At 39 years old, Pam is the mother of a two year-old and a one year-old, and is expecting her third child in five months. Among the many adjustments motherhood has brought to her life, living with postpartum depression was one she wasn't expecting. What she thought was normal "baby blues," turned into weeks of social withdrawal, emotional chaos, and constant physical fatigue.
What was your first sign that something was wrong? What symptoms did you experience?
I was constantly tired and I cried a lot. At first I thought it was just the "baby blues," but it didn't go away. There were many times I had feelings that the baby wasn't mine. I was nursing him and taking care of him, but felt like someone else would be coming later to pick him up.
He was kind of colicky, so he cried a lot, and I didn't know why. Friends would say, "When he goes down, you go down," but I would lie there and worry about when he would start crying again. I was never able to relax. My mind was always worried about what I needed to be doing for him. I couldn't accomplish anything. I felt paralyzed. When people would give me advice, I would wonder, "Why didn't I think of that?" I would feel fine as long as I was talking to people on the phone, but as soon as I hung up, I would start feeling the anxiety. The panicked feeling would come back.
There were so many times I just wanted to run away. I had those feelings from the beginning, but they just kept getting worse. My husband would wonder why I wasn't getting anything done. He would come home, and I would be wearing the same thing I had slept in. I had problems keeping myself healthy. The baby confused me. It was a scary place to be. Paralyzed is the best way to describe how I felt. I would have good days, then I would have really, really bad days. When I would have a good day, I would think, maybe these bad feelings will go away, but then the next day I would crash.
What was the diagnosis experience like?
My husband was encouraging me to get out. Sometimes we would all three go places just to get out of the house. One day we went to the library. While I was at the computer looking for a book, he had taken the baby to another part of the library. As soon as I heard the baby cry, I literally panicked. When my husband saw my reaction, he said, "This is not normal."
The next week, my son was scheduled for a regular check-up with our family doctor. When the doctor asked me how I was doing, I started crying uncontrollably. He said he could help me, but I just kept making up excuses for why I was so depressed. When I got home that day, I started thinking more seriously about what he said. It was two days later that I told my husband "I think I need help." I was having more of the feelings that this was not my baby. I called the doctor the next day, but they said it would be a week before he could see me. I remember thinking, "I wonder if I can make it that long."
When I went in for the appointment, they gave me a questionnaire to see if I qualified as having postpartum depression. I pretty much had experienced every symptom on the questionnaire. I told him I didn't think I was that bad, but I couldn't handle being the way I was. I was afraid of feeling worse. He recommended I see a psychiatrist.
After an evaluation from the psychiatrist, she recommended I go on medication. However, I wanted to avoid medication if possible since I was nursing. I continued to see her once a week for therapy. After the third week, I was home and I bottomed out. I called her and told her I couldn't do it any more. She immediately asked, "Where is the baby?" I told her he was taking a nap, but if he started to cry, I didn't want to go in his room. She told me to call my husband and have him bring me to the hospital. She called ahead to have someone there to evaluate me.
At the hospital, they felt that the outpatient treatment would be sufficient. Beginning the next day, I was to go to the hospital for a program that lasted six hours a day. She also put me on 10 milligrams of Prozac for the first five days. They watched me closely to see how I was reacting to the medication. I was in group sessions with other moms who were really bad, and some who weren't so bad. I was able to talk about all the feelings and thoughts I was having. I was also meeting with a psychiatrist individually. I noticed a huge difference in just three days. For the first time, I could look in the mirror and recognize who I was.
When I started feeling better, I was able to remember feelings I had before. Like when I was driving, it was like I was driving for the first time. Before, I would grip the steering wheel so tight my knuckles would hurt. And when the baby started crying, I would panic, wondering what I should do. The medication helped bring my thoughts back to where they used to be.
What was your initial and then longer-term reaction to the diagnosis?
When the doctors mentioned postpartum depression, I denied it. I kept thinking that the reason I was feeling so bad was because I was tired. When I realized they were right, I started talking to a friend who also had it, but never got treated. I asked her how long it took her to get over it without treatment, and she said two years. That is probably what pushed me to finally get treatment. I knew I couldn't put myself or my husband and baby through this for that long. It wasn't who I was. I couldn't live with myself, and I couldn't ask them to live with me either.
How do you manage postpartum depression?
They started me on 10 milligrams of Prozac a day. After five days, I went to 20 milligrams a day for four months. I was seeing a psychiatrist on a weekly basis, so she was monitoring me closely. After four months, I went down to 10 milligrams, then was completely off of the medication after six months. At that time, I stopped seeing the psychiatrist, but was told I could call her at any time if I had any problems.
Did you make any lifestyle or dietary changes in response to postpartum depression?
I craved sugar, but I had read that sugar is one of the worst things for you when you're depressed. So I tried to completely delete it from my diet. Because I was nursing, I was already eating a healthy diet. When I started feeling better, I started exercising. But when I was depressed, it was the last thing I wanted to do. I did a lot of stretching. As far as my lifestyle, I really had to find a routine and stick with it. My life was easier to follow when I was on a routine, and I felt better about what I accomplished. As I started feeling better, I was able to gradually go away from my routine.
Did you seek any type of emotional support?
I had a great friend who went through the same thing. She really encouraged me to get help, and checked up on me to see how I was doing. It was nice to have someone who understood. It helped me to not feel so alone.
Does postpartum depression have an impact on your family?
It was especially hard on my husband, because he likes flexibility. However, he was supportive in taking care of the kids, so I could get some rest. Sometimes, he would watch the kids so I could get away for a while and shop. This helped me to feel better about myself. As far as the kids go, I think they benefited by being on a routine.
What advice would you give to anyone living with postpartum depression?
One of the most important things is to not let it go too long. Let someone help you. Get all the help you need. Many people are quick to go on the medication, but they don't get the therapy. The therapy is really important because you learn coping skills. Also, you have to take care of yourself so you can take care of your family.
Interviews were conducted in the past and may not reflect current standards and practices in medicine. Talk to your doctor to learn more about how this condition is diagnosed and managed today and what treatment approaches are right for you.