05/02/2007

Record-Eagle photo illustration/Tyler Sipe
Postpartum depression, a hormonal problem that can prompt new mothers to be overcome by feelings of despair, should not be ignored.

From happy to sad

Postpartum depression can be debilitating

By AL PARKER
Special to the Record-Eagle

Record-Eagle/Tyler Sipe

TRAVERSE CITY — Nicole had struggled with depression and anxiety in the past.

But when she became pregnant with her first child, she was determined not to have problems with "the baby blues.”

"I didn't think much of it until I went back to work,” said the Traverse City woman, whose daughter is just about to turn a year old. "And then I realized it was much worse than I thought. I went back after two months and I think I made it about a week-and-a-half before I had to go back on leave.”

Nicole (not her real name) is one of the 10 percent of new mothers who experience postpartum depression, according to estimates by The American College of Obstetricians and Gynecologists.

Postpartum depression is a hormonally caused problem that can prompt a woman to be overcome by feelings of despair compounded by guilt over not being able to snap out of it. Instead of being "just a little down,” new moms can feel uncontrollably miserable and listless, become tearful daily, have problems sleeping (not just because the baby wants to feed or is crying), lose interest in doing anything — and their appetite, and be overcome by an overall sense of disconnect and hopelessness.

"There's a lot of ongoing research into postpartum depression,” said Dr. Charlene Abernethy, D.O., who was not Nicole's physician, but who often treats patients suffering from postpartum depression at the Women's Health Pavilion in Acme. "They are looking into the use of estrogen supplements to treat it and also looking at how the depression affects the baby because of the impact postpartum depression has on the interaction between the mother and the baby.”

Nicole's postpartum depression left her feeling overpowered.

"Everything was overwhelming,” she said. "I couldn't even have a conversation with someone without feeling overwhelmed. I would sit at my job and have things in front of me that I needed to do … things that I always did, and I just couldn't sort it out in my mind. It was awful.”

Nicole and her baby both developed complications following the birth.

"She came early, became ill and had to be hospitalized for about a week after she was born,” recalled Nicole. "The day she came home from the hospital, I started hemorrhaging that night and had to go back in. I think that probably contributed to it because we spent a lot of time in the hospital. When I was admitted, I couldn't hold her much … I think that's when it started. I just would feel really down.”

At first, Nicole attributed her depressed feelings as being ill. "The further along we got, the more I was troubled with a down feeling,” she said.

The smallest incident would set Nicole weeping.

"I'd be crying and I couldn't bring myself out of it,” she said. "Then my doctor had me take another month off work.”

Nicole had been on light dosages of medication throughout her pregnancy because her physician thought she might have trouble with depression.

"Depending on the severity of depression, medications are often prescribed,” explained Dr. Abernethy. "They are the same type used for depression — Zoloft and Prozac, also estrogen supplementation is used in some cases.”

Nicole's dosage was increased and she was sent to counseling, which helped organize her thoughts.

"We came up with a strategy for when I'm feeling overwhelmed … steps I need to take,” she explained. "That made a big difference. I'm not a big fan of counseling … I resisted it for a long time and then my doctor said 'You're not going back to work until you do it,' I was sort of stuck and had to do it.”

Counseling helped Nicole develop techniques to deal with the depression.

"We came up with tools that made so much sense that I had never thought of on my own,” she said. "But it still took awhile to feel good about what I was doing at work … I am back, but still struggle sometimes. I tend to get down and have trouble focusing on major aspects of my job. I have a really hard time pulling myself out of it.”

Her co-workers are supportive, but Nicole sometimes gets frustrated.

"I can see myself doing it (feeling depressed) and tell myself, 'You're bringing yourself down and this is what you need to do it fix it.' But making myself do it is what I struggle with. It's a constant battle, but I'm much happier than I was.”

Nicole gives a lot of credit to her husband.

"He was incredibly supportive,” she said. "He took really good care of me, doing anything to help me and taking care of the baby. If I was in a bad mood, he'd deal with it very well. It was hard for him.”

Mothers who suffer worse cases of postpartum depression sometimes develop resentment toward their newborn, but Nicole was able to avoid those feelings. Still, she felt that if her depression was left untreated it could develop into feelings of anger or hostility.

"I've heard those stories where mothers would resent their children, but I never felt that way,” she said. "I did have feelings of 'I'm not a good mom and she'd be better off with someone else.' I did have feelings of me wanting to leave. I never felt so dark.”

Nicole didn't mind caring for her daughter.

"I was thrilled to have her,” she said. "She's such a happy good baby, but I just didn't feel motivated. I didn't have anything pushing me, driving me.”

Relatives need to be sensitive to a new mother's feelings, said Abernethy.

"It's very important for the family to recognize postpartum depression,” she said. "A lot of women have been sort of blown off — it's the Baby Blues — but it has serious complications.”

Nicole credits the combination of counseling and medications with bringing her slowly out of the depression.

"A lot of it was learning to let go,” said Nicole.”When at work, I'm very 'get things done — just so.' I have to realize now that I can't do it all.”

Nicole offers some suggestions for new moms who may be facing postpartum depression.

"First of all, talk to someone about it early on,” she advised. "Even if you're only feeling down for more than a few days, talk to your doctor. I think a lot of women are in denial about it at first.”

Nicole said she would take more time than two months off work to recover from the birth.

"Two months sounds like a long time, but it went so fast,” she said. "My advice to moms is don't rush back. If you need another week or so, take it. Even if it's unpaid. If that's what you need to do, you need to do it.”

Despite her battle with depression, Nicole is optimistic about having more children.

"When I was at my lowest point, it was 'That's it we are NOT having any more kids. I can't take it - I don't know if I'd survive it,” she remembered. "But now that I'm over it I want to have more. I would still be concerned, but I have a bit of relief that I've already gone through it and know what to expect.”