Guest Blog: Down Will Come Mama: Work & Postpartum Depression

Welcome to the Tuesday guest blog. Every Tuesday, "On Balance" features the views of a guest writer. It could be your neighbor, your boss, your most loved or hated poster from the blog, or you! Send me your entry (300 words or fewer) for consideration. Obviously, the topic should be something related to balancing your life.

Down Will Come Mama: Work and Postpartum Depression

Rebecca Kaminsky writes the column Down Will Come Baby for the online magazine Literary Mama, where she is also the Literary Reviews Editor. Her work has appeared in Literary Mama: Reading for the Maternally Inclined, as well as the anthology Wednesday Writers: Ten Years of Writing Women's Lives. She lives in Berkeley, Calif., with her husband and two sons.

At 29, one month into new motherhood, I went out with my husband and son for our first dinner at a restaurant. On the way out to the car, I slipped on the sidewalk and dropped my son onto the pavement, fracturing his skull. My son fully recovered. I still can't say that about myself.

Barely into motherhood, I felt I had already failed. My working life was spotty before baby--a couple years as a teaching assistant in Media Studies at Hunter College, a couple years teaching preschool full-time. I loved academia but wasn't really sure what path I wanted my career to take. After my son was born, that uncertainty magnified.

I was one of the 10 to 15 percent of new mothers who experience postpartum depression (PPD). Venturing outside a four-block radius of our tiny apartment in Berkeley produced a fireball of anxiety inside my chest that could be cooled only by avoiding the subject of work entirely.

Not exactly a recipe for the perfect balance of happy motherhood and beginning a career.

I had deeply conflicted feelings about my baby, one of the hallmarks of PPD. I loved and resented my son with equal intensity. When he cried, I fantasized about what it would be like if I'd never had him. Would I be writing? Teaching? Finishing up my doctorate? Then, I'd look at my sweet boy. How could I be so selfish, so disgusting? I had already failed him once--and now I was fantasizing about life without him?

Mothers with PPD cope with their conflicting feelings in many ways. I overcompensated by never leaving my son, even for a second. I couldn't fathom anyone else taking care of him. I imagined his little heart breaking if he were left alone with a sitter, or even my husband, sidestepping the notion that perhaps it was my heart that was in danger. I stayed with him in our apartment for days, unable to function other than to meet his most basic needs. I didn't deserve to take him out and have fun, much less the luxury of exploring career options for myself.

I certainly didn't deserve treatment. This was my fault. I blamed myself for not being a happier, more confident mother. For not knowing what I wanted out of motherhood and out of life.

When my son started preschool, I was forced to separate a bit. I began to see that he was okay without me. In fact, he had grown into a well-adjusted, happy toddler. And I had some time to look at my life.

My husband was strained from helping me, caring for our son and working full time. I was miserable and needed help. I managed to seek (and fortunately could afford) therapy and medication. The medication mediated my pain and anxiety. Therapy gave me the perspective to see that my guilt about the accident was preventing me from sharing my child and myself with the world, from enjoying outings with him and connecting with others and from finding my own way to combine work and motherhood.

Eventually, I started writing and connected with a mothers' writing group in Berkeley. In the fall of 2003, the group founded the online magazine Literary Mama as a way to showcase writing by and for mothers. Since then we have grown to become a nationally recognized online magazine.

I rediscovered a love for writing and, while doing so, fell in love with my son all over again, this time without depression. I found a balance between time at home and time away that works for me and my family.

I'd love to hear from other mothers who have or are now suffering from PPD. How has your illness affected your decisions concerning whether or when to go back to work? Did having PPD change the way you felt about staying at home or going back to work? Did your access to treatment (or lack thereof) directly affect your ability to support your family?

By Leslie Morgan Steiner |  June 20, 2006; 7:00 AM ET  | Category:  Guest Blogs
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My husband and I adopted out daughter at age 12 months from China, so I figured I had escaped things like post-partum depression. Boy, was I wrong. I experienced many of the symptoms, even though I did not give birth to my daughter. My feelings of ambivalence about my daughter during her first year with us were especially overwhelming and I feared I was not cut out to be a mother. I did try to get out, but my feelings of guilt overwhelmed me -- shouldn't I be at home trying to bond with my baby?

I, too, found a bit of a way out of it by returning to writing. I had been an attorney for 15 years, but had been in journalism before that, and hoped that writing would be a good way to pull myself out (and cheaper than therapy). Going back to the office for some relief wasn't an option, since the job I had when we left for China no longer existed when we returned, due to the change in administrations. But writing and getting a bit of a life back for myself helped me regain some perspective, even on the days when I feared I would never be the mother my daughter needed. Today, she's a happy 6 year old who just finished kindergarten, and I can't imagine my life without her.

http://punditmom1.blogspot.com

Posted by: PunditMom | June 20, 2006 8:41 AM

Postpartum depression is real. I experienced it after the birth of my first child who was beautiful, healthy and very fussy. The sense of lack of control and lack of sleep became very overwhelming. When he was 4 months old, I learned I was pregnant with my second child, a girl. I wasn't sure where I would find the space and time to take care of them and myself, too. Working away from home was difficult because I was sleep deprived and needed the energy to perform at work. I did the best I could. I worked my way back through journaling and bending my mother's ear (thank you, Mom). Fortuneatly, I had a boss that understood my challenges - this made it easier. It's taken time, but now I am fully engaged in my work and my children. I have a wonderful husband that has grown and takes pride in caring for his children as well.

New moms: persevere, talk and pray. You have the strength inside of you. It's like bulding muscle, the more you work it, the more it grows.

Posted by: On the Comeback | June 20, 2006 9:27 AM

Regarding the first post, there was an excellent article in the Post one-two months back. It described post-adoptive depression. It was very revealing, and started to uncover an area that isn't much talked about.

Posted by: JS | June 20, 2006 9:48 AM

Right now in Houston, the Harris County Prosecutor is trying to send Andrea Yates away to prison for life for killing her 5 children in 2001. Albeit, in the original trial, the prosecutor's own psychiatrists has said she was "schizophrenic", "delusional", etc. from PPD neuropsychosis. I hope the country follows this trial, to see if women's mental health following giving birth is reacted to properly.

Posted by: JR | June 20, 2006 9:59 AM

When I had my son I expirenced PPD. I had heard about it, read about it, even our Lamaze teacher warned us about it, but I did not recognize it. At first I was just so tired all the time (and my son would cry throughout the day.) I always thought what did i get myself into and would envy all my friends that didn't have kids. My husband couldn't relate, but tried to be supportive. Finally, shortly after my son turned one, he asked ok, what do you need to do to be happy. I decided I wanted to go back to school and get a career (not just a job) and needed an occassional "break" from the baby. 2 and 1/2 years later, we're all in DC. I'm in a job I love, started taking better care of myself. I have so much more energy now, and really for the first time "love" my son. I've always taken good care of him, but now I love the evenings and weekends I get to spend with him having fun. Literally, I feel like a fog being lifted off of me. I don't know enough about PPD that if its something you can just "grow" out of over time, or if me actively finding goals for myself and achieving those goals helped me. Anyways, just thought I would share.

Posted by: new to DC | June 20, 2006 10:35 AM

Has anyone experienced severe depression in the first few months of their pregnancy? I was shocked to find myself in that situation. In chatting with other women since then I have never heard of anyone else going through it, It leveled off at about month five.

Posted by: smb | June 20, 2006 10:36 AM

On the comeback said, "New moms: persevere, talk and pray."

I agree that these are good ideas, and certainly also agree that having a helpful support system, as comeback had in her mom, is important.

But sometimes mom, prayer, perseverance, and talks with friends are not enough. Even gorgeous, rich people (i.e., Brooke Shields) can get severe PPD, and it needs to be treated as the illness it is.

If you are not able to get effective treatment from your OB, see a psychiatrist. If you are lucky enough to be insured, treatment should be at least partially covered.

Kudos to the moms who've pulled themselves out, but PPD can be lethal. It has to be taken with great seriousness.

Posted by: THS | June 20, 2006 10:38 AM

This brings up some important issues-- as a mother myself, and a friend to many new mothers I sometimes wonder whether they are just over-tired and over-worked, or suffering from depression and unaware or ashamed of it. It seems like the the media only portrays women with PPD as those who neglect or harm their children--rarely do we ever hear about women who cope by overcompensating. I wonder how many women suffer in silence and try to be the "perfect mom", how painful. Thank you to the author for her courage in sharing her story!

Posted by: Concerned Mother | June 20, 2006 10:45 AM

After 4 rounds of IVF and one second trimester pregancy loss, I finally had the baby of my dreams in 2004. It was supposed to be the happiest time of my life and it was for the first three days...No one, including my doctors, warned me of the very real aspect of post-partum depression. It came on like a ton of bricks in the hospital and continued on at home. The baby was perfect, calm and happy, but I felt like a complete and utter failure...Couldn't sleep when the baby slept because I had to watch him to make sure he didn't stop breathing. Couldn't breast feed because my milk didn't come in. Couldn't ask for help because then everyone would know what a failure I was. Couldn't stop crying or imagining life with and without him. I would walk down the stairs and imagine what would happen if I dropped him. I would give him a bath and imagine what would happen if he went under the water. Thank God I never felt that I had to act on any of these thought. Thank God for a husband that was there to help keep me sane. It's funny, comparing baby 2 to baby 1...night and day. It's important to keep talking about PPD. Talking about it and not being ashamed to admit your feelings help. Knowing what to expect and being prepared for PPD helped when my second child (also through IVF) was born last year.

Posted by: cakes | June 20, 2006 10:48 AM

Pregnancy and early motherhood are supposed to be such a happy time. Nearly everything in our culture tells us that it's the most joyous time in a woman's life. But clearly, this is not true for everyone -- and even if you don't experience PPD, there are really hard times for nearly everyone in pregnancy and early motherhood. It's so important that women (and maybe even men?) who experience depression and other problems speak out -- so that it's not so hard to recognize when you or your partner or a friend are having a hard time.

