This is the second post in my series about PPD. The first part can be found here.
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You think you might have PPD. What do you do about it? One of my husband’s favorite sayings to whip out when I’ve screwed up and am apologizing to him is, “Don’t apologize. Fix it.” That’s exactly the mentality you need when it comes to “fixing” your PPD. Don’t just sit there; do something about it.
Your plan should, first and foremost, include TELLING SOMEONE. This is where I tell you to do as I say, not as I did. I was embarrassed of the feelings I was having. I thought it meant that I didn’t love my son(s). I thought it meant that I was a horrible mother. I though it meant that my kid(s) would be better off without me around. So I just kept everything inside. Sure, there were times when people could tell something was going on, but no one – and I mean NO ONE – knew the full extent of my depression. I didn’t tell my friends, I didn’t tell my husband, I didn't tell my mom, I didn’t tell my doctor, and, when I eventually began seeing one, I didn’t tell my counselor. As the too-sweet-for-words Ree says, don’t be like me.
Step two is getting treatment. This can include talk therapy and medications. As the situational aspects of having a newborn can exacerbate depression symptoms, I think seeing a counselor is a wonderful idea. You need to be able to work through the feelings that don’t seem to fit with the societal representation of the blissful new mommy. My counselor has been, and continues to be, a wonderful support and resource for me. Appointments with her also provide a lovely, child-free hour filled with adult conversation once a week. It doesn’t get much better than that.
If you’re worried about taking medicine while pregnant and/or nursing, don’t be. There is a whole host of antidepressants that are safe for your baby. This is particularly true for nursing moms. Your body does a fantastic job of filtering most of the junk in your body out of your milk before it is expressed. The amounts of medication that remain in breast milk are miniscule, and the half-lives of the antidepressants used for nursing moms are so short that there isn’t much concern about the medication building up in the baby’s system to unsafe levels. Of course, as with every medicine out there, there are some potential side effects, and you need to discuss the risks and benefits with your doctor before making a decision. I personally am getting to the point where I believe that a healthy, happy mom is critical for a healthy, happy baby. If it takes a (legal, medically prescribed) drug to get you there, so be it. Your kid will turn out just fine.
The issue of what doctor to see for treatment is a big one. Generally, PPD treatment starts with your OB. This is fine. I’m sure he or she has seen enough cases of PPD to be competent and confident enough to prescribe a low-dose, fetus- and/or nursling-safe antidepressant and refer you to therapy. The same is likely true of most family doctors. When you get to the point of needing multiple dosage increases or need to switch medications, however, I suggest finding a psychiatrist. I stuck with my OB through two dosage increases, then went to my family doctor for a third dosage increase (because I was too far post-partum for my OB to do it). Then, my family doc started making medication changes. He added one. Then increased my dosage on one. Then took me off one and put me on another. Then took me off another and put me on a third. Then took me off of a third and put me on a fourth. Then I had a medication-induced bout of crazy.
I want to be clear that I don’t blame my family doctor for anything that happened. His reasons for switching stuff up made sense to me (and to everyone I’ve talked to about it), but I had gotten out of his zone of familiarity, I think, and probably should have gone to a psychiatrist before Crazypalooza ’11 ever happened. My completely unprofessional opinion is that an OB or family doctor is fine for one medication and one or two dosage increases. For anything beyond that, go see someone who specializes in dealing with mental disorders and medications.
Coming up - Part III: Post-diagnosis
* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * *
You think you might have PPD. What do you do about it? One of my husband’s favorite sayings to whip out when I’ve screwed up and am apologizing to him is, “Don’t apologize. Fix it.” That’s exactly the mentality you need when it comes to “fixing” your PPD. Don’t just sit there; do something about it.
Your plan should, first and foremost, include TELLING SOMEONE. This is where I tell you to do as I say, not as I did. I was embarrassed of the feelings I was having. I thought it meant that I didn’t love my son(s). I thought it meant that I was a horrible mother. I though it meant that my kid(s) would be better off without me around. So I just kept everything inside. Sure, there were times when people could tell something was going on, but no one – and I mean NO ONE – knew the full extent of my depression. I didn’t tell my friends, I didn’t tell my husband, I didn't tell my mom, I didn’t tell my doctor, and, when I eventually began seeing one, I didn’t tell my counselor. As the too-sweet-for-words Ree says, don’t be like me.
Step two is getting treatment. This can include talk therapy and medications. As the situational aspects of having a newborn can exacerbate depression symptoms, I think seeing a counselor is a wonderful idea. You need to be able to work through the feelings that don’t seem to fit with the societal representation of the blissful new mommy. My counselor has been, and continues to be, a wonderful support and resource for me. Appointments with her also provide a lovely, child-free hour filled with adult conversation once a week. It doesn’t get much better than that.
If you’re worried about taking medicine while pregnant and/or nursing, don’t be. There is a whole host of antidepressants that are safe for your baby. This is particularly true for nursing moms. Your body does a fantastic job of filtering most of the junk in your body out of your milk before it is expressed. The amounts of medication that remain in breast milk are miniscule, and the half-lives of the antidepressants used for nursing moms are so short that there isn’t much concern about the medication building up in the baby’s system to unsafe levels. Of course, as with every medicine out there, there are some potential side effects, and you need to discuss the risks and benefits with your doctor before making a decision. I personally am getting to the point where I believe that a healthy, happy mom is critical for a healthy, happy baby. If it takes a (legal, medically prescribed) drug to get you there, so be it. Your kid will turn out just fine.
The issue of what doctor to see for treatment is a big one. Generally, PPD treatment starts with your OB. This is fine. I’m sure he or she has seen enough cases of PPD to be competent and confident enough to prescribe a low-dose, fetus- and/or nursling-safe antidepressant and refer you to therapy. The same is likely true of most family doctors. When you get to the point of needing multiple dosage increases or need to switch medications, however, I suggest finding a psychiatrist. I stuck with my OB through two dosage increases, then went to my family doctor for a third dosage increase (because I was too far post-partum for my OB to do it). Then, my family doc started making medication changes. He added one. Then increased my dosage on one. Then took me off one and put me on another. Then took me off another and put me on a third. Then took me off of a third and put me on a fourth. Then I had a medication-induced bout of crazy.
I want to be clear that I don’t blame my family doctor for anything that happened. His reasons for switching stuff up made sense to me (and to everyone I’ve talked to about it), but I had gotten out of his zone of familiarity, I think, and probably should have gone to a psychiatrist before Crazypalooza ’11 ever happened. My completely unprofessional opinion is that an OB or family doctor is fine for one medication and one or two dosage increases. For anything beyond that, go see someone who specializes in dealing with mental disorders and medications.
Coming up - Part III: Post-diagnosis
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