PPD

Is It Postpartum Depression or Bipolar Disorder? An Expert Weighs In

By Katherine Stone April 30, 2012 15 Comments

A small segment of my readers who were initially diagnosed with postpartum depression have learned down the road that they have bipolar disorder. Other readers who have been treated for a year or more for postpartum depression but feel the treatment isn’t working have also inquired whether it may be that they were misdiagnosed with PPD and could actually have bipolar disorder. I reached out to perinatal mood and anxiety expert Karen Kleiman, MSW, LCSW, to help shed some light on the differences between postpartum depression and bipolar disorder:

I’m sharing this information for both postpartum moms and clinicians in response to Katherine, who reached out to me because she’s received a number of inquiries about the relationship between postpartum depression and bipolar illness. I’m hoping this can offer some clarification.

To date, research on bipolar disorder and postpartum depression and related illnesses typically focuses on bipolar I and psychosis. According to the research, bipolar depression is often misdiagnosed as major depressive disorder during the postpartum period. [Editor's note: for the readers, major depressive disorder during the postpartum period is a diagnostic term for what you know as postpartum depression.] What does this mean? For one thing, it certainly can delay appropriate treatment. [Read more...]

April 30, 2012 9:30 am Filed Under: Bipolar Disorder, Postpartum Depression

Ongoing Maternal Depression Can Lead To Later Child Behavior Problems

By Katherine Stone April 25, 2012 8 Comments

There’s a new study published in Maternal & Child Health‘s March 2012 issue about the impact of maternal depression on the health of children. What interests me about the study is that it seems to indicate, to me anyway, that moms who get treated for postpartum depression have less to worry about than moms who don’t. If a mom who has PPD goes untreated (as 85% of them do), and her postpartum depression morphs into ongoing chronic depression, her child has a greater risk of chronic behavioral problems as he or she gets older. Here’s the abstract of the study: [Read more...]

April 25, 2012 11:36 am Filed Under: News, Postpartum Depression Research

Seeking Help for Postpartum Depression: A Nurse Practitioner Saved My Life

By Katherine Stone March 27, 2012

Another in our open letter series to doctors. This OB told our letter writer that her postpartum depression symptoms were just part of being a new mom.

I received a call two weeks postpartum from the lactation consultant within my OB practice. I immediately broke down on the phone and told her I was not doing well. She dismissed it as “baby blues” and said, “It’s hormones and it will get better.”

At my 6-week postpartum checkup, I was worse. I complained of severe fatigue yet difficulty sleeping and excessive worrying about the baby. My obstetrician’s response? “That’s part of being a new mom.”

Things continued to get still worse for me. My severe fatigue continued, as well as poor sleep which eventually led to feelings of severe anxiety even though there was nothing to be anxious about. I started losing weight, and at about seven months postpartum I was down to 105 pounds. My resting heart rate was 97 beats per minute. Someone suggested an EEG. I completed that and it showed normal heart rhythms but an unusually high heart rate. I went back to my OB and told him about all my persisting symptoms. He then gave me a choice: to go to a sleep clinic for a sleep study or make a referral to cardiology. I chose cardiology.

My appointment with cardiology led to an echocardiogram. This then led to a trans-esophogeal echocardiogram because they suspected a possible hole in my heart. They had to put me under for this. My heart was perfectly fine. I received a clean bill of health but unfortunately felt no better.

By this point I began to understand how some people commit suicide. I couldn’t imagine going through the rest of my life feeling this way. With this thought, I gave in and felt my last resort was to reach out on my own to have my mental health assessed.

Thankfully I followed my instinct. I couldn’t shake the feeling that this was all somehow connected to pregnancy and having a baby since I never had any of these issues prior to having my daughter. I was fortunate enough to find a nurse practitioner at another OB clinic in my town that specialized in women’s mental health. I made an appointment.

By this time, my daughter’s first birthday was just a month away. I had been suffering for months and months. I met with the nurse practitioner and within two visits she diagnosed me with postpartum depression and started me on medication paired with counseling. She warned me that I had gone so long being sick that it was going to take longer for my brain to rehabilitate and heal. After two months on medication and therapy I started to feel like myself again and I eventually got my life back. That nurse practitioner saved my life.

My daughter will be three years old in four months, and I’m ten weeks away from my due date with our second daughter. I have been off my meds the entire pregnancy and feeling great. I have since changed OBs to the same clinic where my nurse practitioner works. They have been wonderful and have addressed mood and proactive treatment with an antidepressant as soon as I deliver.