But sometimes when you think someone is struggling, it's hard to ask her about it in a sensitive way. For those of you who've gone through PPD or other types of depression, any advice on a supportive way to offer help?

Posted by: Leslie | June 20, 2006 10:49 AM

I dealt with depression before and during my pregnancy. There were some really really dark weeks, but my therapist and a caring OB were very helpful. We geared up for an onslaught of PPD, which in the first few months I was able to keep in check and for the first time in ages, I felt genuinely happy. It was a short lived bliss, though, as my husband got laid off soon after. So wtih a 2 month old in the care of her unemployed father, I went back to a job I was planning on quitting since it didn't look like the part time from home arrangement originally agreed upon was going to work afterall.

Since coming back to work, my depression has gotten worse and worse. I don't regret or have bad feelings towards my daughter, but I'm fiercely protective of her and can't let her go when I'm home. It's harming my relationship with my husband as I won't even let my sister babysit for a night so we can go out. I'm wracked with guilt that sometimes I get so busy at work I forget that I'm a mother with a baby at home. I live for my weekly therapy sessions (thank goodness for the sliding scale fee thing or we couldn't afford it), and just try to get through each day at work without too many trips to the bathroom to dry my eyes and collect myself.

Posted by: j | June 20, 2006 11:09 AM

SMB, my mother experienced severe depression during both her pregnancies. It is rare, I guess, but not unheard of. I'm glad to hear it has leveled off for you, but please do take care of yourself and make sure you have a doctor with whom you can share your feelings and who takes the issue seriously. I agree wholeheartedly with THS. PPD, and depression in general, is an illness that needs treatment. Thanks to all the women who are willing to share their stories, I think it makes it that much easier for the next woman to see what is happening and ask for help.

Posted by: Megan | June 20, 2006 11:12 AM

I apologize in advance for the length of this but I feel it important to share many of the details. Having had a history of depression, I was watching for PPD like a hawk after my son was born and told my OB-GYN right away when I first saw signs. Still, nothing could have prepared me for what happened.

I had the normal "baby blues" in the first couple of weeks following his birth. I was weepy at the drop of a hat, recovering quickly after a good cry. Often I would gaze at my son, crying from pure joy. But then things changed radically. I began to look at him and feel absolutely nothing. An empty void. Then the visions started. I would be holding him and see, in my mind, him alone in the woods as it snowed around him, crying for the help that never came. The vision was overpowering, and I wept for that baby lost in the woods. I swore that I would never do such a thing but it seemed a betrayal of him just to see that image, which haunted me endlessly.

I had difficulties with breastfeeding and took it as a sign that I was failing as a mother. That, the awful vision, and anything thing that went the slightest bit wrong, only solidified my conviction that I should never have been given charge of this tiny, precious life. I would lay awake at night, listening to him breathe, afraid that if I nodded off he might die. But I also daydreamed endlessly about how nice life was before being a mother. Often I wished desperately that I could just give him back, then hated myself for the thought.

My doctor gave me an antidepressant with instructions to find a psychiatrist. By the time I did so, things had begun to spiral out of control. The antidepressant stopped working and soon I was on a whole slew of drugs at increasingly higher dosages. I began to see a therapist and she became my lifeline. My husband and I were having more and more problems; he started seeing a counselor as well and we had weekly sessions together with both of our therapists. Those sessions saved my marriage - we came so close to divorcing that I honestly can't believe we're still married.

My case was a bit more complicated than most. As it turns out, the PPD brought about a recurrence of problems I had last had as a teenager and had thought long in remission, and I now have a diagnosis of bipolar (along with several other diagnoses). I'm still on a combination of mood stabilizers, antidepressants, and antipsychotic medications, but I'm stable for the most part. Intensive talk therapy has helped immensely.

Ironically, working throughout all of this was vital for me and my family. Had I been home with my son, I honestly believe that I would be in prison, in a mental hospital, or dead. However, I'm fortunate enough to have both adequate insurance and a flexible job, as well as a strong support system of friends and family. Also, my son was a very, very well-tempered baby. I can't imagine what things would have been like had any of these factors been otherwise.

Accessible and compassionate support is VITAL for mothers experiencing any degree of PPD. I truly hope that our country wakes up to this fact and one day provides all mothers with adequate care, regardless of income level. As for myself, I plan changing my career one day to enter the mental health field and help women struggling with PPD. It is a difficult, lonely path and it makes all the difference in the world to feel supported and understood.

Posted by: in recovery | June 20, 2006 11:21 AM

I experienced PPD after the birth of my first child. Though I was somewhat aware of it at the time, our family was going through so much trauma from my sister-in-law's troubles. She had a little girl 5 months before me and had post-partum psychosis. She self-mutilated before the birth and attempted suicide after the birth, and was in and out of a mental hospital for several months. All our family's resources were devoted to her (understandably), which made it impossible for me to ask for any support. My depression seemed so petty compared to hers. To top it off, my husband privately referred to her as "crazy" and sympathized with my brother for being married to a crazy person. There was no way I could seek help after that. My husband and I are great now but it's taken a lot of healing to get over his lack of support when I needed him.

Posted by: Double sadness | June 20, 2006 11:21 AM

In addition to depression, I recommend talking to your doctor if you have a family history of thyroid disease. One of the symptoms of a hypoactive thyroid is depression. In retrospect, my depression following two children in two years was probably thyroid disease, with which I was diagnosed during my third pregancy several years later. Four more years after that, I finally have the right medication that lets me function without the constant exhaustion which I and my health care providers characterized as depression. I wish I had been more determined when explaining my symptoms - but, hindsight as they say is 20-20. Yes, new moms are tired, and battling extra weight, and very often depressed and being worn down by raging hormones. But, there can be underlying medical conditions exacerbated by pregnancy and childbirth. Stand up for yourself and get good medical care.

Posted by: SS | June 20, 2006 11:29 AM

To read personal stories of women coping with ppd, I recommend Rebecca Kaminsky's column on Litery Mama (www.literarymama.com), Brooke Shield's book Down Came the Rain, and Dawn Drzal's essay "Guilty" in my book Mommy Wars. You are not alone.

Posted by: Leslie | June 20, 2006 11:39 AM

Thanks for your kind thoughts Megan. Happily I am 14 years beyond that terrible time and have a beautiful daughter and son. I'm glad to hear that at least one other woman experienced the during pregnancy depression as well. I've always felt so odd about it as other women who suffered PPD could;nt relate somehow. I know my hormonal make-up took a radical shift when I was pregnant and has never been as it was before. I agree with the poster who said you need more than prayers to combat this sort of thing. A god therapist and medication is not a bad idea, it does help.

Posted by: SMB | June 20, 2006 11:39 AM

I'll start off with the disclaimer that I've never had PPD.

I have had friends with PPD and seen how devastating it can be - especially coupled with the stress of everyone telling you how happy you should be, etc. Its heartwrenching to watch.

However, I do not think that depression, be it 'normal' depression or brought on post pardum, should be an excuse for murder. I don't think the Andrea Yates trial can tell us anything about how to deal with properly reacting to women's mental health.

I think we see how to react to mental health through seeing people come out for the fact that PPD is a real issue, but that there are answers and it shouldn't be something you have to go through yourself.

Posted by: never had PPD | June 20, 2006 12:02 PM

I knew that I probably had PPD after the birth of my first child in 2000. I would cry for 12 hours each day. It seemed some days I couldn't do anything except sit with my head on the kitchen table. I had thoughts of dropping him down our 3-floor stairwell. I attributed most of it to sleep deprivation at the time. I resented the baby for making me so utterly exhausted, and for straining a marriage (when in fact, I was the cause of this!).

I didn't realize, though, how awful I had it until the birth of my second child in 2004, and I realized how *great* I felt. I felt a bit weepy at first, but mostly I basked in new motherhood. We went for walks, we cooed, we laughed... my 3 month maternity leave with her was among the most glorious times of my life. It occurred to me then that something had gone horribly wrong in my first post-partum period. Feeling so good seemed surprising to me, given the hellish ride I had taken with my son.

I went unmedicated, and now that the fog has cleared, I am sad that I spent to long feeling so bad about my first-born. I encourage all women to speak to their doctors. Don't wait until years later to see how awful things actually are.

Posted by: Elizabeth | June 20, 2006 12:18 PM

Unfortunately, many care givers are still not routinely screening for PPD, or taking seriously signs of PPD that patients may be presenting. I am the daughter of an OB, had a previous depression before pregnancy, knew the risks of PPD, had even shared my concern with my doctor (as had my father, who was a colleague), and STILL did not get the treatment I needed. One of the most insidious aspects of depression is the inability to admit and/or ask for help once you are in the throes of the disease. I remember screwing up the courage to ask my doctor at my six-week post partum check up when I going to feel "normal" again. He told me to find comfort in the baby, I went home and suffered in silence for three months until I finally leveled off on my own.

Now, four years and one other child later, I find it shocking that I--an informed consumer of medical services with more resources at my disposal than most--could not advocate on my own behalf and get treatment when I needed it. The purpose of this post is to encourage all who are reading to never be silent (particularly when you are well!), talk to your friends, family members, and most importantly, your doctors, and put into place a preventative saftey net that will be there for you should you ever find yourself needing it but unable to ask.

(By the way, when I was pregnant with my second child, my new OB sat down with me at my very first prenatal visit and laid out a plan for action to treat PPD: we did need to use it, I didn't have to ask, and by the time the baby was born I was well on my way to feeling better! Lesson learned.)

Posted by: dk | June 20, 2006 12:36 PM

Our daughter was born precipitously in 2002. Upon bringing her home from the hospital my husband and mother were there to assist. Then he went back to work after a few days and mom went back home with promises to return in approx. 2 days to stay for another week. When she returned, she came with my stepfather for an overnight visit. He proceded to criticize the breastfeeding process and our pediatrician. So my husband told my mom it would be better if they left early the next morning. That was the morning that he would be going back to work also and it was my first full day alone with the baby. I completely broke down. As the days progressed, I performed tasks without thought. When our daughter cried, I literally hid under the covers hoping that somehow she would stop without my intervention. As of today, I cannot remember most of the first 4 months of our daughter's life and feel terribly about it. I wish that we would have picked up on the depression so it could have been addressed.

