Thursday, April 14, 2011
Depression Series: Postpartum Depression
I don't talk about it a lot, but I've mentioned it in passing. I have lived with, struggled with, coped with, and failed to cope with depression. It's a part of who I am, and I am not ashamed of it despite the stigma I know that comes with it. Alone it does not define me, but I will not hide from it.
This will be a short series talking about my personal experience with depression - postpartum or otherwise including ways I have dealt with it along with resources I've happened upon along the way. This in no way constitutes medical advice. This is simply a sharing of my journey and whats helped me along the way in the hope that it might help someone else experiencing depression or someone who knows someone experiencing depression.
I was first diagnosed with postpartum depression (PPD) about seven months following the birth of my first son. He was born in January 2007. He was colicky spending hours at a time every single day screaming his cute little head off. He didn't sleep for more than twenty minutes at at time for months and even then it was only in our arms. That same spring I wrote my masters thesis (The Gift of Sacred Place: Responsibly Teaching Place Practices in Outdoor Ministry) so I could graduate in May. S-T-R-E-S-S was the name of the game. But when things settled down and I hadn't found an emotional normal, I sought help.
What does PPD look like?
Post-partum depression doesn't look the same for everyone. It's not a one-size fits all kind of thing. According to Post-partum Support International, 15% of women experience significant depression following birth. Symptoms can manifest anytime during pregnancy or the first year following birth. Symptoms can include any of the following: feelings of anger or irritability, lack of interest in the baby, appetite and sleep disturbance (ok what new mom's sleep is not disturbed?), crying and sadness, feelings of guilt, shame, or hopelessness, loss of interest, joy, or pleasure in things you used to enjoy, and possible thoughts of harming the baby or yourself. Often times, you may not know someone around you is experiencing PPD; other times, it may be more noticeable.
Because of the stereotypes of PPD, because of the picture of it that had been painted for me, I wondered for a long time if that could be what I was dealing with because I was functioning. I was able to fake it and do things around other people. Meanwhile, at home, where I felt safe and didn't have to put on a show, I crumbled into an exhausted, miserable mess.
If you or someone you know may be suffering from PPD, please get help now. There are hotlines and support groups. They vary by region. Your doctor is often a good place to start.
I went to my doctor. For many reasons, I don't use this practice anymore. In a practice with three doctors, I got an appointment with the one I liked the least. It was traumatic. I explained that I thought I might be experiencing symptoms of PPD. His responses included the following.
That's impossible, your baby is seven months old.
All post-partum depression literature, including that received from this doctor's practice explain that symptoms of PPD can appear anytime in the first year following birth.
Clearly, you've had issues with depressions before. Haven't you been on medication?
While, in retrospect some of these issues are things that I can see present in earlier periods of my life and that I continue to deal with, I had never been treated for depression with or without medication.
I don't know why you're talking to me. You need to see a psychiatrist. This has nothing to do with birth.
As is shown from the numerous screenings they are required and encouraged to do, birth professionals are the first line of defense and care for postpartum depression. They are a great place to start when you are unsure how to proceed. They can recommend possible treatment options and refer you to other practitioners where appropriate.
I don't tell you this to encourage you to feel bad for me or make you fear talking to your doctor but to point out that despite all the hype that PPD receives in our culture, many people from health care professionals to family and friends have a lot of inaccurate information and misconceptions. This is why we must continue to share our stories, spread the word, and support mothers. If you or someone you know has encountered bad advice or a lack of response when they asked for help, seek more help. There are good people out there who can help you.
There are various treatment options for PPD, the two most popular being talk therapy and antidepressants. Besides these two popular options, there are alternatives. I wanted to avoid medication. I went to counseling. After a few months my counselor told me that after talking with me and hearing the disconnect between what I thought and could articulate versus the symptoms I was experiencing, she really believed that I was dealing with a hormonal imbalance that no amount of talk therapy could address. She recommended medication. At that time, I wasn't aware of the many alternatives outside of counseling and antidepressants so there was little else for me to consider. I began a low dose of Prozac. The medication helped me, and I'm glad it was there. It's not right for everyone, but it can be a very effective treatment option.
I took the antidepressants until I got pregnant with my second child when my first was seventeen months old. about ten months from the time I sought help. At that point, I attempted to wean from the medication and had an incredibly difficult time. I chose to remain on the antidepressants through my second pregnancy and initial postpartum period. It was a challenging decision with so many risks and benefits to consider. Yes, there are medications that can be compatible with both breastfeeding and pregnancy, but whether to take them is an individual decision that should be made between mother and health care provider.
I am not an advocate for or against any particular treatment option, but I am an advocate for researching all the options.
My children are now two and four years old. I am medication-free, though I still struggle with various pieces of depression related and unrelated to PPD. I'll talk more about that along with treatment alternatives in another post.
I am writing all this to 'come out of the closet' so to say. In the past few weeks and months, I have had countless unexpected conversations where someone whispered to me that they were struggling or they had struggled with depression, postpartum or otherwise. I was able to share my experience with them, support them, and assure them that I was not going to judge them for this. PPD affects real normal people. The more we hide it and stigmatize it, despite countless PR campaigns, the more we risk people who need support not getting it. When we share our stories, we help empower others to do the same, standing proud for what they have been through and not feeling guilty for having been sick.
All moms are exhausted and overwhelmed. All new parents feel stress, guilt, and fear. Mood swings and irritability can be expected. The hope is not that everyone will think they are experiencing postpartum depression but, instead, that those that are will have the support and resources to get help without being ashamed or embarrassed. Because PPD sucks.