Postpartum depression is a serious illness, not something to be dismissed. I hope continued research and education leads to holistic care for all women postpartum.

~ Brooke M.

Photo credit: © rgbspace – Fotolia.com

March 27, 2012 9:12 am Filed Under: Postpartum Depression

Postpartum Depression Survivor Series, Day 5: Coming Together Around A New Baby

By Katherine Stone February 17, 2012

Seven women who had survived postpartum depression and anxiety all became pregnant around the same time and decided to support each other using social media and email as they navigated a pregnancy and childbirth after PPD. We have featured all seven this week in a special 5-part Postpartum Depression Survivor Series. Today is part 5, and shares a conversation the group had after one of the group members, Grace, delivered her baby boy.

Deborah: Welcome, readers, to a real-life conversation that our group had over the course of 24 hours when one of us delivered a baby boy last Fall …

Grace: Hi ladies. I just wanted to take a couple minutes to drop in. RM was born on Monday morning via scheduled cesarean. Two nights in the hospital – went well, I was feeling great! Yesterday we came home and had a wonderful afternoon and first night together as a family of four. Today at about 1pm is when I started to break down. I know it’s normal to be a puddle of tears, but of course I worry and fear what couldcome. I’ve been unable to stop crying for about three hours straight. So, please just keep us in your thoughts and prayers! Again, I know this is normal first week postpartum stuff. But still … Most of what I feel is grief — missing my one and only, worrying about what I’ve given up forever, grieving the loss of our family as it was, etc. Feeling overwhelmed, worried, and scared that I could lose it at any point. Anyway, here’s to a good night’s sleep and starting fresh in the morning!!!

Deborah: Congratulations! I’m thinking of you. Not sure where you are on the medication front, but I really believe that taking my medication made a huge difference for me with DG along with getting sleep. I know this is never an easy choice. Love to talk with you about it if that is ever helpful. Take care!

Amber: Amen to what Deborah said. I chose to give up breastfeeding (per my contingency plan, though such a difficult decision) and go on my meds when I had that hormone crash. In hindsight, I might have been able to combo-feed so I didn’t have to completely dry up, but I try not to live in hindsight. You will be okay… either way. If I chose to have a number three, the thing I would focus most on is balancing how much I could take during the “wait and see if this is just bad baby blues or postpartum depression and anxiety again” phase versus being proactive and pulling the trigger on full attack treatment for PPD. I think everyone has a different capacity and can move forward with a plan without regret at a different point. Praying for you … call me day or night.

Amy: So excited to get your email announcement! This time has got to be hard – the wondering. I will be keeping you in my prayers, that you would feel good, get the sleep you need and get to know your boys together. Blessings and hugs to you!

Suzanne: I’ve been thinking about you so much, Grace. Sending lots of good vibes. I stayed on my medication throughout pregnancy and postpartum. I had to increase my dose a few weeks after S arrived because I felt that familiar crashing. It worked. And I was able to continue breastfeeding (which I was ready to stop doing and nearly did almost every day). I think my self-awareness got me through. And I see that very same thing in you. And I promise (PROMISE) that the feelings of grief over your firstborn and your family of three, while intense, will go away. I was devastated. And now I can’t imagine our family any differently than it is right this very moment. Please keep in touch! Thank you for reaching out. That’s why we’re here.

Amber: I completely agree with Suzanne. I CANNOT imagine life without L2 for even a second. I literally just talked with Katherine about this very thing … that somehow, as crazy as it sounds, I actually love my first child more (not less) after having another. It’s like my heart doubled in size or something. Sure, managing #2 and giving #1 time to grow into having a sibling is challenging, but seeing the beautiful relationship blossom is amazing. And you may not, but even if you do have some PPD again it will never be like the first time because you are so well-armed. We are all here for you and have different perspectives and experiences to offer with the common goal of supporting each other. I am so glad you reached out. I hope we all will give ourselves and each other that continuing self-care.

Yuz: Congratulations – what lovely news!!!!!! I’m so happy for you. Sorry you’re feeling low at the moment, but hopefully this will pass and it will be what people call the ‘normal baby blues’. Whatever you decide to do with your meds, just an FYI that I stayed on meds throughout my pregnancy and am still on it. I was advised by many to ‘see how you go’, but I just didn’t want to take the chance. See how you go and do what you think is the right thing for you, but my advice is not to stop taking your meds if you’ve started them (or stayed on them during your pregnancy).