Posted by: D | June 20, 2006 12:45 PM

Never had PPD, you disagree then with the insanity defense as a concept? Or just that women with PPD are insane?

Posted by: Anonymous | June 20, 2006 12:50 PM

I agree with the insanity defence, i just don't agree with what most people think it says.

"To establish a defense on the ground of insanity, it must clearly be proved that, at the time of the committing of the act, the party accused was laboring under such a defect of reason, from disease of the mind, as not to know the nature and quality of the act he was doing; or if he did know it, that he did not know he was doing was wrong"

So, unless it can be proven that she did not know she was killing them or that she did not know what she was doing was wrong (which i think would be refuted by a shown the fact htat she called the police afterwards, among other things), she would not meet the test for not guilty by reason of insanity. Unfortunately, I think that popular culture believes that if we'd think you're crazy, it would meet the inanity defence.

Posted by: Never had PPD | June 20, 2006 12:57 PM

Wow. I've been writing my column (http://www.literarymama.com/columns/downwillcomebaby/) for nearly three years now and never have I had so much feedback. Thanks so much to Leslie for the opportunity.

I am moved to tears by all these beautiful and sad stories--how brave of everyone for writing. Thank you thank you. I identify with almost all that everyone has said. I also had depression during my first pregnancy, before the PPD set in. It is more common than one might think. Premenstrual depression (called Premenstrual Dysphoric Disorder or PMDD) is also common.

As for the difficult thoughts-- incredibly common. When I first confessed to my therapist that I would imagine awful things happening to the baby and then slam my hand against the wall instead-- she told me story upon story of women who pull their hair out, cry in the bathroom etc-- who do anything (including mutilate or kill themselves) to cope with their suffering and avoid harming the baby. Of course there is no excuse for harming a child much less murder. But reality is that if we knew more about PPD and treated it better these awful instances could be prevented-- saving the lives of numerous women and their children.

My husband and I did a lot to prepare for our second child (now almost 3 yrs old-- first is 6). We went to couples counseling to really examine what happened with our first. I went to my own therapist. I have a great OB and an amazing Psycopharmacologist. The right medication is important for those who choose to take it. Their are many meds that are approved for use while nursing and even while pregnant--esp. depending upon the severity of the depression. It can be very hard experimenting with the right dosages because every change can bring back the pain.

My advice to those of you (pregnant, postpartum, adoptive, fathers, etc) who are suffering is please please get help. Talk to your partner and if he/she doesn't get it talk to your doctor. if you doctor doesn't understand make the effort to find another. It may seem like an impossible task but it may be the most important thing you ever do.

If you think a friend is suffering, don't be afraid to ask. She may not realize it until you point it out.

Again thank you to everyone-- please keep the stories coming! You never know who you might help by writing.

Posted by: rebecca Kaminsky | June 20, 2006 12:57 PM

A few observations from a criminal defense attorney and former PPD sufferer:
First, it appears from press accounts that Andrea Yates suffered from more than PPD. Experts at her first trial recounted full-blown psychosis that she is still being treated for five years later. We are not talking "baby blues". She was a woman who was completely detached from rational thought ie. hearing voices, hallucinations, etc. Because of the particularities of Texas' definition of criminal insanity, her first trial ended up in a conviction. The retrial may prove very different.
As to my experience, a history of clinical depression still did not prepare me for the birth of my first, much-loved daughter. I could not pull myself out of the dark well I felt myself falling into, despite all that I knew about depression and its warning signs. My feelings of isolation, helplessness and sadness were not helped by having a colicky baby who howled for five hours a night for four months. Finally, after about nine months, the world shifted. I am still saddened by how much time I lost needlessly.
When I became pregnant with twins seven years later, during the last months of my beloved mother's life, I knew I needed to protect myself and my babies. Although I stopped taking antidepressants during my pregnancy, I told my Dr. I wanted him in the delivery room lobbing the meds into my mouth the moment they were born. It was the best decision of my life. My Mom died three weeks later, our home life became chaos, my older daughter had difficulty adjusting, but the babies and I did fine. Given the latest studies about antidepressant therapies during breastfeeding, I would still make the decision to bottlefeed. Which leads to my next point: the mother you are criticizing for bottlefeeding, dear "breast is best" police, may be one who is saving her own life and that of her baby by taking antidepressant medication. Keep your mouths shut.

Posted by: lifermom | June 20, 2006 1:19 PM

Something is wrong with the links in my entry. I will try to fix. Sorry everyone.

Posted by: Leslie | June 20, 2006 1:23 PM

Prenatal Depression is a very real, very scary experience. I had it -- terribly -- with my first and second pregnancies. I went from being a happy-go-lucky, lighthearted young wife to a terrified, anxious, profoundly sad pregnant mother. I had never been depressed before, and I had no idea it could happen to me, especially during pregnancy. Luckily, for my third pregnancy, I was able to find good care and the right medication to help me through.

The hormones of pregnancy can have a powerful affect on the brain. Unfortunately, PND is still one of the few women's illnesses that isn't talked about, so most women who experience it are blindsided. They expect pregnancy to be a miraculous, joyful time in their lives, and are totally unprepared for the debilitating takeover of PND.

We need to help women prepare for PND by talking about it. If you have had PND, tell your friends, so they can feel comfortable confessing their own feelings. Talk, get help, and reach out to others so they'll do the same. Resources are available! For online info about PND, women and their partners can go to www.beyondtheblues.com. I know Stanford University has also studied alternative treatment options, and more information can be found about the results of that study at http://psychiatry.stanford.edu/research/acumass.html.

Rebecca, thanks for writing about your own story. I imagine you've helped many, many women along the way.

Posted by: Prenatal Depression | June 20, 2006 1:24 PM

Never Had PPD correctly states the majority view of insanity, however, some states have supplemented that test with the "irresistible impulse test" which applies if the person, at the time of the offense, was unable to control her conduct because of a mental disease, which might apply in the case of extreme PPD. Not a big deal but thought I'd throw it out there (since I happened to have just looked at this last night while studying for the bar).

Posted by: Megan | June 20, 2006 1:27 PM

Thanks Megan. So true. But in TX, they use the stricter test, the McNaughton Rule. I should have said that in my post.

[and good luck on the bar!]

Posted by: Never Had PPD | June 20, 2006 1:31 PM

Great post, Rebecca! As always, your honesty with this topic and your personal experience has sparked a great discussion. Like a previous poster said, I'm sure you've helped a lot of women by having the courage to tell your own story.

Mary Tsao
http://marytsao.blogspot.com

Posted by: Mary Tsao | June 20, 2006 1:36 PM

dk, what a great idea--planning for PPD just in case. I heard and read so much about "birth plans" during my two pregnancies, but PPD wasn't covered at all in any of the resources that I had access to. If you plan ahead for it, your safety net is there, and you don't have to "screw up" the courage to get help--which I've done twice in my life, the second time after going back to work after my second child--when you're suffering afterwards. Even if it's just working with your OB to establish whom you would see for therapy or whether or not you would want to take drugs, those are decisions that are a lot harder to make when you're feeling like the worst mother in the world after the baby's born. Like other elements of a birth plan, if you need it, it's there, if not, no worries. I'm definitely going to do this if we decide to go ahead with #3.

I always suspected that I had post-partum depression, but it wasn't until I heard an excerpt of Brooke Shields' book that I realized that the terrifying visions that I had, like others have shared, were exactly PPD. I still get them sometimes, especially recently because of other stressors in my life--primarily that my husband was away for four months for work, with no idea of when he would return. (Which highlights another misconception about PPD: that it goes away shortly after birth, which was NOT the case with me.) The most recent vision was of me standing with our two kids (3 years and 16 months) in the middle of the four-lane road behind our house, at night in our pajamas, in the headlights of an oncoming car. Fortunately, my depression isn't severe enough that I would cause this to happen, and my husband's home now, so things have levelled off emotionally. But, when do women get pushed over the edge? Brooke Shields imagined slamming her baby up against a wall and driving into an overpass. But she didn't. Andrea Yates had visions of knives and had premonitions that something terrible was going to happen. It did.

And, tangentially, I will never pay to see a Tom Cruise movie EVER again. Like he needs my money, I know...but his dismissiveness of PPD reflects part of the overall problem: that we should just suck it up and be able to handle it all. That attitude is why dk, me, and who knows how many thousands of others have to "screw up courage" to get the help that we need, BEFORE something awful happens.

Posted by: niner | June 20, 2006 1:41 PM

Thank you for addressing this issue. I had PPD with my first pregnancy 14 years ago. The most insidious thing for me was the way my sense of reality was distorted, not in the sense of psychosis, but in that everything about the world was colored by my "crisis." A hurricane hit soon after my daughter was born, and I remember seeing pictures on the news of people living in shelters and standing in line waiting for ice. I envied them because they weren't isolated in their homes with a baby who never slept! After 6 weeks I begged for medication, but the psychiatrist I saw said I would "get over it." This despite the fact that I had had 2 previous episodes of clinical depression. I was warned that I couldn't breastfeed if I took medication, and was made to feel that I would be a bad mother if I chose antidepressants over nursing. By 9 weeks I knew that I had to get help. I found another doctor who prescribed medication. The 3-4 weeks before the medication took effect was an eternity, but by the time my daughter was 4 months old I had become the happy mother I had hoped to be. 11 years passed before my second child was born (after miscarriage and IVF). I insisted that my doctor provide me with a prescription, but even though I had told all my doctors about my history, I still had to spend my time in the hospital hunting the doctor down to get my prescription written. I suffered some depression the first 2-3 weeks of my son's life, but because I was already taking medication, it never got as severe as the first time.

Like lifermom, I think the challenges of women with PPD have to be considered in the breast v. bottle debate. The article in the NYT last week about a new campaign that likens bottle feeding to smoking while pregnant really worried me. Although many doctors now feel comfortable putting nursing moms on anti-depressants (this was not the case 14 years ago), the demands of breastfeeding can be overwhelming to a depressed Mom. I nursed my second child for 4 months, but I supplemented with formula. Having an emotionaly stable, and emotionally connected, Mom seems so much more critical than any of the benefits of breast feeding. I salute those who can attend to their family's and their own needs and breastfeed. But no Mom should be treated as reckless or uncaring for choosing to use formula.

