Featured Question
Is there any advice you would like to give to healthcare providers who deal with pregnant women or new mothers?
I would ask that OB/GYNs screen for it more aggressively. I think pediatricians should as well, as they are the ones who see the moms more than the OB/GYNs.
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Answer: Always do a prior history of mood disorders with the mom and go over the possibilities of PPD happening and prepare the family for this. Educate and be proactive.
Answer: Healthcare providers must educate themselves about the spectrum of postpartum mood disorders, from the blues through depression, psychosis, bipolar, etc. They must learn how to properly screen for the disorders as well as make the proper referral to specialty care. OB/GYNs, pediatricians, and nurse practitioners must take training to screen, assess and treat the disorders!
Answer: I think there needs to be more information during pregnancy for both new mom and dad. Also, maybe make it a part of Lamaze.
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More Questions Answered...
Q: Had you heard of baby blues?
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A: No, I was unfamiliar with the term.
Q: Had you experienced other mood disorders in your past, such as bipolar disorder, anxiety disorder, eating disorder, or obsessive-compulsive disease?
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A: There is a history of depression in my family, which I was also afflicted by. My relationship with my family has been difficult since I was a teenager and my brother died in a tragic accident. I don't think anyone really ever got over that.
A: I never experienced clinical mood disorders in my past. I only experienced times of anxiety during final exams in my university classes, which passed relatively quickly, and normally.
A: I had an eating disorder as a young teen, anorexia. I also had a couple of major depressions prior to pregnancy.
A: I never experienced anything like that although my boss says I have OCD (I'm totally anal about everything in a perfectionist point-of-view).
Q: Did you have a supportive partner during and after your pregnancy?
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A: My husband tried to be supportive, but there wasn't anything that he could actually do to snap me out of it. I think that frustrated him, but it's not something you can just snap out of.
A: Absolutely, my husband was amazing during and after my pregnancy (and continues to be great)!
A: Yes.
A: Absolutely! My husband and Mom were fantastically supportive.
Q: How long did it take for you to decide to seek treatment?
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A: I sought treatment when I started having suicidal thoughts. I couldn't function anymore – it was get help or kill myself.
Q: Did you take medication as part of your treatment? If so, were you hesitant to take it at first?
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A: My general practitioner referred me to a psychiatrist who prescribed an antidepressant and recommended that I also go see a therapist, which I did.
A: I was extremely hesitant to take it. I believed only weak people took antidepressants.
A: Yes, no hesitation, since I knew medication could help, it did in the past.
A: I didn’t have a choice not to take medication.
A: Yes, I was very hesitant and thought maybe counseling would be enough, but it wasn't.
Q: Did you want anyone to ask you how you were feeling?
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A: Of course. I needed an opportunity to confess all the terrible feelings that I was keeping inside.
Q: How old were you when you had your baby?
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A: 35 years old.
A: 35 yrs.
A: I was 30 years old, and married for 3 years to a wonderful man. This was 1997. We just celebrated our 12th anniversary.
A: 32 years old.
Q: Did you know about postpartum depression (PPD) and if so, how did you hear about it?
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A: Yes, mostly on the television.
A: No, I didn’t know about PPD or psychosis until I experienced psychosis myself.
A: Not before I had my daughter. I learned so much through having it.
A: I had heard about it, but I heard more about it through a talk given by Las Madres.
Q: If you have more than one child, did you experience PPD with the previous children?
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A: Just with the first child (we have 2 boys and, so far, so good on number 2).
A: No other children.
Q: Were you happy about having children?
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A: Yes.
A: I was very happy to start my family. We were ready, willing, and stable, etc. I had no known health problems (emotional or physical) going into the pregnancy.
A: Very happy.
Q: Did you have a difficult pregnancy?
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A: No, I had a very uneventful pregnancy.
A: No, I enjoyed it.
A: I didn’t have any problems until the very end when my back became almost too painful to bear.
A: Yes with my first, but I did not experience PPD. My second pregnancy was normal and I had PPD.
Q: How did you feel the first 2 weeks after having the baby?
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A: I didn’t want to leave the hospital. I begged to stay just 1 more day. I didn’t want to "deal" with everything.
A: I felt scared to death because I was insane. I was having delusions; I had nonstop panic attacks; I wanted to die.
A: Very tired and had a lot of questions.
