After my third child was born I developed what I thought was postpartum depression. I was in a stressful second marriage and noticed that all during this pregnancy (following so quickly on the heels of my second child's birth) I was more emotionally volatile, insecure, and weepy. I needed a lot of support that my husband did not know how to give me.
After the birth, things really started to change. I would get bursts of energy and then I would crash into pitiful helplessness, barely able to crawl out of bed. I was so frustrated with my husband for not understanding that something radical was happening to me that I would throw our lawn furniture around.
I'm from a fiery Mediterranean background, so it was not totally out of the question for me to throw things out of frustration. A pot maybe, or a plate to get someone's attention. But I was feeling very out of control. I would go quickly from rage into heartsick weeping. I was unable to cope. Of course I blamed myself and decided I was just a terrible mother and an overall worthless person.
What was also frightening was that I had very dark thoughts. I would look at my baby and worry about the most horrible things happening. It is perfectly normal to worry about your newborn. It is a sign of a possible problem when you become obsessed and immobilized by irrational fears.
My experience wasn't unique, as I quickly learned. My husband and I went to a support group where we talked to couples who were experiencing postpartum depression, and got some good ideas of how we could better cope. They encouraged us to make sure we stuck to a bedtime schedule for the children, and for ourselves. They also suggested other ways to reduce stress in our daily lives, and one of the support group members told me of her experiences with temporary medication for her postpartum depression.
All these alternatives are worth checking into if you're dealing with dramatic emotional and mood-swing problems after childbirth. For many mothers, as for me, the idea of medication poses immediate problems—drugs are not the best choice when you're nursing your newborn. But there were lots of helpful tips to learn at that support group.
For example, I examined my diet and consulted with a macrobiotics counselor. I tried alternative remedies from the health food store and consulted with all kinds of people to help me get a grip on what was happening. Thank goodness I had friends who were able to help me with the babies, because I was a wreck.
When you suffer from postpartum depression you can suffer some of the lowest of emotional lows. In my case, I finally felt so out of control and frightened that I prayed for help. I couldn't deal with my agitated, angry moods because I could blame my husband or my circumstances and explain it away.
What finally opened my eyes to the seriousness of my condition was that I became suicidal. I would sit on the floor in the bathroom with the door locked and cry. I found myself contemplating the easiest way a person could kill herself. Then I would think about my children, cry some more, and talk myself out of falling into what I can only describe as an elevator shaft. I talked to God a lot and said, “God, I may be an angry person, I may have low self-esteem at times, but I love life and I especially love my children. What is wrong with me?”
This is what can happen to you when you have some forms of postpartum depression. It is as though your mind is attacking you from the inside. Your moods go wacky and your thoughts are not what they would be under normal circumstances. It is important for you to understand that this is a biochemical response and should not be ignored, and it is not something to be ashamed of. It is not your fault if you become ill after childbirth. It is your choice whether you take it seriously enough to get help.
I was very stubborn and thought my problems would work themselves out. But one day I became so frightened that I called a local mental health hotline. The woman who answered referred me to an expert in dealing with postpartum depression. After listening to my story, she took a very firm line with me and made it clear that this was not something that would just go away by itself. She was emphatic when she told me that if I didn't seek help the condition could worsen and I could become a danger to myself or to my children. She said some people need medical intervention before they can get back on their feet. When I became more frightened of not seeking help I found my way to an excellent psychiatrist.
Some manifestations of postpartum depression can appear more severe than others—some women's experiences are harder to identify because they may be unmasked by other underlying, chronic conditions such as bipolar disorder (also known as manic depression—a condition that complicated my own PPD experience). The important thing to remember is that once you do have a preliminary diagnosis of possible postpartum depression, you need to take action.
Many women share the attitude I had at the time—I was resistant to admitting the need for psychological help, and strongly resistant to using medication. My doctor took me through the logical steps of treatment. He told me to wean the baby to see whether my hormones would right themselves on their own. (Of course, you know they didn't. I wasn't so lucky.) Next, he suggested mood-stabilizing medication—only to come up against my then strongly held rejection of drugs of any kind. But he was patient with me, and after he completed my medical and family medical history and made his preliminary diagnosis he said, “Deborah, you deserve this medication. If you were diabetic you would take insulin. You need this medicine to return you to balance.”
Even if your condition is mild and not chronic, any pervasive mood change after childbirth should be taken seriously and a mental health professional, preferably a psychiatrist familiar with this highly misunderstood disorder, should be consulted.
I responded so well and so thoroughly to the medical intervention that I was spared what could have been years of poor mental health. Even more important, my children were spared the loss of a mother due to a chronic mental disorder, or worse.
After six years in remission I conducted a writer's workshop and recognized on the roster the name of the woman who had so firmly guided me through the mental health hot line. At the end of the workshop I told the story of my foray into manic depressive disorder and told her how much she was responsible for my stable and happy life. There wasn't a dry eye in the room.
Postpartum depression comes in many forms. If you are suffering from a full-blown, chronic case, you may require medical intervention. If so, it is important that you stick with your treatment. If you are fortunate enough to have the more common form of postpartum depression, your condition will right itself over time.
It is likely that if your condition is severe enough to require intervention, you will need some kind of drug therapy. And the available medications can bring about dramatic improvements quickly. But do not become cocky and go off your medication when you start to feel better. Follow your doctor's advice on dosages and duration of treatment. For some women, drug intervention is only a temporary necessity. But for people like me, who have a more serious underlying biochemical disorder, the treatment may need to be ongoing. If you go off your medication without a doctor's supervision you may have a relapse.
There is no blood test, at least as yet, to determine whether a person is manic-depressive, has postpartum depression, or a myriad of other mental health issues. The diagnosis is done through taking a history, through observation, and through a knowledgeable and calculated trial-and-error process with appropriate medication. This means, unfortunately, that what works once may not work again as effectively if you have a relapse.
Not long ago, postpartum depression was largely unrecognized as a legitimate medical condition—it was called the “baby blues” and dismissed as just another of many typical female problems. So research into the condition was rarely done. It is known that PPD, like manic depression, may have a genetic origin, and that it can be (but is not necessarily) triggered by sustained stress in one's life. And we do have enough information now to be good consumers of mental health resources, which can bring relief.
Sometimes the circumstances of your life around the time of childbirth can make you more prone to crossing the line into the realm of postpartum depression. It is biochemical in origin, but the impact of stress on our biochemistry has long been recognized. You can take steps to minimize your risk before PPD strikes by making your home environment as supportive and positive as possible. Make sure you can take care of your needs.
You need to learn how to take care of you. This may seem to go against your mothering instincts to care for your children first, but think about it. When you fly with small children in an airplane, the flight attendants tell you to put on your oxygen mask before you put one on your child, in the event of a midair disaster. Why? Because you have to be safe and healthy before you can truly help your child. It's not selfishness to see to your own needs—it's just good mothering.
Your children depend on you to be as healthy and strong as you can be so you can be there to guide them through their lives—not to sacrifice yourself. So do not be self-sacrificial. Be self-validating. Look at the circumstances of your life and do whatever you can to make your life good and conducive to your continued confidence and mental health.
Excerpted from The Complete Idiot's Guide to Motherhood © 1999 by Deborah Levine Herman. All rights reserved including the right of reproduction in whole or in part in any form. Used by arrangement with Alpha Books, a member of Penguin Group (USA) Inc.
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