Posted by: happymom | June 20, 2006 1:46 PM

I second lifermom's point wholeheartedly. A mom knows best whether or not to breastfeed, despite what La Leche League miltants say. My wife had severe PPD. We were somewhat prepared because she had depression before we got pregnant. In fact, it took us three tries to find a doctor that would prescribe her antidepressants during her pregnancy (8 years ago). She stopped the medication after the second trimester, and was determined to breastfeed so stayed off of it after birth. It was a downward spiral from there, with thoughts of suicide and visuals of harming our baby. After 5 weeks of trying to breastfeed because "it's the right thing to do for the baby" she stopped and went back on Prozac. She also took another antidepressent that works immediately, which made her sleep 14 hours a day for 4 weeks.

It was a hellish period, a far cry from the joyful visions that we expected when we found out she was pregnant. I worked from home for 5 months. When I went to the office I took our baby. My wife recovered enough to begin working part-time until she returned to full time at the office after 6 months. To this day, 7 years later, it still has lingering effects, although all is well with everyone.

We had another child 3.5 years ago and approached everything with a plan. All doctors were on the same page, my wife stayed on her medication throughout the pregnancy, and we bottlefed from day 1. There were some rough times but nothing like we experienced before.

My only other comment is a reaction to several other postings that say "if you feel you are suffering, talk to someone, ask for help." That's easy to say when you're rationale and not in the throes of a desperate situation, but my wife tells me that at her darkest moments she couldn't bring herself to even mention it to others beyond me and her doctor. My follow-up advice is: if you think a friend or relative is going through something like this, ask, ask again, do what you can to find out, until you're convinced otherwise. If I hadn't been lucky enough to work from home (and my work during that period was not my best), my wife would have had to be on her own through much of this, and it would not have turned out fine.

Posted by: SJR | June 20, 2006 1:52 PM

Amen to the Tom Cruise comment. I'd like a few minutes alone in a dark alley with him (w/o his M:I gadgets) to show him what my wife and I think of his psuedo-scientific assessments of depression.


Posted by: SJR | June 20, 2006 2:02 PM

"However, I do not think that depression, be it 'normal' depression or brought on post pardum, should be an excuse for murder. I don't think the Andrea Yates trial can tell us anything about how to deal with properly reacting to women's mental health"

First, Yates had postpartum psychosis, which is different than PPD. Mainly in the amount of delusions a person has and their severity. Yates truly believed the only way to save her children was to kill them, and because of her illness, she did. She was psychotic. She had a total break with reality. If that's not knowing what's right, then I don't know what is. For that reason, she deserves to be in a hospital, not in jail.

And it does provide an insight into mental health - why was Yates taken off of drugs that has helped her in the past? Why was her husband not being supportive? Why were her mental health problems ignored? Those questions can (and do) apply to every woman, not just her.

Posted by: AG | June 20, 2006 2:08 PM

"Amen to the Tom Cruise comment. I'd like a few minutes alone in a dark alley with him (w/o his M:I gadgets) to show him what my wife and I think of his psuedo-scientific assessments of depression."

Can I join you? Please???

Posted by: AG | June 20, 2006 2:09 PM

niner,

glad you like the idea. It makes me feel better to know that we can connect somehow and help eachother out. Thanks to all who have written, PPD is so common and still so undiscussed. I fervently hope that the medical community is taking note and is doing a better job of incorporating diagnosis and care of PPD into the medical education for OB/Gyn residents. Nonetheless, we all have to advocate on our own behalf, or choose in advance others to do so for us.

Although the memory of PPD still makes me feel sad because it kept me from giving myself freely to my daughter when she was first born, she is none the worse for my suffering and is now (as is her sister) my greatest source of joy. Thank goodness for happy endings!

Posted by: dk | June 20, 2006 2:12 PM

Thanks, AG, for the definitions--that answers my questions as to when visions and other symptoms are disturbing (depression) versus dangerous (psychosis).

Posted by: niner | June 20, 2006 2:13 PM

It's important to remember that PPD comes in different degrees. I look back and realize that after the birth of my second child I didn't bond with my baby right away. I viewed him with interest but not the uncontrollable love I felt for my first child. For two months I felt all the drudgery of caring for a baby and getting little sleep. I never had ugly thoughts, but I also found no joy in caring for my child, which I had with my first child. Then around the 2 month mark, I all of a sudden looked at my baby as if he was an angel sent from heaven. I remember thinking that he almost appeared to be glowing with beauty -- I was in love! My depression was over just like that. I really had not realized that I was depressed until it was over.

Posted by: SLP | June 20, 2006 2:19 PM

I'm coming out of retirement. Haters beware, I am in no mood.

This is a scary topic. I would have thoughts that someone was going to break in and steal her, that, she was going to stop breathing or that in the middle of the night I would accidentally hurt her in my sleep. I couldn't sleep, sometimes I couldn't eat, it was horrible. I would never hurt my daughter, but it sure made my life scary for a few weeks. At six weeks I developed pancreatitis and when I was in the hospital, I wouldn't get out of bed, I'd just lie there and look out the window, but you know what? I was secretly happy for the break even though I almost died and missed my daughter terribly.

Unfortunately, I had no idea this was a sign of depression. Thanks to the people who speak out about this. Because of people who share, I know next time what to look for, and how to ask for help. My sister is 15 years older than me and when she had my nephew, now 20, she had the same thoughts and symptoms.

And on breast feeding, the medical industry are crazy about pushing it, I mean as I was lying in the hospital near death, the nurses ask me if I wanted to pump. I was like, no. I do agree that it's better, but my daughter survived on formula after I got sick.

Posted by: SCARRY | June 20, 2006 2:19 PM

I think mothers that are struggling with postpartum depression have a hard time admitting that they are depressed. I know I did. I would never admit it to others. I would just say, "My recovery was challenging." Being depressed has such a stigma attached to it and it was hard to admit it to others although I knew it to be the case. I sought help from my health care provider and she just said I was just "stressed out" from the demands of being a new mom. I felt blown-off, but did not want to push a clinical diagnosis of depression for fear it would haunt me later. I'm a pretty reasonable woman and I know this sounds sheepish, but it's true and I'm sure others have been in the same boat.

I have a close friend, who happens to be my professional mentor, experience the same back-to-back birth, back to work, overwhelmed situation as I did. I supported her by empathizing with her and reassurring her that things would become easier and what to prepare for. But that was because she wanted the truth straight. The early days of being a new mom is so romantacized that women feel too embarrased to admit that they are in fact miserable and are too ashamed to admit it to even their closest friends. At the same time, I will not bring up the subject of ppd to a new mom in my family because I cannot assume their experience is the same as mine. If they did bring it up, I would help them in any way I could. We just have to be vigilant about watching the signs in our families and friends and helping them get the help they need.

Posted by: On the Comeback | June 20, 2006 2:20 PM

Thanks to Leslie, Rebecca and posters for a great discussion. I'm due in about 3 months and have a long family history of depression including both mother and father (mother was recently diagnosed with Hashimoto's disease at age 59, thanks to the poster who mentioned the thyroid link, I think that could be a huge part of my mom's struggle over the last 25 years!) as well as having dealt with depression myself during college. I am terrified of PPD, to the point that I'm pretty much convinced that it's going to happen no matter what. My midwife /OB practice has just said to wait and see and we'll deal with it when it comes - but I'd love to find out what kind of planning or reading I can do now? Does anyone have any suggestions? I've been so lucky so far, this has been an easy pregnancy (compared to friends who have suffered much more) with just a little nausea and great energy, my only problem has been my emotions which run so high and then low and make me so paranoid that it's almost crippling at times already. I don't know if it's the ups and downs that are normal during pregnancy or if I'm already exhibiting signs of depression that PPD will exacerbate. Did any of you who had PPD feel that you were struggling during the pregnancy itself, or did it hit like a bolt out of the blue once the baby arrived? Help?

Posted by: due in Sept | June 20, 2006 2:24 PM

To SMB and the other women asking about or interested in depression *during* pregnancy, there was an article about it in Newsweek not too long ago. It explained that depression can be tied to great hormonal fluctuations, and in women there are few great fluctuations like during pregnancy and right after birth. (Personally, I found that interesting because I've had issues with depression the two times I've gone off birth control pills in order to conceive, and I'd been wondering if it was just me.)

Here's the link:

http://www.msnbc.msn.com/id/12321428/site/newsweek/

Posted by: Mo2 | June 20, 2006 2:29 PM

Let me join the anti-Cruise chorus. Let me also say that babies can survive with no ill-effects if moms get treatment. Toughing it out is the worst thing to do because there is so much at stake.

I also want to note how underreported PPD is. During my second pregnancy I was very open about my first experience with PPD, and I was amazed at how many mothers of older children related to me their terrifying experiences as depressed new moms. Almost none of these women had gotten treatment for their depression, and I am sure that among them there was a wide range in the severity of symptoms. I have come to think that having something more than the baby-blues, but something less than psychosis, is probably more the norm. Many women said that they just thought that their spirit-crushing sorrow was part of being a new Mom. The experiences of the few people I know who did not have any form of PPD suggests otherwise.

SJR, it sounds like you were a wonderful support to your wife. During my second, briefer, depression, seeing how much my husband delighted in our son was both a reality check (helping me to see the extent of my own depression) and a sign of hope. I knew that one day I would feel that joy, too. And I did (do)!

Posted by: happymom | June 20, 2006 2:31 PM

I agree PPD is something you need to be aware of and plan ahead for. I had it with my second child and the ONLY reason I recognized it was that I could tell that how I felt was vastly different from how I was with my first. With the first I had the 1-2 weeks of teariness, with the second I felt fine and then one month later couldn't sleep, couldn't eat, didn't care about the baby, etc. I was in a complete fog. However, I knew enough to call my doctor, who knew enough to bring me in right away, take one look at me, and slam some antidepressents into my system asap. It took a couple of horrible weeks but they worked and I felt like a completely different person -- back to myself. I stayed on them for about 6 months.