A: I was emotional and tired. I cried from exhaustion and was very sensitive.
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Q: When did you realize that what you were feeling might be worse than the baby blues?
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A: I didn't realize it until about February and even then I convinced myself it was just exhaustion. It wasn't until I went to a talk that I thought something might be wrong.
A: Around the third or fourth week.
A: It was very apparent to all involved (my family and my OB/GYN) that I had psychosis when I ended up in the ER after attempting suicide.
A: About 3-4 weeks after the birth.
Q: What were you feeling/thinking?
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A: I felt guilty, like I should be so happy with this new baby. Tired, extremely exhausted, ashamed, sad, I cried all the time. I also experienced anger and resentment towards my husband and friends who don’t have children.
Also, I had thoughts of killing myself and how I would do it. I wanted to leave my children.
A: All I knew was that I couldn’t control the videos playing out in my head. The scary visions included dropping my newborn son out of our second-story window and seeing him going "splat" onto the pavement below. There were other haunting scenarios, but I’ll spare you the gory details.
A: I started with not being able to sleep or think clearly, anxiety and nonstop thinking and worrying about my abilities as a mom.
A: I was anxious about every little thing, which is typical of me (I'm totally a type-A personality). But it went beyond worry – it was almost obsessive worry.
Q: Did anyone ask you how you were really feeling? Did you want anyone to ask you how you were feeling?
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A: My sister asked me how I was feeling, but she was convinced that it wasn't PPD since I am probably one of the happiest people she knows.
A: Yes, most of my family, of course my husband and some friends. At first I didn’t mind then I felt so out of it and bad that it was harder to communicate properly.
A: Nobody asked me anything. Did I want someone asking? I have no idea. I was going nuts, but I don’t know if anyone knew what was really going on. I suspect my girlfriends thought I was just sleep deprived.
A: No one asked.
Q: Is there a history of these illnesses in your family?
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A: I don’t know for a fact, but I do know my cousin committed suicide, my brothers both have had depression. My mom and dad never really spoke of that or how they felt in terms of this.
A: Yes. When I was admitted to the hospital for several days of inpatient treatment, a couple of family members stepped forward to discuss with my care providers what psychological health problems are in our family tree. There is 1 successful suicide on my Dad’s side of the family, and 1 incidence of postpartum psychosis on my Mom’s side of the family.
Q: Had you experienced sexual abuse or domestic violence in the past or during your pregnancy?
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A: I had experienced some inappropriate touching from my mom’s dad, maternal grandfather to me. This was at a very young age, 5 or 6.
Q: Did you seek help for PPD, or did someone suggest it?
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A: It was suggested.
A: Due to my suicide attempt. I was treated in the hospital for 3 days and then discharged to outpatient psychiatry services for several months. I completed intensive treatment – counseling and medications – in 18 months. I’ve been off all medications since then.
A: I went into my OB/GYN’s when I knew something was very wrong. They recommended Dr. Pec Indman and an M.D. to prescribe medication too.
A: I sought out some help. I asked my OB/GYN and they had Pec Indman's name as a reference. I sought her out and she was awesome.
Q: How long did it take for you to decide to seek treatment?
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A: About 1 month.
A: About a week.
A: I didn’t seek treatment on my own. My husband and a good friend performed an intervention. It was 3-4 months postpartum.
Q: From the following list, where did you go for help: pediatrician, family physician, OB/GYN, therapist, pastor, doula, breastfeeding expert, or a social worker?
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A: I first went to my OB/GYN and then to my family physician.
A: Hospital, adult psychiatry for medication management, MFT for therapy and support group, OB/GYN for regular check-ups, and pediatrician for well-baby check-ups and to ensure the mother-baby bond was happening.
A: OB/GYN, then to a therapist who specialized in postpartum mood disorders, and also a psychiatrist.
A: OB/GYN.
Q: Was it difficult to ask for help?
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A: Yes because I thought this could NEVER happen to someone as "together" as me. I always thought depression only affected "weak" people.
A: At first, with my husband and then when he decided I really needed help I felt some relief from carrying all the burden of it.
A: Extremely.
Q: What kind of treatment did you receive?
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A: My OB/GYN treated me at 6 weeks with a low dose of sertraline HCL that women take for PMS. It didn’t work. My primary doctor ended up treating me with venlafaxine and trazodone.
