There is probably no question I am asked more often by moms suffering from perinatal mood or anxiety disorders than “How long will it take for me to get better?” Suffering moms are seeking the exact date when the box will be delivered to their door with their old self inside of it.
“Is it 4 months? 6 months? I heard so-and-so got better by 5 months postpartum, and I’m 10 months postpartum and I’m still miserable, so does this mean I’m a lost cause?”
I actually looked this up in my library of PPD books, and searched online, and couldn’t find a single citation of the exact amount of time it takes to recover from postpartum depression and related illnesses. That’s because there isn’t one! There are many different variables affecting how long it takes each person to get better.
This installment of the Postpartum Progress Six Things series will address six things that can affect your length of recovery from postpartum depression and other mental illnesses related to childbirth. I am hopeful that, armed with this information, you will be able to have a smoother road to recovery.
1. How long did you suffer from PPD before you reached out for treatment?
Most moms with postpartum depression will fully recover, especially if the illness is diagnosed and treated early. It stands to reason that the longer you wait to get help, the longer it may take for you to get better. Recent research found that the rapid remission of depressive symptoms is the most important predictor for the favorable long-term outcome of a depressive episode. (Scadoczky et al, Journal of Affective Disorders, 2004) Insimpler words, the quicker you are treated, and the more effective the treatment is, the better result. Why wait to reach out for help when it may only prolong your misery?
2. How severe is your illness?
The more severe your postpartum depression symptoms, the longer it may take for you to get better. A 2002 study found that more severe depression was associated with a decreased likelihood of early recovery. (Meyers et al, Archives of General Psychiatry, 2002) NOTICE, that doesn’t say decreased likelihood of recovery, just decreased likelihood of early recovery.
3. How effective is the treatment you have been using?
Some women receive treatment that isn’t particularly effective, so their illness doesn’t resolve. There are a variety of reasons why this might be the case. There are different kinds of therapies (cognitive behavioral therapy, dialectical behavioral therapy, interpersonal therapy, group therapy, etc.), and different kinds of medications (serotonin reuptake inhibitors, serotonin and norepinephrine reuptake inhibitors, tricyclics, antipsychotics, etc.), different kinds of alternative methods (light therapy, exercise, etc.) and even different kinds of support groups (new mom groups, PPD groups that allow moms to bring their babies, PPD groups that don’t allow babies, freewheeling groups and groups with specific agendas at each meeting). It has been proved time and time again that, in the arena of mental health, what works for one person does not always work for another.
In the book “This Isn’t What I Expected”, Karen Kleimanwrites “If you haven’t met your goals or if you are actually getting worse instead of better, it is time to consider a change in treatment or a consultation …” If what you’ve been doing isn’t working, work with your healthcare professional to try something different. Don’t give up.
By the way, some people actually have treatment-resistant depression. According to the Mayo Clinic, you may have treatment-depression if standard treatments don’t help much or don’t help at all. It can be caused by significant emotional stress, not taking medications exactly as prescribed, or other underlying health problems you may have like thyroid disorder, heart problems or substance abuse. Another possibility, if youhappen to beon meds,is that your body metabolizes medication more quickly or more slowly than most people. The Mayo Clinic states that you should make sure you’re being treated by a mental health professional (not just your regular doctor), be patient and be willing to try different methods of treatment. This may include different types of therapy, different medications, tryingasleep and exercise program, ornewer treatments like vagus nerve stimulation or trans-cranial magnetic stimulation.
4. How effective is thedoctor or therapistyou are working with?
We sometimes make the mistake of assuming the people in the “white coats” know more than we do, so we go along and don’t speak up for ourselves when we know we aren’t getting better despite following the treatment recommendations. It could be that the doctor you’re working with has limited knowledge and experience in the area of perinatal mental health, and has already tried whatever method they know how to use. If you’re in therapy, perhaps the method they are using just doesn’t work for you or fit your personality. If you’re on medication, perhaps they’ve given you a sub-therapeutic dose, or something that has side effects that are hindering you, or something that flat out doesn’t work for you. This may be because they aren’t psychiatric specialists, or because they don’t know enough about the medications. Or, perhaps you arein a support group that just doesn’t make you feel comfortable or supported.