Luckily my doctor acted quickly. No one else in my family could understand what was going on. Even now my mother looks back and thinks she may have had the same symptoms when she had her second.

I am now expecting my third. I will start SSRIs about 2 weeks before I deliver (haven't decided whether to breastfeed or not). This is already in my medical file. I also was completely open with family and friends about what happened with my second child so they know to watch me this time around.

It is so important to talk about it -- I found I was not alone for one thing. And helping others recognize that this is not craziness but a real medical problem will enable women to get help faster. No one should have to "come out of the fog" five months later on their own. Yeesh!

Posted by: FS Mom | June 20, 2006 2:33 PM

Thank you for being so open about your experiences with PPD. I too experienced PPD with both my children. With my first child, I was reluctant to seek help and take the medication presecribed ('surely as a mother I ought to sacrifice my mental health so that her breastmilk be chemical-free' was my depressed line of thinking) With my second child, I sought help right away and that made all the difference. Now, I make sure that I do not take on too much or I risk back-sliding into depression. One of the reasons I am an "at-home mom" (whatever that means) is that I just am not up to the ultra-demanding work-life juggle right now. If the proper social infrastructure was in place to support child-rearing, it might be a different story...

Posted by: Jen Lawrence | June 20, 2006 2:33 PM

To due in Sept -

My sister was about 6 months pregnant when I was diagnosed with PPD. Since she had past history of depression and we now had a family history of PPD (thanks to me), her OB put her on medication before her baby was born.

You may want to talk to your OB again or a psychiatrist and make sure they understand your's and your family's history of depression before they take a "wait and see" approach, because that waiting and seeing can really suck!!

Posted by: FS Mom | June 20, 2006 2:39 PM

SJR, that is quite a story. How was the office environment with the baby?

I dont mean to detract from the threads on mom's PPD experiences, treatments and therapy but am just curious as to how accepting the workplace was with the baby around.

TC and his antics and idiocy was gross. But that thread leads to, Why do Americans take the opinions of celebrities seriously whether politics, economic policy or medecine? I just dont get how acting makes you an expert on anything except faking feelings, expression, and action. But that wont stop America from getting its news from Access Hollywood.

Posted by: Fo3 | June 20, 2006 2:40 PM

due in Sept:

Like dk suggested, have a backup plan as part of your birth plans. It doesn't have to be a big formal document, or even anything written down. Find out which mental health care providers are in your insurance group and ask your OB to recommend one, and maybe meet with him/her to discuss your concerns beforehand. Think about whether you would want to take anti-depressants--and by all means, don't beat yourself up if this would interfere with breast feeding, as others have pointed out. Just get the info about the drugs and how they work, and which you would consider taking. Just getting the info and being prepared will go a long way. As several other posters have noted, too, once you're depressed, it's MUCH harder to get help. And most importantly, don't beat yourself up over any of your decisions. You have to take care of your baby, but you also have to take care of yourself!

Scarry! Welcome back!

Posted by: niner | June 20, 2006 2:45 PM

Thanks to FS mom and Niner - am looking up covered MH providers now, and finding out if I need a referral...ah, managed care. : )

Posted by: due in Sept | June 20, 2006 2:50 PM

Again, thanks everyone! A couple things:

1. Pressure to breastfeed (or pressure to mother in any particular way and eschew others) is such an important topic for depressed moms. A happy mom doesn't make only a happy baby, but also a *healthier* mom and baby. Everyone's body is different, and I've heard evidence that breastfeeding can exacerbate or alleviate depression, depending on the person.

2. To take or not to take meds is also an important, very individual decision. I remember talking about my guilt over taking meds to my psychopharmacologist. (man I love berkeley but I heard enough about drug companies oppressing the masses to make me crazy--or is it crazier?) My Psychopharm pointed out studies that show that untreated depression causes brain damage. Worse than what taking ssri's can do-- and not treating depression also increases the risk of relapse. So much for "toughing it out". I'd love to hear if anyone knows specific studies about this-- I'm having a hard time finding the exact info.

Posted by: Anonymous | June 20, 2006 3:01 PM

Again, thanks everyone! A couple things:

1. Pressure to breastfeed (or pressure to mother in any particular way and eschew others) is such an important topic for depressed moms. A happy mom doesn't make only a happy baby, but also a *healthier* mom and baby. Everyone's body is different, and I've heard evidence that breastfeeding can exacerbate or alleviate depression, depending on the person.

2. To take or not to take meds is also an important, very individual decision. I remember talking about my guilt over taking meds to my psychopharmacologist. (Man I love Berkeley but I heard enough about drug companies oppressing the masses with "happy pills" to make me crazy--or is it crazier?) My psychopharm pointed out studies that show that untreated depression causes brain damage. Worse than what taking SSRI's can do-- and not treating depression also increases the risk of relapse. So much for "toughing it out". I'd love to hear if anyone knows specific studies about this-- I'm having a hard time finding the exact info.

3. In my column I publish a list of links to go to for more info if you or someone you know is suffering from PPD.

Posted by: Rebecca Kaminsky | June 20, 2006 3:05 PM

I wanted to add my personal experience to these very helpful stories above. I have a history of depression (pre-pregnancy), and did get some PPD during the first few months after my son's birth 2 years ago, but opted not to treat it with medication (I was breastfeeding, and the depression was managable with therapy). What took me by surprise, however, was that when I stopped breastfeeding when my son was around 9 months old, a much more severe depression set in about 1 week later. I had figured I was home free that long after the pregnancy, and it had not occurred to me or my doctors that the hormonal changes that occur when one is stopping breastfeeding can trigger depression just as they can at other times in a woman's life. Fortunately, my doctor and I caught it early and I was able to treat it quickly.

Anyone else notice this type of thing associated with cessation of breastfeeding? Please be aware of it if you are breastfeeding.

Posted by: been there | June 20, 2006 3:08 PM

To Fo3:

About me taking the baby into the office: there wasn't any choice in the matter (for me or them), is the way I put it to them, although not nearly so bluntly. Since they really needed the work done, this was how it had to be for a few weeks. I was focused on getting a few hours of work done and returning home to check on my wife. I told the details to my boss (a woman) and she told her boss (a man). To everyone else, I said there were some adjustment issues at home and left it at that. It was a pretty small office and there were no written policies on the matter that I knew of. Hopefully, I made it possible for Moms to do the same thing should an emergency arise for them.

I did work somewhere before that where it would have been an issue, but I knew that wasn't a family-friendly company and left a year before we started our family. I'm glad I did.

I also think everyone thought it was "cute" or "neat" to see a dad bring a baby into the office. I don't know if it would have gone quite the same if I was the mom instead. Moms, you have my sympathy on this issue and I vote with you every time.

About Tom Cruise: it doesn't matter to me that it was a celebrity that said what he did... It was simply the sheer arrogance of it. I don't know that anyone, outside some of his fellow cult members, agree with him. Whoever says something that asinine has to be called on it.

Posted by: SJR | June 20, 2006 3:17 PM

thanks Niner,

I can't believe all the people on this board who have experinced this. What in the world did they do in the good all days?

Posted by: Scarry | June 20, 2006 3:25 PM

My wife was so happy during her pregnancy, just coming down to normal was a big difference in the feeling of well-being. When she gave birth to our first child, I wanted to be a participating parent as much as her. But every time the baby cried, my wife would pull my daughter out of my arms, whip out the heavy artillery, and connect her up with the nipple. After a month, she finally trusted me to take care of my daughter for a whole day. An hour after she left, the doorbell rang, and guess who it was? My wifes sister! How convenient! Her mistrust in my parenting irked me.
A few weeks later, my daughter developed collic, wich is the name for a unknown condition that makes a baby cry uncontrollably for hours. My wife would drive her around in the car seat all night in an attempt to get her from crying. It didn't work. She gave the baby medication that had a warning label on it that read, "Do not operate heavy machinery". Knockout meds for a 6-week old? It didn't work either. Funny thing though, the crying would start an hour before I walked through the threshhold from work. One day I came through the door and my wife had the crying baby like she was going to shake the life out of her and she screamed at my daughter, "I just want to throw you up against the wall!"
I flipped. Actually I fired my wife. I sent her out of the apartment and told her not to come back until she was good and ready. She left, and I had my screaming little angel all to myself for the first time. I just rocked her, back and forth as she squealed, kicked and twisted for hours. She finally fell asleep. My wife came home late that night, much more refreshed. A sleeping baby! What a beautiful sight! For the next 2 months, I was assigned crybaby duty.
As for my wife, when I recognized things were getting bad, well, many times I called her sister and she would show up at our apartment after I left for work. Sorry, folks, for using the rugh-it out method, but that was almost 15 years ago and there wasn't the Mommy Blog back then.

Posted by: Father of 4 | June 20, 2006 3:46 PM

I've had depression pretty much all my life. I've now been diagnosed with anxiety disorder as well, which can often lead to onset of my depression episodes. I am in complete fear of becoming a mother. All my life I assumed I would have to adopt to escape PPD and the dangers of passing on my (seemingly) heriditary depression to my children. But then I read that even with adoption I can still suffer from a form of PPD, and that just from being around a depressed mom they can pick up my depression. I've been in therapy off and on since starting college, but none of my therapists seem to understand that my depression is such a fear for me that I am literally scared to have children.

I guess this isn't really a PPD experience so much as a look in from the other side. If anyone has any advice for me, I would love to hear it. I have thought about not having children, but I think I really would like to have a family someday. I know my husband would.

Posted by: Not Yet a Mom | June 20, 2006 3:47 PM

to due in September,

I really sympathize with your fears. As I already mentioned, my mother had severe depression during both her pregnancies; she also became clinically depressed when we were children (a few years after I was born). It took her many years to seek treatment, but she finally did and she is doing so well now but will probably always need medication. There's also some other cases of depression, bi-polar disorder, and schizophrenia in my family, so I was extremely concerned about the possibility of PPD or pre-natal depression. I talked it over with my care providers and they were very supportive. We decided together to opt for the "wait and see" approach since I personally had no history of depression, but they knew to ask me every time how I was doing mentally, and that made a big difference.