A: First I had one-on-one therapy with Pec Indman, a MFCC counselor, and a support group she ran. Also, saw a psychiatrist for fluoxetine hydrochloride.
A: I had some counseling and then I finally went on antidepressants even though I was really against taking any type of medication.
Q: Were you breastfeeding at the time of your treatment? If so, did this affect your choice of treatment?
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A: Yes, I was breastfeeding so it did affect my choice of antidepressants.
A: Yes, I decided to stop, cold turkey, and bottlefeed and take the fluoxetine hydrochloride.
A: Anti-psychotic and anti-anxiety meds are not compatible with breastfeeding, so my son was bottle fed.
Q: Did you feel any shame because you were receiving treatment for PPD?
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A: Very ashamed.
A: No shame in wanting to live, right?
A: Yes, somewhat, especially with my mom, dad, brothers.
A: I definitely felt ashamed even though I knew it wasn't my fault and that this happens to about 10-15% of all new moms.
Q: Did you share what you were going through with family and/or friends?
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A: Yes, with close family and close friends only.
A: Not at first, just a few people. I told my family later on.
A: A few close friends and family members knew that I was hospitalized. I shared my story with my greater neighborhood later on by writing a story about my experience for the local weekly newspaper. Later on, I was interviewed by NPR radio for a feature story about PPD about the same time that the Andrea Yates story broke.
A: Yes and no. I told my friends I was having a hard time but I kept a lot of my feelings to myself because I felt so guilty.
Q: Did your doctor run any tests to see if other health problems might be causing your symptoms?
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A: Yes. He checked my thyroid.
A: Yes, I was examined for thyroid disorder. I was found to have a very inactive thyroid function. I will take that medication for life.
A: Yes, thyroid blood test.
A: Yes, they checked to make sure I didn't have a thyroid condition.
Q: Do you feel there was anything you could have done differently to have prevented or lessened your chances of getting PPD?
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A: I could have let the little things go. I could have relaxed, but that is impossible with your first child. I should have napped when the baby napped like everyone told me.
A: My OB/GYN could have asked if I had prior mood disorders and then been proactive in my prenatal care and prepared me for what could happen and possibly put me on meds sooner.
A: Since I didn’t have a known health history of mood disorders, nor did I know about the problems in my family tree, I couldn’t have prevented the PP psychosis situation. It came out of the blue. My prenatal care was excellent, and my pregnancy progressed smoothly and normally. Delivery was complicated but care rendered in the hospital was excellent, too.
Q: Did having PPD affect your feelings about having more children?
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A: It scared me to death to have a second, but I have a 3-month old now and I don't have PPD with number 2 (so far that is, but I am optimistic I won't get it).
A: Oh yes, we decided and have kept to it, that we wouldn’t go through it, even after having gone through it and knowing so much.
A: Since there was then, and still is now, a super huge chance that PP psychosis will repeat, my husband and I made the decision not to have any more children.
Q: Is there any advice you would give women who are experiencing PPD?
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A: It is ok to ask for help! Talk with other friends that have had children. To my surprise I was not alone once I spoke to a few friends.
A: Seek medical attention right away! Don’t delay. Don’t think for a minute that you can pray, meditate, or will your symptoms away. Get help and get help ASAP. If your OB/GYN provider doesn’t believe you, get a second opinion right away or go to your nearest ER for assessment. Understand that the time frame for healing depends on your following through with counseling and medication, and your willingness to take good care of yourself, ie, eat a really healthy diet, drink water, get rest, and get out for sunshine and exercise.
A: Listen to your body and mind, and trust yourself. Seek professional treatment as soon as possible and get the proper medication, support group, and therapy.
A: You don't have to feel this way and you should get help right away. The sooner you seek treatment, whether counseling or antidepressants, the better for everyone including yourself, your baby, your partner, etc.
Q: How are you feeling now?
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A: It is hard for me some days to hear what I said or did. I do feel good now though.
A: I feel wonderfully well! Of course I should… my son is now 10 years old.
A: Much better, I still take antidepressants, since my professional health care providers have always said I need to the rest of my life due to the severity of my prior depressions and the PPD I experienced.
A: I feel great. I'm 3 month post-partum with my second child and I am tired from interrupted sleep at night but overall I feel great and happy!
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