You MUSTspeak up about how you’re feeling and how the treatment plan you are on is, or is not, affecting your symptoms. You must talk about how you feel in the doctor’sor therapist’s office and whether you feel you are being heard and understood. If the healthcare professional you’re working with isn’t willing to try something else or isn’t willing to listen to you, there is another out there who will. Again, Kleiman writes “Treatment failure is not necessarily the fault of the therapist [or doctor]. ‘Good’ therapists often need to change treatment modalities or consider new options when [the treatment] doesn’t have the desired outcome.”
Sometimes, though, you may have just gone to the wrong person. That’s okay. You have every right to make a change. If you are looking for specialists in the treatment of perinatal mood and anxiety disorders, you can click here, here and here.
5. What is your current life situation and how may it be affecting your recovery?
Getting professional help is crucial, but your doctor or therapist can’t come home with you and ensure that your environment is the right one for recovery. If you are in a situation where the people around you are not supportive this may well slow down your process. If your partner, for instance, doesn’t believe postpartum depression or anxiety or psychosis are real, or isn’t willing to help you get the right amount of sleep or give you help around the house, the resulting stress of that can make it harder for you to get better. A study on the role of support from family and friends in recovery from major depression found that emotional support is significantly associated with depression outcome. (Nasser, Acta Scandinavia Psyciatrica, 2004)
As much as you can, reach out to those who are supportive when you need to talk. Ask your most reliable and encouraging family members or friends to pitch in, or maybe reach out to a local moms group or PPD support group for help. If you can’t find local help, you can at least find virtual emotional support from people who know what you’re going through here at Postpartum Progress or at places like the Online PPD Support Groupor Postpartum Support International.
6. What have you been doing to follow your treatment plan and take care of yourself?
In the end, no doctor can make you show up for appointments. Therapy will fail if you don’t open up to your therapist and aren’t willing to try some of the coping techniques your counselor suggests you try. No medication will work if you don’t take it. No support group will help if you don’t attend. Poor sleep and lack of nutrition can prevent anybody from being healthy. Remember that you need to take a key role in your recovery process. I know it’s hard. I know you feel like crap. I also know that you candig deep down and do this. Taking care of yourself and making your health a priority is the best gift you can give to both you and your baby.
One final note: Once you start to feel better, and you will, the Mayo Clinic suggests that “It’s important to continue treatment after you begin to feel better … Stopping treatment too early may only lead to a relapse.”
Photo credit: © Tino Mager – Fotolia
Thank you so much (as always) for such a wonderful article! Your words are so true. I had a long and difficult recovery because my PPOCD was very severe but I worked it and showed up to every appointment and tried every option…and look where I am now. I am in a better place than I ever have been.
Amen, amen, amen Katherine!
#2 is missing!
This is GREAT, Katherine!!!
Thanks Katherine. When WE (me and my army) get there, we will get there. You are such a gift. XO Helen
Thanks Katherine. I LOVE this blog. I am so thankful for the honesty. I too struggle at times with the 'time' factor. I am five months post partum, and having more good than bad days, but wonder when will it all be OVER. I am BLESSED beyond measure to have the most WONDERFUL husband, and when I feel down, and pretty crappy, he takes me by the hand, reads me my bible, and prays with me when I don't have the words or the strength to do it myself. . .GOD IS SO FAITHFUL. . .
Thanks again. . .and I'll see you on the other side of PPD!!!
I don't know why it did not put my name. . .Thanks Vanessa
This is a true and insightful article about some of the many complexities of postpartum mental health. Thank you for setting it out with such clarity, and for all you do.
What you do on a day to day basis is outstanding. There are so many questions that I've wanted answers to and it never fails that I'll get an email update from your blog that answers my question. I suffered from PPD for almost two years. I had a hospital stay that upset me more than it helped and was put on various antidepressants, mood stabilizers, etc. About 2 months after my hospital stay, I had gained weight and thought I couldn't feel worse than I did on the medication, so I went to my doctor and told her that I stopped taking it. She didn't argue – but I never felt like I had her undivided attention either. I also had a therapist who told me that he didn't necessarily think that I had PPD, but that we would explore what was going on. Ultimately, I ended up finding a therapist who specializes in PPD and related issues. I was feeling better with therapy, but still not myself. I was referred by my therapist to a Psychiatrist who also specializes. Two years later, I am myself again but since I stopped taking medication too early on the first time, I continue to see my therapist and still remain on the medication. I endured a lot the past couple years, but finding the right therapist and the right doctor ultimately helped me find the treatment that assisted in my recovery.