As it turned out, I did ok after my son was born. I was definitely tired, and also felt isolated and lonely, but it was ok.

I would second the comments above that laying out a plan ahead of time, as someone else reported, doing the research now about the drugs, and making sure everyone understands how important this is. After that, I think it's really a question for you whether you feel comfortable waiting or want to take a more precautionary approach.

Good luck to you!!

PS - Thanks Never Had PPD for the well wishes and the Texas tidbit!!

Posted by: Megan | June 20, 2006 3:50 PM

Scarry,

My grandmother, who had children in the 1920s and early 1930s, told me that she believes she suffered from PPD as well. Of course there was no treatment, but she did have the advantage of a large extended family. Her mother and younger sisters were able to help out, and she was not left alone like so many women today are. My best times during my PPD were when my Mom or other family members were visiting. Even though their visits were short and they didn't relieve me of babycare responsibilities, they made me feel less alone and gave me hope that things would improve.

Posted by: happymom | June 20, 2006 3:52 PM

Ok, sorry to post twice in a row, but Not Yet A Mom, I just wanted to say that as I just mentioned, my mother has been very depressed most of my life, and also struggles with anxiety issues. But she is a wonderful, amazing mother. I know it was extremely hard on her especially when we were little, but I really didn't know anything about it until I was older. She finally sought treatment when I was in junior high, and it was a great gift to me that she let me see her struggle and her progress. Watching my mom have the courage to seek help (when she wasn't getting a lot of support for that from my dad) and work so hard to change her life taught me a lot. I have yet to have any signs of depression, even though my mom and her mom both did.

Obviously it's a choice for you as to whether motherhood is something you want to take on, but I wanted to let you know that depressed mothers can be wonderful mothers too. My dad's mom was severely bi-polar, and he too came out just fine. He has often said to me how it bothers him that people assume his childhood must have been unhappy because of his mom's illness; it wasn't, it was different for sure, but they still had happiness and joy and he still loved his mom. Good luck!

Posted by: Megan | June 20, 2006 3:58 PM

I'm going through this now; my son is 10 weeks old. I started back to work two weeks ago. I'm lucky in that I felt the PPD coming on about a week and a half ago and I got help - the OB put me on antidepressants and I started seeing a counselor right away. The talk and ideas from the counselor help me cope, and hopefully the medication will start helping in another week.

I'm the breadwinner for my family, so I didn't have any choice about going back to work. Fortunately, I work from home, and it actually sort of helps to have something technical to concentrate on.

Rationally, I know things will get better, so I just concentrate on doing small things to try to improve my morale, and taking little steps.

Posted by: C | June 20, 2006 4:02 PM

Been there:

I had the same problems you describe when weaning with both of my girls - the hormone shift is so huge. After a week of crying/guilt/etc, my hormones levelled out so it was OK. I think that is pretty normal, especially in women who get bad PMS. I also had PPD with my first daughter (we call it my crazy time) and was surprised to read that everyone else had the thoughts about the baby being hurt too. Thankfully, it was easier with the second one and I didn't get the PPD.

Posted by: steph | June 20, 2006 4:03 PM

Gotta weigh in on the Andrea Yates debate. I agree with AG.

Andrea Yates' situation is tragic and it goes way beyond typical PPD. She was psychotic, she thought she was saving her children. It is such a sad story and I think there is much to learn from it.

My OB was great about checking for any indications of PPD, I feel lucky I did not get that. Just plain old baby blues and adjusting to life with a newborn was hard enough for me. My heart goes out to all of you who went through this and kudos to you for getting help.

I am more than willing to join the TC boycott. What a nut, I feel sorry for his child.

Posted by: Another DC Mom | June 20, 2006 4:22 PM

This depression talk is all nonsense. I am so sick of hearing about a diagnosis of depression for everything.

Its CALLED LIFE PEOPLE. Thoughts happens. Emotions happen. STUFF HAPPENS. Deal with it. Just because you wonder what its like if you had never had a kid or this and that, does make you a bad parent. It doesnt even make you a bad human. Stop listening to what these talking heads falsely claim about depression of any sort.


Why does it seem like we as a society have been lulled into believing this stuff. And worse yet, that the answer to dealing with issues deemed as "depressions" is almost always medication.

Reality check folks. Can we all please have one.

Posted by: kme | June 20, 2006 4:24 PM

I've struggled against depression most of my life, and it's a very, very tough struggle. I don't have children myself, but I nonetheless want to echo what others have said re the importance of good medical advice and treatment.

I do think people (i.e., OBs and primary care docs) are getting a lot smarter in this area, as many of the comments above attest, but if you aren't getting treatment or the treatment you have isn't working, find the most highly qualified psychopharmacologist/psychiatrist you can. Sometimes the first medication doesn't work and you have to try another; sometimes you have to combine meds. If you have to go through that, it's really good to have somebody who really knows the territory with you.

Also want to echo what others have said re thinking about this possibility in advance, especially if you have an individual or family history of depression. Depression so distorts thinking and diminishes energy that expecting a depressed person to seek help on her own is more or less like asking a person w/ a broken leg to walk to an emergency room.

I've been very touched by what I've read here. You all are very strong to find your way back from the hell that is depression to dealing with the demands of tiny babies and small children. I admire you, really. And, SJR, there will, I'm sure, be an extra star in your crown in heaven. It's bad to be depressed, but even worse to be alone and feel that no one understands or cares. To have a husband who so deeply understands your despair, helps in the most practical ways, and still loves you must be a source of great joy to Mrs. SJR.

Posted by: Anonymous | June 20, 2006 4:26 PM

Even today, 2 ½ years later, it still shocks me how I managed to miss my own PPD. And I also never tire at hearing these courageous stories.

Pre-baby, I had a fulfilling career, a great marriage and took life's disappointments in stride. My husband in fact, was the one who suffered from depression and mood swings.

After my son was born all that changed. While I remain a breastfeeding advocate, like so many other women, I was on an unhealthy quest to breastfeed despite major obstacles. He didn't actually latch on for 6 weeks, during which time I thought never getting more than 2 hours sleep, feeding a baby through my finger, watching an infant choke, scream and wail at feeding time, was what any tenacious women would do under similar circumstances. Boy, was I a dope. In my PPD haze I somehow believed that if I stopped breastfeeding I would be unmasked as the awful mother I really was.

I certainly didn't want to worry my amazing support network. How could I admit that going outside (which I knew would commence screams of protest from our infinitely fussy baby) had become terrifying. Any potential outing brought fits of despair (birthday parties, the park, even the car) and there was no way I was letting anyone know how monumentally insane I had become.

Returning to work at 3 months, I set out to prove what a great mother I was by pumping three times a day at my stressful job. What irony that in truth, I was trying to hide what an awful mother I thought I was.

However, it was being back at work where I finally started to heal. It was there that life started to feel "normal" again. At work, I morphed back into a coherent, functioning person. Finally, I talked to my amazing OB/GYN who figured it all out.

I can't say that work will help anyone but me see PPD for what it really was, and work is no substitute for the drugs I wish I had realized would have helped me. And while I'm happy to report that I feel really, really good, we're on to the next chapter in our family issues with PPD: my husband is now in therapy talking about how anxious my depression made him, and how he secretly dreamed of divorce (the perfect couple: no way!) And while it appears terribly, despicably selfish for him to say that my disease made HIM sad/mad/crazy, if this admission can help even just one person, it is worth sharing a tough truth.

Posted by: brooklynmama | June 20, 2006 4:27 PM

I'm still trying to figure out how the poster "kme" is an acronym for Tom Cruise. Can anyone help?

Posted by: :-) | June 20, 2006 4:30 PM

kme, please tell me you are not serious.

Posted by: You're joking | June 20, 2006 4:32 PM

KME - I'm really sorry you feel that way. Maybe you should schedule a mental health evaluation.

Posted by: Is kme for real? | June 20, 2006 4:33 PM

People judge you for not breastfeeding??

Posted by: no kids | June 20, 2006 4:33 PM

"I'm still trying to figure out how the poster "kme" is an acronym for Tom Cruise. Can anyone help?"

I was trying to figure that out too, by nothing comes to mind.

Posted by: Not kme | June 20, 2006 4:34 PM

"Kate (Holmes) Might Escape"? (Sorry, couldn't resist.)

Posted by: niner | June 20, 2006 4:41 PM

KME--I think you need to get your Thetans in order and wait for L.Ron to call you...

Now, back to the real topic. Beenthere, I didn't breastfeed, but had PPD set in when my son got RSV at five months. It really knocked me on my A$$ and I didn't even connect it to PPD--my wonderful doc did when I burst out crying at his six month checkup. PPD can show up anytime in the first year!

Posted by: PTJobFTMom | June 20, 2006 4:46 PM

People judge you for not breastfeeding??

Yup, and they judge you for breastfeeding too long, or not long enough, or in public or in private. And for everything else under the sun.

I remember Aesops fable, about the man and his son who were walking with their mule to market. At first the man rode and was criticized for making his poor son walk. So then the son rode, and was criticized for making his old father walk. So then they both got on and were criticized for making the poor mule carry both of them. So then they carried the mule I think, and accidentally made the mule fall off a bridge and so the moral of the story is:
Drive a car.

Posted by: Rockville | June 20, 2006 4:47 PM

MO2 thanks for the link, I'm going to have a look. I'd just like to say that KME has no idea what he/she is talking about. You can't tell me that a perfectly happy, reasonable person who suddenly has crying jags in the bathroom, who shuts him/herself in her room and can barely get out of bed is normal? I don't think so. That is not "just life" it can become life-threatening if not dealt with seriously and quickly. I hope all new moms have better advise then I got 14 years ago (Doctor: You might want to try shopping for baby clothes) and if your not getting help go and find it.

