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Coming Out of the
Fog
Suzanne Taleff
I can hardly believe
it's been nearly eight months since Sam was born. Every time
I look at his beautiful face, I am awed that he is mine. My husband
and I waited a very long time for this miracle, and we feel so
blessed that our dream of having a family has finally been fulfilled.
The first few months
following Sam's birth, however, were far from dreamy. My hormones
went berserk, resulting in a serious case of postpartum depression.
Combine that with severe sleep deprivation and you've got a woman
completely unable to cope physically or mentally. Here I was
with this beautiful, healthy baby that I had waited so long for,
and I was completely ambivalent about him. I just wanted him
to go away. What was supposed to be a joyful time was instead
a nightmare. I was exhausted and overwhelmed. I wasn't myself.
I was numb, but at the same time I was very anxious and suffered
panic attacks. It was the most frightening experience of my life.
My husband, family
and friends were very concerned about me. Thankfully, I had a
good support system. My husband was home with Sam and me and
my mother and lived nearby. Since I had suffered from anxiety
and depression in the past, I knew the signs and immediately
got help. I was already taking a low dose of antidepressant medication,
and he adjusted the dosage. After a few weeks on the higher dose,
I started to come out of the fog that was enveloping me.
I am happy to report
that I am doing very well now. Sam is the joy of my life. During
my darkest days, everyone kept telling me it would get better.
It was hard to believe it at the time, but it really was true.
When I see that smile at the end of a long day, it makes it all
worthwhile.
I am sharing my story
because I feel strongly that we need to raise awareness of postpartum
depression. It saddens me to think of all the mothers out there
who do not seek help and suffer needlessly. When I started talking
to other mothers about what I was experiencing, I was surprised
at the number of women nodding their heads and telling me a similar
story. We are not alone! I urge any woman who thinks that she's
experiencing PD to seek treatment. Your experiences are valid
and real. Reaching out for the proper help is an important step
toward recovery. Although treatment varies depending on the type
and severity of the symptoms, all of the symptoms from the mild
to most severe are temporary and treatable with professional
help and support. Trust me, it will get better. I know, I've
been there.
Postpartum Depression
PPD is the most common complication of childbearing.
PPD occurs in 13% (one
in 8) of women who give birth.
PPD affects approximately
half a million women per year in the US.
Defining PPD: Women
who have given birth within the past 3 months who have five of
the following symptoms of major depression, at least one of which
must be either depressed mood or decreased interest or pleasure
in activities (Diagnostic and Statistical Manual of Mental Disorders,
fourth edition):
Depressed mood, often
accompanied by severe anxiety
Markedly decreased interest or pleasure in activities
Disturbed appetite, usually loss of appetite and weight loss
Disturbed sleep, usually insomnia and disrupted sleep (even when
the baby is sleeping)
Physical agitation or, less commonly, physical slowing down
Fatigue, decreased energy
Feelings of worthlessness or excessive or inappropriate guilt
Decreased concentration or difficulty making decisions
Repeated thoughts of death or suicide
PPD is believed to
be related to the rapid decline in the levels of reproductive
hormones that occurs after delivery.
Characteristic symptoms include crying jags, sadness, emotional
lability, guilt, loss of appetite or anorexia, profound sleep
disturbances, poor concentration and memory (most likely a consequence
of the sleep disturbances), irritability, feelings of inadequacy,
and feelings of inability to care for the newborn or other children.
There is no consistent
association between PPD and age, number of children, the sex
of the baby, socioeconomic status, whether the pregnancy was
planned, or any biologic factors.Ý
Risk for PPD is increased
by:
Personal or family history of depression
Unmarried status at the time of birth
Lack of social support
Occurrence of negative life events during the pregnancy and/or
delivery
Personal history of premenstrual syndrome (PMS)
ÝTreatment must
be medical and psychological; physical conditions (e.g. pituitary
or thyroid disorders) must be considered and ruled out before
the diagnosis of PPD can be given.Ý
The most important
but most difficult condition to rule out is simple sleep deprivation.
Test whether the symptoms persist even after mom has had a good
opportunity to rest, undisturbed, for several hours.Ý
A sleeping pill may
be prescribed.Ý
Once the diagnosis
of PPD is made, group or individual psychotherapy may be helpful.Ý
Education about newborn
care, providing increased social support, and non-pressured lactation
counseling are often helpful.
Drug therapy is highly
effective and does not necessarily require women to stop nursing.
Even though anti-depressant medications all get into the breast
milk, it is unclear that this has any untoward effects on the
baby (Discuss this issue with your physician for any prescription
or over-the-counter medication you may take).Ý
There are several choices
of antidepressant medication; each has different side effect
profiles and length of usage experience for PPD.Ý
If antidepressant medication
is prescribed, it will generally be continued for at least six
months.Ý
Occasionally, women
have been prescribed estrogen as part of their treatment regimen
for severe PPD once their periods have resumed.
Any woman who has
thoughts of suicide, harming herself, harming her baby or harming
others needs an immediate psychiatric consultation. This must
always be taken seriously.
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