"Cynthya was our doula for the birth of our third child in April 2016. As this was my third birth, and I had been attended to by a doula at the first two, I knew that finding the right doula was crucial to a successful and satisfying birth." - Winter Wheeler-Young
Treatment of Depression During Pregnancy and the Postpartum Period
As a society, we need to remove the stigma of mood disorders and mental illness.
"Several adverse obstetric complications have been reported with untreated prenatal stress and depression, including pre-eclampsia, preterm delivery, low birth weight, miscarriage, small-for-gestational-age babies, low Apgar scores, and neonatal complications.7,8 In addition to being debilitating for the mother, postpartum depression affects maternal-infant interactions and some measures of infant development."
This is an excerpt from this article titled Treatment of Depression During Pregnancy and the Postpartum Period, published by the US Department of Health and Human Services.
While there is a fine line between normal hormonal changes and clinical depression and anxiety, any symptomatic woman in the perinatal period should seek clinical evaluation and possibly treatment.
Won't the Medications Cause Harm to Baby?
It is a common concern for women with known depression to be wary of taking medication during pregnancy and/or breastfeeding. Quite frankly, for most pregnant women, there is some sense of fear of putting anything in their bodies. However, more and more is being published about the much GREATER risks of untreated depression in pregnant women. I spoke to an OB and a Pediatrician personally and asked for their opinion on the subject. To paraphrase, each physician emphasized how grateful they are when women come forward with these concerns so that they can be appropriately taken care of. Both of the doctors reiterated the vast research on the damage that untreated chemical imbalances can cause the mother AND the child. There are many safe antidepressant medications for pregnancy and breastfeeding.
There are Facebook support groups for women struggling with pregnancy and postpartum depression/anxiety with literally THOUSANDS of members. This is an epidemic that deserves more attention and less judgment. We are afraid to seek help for fear of looking weak or unfit as a parent.
As a society, we need to remove the stigma of mood disorders and mental illness. A mother who feels out of control of her emotions or feelings should not feel ashamed or like a bad mother. She should feel empowered to do the right thing for herself and her baby and seek the best treatment, as decided by her provider and herself.
A Long Day's Journey
I didn't lie in bed and cry every day. I got up and tried so hard to be okay. But that was the thing; I spent so much energy trying to be happy and okay that I didn't have energy for anything else. I isolated myself more and more.
When my son was 3 months old, my midwife diagnosed me with postpartum depression. She gave me the name of a highly recommended therapist and told me that things would get better. I didn't go.
When my son was a month old, I stopped sleeping. He would wake up to nurse around midnight, and I wouldn't go back to sleep, usually not until the next night. I desperately wanted to sleep. I was beyond exhausted, but I had become so anxious about not sleeping and not getting enough sleep that I couldn't shut my mind off, and the cycle would continue. I started fantasizing about going to stay in a hotel, just so I could be alone and sleep. Then the fantasies turned darker. I imagined faking a suicide attempt so my husband would commit me to the hospital, SO I COULD SLEEP. I felt depressed, overwhelmed, and so guilty for wanting to be alone. I thought that I never should have become a mom.
I had all the symptoms of postpartum depression but I convinced myself that I could be strong enough to handle it on my own. Women, mothers in particular, have been told that we can do anything. Often, what we hear is you have to do everything. I didn't want to have to get therapy or take medication during a time that was supposed to be the happiest time of my life. I became more defiant. Wasn't it supposed to be hard? I was learning how to be a mother, take care of a baby, not eating or sleeping like I used to, adjusting to a new life. It was supposed to be hard, and I really needed people to stop telling me that I was abnormal in my thoughts and feelings and that I needed help. I became angrier and more frustrated when my husband urged me to get help. There were times when I felt so much rage that I did want to hurt myself. I didn't feel like myself. I would lose control of my emotions and cry, scream, and break things, in front of my child.
“I thought that I never should have become a mom.”
There were moments of joy. I saw glimpses of light in the darkness. I would smile and laugh as I watched my son grow and change. There were days when I felt happy. That's how I continued to deny that I was anxious and depressed. I didn't lie in bed and cry every day. I got up and tried so hard to be okay. But that was the thing; I spent so much energy trying to be happy and okay that I didn't have energy for anything else. I isolated myself more and more.
When my son was 15 months old, he stayed the weekend with his grandparents. My husband was out of town. I sat on the couch and watched TV all weekend. When I went to pick up my son, I hugged him. I lied and told him that I had missed him. I hadn't missed him, and I felt so numb. The thought of bringing him home was overwhelming. I cried on the way home.
That's when I made the decision to get help. I wanted things to be better, not just for me, but for my family. It is hard to love others unless you love yourself, and I wanted my son to grow up with a mom who was happy and whole. I made an appointment with my primary care doctor, and she prescribed me Zoloft. I noticed a difference within a few days. I had more energy. I felt like doing things that I used to enjoy. I didn't feel angry or overwhelmed when my son needed my attention. My thoughts were clearer. I wanted to be outside and play with my son. I was laughing again.
It's been almost a year now since I started taking medication. It's not a magic pill. I don't walk around in a constant state of bliss, but it did clear the fog so I can see moments of bliss. I can wake up each morning and choose to see joy instead of sadness.
“The guilt and shame I felt about needing help were part of my depression.”
I regret not getting help sooner. The guilt and shame I felt about needing help were part of my depression. Since the depression was also tied to being a new mom, there was an added layer of uncertainty about what was normal and abnormal. Being a new mom is hard. There are challenges and adjustments, but you know yourself and your body. Your family and friends know you. Listen to yourself and others. If you are having a difficult time, it is okay to say I am not okay and to talk to someone about it. It can get better, and you and your family deserve that.
Postpartum Support International hosts free, live phone sessions every week, including Wednesday chats for moms and first Monday chats for dads. In Atlanta, new parents can explore therapy options via North Star Support. They also offer telephone therapy sessions so you can talk with an expert while caring for your baby.