I totally get where you’re coming from going from a family of three to four. I felt completely guilty when I had to be admitted to hospital early and leave O at home for that. I felt as if I was choosing one child over another and I didn’t even know this other child yet! BUT and wait for it, you have just given your toddler the best gift ever. And watching your two kids get to know each other and begin to interact with each other is one of the most AMAZING moments in your life and a reminder as to why you went down the path again. And when your toddler kisses, cuddles or holds the baby’s hand, ahhhh, get ready for it my friend, it’s awesome.

For now, just take one day at a time. Getting used to having and caring for two kids is a massive adjustment. It’s not easy. Be kind to yourself and give yourself the space to go through your motions and emotions. Please stay in touch as these first few weeks are tough for anyone, not just us PPD mamas.

Grace: Thank you everyone -Your words have helped so much! I stayed on medication my whole pregnancy and will continue to. It’s nice knowing the option is there to increase if I feel I need to in coming weeks/months. Last Thursday was awful, but I managed to re-group and things have been better since. Positive self-talk is so important! Last night was rough – babe up for hours it seemed, I was bleary eyed and exhausted. This morning I felt despair briefly – but I know, I KNOW that tonight will be better. My three year old, is back at preschool today (we had a two-week vacation, city-wide) and my husband is back at work. Just me and R at home, which I was sort of dreading last week, but today I’m trying to embrace the beauty of it. Thank you for your support, I’ll keep checking in! Hope all are doing well. Happy Halloween grace

Grace: Update: things are going much better! I think my hormones have leveled out for the most part and the intense crying episodes have hopefully ended… I haven’t cried since Thursday

My parents are here now for two weeks and that has been a very helpful distraction!One thing that has been my saving grace is going to bed really early with R (usually between 7:30 and 8!). It helps me to get a longer stretch of sleep at the beginning of the night so that I don’t completely lose it by the wee morning when he tends to be more fussy and needy.It’s been freeing to just remain in the present, only focusing on one day at a time. Sounds simple but it’s been very important for me in just these short weeks. My anxiety is triggered when I over analyze and get too far ahead of myself, so I’m practicing shutting off those thoughts and just staying present. How is everyone else doing? Thank you all for the support, advice, kind words, it all helps sooo much!

Amber: Thanks Deborah for organizing this last of our week-long posts and to all of you for sharing your experiences so publicly. I know that it will help others so much to better understand how having a baby after experiencing a PMAD is not only possible, but that often the experience can be better than you imagined. I also hope that the unique aspects of our experiences and plans, as well as effective treatments will speak to moms and let them know that while there is not one magic fix to these awful disorders that they are treatable, knowing that we all fully recovered and found lots of self-awareness and gratification in that process.

Thanks, also to Katherine to allowing us to share our stories at Postpartum Progress, a source of reliable information and support for each of us, and therefore a special “place” for us. And, most of all, thanks to all of you Survivor Mamas for reading. Best wishes for a future filled with promise and peace.

Editor’s note: I have so much gratitude for Amber, Grace, Suzanne, Kate, Amy, Deborah and Yuz for sharing their experiences and wisdom here all week. Way to go Warrior Moms! I hope you have enjoyed this series as much as I have! ~ Katherine

February 17, 2012 9:15 am Filed Under: Postpartum Depression

Postpartum Survivor Series Day 4: What Happened After The Next Baby

By Katherine Stone February 16, 2012

Postpartum depression survivor series day four focuses in on when our seven Warrior Moms made the decision to have another child and what that experience was like …

Amber: Today, I invite you all to share with readers about your experience with pregnancy, adoption or trying to conceive or adopt after postpartum depression.Suzanne: With my second baby, I developed antenatal depression, which, believe it or not, surprised me. My first pregnancy was wonderful. My second one was awful. I was sick the entire time and became so depressed by the five month mark that I decided to get help. I started on a new medication that I was told was safe for pregnancy (I had stopped my other medication for the first trimester), and I was able to keep taking it — and safely breastfeed — during the postpartum period.

Grace: We were so terrified of having another baby. It took probably six months to convince my husband that we could do it. I know he agreed for my sake – we both knew that having another child was crucial to my full healing. I said to my husband the other day that our first son made us parents & our second son healed us.

We made the decision together that I would stay on my antidepressant throughout my pregnancy and postpartum period. My pregnancy was completely uneventful, which I am so very thankful for. I am a ceasarean mom, and we decided to go for a repeat cesarean so as not to trigger any anxiety. It was the right decision for us. [Read more...]

