Question about the treatment of postpartum depression

[Ciciwoowoo]

I have a question for recent mommies... I think I might be experiencing PPD (had the baby Feb 9th). I saw one of the doctors at the office and told him about it during my 6 week visit. I had never seen him before. He asked me if I considered it to be mild or severe. I believe it is mild and said so. He told me to try and get more sleep and eat better. He said if that doesn't work, to go see a therapist. Thats it.

So how is PPD usually treated? I sort of thought they would begin by giving me a mild antidepressant. I was really quite angry about the perceived brush off I got. It was especially troubling because I had an appointment scheduled with the doctor who delivered my son and when I went in, they basically told me I would have to see this other doctor instead, despite the fact my doctor was in the office.

I guess I'm looking for a second opinion on whether or not I should pursue this further by calling the doctor back or should I just wait and see if things get better as time goes on. I suffered from pretty severe PPD with my first son 13 years ago and I'm rather afraid of dipping back into those doldrums again!

 

[Lisa loves Pooh]

Either via counseling or meds.

Sometimes--you just gotta come right out and ask for it.

I had it for 3 of my babies---my last, I was planning ot automatically go on the medicine when he was born, but my depression developed during pregnancy.

I am undecided of what to do with this baby--but if I ask, my doc will give me meds b/c of my history.

I don't think your OB necessarily blew you off, since you said it was mild. Some people can cope with mild PPD on their own or just by making some subtle changes in their routine to give themselves some mommy time. So it was probably good that he didn't prescribe you pills just b/c, you know?

I would reschedule with your preferred OB and discuss it. They do have the authoritiy to prescribe meds--not sure for how long before you have to turn it over to a psychiatrist. I want to say that I had scrips available to me in 3 month increments for up to a year--I think. But I don't remember.


Definitely self-monitor in the meantime.

I kept denying my issues after baby #2 and I went from minor to major in a number of months. But a simple phone call to the midwife--i didn't even have to go in. She called in a script for me.

 

[MickeyMomOfThree]

Ask for it, demand it if you must. I had it bad with my oldest. I never thought about hurting her but myelf...I'd be lying if I said it never crossed my mind.
Mild, mild case with DD10 but was fearful after DD15 so went on it.
With DD8 it started in the pregnancy. I was on Prozac my whole pregnancy. It wasn't to the point as it was with my oldest but was bad enough and having to deal with 2 kids was tough. I went off and had to go back on.

This is an amazing time in your life and you should be able to fully enjoy it. If you need a little help, so be it. Nothing to be brushed off over wither. Get yourself what you need, you are a good momma for doing it!

 

[Normangirls]

What a putz. Does he seriously think the appropriate way to diagnose or address potential PPD is to ask, "Is it mild or severe?" And he recommends you get more sleep? Wow, all those years of medical school apparently going to waste.

Talk to your regular OB/GYN, talk to your regular doctor, talk to someone. Mild or severe, it does not matter. If you went through this before then you know it can/should be treated -- it's not something you should just have to suffer through.

 

[Luv Bunnies]

Definitely talk to your own OB about it. Call the office, explain the problem and see if they can get you in right away. I think it's better to do a face-to-face visit so you can really discuss what's going on.

I had a case of PPD after my first son was born and I wish I had addressed it more aggressively. I remember having this awful sad feeling all the time and couldn't stand to be away from my baby. It got worse when I went back to work full-time. I just felt like I wasn't in control of anything, was always in a fog and was about to fall apart at any moment. I ended up toughing it out but think I would have felt better sooner if I sought help. I had it again when my 2nd son was born but it was milder and resolved more quickly.

Please address it with your OB so you can feel better soon!