On Tom Cruise: he is a certified nut. On breastfeeding: my husband always bottle fed both of our kids once at about 11 p.m.. so that I could get at least four or five hours of sleep a night. Plus he enjoyed it. We have bright, happy, funny kids.

Posted by: SMB | June 20, 2006 5:05 PM

Wow. Interesting stories. Thanks for sharing them. Some thoughts from someone whose not yet a mom...

The thought of caring for a baby full-time is scary. So everyone's post-partum stories seem completely reasonable to me. I'm sure I'd feel the same way about a newborn. Does this mean I shouldn't have kids? Hmmm...

What are considered "normal-adjustment-issues" and when is the line crossed into PPD? Are there risk factors?

Most of my friends who've had kids seem blissed out by motherhood, even the ones who had difficult or ambivalent pregnancies. Is the blissed-out-breast-feeding stage considered normal? Or is it linked to the same hormonal issues that can trigger PPD?

Posted by: just curious... | June 20, 2006 5:07 PM

Rockville, that's a great story.

Yes, people are extremely judgmental about how you feed your baby, whether it is by breast or by bottle. It's really sad.

I would love to see the increased campaigning for breastfeeding focus on removing the barriers for women who want to and are capable of breastfeeding but who stop because they don't get enough support or get criticized for it, rather than putting increased pressure on all women. Why not focus on properly educating pediatricians and passing laws that establish a woman's right to breastfeed in public and require employers to allow lactation breaks, rather than just adding another layer of guilt onto all moms, some of whom really are not able to because of PPD or other issues. Nobody should be judged for either breast or bottle feeding.

Posted by: Megan | June 20, 2006 5:07 PM

I would love to see the increased campaigning for breastfeeding focus on removing the barriers for women who want to and are capable of breastfeeding but who stop because they don't get enough support or get criticized for it, rather than putting increased pressure on all women. Why not focus on properly educating pediatricians and passing laws that establish a woman's right to breastfeed in public and require employers to allow lactation breaks, rather than just adding another layer of guilt onto all moms, some of whom really are not able to because of PPD or other issues. Nobody should be judged for either breast or bottle feeding.

Megan, I agree with you on this one. Breastfeeding should be made easier, but certainly there are lots of reasons not to breastfeed, including medical ones, and people should be sensitive to that and not so quick to judge others. I got the most flack from my mother, who did not breastfeed her kids and was kind of grossed out by the concept. I also think she took my decision to do things differently as a criticism of her way, which it was not. I think this would make a very interesting discussion. How about it, Leslie.

Posted by: Rockville | June 20, 2006 5:12 PM

One of the few things that gave me support during my PPD days, strangely, was the older women who passed by me in the store when my colicky daughter was having a meltdown. I was afraid everyone would be furious with me for disturbing the peace, but several women walked by me and said warmly, "I remember those days."

It actually helped a lot. I felt some sympathy, but more importantly, I felt hope. There would be a point in time when this would be over. It seems silly to have to be reminded of this, but I was so overwhelmed by the situation that I couldn't imagine it would ever end.

Posted by: Double sadness | June 20, 2006 5:12 PM

well, Father of four just keeps getting better and better in my eyes. When I was down, at least I didn't have a colicky baby.

Posted by: Scarry | June 20, 2006 5:20 PM

Rockville -- Exactly. We need to have an entire entry on breastfeeding. I will get cracking.

Posted by: Leslie | June 20, 2006 5:25 PM

As long as I'm getting into it, my husband had an extremely demanding job and was totally clueless about what it was like to have a baby. We were buying a house, selling a house, and moving, so we couldn't just focus on the baby. He thought I was on vacation or something, since he would ask me before going to work, "can you at least do X?" involving the house sale. Finally I snapped and told him all I was doing was keeping my (extremely colicky) baby and myself alive for that day. Looking back, that was a cry for help.

Posted by: Double sadness | June 20, 2006 5:46 PM

Before I had my son (now 3 1/2), I had several years of infertility treatments and four miscarriages (one of triplet girls at 17 weeks). During the pregnancy, I had a cerclage and was on bedrest for 4 1/2 months. When I went into labor, my son's heart rate started dropping every time I had a contraction, so I ended up with a C-section. In short, neither my efforts to become pregnant nor my one, successful pregnancy were all that pleasant.

Although I had experienced some depression after two of the miscarriages and a bit of anxiety during the final, successful pregnancy, I didn't expect what happened after I had my son. I didn't sleep well while I was in the hospital recovering from the C-section because I kept waking up to check on my son's breathing (he stayed in my room). I also had trouble breastfeeding him. This in turn, made me even more anxious about my son because I was afraid I was damaging his immune system/brain/etc. whenever I gave him a bottle of formula.

The most "interesting" thing happened when I got home, though; I had a bout of amnesia that lasted about 24 hours. I didn't know who I was, who my husband was, where I was, or why I had this screaming baby. I couldn't remember ANY of my life before I went into labor and went into the hospital. The amnesia went away after a day, but I became manic; I didn't sleep for a week and instead spent any time I wasn't caring for the baby in cleaning the house -- I rearranged everything in the freezer, vacuumed constantly, sprayed everything with antiseptic .... it sounds funny, but I was really anxious that the house be absolutely clean so my baby wouldn't get sick and die, so I literally didn't sleep for about a week. My husband realized something was really wrong when I locked him out of the master bedroom in the middle of the night (he had gotten up to feed the baby) so I could clean the bathroom in peace.

Fortunately I had been working with a good therapist throughout my infertility treatments and during my pregnancy. She had seen me through several of the miscarriages and knew about the cerclage and bedrest. My husband was the one who had to call her for help, though, as I was too embarassed by how crazy I had been acting after we got home from the hospital. My perinatologist (OB that takes care of high-risk pregnancies exclusively) was NO help, though; he told my husband he just should put me in the psych ward until I recovered. My husband is still mad at him about that and if I ever get pregnant again I don't think we'll work with him again.

Posted by: Split-Shift Mom | June 20, 2006 5:51 PM

Holy Cow Split Shift mom you defanitly don't want to go back to your OB again if you get pregnant. How dare he say that? Your entry is sad and uplifting. I'm glad your husband had the smarts to get you some help. My husband, God bless him before anyone jumps on me like they do Leslie, didn't even know I was depressed.

Posted by: Scarry | June 20, 2006 5:58 PM

To just curious:

Being "blissed out" by parenthood can be the upside of being "flipped out" by it. I'm routinely both, and some of your "blissed out" friends may have been, too! And don't let your fears prevent you from having kids. Every single person who's posted has had fears, and every single person is doing the best s/he can at parenting!

Posted by: niner | June 20, 2006 7:23 PM

When my first daughter was a day old, I looked at her and felt completely full of emotion that I can't describe. I wasn't overwhelmed in the sense that I didn't feel capable. It was more a feeling of complete awe that this precious little being was completely dependent on me and my husband to live and grow. What a responsibility. I cried because there was so much emotion, it had to come out of me in some way. I was not depressed. It was more of an overwhelming honor that I would have the privilege of taking this child to adulthood.

I also cry at weddings, graduations, movies and Hallmark commercials so I know that it wasn't depression.

For those of you who had problems with hormonal mood swings from pregnancy, just watch out for menopause. I never had more than occasional mild PMS and had no PPD, but menopause sent my family running for cover when I entered the room.

As far as breastfeeding: Maybe women shouldn't put so much pressure on themselves about this. My attitude was that I would try, but if there were any problems, I would use formula. Millions of people have been raised on formula and are just fine. I nursed my 2 children for 10 weeks and 7 weeks. I didn't feel any guilt at all about stopping. I never pumped and actually was happy to be able to run an errand without leaking if I heard a baby cry.

I believe that post-partum depression is real, but I also believe that there are some people who claim depression when they are only feeling normal "down" feelings. Who wouldn't have some mood fluctuation when dealing with a major change in their lives while also being sleep-deprived.

kme - I don't think that the depression talk is all nonsense. I believe that it is a real illness. However, I would agree that it is over-diagnosed and that many people consider themselves clinically depressed when they are actually just going through a normal spell of the blues.

Posted by: my2cents | June 20, 2006 7:51 PM

Sometimes it isn't until many years later that you even realize that you had PPD. In my case it took over three years for me to realize what I had been thru. PLEASE PLEASE all those friends, neighbors, relatives, husbands, SAY SOMETHING, butt in, be busybodies. If nothing is wrong, well good. If there is then you might have saved someone a lot of pain and fear.

Posted by: LDB | June 20, 2006 7:56 PM

"I believe that post-partum depression is real, but I also believe that there are some people who claim depression when they are only feeling normal "down" feelings. Who wouldn't have some mood fluctuation when dealing with a major change in their lives while also being sleep-deprived."

I think the opposite may be true -- I believe PPD and depression are probably both underreported. And, many many people try to "tough it out" on their own and do not seek help. Perhaps there are people who are hypochondriacs who seem to have every illness under the sun who simply jump on that one too, I don't know. But I've never met any of them.

Sleep deprivation and hormonal changes can make depression worse of course. And giving yourself TLC is sometimes helpful for mild depression.

But for people like a friend of mine who developed psychosis as part of PPD, it's not just about getting more sleep. Or a babysitter, or whatever.

I was upset to learn after the fact (she's on the other coast) that she was having psychotic episodes. Fortunately, she got help before she harmed herself or the baby, but it's the reason she chose not to have a third child.

Posted by: Kate | June 20, 2006 9:16 PM

To "in recovery": I just read your post, and I'm glad you received the help you need. It must have quite frightening, and it's great that you shared your experience here so others can learn from it.

Posted by: Kate | June 20, 2006 9:18 PM

Just Curious: "What are considered "normal-adjustment-issues" and when is the line crossed into PPD?"

I don't know how medically you tell the line between normal postpartum and PPD, but I think for me, I knew I wasn't suffering from PPD because I was always aware that the hard times would pass and could find things that helped me deal with those overwhelming emotions.

I dealt with a lot when my daughter was born (miscarriages, childbirth complications, a company shutdown/job loss/move to another state where I knew no one right at the same time, etc.). So I was extremely stressed and emotional -- would cry at the drop of a hat, worry over the littlest things, obsess over walking down stairs with her, etc. Even when I wasn't upset or fretting, I would frequently cry just at the beauty of my daughter and the overwhelming love I felt.