February 16, 2012 9:10 am Filed Under: Postpartum Depression

Postpartum Depression Survivor Series Day Three: The Husbands

By Katherine Stone February 15, 2012

And now day three of our special postpartum depression survivor series on having more children …

Amber: Let’s talk about our families today. What was the birth order of your “postpartum depression baby”? For me, I was a first-time mom so I had no idea what to expect physically, emotionally or practically … nothing to compare it to. I kept asking myself, “is this NORMAL???” If you are married or partnered, what about your spouse/significant other? How did it affect them? How can one be helpful in the midst of postpartum depression?

Suzanne: I also suffered with my first baby. The most challenging thing during that time with my spouse was the tremendous burden he had to bear. On most days, he’d be in one room trying to console our screaming baby while I was in the other room sobbing. Neither of us knew what was wrong with me. I don’t think he fully understood my condition until I felt better and was able to function more normally. We were in survival mode for those first few months; it redefined our relationship and made us stronger.

Deborah: I also experienced a perinatal mood disorder after my first. My husband never acted like I did something wrong in terms of causing my postpartum OCD and really embraced this as the disease it is, requiring all sorts of treatments, from medicine to therapy to sleep. This gaze on me and my disease in the middle of my crisis was a godsend in terms of not adding to my stress.

Yuz: Like both of you, I too fell ill after my first baby. I felt so much confusion and anger – I had no confidence as a mother or with my daughter. I felt like a fraud. I felt like a failure as a mother. I felt as if I had failed her. I felt as if I had ‘ruined’ her emotionally due to our lack of bond and, sadly, because I often regretted having her at all. I wanted to have her adopted out. I felt ashamed for feeling everything I felt and for everything I thought. I just didn’t want to have to admit this to anyone that wouldn’t understand why I was thinking and feeling all these things, and frankly I didn’t see the point in telling them as I couldn’t see how it could have helped me or made the situation better in any way. [Read more...]

February 15, 2012 9:30 am Filed Under: Help for Fathers, Postpartum Depression

Postpartum Depression Survivor Series: Day Two

By Katherine Stone February 14, 2012

Welcome to day two of our postpartum depression survivor series on having more children …

Amber: Our little group was formed because we are all Warrior Moms. What form of perinatal mood or anxiety disorder did you suffer from and what were your symptoms?

Deborah: I suffered from postpartum OCD, which took the form of intrusive thoughts that involved images of harming my baby. It started out with racing thoughts a few days after my son was born, consisting of all the horrible things that I could potentially do to harm my newborn baby and quickly descended into a never ending loop of images that I could harm him. Scary scenes from movies I had seen decades ago would also race through my mind. I was in one big playback loop of fear and there was a tangible, biological response happening in my whole body, which I think was some sort of panic attack.

Yuz: I thought I had my bases covered in anticipation for postpartum depression while I was pregnant. I have a history of depression and anxiety and started seeing a psychiatrist specializing in mother and baby attachment in case I needed it following the birth. [Read more...]

February 14, 2012 9:30 am Filed Under: Postpartum Anxiety, Postpartum Depression

7 Postpartum Depression Survivors Share Their Stories Of Having More Children

By Katherine Stone February 13, 2012

This week we’re doing a special five-part series featuring seven mothers who survived postpartum depression or a related illness and went on to have more children. The series was put together by Amber Koter-Puline, and will feature input from these mothers on their experiences. I know you’re going to love this:

Welcome to our world. The world of survivors of perinatal mood and anxiety disorders, like postpartum depression, who have decided to have more children. Some of us are well down the path with those additions, and others are waiting. You’ll learn more about that later. For now, I invite you to sit back, relax, maybe even grab a cup of tea and meet the women who changed my life…

