Overcoming Postpartum Depression

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This week on the podcast, I joined with Dr. Pereau to talk about postpartum depression, both from a personal level and as those who treat it in our patients.

Dr. Pereau is incredibly honest and vulnerable in this emotional episode as she shares her story. Throughout it, she talks about the symptoms of her postpartum depression, including:

Intrusive thoughts
Emotional disconnection from her baby
Sleep deprivation
Hopelessness
Problems with concentration
Disconnection from passion and joy
Panic attacks and anxiety
Poor self care

It had never occurred to Dr. Pereau that she would struggle with postpartum depression, though she had treated many people with it, and could easily recognize symptoms in others. Often, when we are experiencing these kinds of things, it's hard to identify the symptoms within ourselves. We understand the need for someone with a recognizable disorder, such as bipolar or schizophrenia, to get help. But depression can be a slippery, indefinable problem when it comes to labeling ourselves.

If you are dealing with postpartum depression, know that it can be treated, and there absolutely hope to work through it. Here are some things that can help:

Breastfeeding to stimulate connection and positive hormone production
SSRI treatment (medications prescribed by a doctor)
Talk therapy
A good support system

If you've been experiencing the symptoms we discuss in this podcast, there are plenty of resources, plenty of people who can help you during this time.

The Edinburgh Postnatal Depression Scale is a simple questionnaire that can tell you if you are experiencing postpartum depression.

For a list of local support groups in the region, www.postpartumprogress.com is a wonderful resource.

Postpartum Support International is another great resource for online support groups and educational materials. www.postpartum.org

2020 Mom is an online advocacy group for maternal mental health. It includes blogs, educational materials and legal support. www.2020mom.org

Below is a touching excerpt from her story:

"My mother always said that when I had a child, I would know true love in a way I could never conceptualize. It had been a very long path to finally getting the child, and when he finally came I felt nothing. Actually, I felt worse than nothing. For the first couple months, all I can remember is darkness. I felt alone to my core. I felt like I was drifting, disconnected and lost. In my mind, my life was over. It was forfeit. The child wasn't a beaming ray of sunshine, filling me with hope and life and love. When I looked at him I felt nothing. The guilt of this overwhelmed me.

I found myself wrestling through the options, fantasizing about packing a bag and running away in the middle of the night, or giving the baby up for adoption, or crashing my car off the edge of the mountain on my way home from work, or throwing myself off our cabin's third floor balcony. The images whirled through my mind and I would clench my teeth and force them away. It was all so dark. I didn't want him. I didn't want my life. I believed I knew these things for certain. I believed these were my thoughts.

I mentioned to my husband Bryan about having a dream where I jumped off the balcony, but then I quickly minimized it. I filled out the Edinburgh Scale in the OBGYN office with just enough depression items to be flagged but not enough to get hospitalized. We use the term, "A cry for help," and generally refer to something gamey or indicative of less severe illness. I can see how it looks that way. But I now know without any doubt what a cry for help really is. It was the weak, thready voice of the last piece of me left in my mind, the last flicker of light not darkened by postpartum depression. It was the last bit of me that was not pinned down under the weight of illness. Those weak cries were the best I was capable of. The illness was too great. My mind did not belong to me. My thoughts did not belong to me. I just didn't realize it.

As a society, we believe that depression is something that can be willed away if a person is strong enough. If they just try hard enough. And yet nobody tells a schizophrenic to just try to not hallucinate. We don't tell a person with bipolar disorder to just try to not cash out their retirement to finish that half built bomb shelter in their back yard they've been building the last few weeks. Even conditions like alcoholism have been embraced within a medical model. We don't tell the alcoholic to just try to stop drinking anymore. We recognize this to be a medical illness deserving of care and treatment. And yet we tell the depressed person to try to be positive. Try to be happy. And I think I know why. As humans on the planet, each of us suffer, faces grief, loss, and even hopelessness. And we find ways to survive, often becoming stronger because of it. We assume our experiences with emotional pain are similar to what a person with depression goes through. I know I thought that, and I've faced considerable loss throughout my life.

Unfortunately, depression isn't anything like that. It's disease. It's organic. It's neuro chemical. It is an illness where your very thoughts become twisted and distorted, your perception of the world around you becomes altered. You lose who you are and generally have no idea that it's even happening. We have to stop assuming that depression is something like the subjective painful experiences we all encounter in life. It's a biological illness of the brain. In the past decade completed suicide rates in the United States have increased 20%, taking the lives of 121 people a day. Attempting to will away depression cost me 11 months of my life, where each month that passed took me deeper into a hole I couldn't claw out of.

Postpartum depression affects the lives of over half a million women a year. It destroys families and severs the connection between a mother and child. It is a deadly disease which cannot be combatted through willpower. I believe a new approach is needed to proactively educate and better screen our patients. I don't begin to have all of the answers, but I can say that the culture around mental illness must change. There is no room for judgment. Maybe it starts with a simple, "I'm worried about you. I think you're hurting." Maybe it starts with spending the time to paint a clear biologic picture for the family surrounding a mother to heighten monitoring. All I know is that "holding it together" is no way to live, work, or raise a child.

I chose to accept help. I chose to take medications to treat postpartum depression, nearly a year later. Eleven months after my son was born, I remember a pivotal moment. It was 3 in the morning and he had just fallen back to sleep, there in my arms. As I looked down at his beautiful face, there in the darkness, I whispered to him, "I would choose you." It was like it was the first time I had ever seen him. The Joy that normally present in my everyday life came back. My thoughts became my own again, no longer twisted and distorted. I have firsthand knowledge of what it looks like to be overcome by an illness of brain, of the mind. It's chemical. It's biological. And it's one of the most terrifying illnesses I can imagine. And help exists. I know Sharing this helps to dispel shame, despite this being...a bit overwhelming. But it's seriously about life and death, and if hearing my story helps you to better understand what 1 in 7 women who have had a child is experiencing, then this is worth it to me."

By listening to this episode, you can earn 0.75 Psychiatry CME Credits.

Link to blog.

Link to YouTube video.

Postpartum Depression with Dr. Pereau

Psychiatry & Psychotherapy Podcast