But I was also still able to realize that a lot of those emotions and feelings were due to very natural stresses, and I always knew that things would eventually calm down and get better. I was also able to find things to do that helped me deal with those emotions -- let myself be sad when I felt sad, called or e-mailed people for support (my husband will still tell you about the hysterical call he got the day the daycare fell through a week before she was due to start!), and made myself go to the gym regularly. And the key is, those things DID help. From what I understand of the disease, with PPD, none of those things would have been enough to ease the pressure or help me deal with those emotions -- if I had still been dealing with that same degree of intense emotion 3 or 6 months later, that would have been a heck of a tipoff.

And KME, it makes me sad that you would read all of these touching stories from so many women who have gone through hell, frequently in large part because no one took their struggles seriously, and respond to by telling them that it's all in their head. My brother has been in treatment for clinical depression for years, and I defy anyone to evaluate him and tell me that his complete inability to function in the world is just something that medical science or drug companies made up.

Posted by: Laura | June 20, 2006 9:26 PM

Just Curious -

I think Laura (as always) makes a nice point. What I have seen in my loved ones who are depressed is a level of all-encompassing despair, and often a real inability to function on a daily basis. This is why it's so hard to seek help, by the time they've gotten to this state it seems pointless or so far out of reach. My mom said she has learned to identify a little earlier the feeling that she is slipping over the edge, and that is the time to ask for help - as soon as she realizes that her mental state is interfering with her day to day life.

Posted by: Megan | June 21, 2006 10:12 AM

For Rebecca:

"and not treating depression also increases the risk of relapse. So much for "toughing it out". I'd love to hear if anyone knows specific studies about this-- I'm having a hard time finding the exact info."

I don't have a study handy, but I do know that my doctor has told me that if I go off my meds, there's a very good chance they won't work again if I went back on them. Which is one of the reasons I doubt I'll ever have kids - I'm on one of the few psych drugs that you can't take at all during pregnancy.

Posted by: AG | June 21, 2006 10:13 AM

To AG:

You might check McMan's Depression and Bipolar Web. It's a site for lay audience, but the author is very tied in to research. I believe he also answers email, so he might be able to direct you to a source that addresses your specific question.

Here's a quote that seems related to your issue: one episode of depression results in a greater than 50 percent probability of recurrence. With two episodes, the risk is greater than 70 percent, and three or more depressions makes another a virtual certainty at more than 90 percent.

See http://www.mcmanweb.com/article-181.htm for the source. The authors of the research cited in this web item are all very distinguished researchers with hundreds of publications on the treatment of depression to their credit. And one of them is my doc!

Posted by: BJH | June 21, 2006 10:42 AM

Laura makes a good distinction between normal postnatal adjustment and PPD. For me, the difference between the two is the hopelessness and distortion that accompany depression. When I was depressed, I couldn't believe that life would be anything other than bleak even though I was surrounded by reasons to believe otherwise. Those moments of clarity just don't appear when you are clinically depressed.

I hate to hear that someone would forgo motherhood because of depression that can be treated. If you are too worried about the side effects of medication on the fetus, consider adoption. We are adopting our third child (a 6-9 month old)primarily because IVF was the only other alternative. But I have to admit that bypassing the newborn stage and its attendant burdens will allow me to care for the whole family better.

Posted by: happymom | June 21, 2006 11:21 AM

The distinction that makes the most sense to me betw "blues" and depression is that depression is diagnosed when one cannot function "normally" in life. For a depressed mom that could mean anything from being literally housebound (after a normal newborn period) and unable to connect with others/go on outings to not being able to pursue a needed or chosen job or career to not being able to care for herself or her child at all. Blues can make it hard to get along for awhile but shouldn't prevent something significant to one's level of functioning like a job or caring for a child. again--thanks for the great discussion!

Posted by: Rebecca Kaminsky | June 21, 2006 11:57 AM

Re PND, PPD, and another "D," premenstrual dysphoric disorder: far too little research has been done on the interactions between hormonal fluctuations and levels of the various neurotransmitters affected by psychotropic medications such as antidepressants. I know from personal experience that these medications can have very different effects depending on one's current "hormonal status" - but for most of the makers and dispensers of these medications, those pesky female hormones are of little interest. Research in this direction could lead to better medications to alleviate the terrible suffering so many have described here.

Posted by: Jill | June 21, 2006 12:41 PM

"Research in this direction could lead to better medications to alleviate the terrible suffering so many have described here."

More research into mental health in general is needed. The hardest thing about it is that no one really knows why the drugs work, or how. (I mean, look at how long we've had lithium, and we still aren't totally sure why it helps people.)

If you have an infection, you go in, get tested, and have a clear pick of drugs. If you go in with a mental illness, it's hard to pick a specific diagnosis, and even if you get one, choosing which drugs you get is fairly random. My doctor told me it's still an art, not a science. If could get more research, we could help so many people's suffering. And help quicker - it took over 3 months to figure out which drugs would help a friend of mine.

(Sorry for the soapbox, this is a pet topic of mine...)

Posted by: AG | June 21, 2006 1:49 PM

PTJobFTMom, I think that maybe you need to go get a FT job for yourself.

Dont lump me in with L Ron's morons. Thank you.

Posted by: kme | June 21, 2006 2:57 PM

kme -

Why not? It appears you're as ill-informed about modern psychiatry as they are. If it walks like a duck, talks like a duck....

Posted by: AG | June 21, 2006 4:23 PM

KME-

There was a time when I, too, believe that depression (and all similar diagnosis) was a manufactured disease solely for the benefit of the Pharm companies. I've since learned that it isn't. Really, none of them are. There are some people who can "bring themselves out of it" by sheer determination, but they are few and far between (one difficulty with this is the suffering and the burden this puts on their loved ones.)

My SIL's mom was depressed through much of SIL's teenage years. As the only girl and the youngest in her family, she bore the brunt of her mom's depression and outbursts for years and left home as soon as she was capable of living on her own. While SIL was in college, her mom was diagnosed with depression and was put on meds. SIL has said that during that time she only came home on break for her dad's sake. Now, 10 years later, she and her mom have a pretty good relationship, but her mom still struggles with the guilt of what she did before she was diagnosed. SIL has said that she and her mom have discussed the permanent guilt trip mom seems to be on, with the assurance from SIL that it isn't necessary, but her mom struggles with it still, and it further contributes to her depression. It's not "in her head" or something she can "work through". It's real, it caused some really awful behaviors (like verbal and physical abuse) and some even worse repercussions.

Don't dismiss those that seek help, at least they realize that something is wrong and are willing to admit that it is beyond their control. That one admission is what stops most people from getting treatment, whether we're discussing run-of-the-mill depression, PMDD, PND or PPD.

Posted by: Anonymous | June 23, 2006 3:48 PM

Wow, it's so refreshing just reading these posts. Before having my daughter I had a 17-year history of bipolar II disorder (no true manic episodes, mostly depression), including a few hospitalizations and many experiments with meds that didn't work until I found some that did. So I took the threat of PPD seriously. I was sailing along during pregnancy taking only a very small dose of antidepressant, but three days after my daughter's birth, I was at the lowest point of my life. My husband rushed me to the ER and I was admitted to the psych ward. Turns out I needed to take meds that would completely preclude breastfeeding (even La Leche said so). It was SUCH a tough decision- made even tougher by the fact that I kept encountering messages like, "Breastmilk is a baby's biological right" and "Bottle-feeding impairs the mother-child bond." But you know what? Having a functional mother is also a child's biological right, and nothing impairs the mother-child bond like severe depression. The PPD experience has made me realize how important it is to care for myself so I can care for my daughter. I'm now working 16 hours a week, which is what I can handle, and I'm working even harder not to compare myself to other moms!

Posted by: Joella | June 26, 2006 8:55 AM

The medical community of nurses, nurse midwives, doctors, obgyns - are not as informed or experienced in post-partum depression or post-partum psychosis as we would like them to be. If every woman who has either had this, or had a friend or family member go through something like this - if everyone brought their story to the attention of medical professionals - then maybe they would start talking about it amongst themselves and start urging their medical associations to do more research and the conferences that they go to could feature and highlight post-partum problems and then we would *start* to see some improvement in women's healthcare.

I think this is going to have to start from the bottom up. A great start is Brooke Shields opening up and telling her story. Another great start is the governor of New Jersey's wife being the spokesperson for this cause, and putting an awareness campaign together. The Andrea Yates situation is frightening and sad, but even that story is a good start, because it gets people thinking and bringing attention to this subject matter. Andrea Yates had a severe case of postpartum psychosis which is way more rare than postpartum depression -

I would like to see health care providers take a more pro-active role in understanding, identifying and treating these post-partum problems. For my part, when I go for my annual exam I talk to the Nurse Practitioner about this, so maybe if she spots it in someone else, she can help that person. I think if each of us just made sure that our own doctors know about this wide-spread problem then maybe we can get momentum going in the healthcare world, and we can make the world a better place for our daughters' daughters, at least.

Posted by: interestedinthistopic | July 6, 2006 3:01 PM

It was nice to read this article and comments made by others. Last year my sister 25, had her second child, he was beautiful and it was such a happy occasion but something was off with my sister. She was not returning phone calls, she didnt want to see anyone and she would not take help not even from me or my brother. On april 7 she put my two nephews in the car aidan being 1 and 1/2 and deryn being 2 weeks old, she strapped both babies in drove her car onto the tobin bridge which is in east boston it was about 5:45 pm, which is a very heavy trafic time and she got out of the car and jumped off the bridge. It has been so hard for me but one of my biggest struggles is to understand post partum depression or post partum physcosis, which is what my sister suffered from. I am learning more and more which will be helpfull for me in the long run but I am very happy to know that it is being talked about more and more and that more women and their families are being educated. I wish I had known about Post partum so that i could have seen the warning signs.

Posted by: Rachelle Jones | August 9, 2006 3:21 PM

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