I asked the following question at the Postpartum Progress Facebook Fan Page last week:
How many of you, looking back, feel like you suffered longer from postpartum depression than necessary because you were afraid to take medication for your illness?
I asked because we all know there is enormous stigma around taking psychiatric medication. There are so many questions: Do we need medication? Why should we need it? Shouldn’t we be able to be happy or content all on our own? Does it really work? Why don’t we understand how it works? What about the side effects? What about the people who say it doesn’t work at all, except maybe for the placebo effect? What about the people who say it’s just big pharma trying to convince us to take their drugs? What about the docs who overprescribe? What if it doesn’t work for me anyway? Will it harm my baby?
Those are all VERY legitimate questions. Really. So, given how many questions there are, I wondered how many people avoid getting treatment for postpartum depression altogether because of those questions and fears. Here are some of their responses I received on Facebook (you can see them all, and who said them, here):
“I didn’t want to take medication after the birth of my first child, mostly because I didn’t want to have to admit to anyone the thoughts I was having. Well after she was born, I learned more about intrusive thoughts and how common they are, and so the second time around, I didn’t fear talking about it with my doctor and asking for medication. It’s been a lifesaver.”
“Me. 1000%. Because I didn’t take the disease seriously enough.”
“I suffered from postpartum depression and anxiety with all 4 of my children. I did not get a diagnosis or treatment until after my 3rd. Looking back, I do not think I recovered at all between my 1st and 2nd and up until I had my 3rd. It is just one blur of never-ending sadness, anxiety and overwhelming fear. As a result of waiting so long to get treatment, it took me a lot longer to find a medication and dosage that worked and I was on it for a lot longer than I would have been if I had gotten treatment sooner. As a professional perinatal social worker, I now tell any woman suffering to seek help immediately. Why punish yourself for a disease you have no control over? You would not expect a diabetic to just “grin and bear it” to keep their blood sugar stable. Why would we expect ourselves to be able to do the same thing with another unseen illness?”
“I waited too long, 13 months! The thought of not breastfeeding and thinking I would just get better on my own plus I thought they would take away my baby stopped me. I’m glad I got the help I needed!”
“I suffered much longer than necessary. I kept telling myself that the postpartum depression/anxiety would just go away … and instead it just kept getting worse. I still mourn the loss of the time I could have been enjoying my babies, and instead, I was a complete mess.”
“Not only did I wait 15 months to seek help, I denied myself relief for another 3 months because I believed in mind over matter, or in this case mind over meds! But within 4 days of taking meds, I felt so MUCH better!”
“I suffered postpartum depression for a year-and-a-half before I asked to be put on meds. There is such a stigma. I felt as though because I made the choice to have kids I should deal with it – even though I was drowning silently…”
“I waited until about 3+ months. Knew there was something wrong, but blamed the anxiety, feelings of being overwhelmed on my son’s colic & 1-month-long hospital stay/ICU experience when he was 2 months old. After he came home healthy, the severepanic attacks took over until I was barely functioning. Seven med trials, 2 psychiatrists, an ER visit, a hospital stay, & FINALLY I found someone who knew what PPD was & succesfully treated my full-blown panic disorder & severe depression. Meds are not an easy choice, nor is it any easier when your body violently rejects SSRI’s, but I kept fighting the fight not for myself but for my son. I had long given up on myself during that year. Combo of therapy, [meds], increased support, other women who related, my diet, exercise, supplements, accupuncture, etc. & I can finally say that there is light at the end. My PPD experience & the choices I was forced to make made me realize a raw, inner strength I never knew I possessed.”
“I tried medication about 5 months after having my son and I didn’t like how it made me feel so I didn’t take it and decided I felt better off of meds then on. I never made a follow up appointment with my Dr. like I was supposed to. I kept on going, trying to survive, pretending everything was ok. When my son was just over a year and my postpartum depression had run my life into the ground and ruined my relationship with my husband, I went back in to my Dr. and tried a different medication. It was like magic. I felt a difference almost immediately. I wish I would have gone back sooner and communicated with my Dr.”
These are just a few of the comments. There were moms who were afraid they’d become addicted. Moms who had bad side effects. Moms who had incorrect diagnoses. Moms for whom the first med didn’t work, or the second or the third. (FYI, I’m sure moms could say the same thing about their fear or anxiety around therapy if they’ve never done it before.)
I don’t share this with you to say that medication is your answer. It may or may not be. Maybe therapy is your answer. Maybe a combination of both is your answer. Maybe you have mild postpartum depression and need neither. Maybe you need something else. I share these women’s comments with you so that you’ll know how many others who’ve been in your shoes are/were scared too, but they opened themselves up for treatment anyway and are glad they did.
for me, it was the lack of treatment I received because I we unable to find resources in my area. I kept getting diagnosed as Bipolar which I already knew I had. But, I knew something else was wrong. I kept suggesting possible PPD and every time I was told by my doctor or should I sat doctors. Then I had a reaction that could have been fatal to the bipolar meds. I was taken off every thing immediately and within days I was in full blown PPP. I ended up in inpatient care which I needed for the safety of myself and others.