Thank you for this blog. I think so many women and their families can truly benefit from the information that is so hard to find elsewhere. ~ Diana
Oops. It was in there but I forgot the headline. Fixed! Thanks so much for the heads up Laura!
Thanks to Diana and everyone for your kind comments. I'm so glad this is helpful in some way!
I'm so thankful to have found this blog. I've been undergoing treatment for my postpartum depression for a little over a month now, and it's so reassuring to read all of this helpful information. Thank you!
I have been suffering from postpartum ocd for almost 20 months now. I have going through treatment and therapy. I finally found the right pyschiastrist but I still have my days where I feel like I'm the only one going through this. I keep thinking that this is never going to end sometimes but after reading this blog I know there is a light at the end of the tunnel. Thank you!
Hi Laura – I am at the 20 month mark with ppocd too. I am starting to believe maybe you just learn to live with it?
Kate & Laura,
Having never had a depressive episode prior to giving birth–I was diagnosed with SEVERE PPD in 2005, 5 months after having my 2nd child. I stopped meds early, 8 months after starting them, (I felt better-oops!) and spiraled back into the severe (read: suicidal) PPD. So 2006, I voluntarily checked into an inpatient hospital for 31 days. It was a terrifying yet helpful experience that saved my life. I'm telling you all this because, today, 5 years later is the first time I can say I feel "normal" again. I expected to feel normal imediately. Every year I do get better. I'm still on antidepressants. It's taken me this long to notice the change but, time really does fly by; I can't believe it's 5 years already! So hang in there, you will see little things that get easier & don't feel so "forced". I realize we are all different but there is always HOPE for recovery!
Hi, I’m a 26 year old mum of 3, ranging of 1 girl 2 boys, daughter aged 8 nearly 9 & boys 3 and 2 years old. I am a 3 time ppd sufferer, but with my youngest son had a complete breakdown in which I attempted suicide multiple times & was ‘treated’ by a mental health worker & social services for 18 months. Apparently I’m in recovery, but in my honest opinion I don’t feel I have progressed really… I have been recently signed off by both services and as happy as I am that they feel I no longer feel a need to be involved & now left to get on without someone at my door every five mins, I still feel very much in the grip of ppd, and mentally unstable at times.
I would like to thank the person who took the time to make such an informative and supportive site, but also to ask other women how extreme, intense and dehabilitati g their illness is over them. I feel like a monster not a mother with the thoughts and episodes I have. I was on medication – 150 sertraline, but I find the side effects horrid. I have tried so many different meds, none truly work as I feel so unhappy in my life and circumstances, I honestly do not feel like I can recover to the person I once was. I was very nearly sectioned this time last year, I nearly rang today to voluntarily admit myself. I also am struggling to understand how to seek any real. Treatment, I was briefly seen at the psychiatric hospital by a shrink for a few months but that was it. Weekly, monthly meetings with all professionals for. 18 months but no actual treatment, just meds and asking how I am. I told them about hearing and seeing things that were not there, complete distorted sense of reality, altered state of time, eating disorder and self harm that had manifested out of the depression, anxiety so severe I couldn’t do the school run, I wouldn’t leave the house with the intensity of the feelings, constant crying, intrusive thoughts etc etc. I still feel suicidal most of the time and my thoughts are like the devil coming out of me, I scare myself in a episode. I struggle to believe and see how I can truly recover without any real treatment or any talking therapy. I feel too broken about life altogether now, so much more than just ppd itself that I feel I’ll be like this forever… Or until I finally give in & kills myself. Not if but when…. Can this ever change, will I ever be the lovely person I was before, not just the physical body of that woman with a poisoned and tainted personality. Ugliness bubbles beneath me, I was a great mother to my other kids even with ppd, now I feel I reached a point of no return, my mind is not the kind, sympathic and nurturing anymore. I feel cold, with no love for anything anymore, I feel evil sometimes with the dark and twisted things that’s manifests itself out of the depression. I’m scared I’ve ruined my children’s lives by having them, I’m not the mother I want to be whilst in the wrath of manic depression and I’m scared I will scar them emotionally whilst I try helplessly to improve my desperate state of mind. Thank you for some hope but so many questions, I was never offered any treatments as they weren’t there, but I don’t have the resources to seek help elsewhere. I still struggle with crippling anxiety so it’s hard to ‘get out’
Please help, thank you in advance.