You’re doing good.”

Chad: Her family really stepped up, but when people started bringing meals over and giving their support, that was so very uplifting, and it did make it easier. I think it’s important to give family space, but do the things you would do if they were going through another kind of illness. Bring in the same support because it really is a medical condition.

Thank you to Dr. and Mrs. Swan for sharing their story of hope and survival. 

If you suspect you or a loved one is suffering from postpartum depression, contact your medical provider immediately.

FACES of TriStar is sponsored by TriStar Health. Photography by Grannis Photography.