Amy Brannan
http://www.livinglifejoyously.blogspot.com/Amy has a four-and-a-half-year-old daughter and is working on adopting the next. She and her husband have been married for five years and live in Washington State.Here’s Amy, in her words:
I never had any symptoms until my daughter was five months old. I went to numerous doctors because I knew something was “off” but no one mentioned postpartum depression ever and that is the hardest thing for me to still accept. I finally started doing my own research and found a website about PPD – I had every symptom listed. My husband and I went to my doctor and I was finally diagnosed with postpartum depression and anxiety with OCD tendencies in 2008. I started counseling and medication when my baby was ten months old – this continued for 2.5 years. In late 2010, I wasn’t getting better or at least felt like I was stuck, like I was almost over the last hurdle. I was encouraged to start seeing a psychiatrist and she helped tremendously.I also began to diligently start seeking out women who have/had postpartum depression which was when I found PPD blogs and finally started seeing the light at the end of the tunnel so to speak. Facebook, PPDChat and this group of survivor moms saved my life and my sanity and allowed me to accept what is now my testimony in hopes to help others. I also started my own PPD survivor’s blog, to start writing as a way of healing for me. I still battle anxiety and depression that was brought on by the PPD but it is no longer PPD. We have chosen to not get pregnant again because of the severity of my postpartum depression so we are on the waiting list of adopting our next baby! That in itself was the hardest decision to make – choosing not to become pregnant again and feeling like I was broken, no good, choosing second best and a failure.I’d like to assure women that everyone will have a different journey and every woman will have different symptoms. I’d like to encourage women that they are not damaged or different, that they are not failures as moms or wives. Guilt can be a very damaging aspect of PPD – I am proof of that. I’d like to share some thoughts on choosing “not” to become pregnant after PPD again and how women make that decision. I really needed to read about that and I found very little last year when I was struggling the most over this.

I hope to be able to reach women like me who found help when they thought they had reached the end. Women who don’t know what is wrong with them and feel alone. I want to offer support and encouragement to their families, especially their husbands. I would not have made it if it weren’t for my incredible husband and his support and love.

Deborah Rimmler
Deborah is a married mom to two boys.

Meet Deborah:
In this series, I would like to share what we as a group and individually found that worked to help create a new postpartum experience for us and our families. I hope we’ll reach any moms thinking of having a baby after postpartum. Kind of like those who have successfully had a vaginal birth after c-section or VBAC. We are the “BAPPD” (Baby After PPD) survivors with a positive message. [Read more...]

February 13, 2012 9:33 am Filed Under: Postpartum Depression

Winter Blues: What You Need To Know About Seasonal Affective Disorder And PPD

By Kate Kripke January 27, 2012

On seasonal affective disorder, what the symptoms of SAD are, and how it may impact moms with postpartum depression …

It has taken me a while to get this post to all of you. Each time that I have tried to sit down and put thought and experience onto paper, I have felt stumped by lacking creativity. Perhaps it is the transition back from the holidays, I have wondered. Or the demands of a developing tw0-and-a-half-year-old. Or a busy practice and paperwork on my desk. Or the driving desire to get out of my office and release some steam outside only to be reminded that it is wet and gray and too cold out there for my running preference.

Or, as Katherine reminded me, it might just be that it is the middle of winter.

Winter. It can be a tough time for all of us. The days get shorter and colder, the weather often chaotic, the roads sometimes dangerous, the gas bills go up. Fresh fruits and vegetables can be harder to find and usually become more expensive in these long months. Runny noses abound and the flu seems to be around every corner. The air gets drier, our skin cracks, and we often are not drinking enough water. Children tend to go stir crazy when the playtime outdoors is limited. And, if we do attempt to get those little ones outside, the efforts at managing struggling kiddos into appropriate layers can feel for naught when red-cheeked toddlers decide that they are cold and wet after only a few minutes of play.

Winter tends to be a time when our neighbors are rarely seen, when communities are harder to access, and when we find ourselves spending more time at home. We tend to loose our patience more. We tend to have a harder time concentrating. We often have less energy. We feel less creative. We might, even, suffer from a bit of Seasonal Affective Disorder. [Read more...]

January 27, 2012 5:18 pm Filed Under: Postpartum Depression

I’m Not A Bad Mom Because I Had Postpartum Depression

By Katherine Stone October 26, 2011

Uh what!?! Why in the world would anyone think they’re a bad mom because of a real and true illness like postpartum depression?

Unfortunately when you’re trudging through the midst of it, you may not even know you need medical attention. Inside of the illness “feeling” like a bad mom is very commonplace. And that guilt and shame can keep you from reaching out.I know I felt like a bad mom, and at the time for what felt like very good reasons.Most days I was so overwhelmed parenting two children. I was endlessly on the defense protecting my newborn daughter from my terribly jealous 2-year-old son. I watched helplessly as he destroyed the living room as I nursed her, the dog barking all the while.

It felt like a nightmare and I just wanted to wake up. I wanted to run away, fly right out of the front door screaming. What. Did. I. Do?

There were days when anger flared so quickly my fist would hit the floor hard just to release some of the rage. Days when all I could bring myself to do was stay in bed. When the stress built up so intolerably high that I would be physically, as well as mentally ill. My husband forced to stay home from work, again. When all I could do was ask myself through tears, why can’t I handle this?

I can NOW say with no guilt and no shame…

[Read more...]