 

[TinkerbelleAbbysMom]

I am a nurse that works with women after delivery. I am usually there to see their babies who were born prematurely or have health conditions. But we do screen all of our moms. 80% of PPD is undiagnosed. I think it's b/c so many people think the symptoms of no appetite, feeling lonely, not sleeping,etc are nl. However, it would be worth talking with your ob. Some women do respond to just making time for themselves. I always tell my moms "you've gotta get 15 minutes a day to yourself". However, if it has been going on for a while, your chemical levels me now be too low to come up with stess management and coping changes. This is where your ob comes in. Just make an appt to see them. Realize it's not lifelong but it won't clear up overnight. Plan for meds around 6 months or so. Maybe less, maybe more. This is just to give you an idea. Good luck and remember we are here for you. Feel free to PM me if you have further questions. Above all, if you get to a point where you are thinking of hurting yourself or someone else, please call a crisis center right away. I am not saying you are there.. but just in case okay.

 

[smidgy]

from what I understand, the hardest part about PPD is getting the woman to recognize and admit it. you have conquered the hardest hurdle! If you think you are having problems, see another doctor! kudos to you for being willing to accept help.
(and a big to the doctor for brushing off your concerns)

 

[VillageMama]

When my last baby was born and I went for my 6 week check-up, my doctor went through a post-partum depression checklist with me.

She said that my score was 10 and that a score of 10 or higher was considered an indication of PPD.

I told her that I didn't feel that bad and that since my score was "only" 10, I was hesitant to go on meds.

She then said something that I thought was very, very wise: It is quicker and more successful to begin treatment while the PPD is "mild" than to wait for it to get severe.

I agreed and began taking Zoloft, which is compatible with breastfeeding. I'm glad that I did because the day after my diagnosis something changed and I went from mild to moderate within that day.

GOOD FOR YOU for seeking and continuing to seek help! Boo on any doctor who expects a patient to self-diagnose and then expects her to self treat.

Best wishes to you, hon! You can feel much better. Just please keep pursuing more help.

 

[Lisa loves Pooh]

She then said something that I thought was very, very wise: It is quicker and more successful to begin treatment while the PPD is "mild" than to wait for it to get severe.

Wise words, Village Mama!

 

[shortbun]

Call a social worker or a psychiatrist. I'd try one more visit with my OB-and specify that you do not want to see anyone else-also that it's urgent. Tell them what you are experiencing and that a change in diet is NOT doing it and that you have small children and will NOT be getting loads of rest for a while. You are such a great Mom and to be proactive about this shows that you are smart and capable. Go for it, get the help you need. Don't worry about bothering anyone, it's their job.

 

[minkydog]

I guess I'm looking for a second opinion on whether or not I should pursue this further by calling the doctor back or should I just wait and see if things get better as time goes on. I suffered from pretty severe PPD with my first son 13 years ago and I'm rather afraid of dipping back into those doldrums again!

Given your past history, and the fact that those of us who have had PPD before are at high risk for having it again, I would suggest that you call your real doctor. THat other doctor doesn't even know you, doesn't know what you've been through before. I'm all for improving diet and exercise too, but sometimes an antidepressant is what you need. Therapy helps too.

I had moderate-severe PPD with my first child. Except I didn't tell anyone. I just went day in and day out with constant thoughts of suicide, crying, depressed, irritable. My DH didn't know what to do, so he did nothing. It was all new to us. After 15 MONTHS I finally called a doctor, who immediately put me on an antidepressant and set me up with a therapist. It was invaluable. I hate to even think how much my depressed mood affected my new baby.

When baby #2 came along, I was proactive. I saw a psychiatrist in my 8th month who outlined a course of treatment that I could either start immediately postpartum or I could wait and see. I chose to wait & see, and it was the right hting to do. I didn't have PPD at all.

Then baby #3 came along. He had multiple disabilities and was very fragile. All we got was bad news, month after month. By the time he was about 5 months old I was having constant migraines. We were spending 3-4 days a week in some doctors or therapists office. My whole life was depressing. Then came the bad news--after over 200 tests we still had no diagnosis. Therefore, they didn't hold out much hope for his prognosis. He was so very very affected. With that, i crumbled. I couldn't get out of bed. I couldn't take care of my kids. Friends had to literally step in and take over. Looking back on it, I really should have been hospitalized. It took about 6 weeks of an antidepressant to make any difference at that point. It was just a sad sad time. I wish I had been more proactive. I could have saved my family a LOT of heartache.