Once release I found an amazing doctor who acknowledged my illness and treated it as such. I did have a hard time taking the medicine because it was a realization that I had an illness and I was not the perfect mother I was thought to be by the media and every image I came across through out my life. It took me a long time to understand that I was not broken and not a bad mother or wife. I was a responsible mother even fantastic mother when I took those pills in the morning and at night. But that came with a lot of treatment and support.
I feel like there is so much pressure on women to be this image that is so unrealistic that it sets us up for failure and when we do fall we are embarrassed to receive help . By the time we do we are so deep that it becomes very hard for us to reach and pull ourselves out. We need support. We need for more people to be observant and educated. My hope is that one day the stigma of PPD,PPA,PPOCD and PPP will die out so that women are not afraid to receive help. Because when women do they take away the power of the illness and give power to themselves
sorry that should have read "kept suggesting possible PPD and every time I was told by my doctor or should I say doctors, that PPD was not real." ugh… autocorrect.
I definitely think that my fear of medication kept me from getting treatment for PPD earlier. I was not averse to medication in general (had been on SSRIs before), but I was 100% committed to breastfeeding my daughter for one full year and did not feel comfortable taking a medication when it wasn't known what the effect on her might be. Finally my therapist convinced me that I had choices: I could keep nursing and take a medication which was considered okay, I could stop nursing and take meds, or I could keep nursing, take no meds, and continue to get worse. I chose option #1 and have never regretted it.
I will admit that I am one of those people that used to stigmatize psychiatric medication.
That being said, postpartum OCD shook me so badly and so completely that I was willing to try anything that I needed to. My doctor started me on a hormone patch first but within a week I was on an SSRI. I imagine I will leave the hospital with a prescription for the same medication should I choose to have another child, and I am not ashamed at all.
I definitely had fears about meds. Depression runs in my family, but I still had this idea that I was too strong to let it overcome me. It wasn't until after I had my second child that I decided to research PPD, suspecting that I'd been through it already and didn't know it. I was right. And it hit me again, but this time I was prepared. Reading the book "Living Beyond Postpartum Depression" by Jerusha Clark really helped me to understand the physiological background of depression and removed a lot of stigma surrounding medications. But it wasn't until my second child was nine months old that I figured out (along with my counsellor & doctor) that an SNRI would benefit me. I've only been on it for a few months now, but it has made a world of difference. I know it's not for everyone, but if the stigmas are removed, I believe that meds could benefit more moms like me.
Hi Katherine,
Your article highlights to readers the importance of early diagnosis and early prevention. As part of my practice as a Family Doctor, I routinely screen and anticipated postpartum depression in those with a past history of depression/anxiety or those with a family history of depression/anxiety. As you will deeply appreciate, having a child and parenting is one of the most difficult job in the world and couple this with the hormonal and physical changes of having the baby, it is not hard to understand that the postpartum period is a high risk for depression and anxiety.
I highly encourage those with a history or family history of depression/anxiety to see their Doctor early for pregnancy and "preparenting" counselling.
In Australia, there is a government funded program for patients who are pregnant or who have been pregnant in the last 12months to see a psychologist for 3 visits to help with adjustment issues. I encourage people to talk to their Doctor about this.
Hope this helps.
Dr Vin
MBBS FRACGP Australia http://www.doyouhavedepression.blogspot.com
I waited way too long. I was suffering PPOCD, but didn't know it and I was scared and confused. When my daughter was a year old I started medication at the urging of my therapist, prescribed by my primiary care doc. Six months later, my doctor moved. I talked to my therapist about going off and she supported me if I said I felt better. So eight months later I discontinued my antidepressant, under no doctor supervision, three months later I relapsed and suffered for the next seven months until I was under the care of a new psycologist and psyciatrist. It turns out I have always had OCD, the postpartum phase made it flare up worse than ever. I urge anyone on medication to give your mental illness the same respect as any other bodily illness and stay under the care of a professional who truly understands your condition.
I completely relate to fearing medication. I put off taking meds for a short while as I feared side effects, not being “me”, going “crazy” or becoming manically happy. It doesn’t helps that I was suffering intense anxiety at the time which exaggerated all those fears.
In some ways I was lucky, because my onset was so sudden and severe it didn’t take long for me to realise that I HAD to trust my doctor and try the meds. The irony is that the moment I started taking them I then expected instant relief and actually out TOO much emphasis on the drugs.
Thankfully, with the help of therapy (which I believe has helped just as much as medication) I was able to get a more rational understanding of my illness and was able to be more relaxed about the meds. They have helped me with all the basic functions – sleep, appetite etc.
They aren’t this dramatic magic pill that I hoped for but they are one of the many factors that have contributed to my recovery, and I no longer fear them at all. I wish there was less stigma attached to psychiatric medication.