Best of life whatever you decide. I would take PPD very seriously, even if it just seems mild. It has a way of sneaking up on you and can drain your energy and emotions like nothing else can.

 

[karenos]

OP, I am not a recent Mom (my youngest is 7) but I have experience with ppd. PM me if you want to - I can share my experience, but do not feel comfortable doing so on a public message board.

Know you are not alone!
karenos

 

[KristineN]

First time I had it, my OB told me I was "just tired". I was too dumb to argue....thank God I went to my internist who took one look at me and knew something was terribly wrong. She prescribed Prozac and I took it for a few months and I pulled through.

I was proactive for the next birth and I was prescribed an estrogen patch...put on immediately after birth. What a huge difference it made...just having those hormones taper off instead of crash. I only needed a couple of patches and felt perfectly fine.

OP, not sure if it's too late to consider estrogen....but for me, it was a miracle cure, and there are now lots of studies with PPD and treatment with estrogen patches.

Good luck, and as said before, you are not alone.

 

[DMickey28]

As others have posted, meds/therapist is usually the way to treat PPD. Not just more sleep, more mommy time, etc. I'd go back to your normal OB and have a talk with them. Call the office, explain the situation and see if they can get you in this week.

I just had DS #2 on Monday and have an appointment with my OB tomorrow to get my stitches out and to talk about PPD. I had it with my first son and didn't get help until about 4 months in ... I didn't know that I could go to my OB. They never screened me or anything. I had prior bouts with Depression so I was in a risk category. This time, my OB (new OB) wants to be pro-active this time and we have already talked about me going on to meds starting now. For me, I was feeling the fingers of depression start to seep into my mind around 34 weeks pregnant and think it's a good idea to get started now even though what I am feeling could be contributed to normal baby blues ... for me, it's safer to be proactive.

Please call your preferred OB and explain to them the situation so they can try and fit you in this week. Personally, a therapist doesn't work for me. I have been to 6 different ones in the past and always feel like it's a waste of time for me and also a source of anxiety because I have to make arrangements to get to one without the kids.

 

[Wendy31]

Speaking of post-partum depression, does anyone have any experience w/ post-partum anxiety?

I think I have this, but I'm afraid to talk to my doctor & afraid of meds because I'm afraid of the side effects.

This past pregnancy was a suprise, but it was a happy surprise. However, at our 20 week ultrasound, we were told the baby had an enlarged kidney. From that moment, I went into high-anxiety mode, & I haven't left it.

I have a high-anxiety/worrier type personality anyway.

I've been told that mothers who are older (I'm 36) tend to develop PP-anxiety more frequently.

Due to the enlarged kidney, I was referred to a high-risk ob, & for the last half of the pregnancy saw both my regular ob & the high risk ob. I ended up having an early third tri-mester amnio to determine whether or not the enlarged kidney was indicative of other developmental problems (like Down's). Thankfully, everything showed up fine - except for his kidney. But, in the last month, I developed pregnancy-induced hypertension, & I was induced a week early.

I have a serious doctor/hospital phobia, and, instead of giving birth in the nice women's center where I'd given birth previously, I had to give birth in the regular hospital. A week after he was born, we had to go back to the hospital to get a scan of his kidneys, and, thankfully (again!) everything looked good & didn't indicate surgery was needed.

Anyway, the first months after he was born, I was an anxious mess. We didn't go anywhere because I so afraid that he would catch something. He was born in July, & I didn't go to church w/ him until early December. I was petrified of the h1n1 flu!

DH would try to give me breaks, but I hated leaving DS. I had a panic attack in the middle of Target because I was by myself.

When he almost 6 months, he caught RSV - despite my best efforts. I was crazy - wouldn't let anyone touch him w/o hand sanitizer, changed my clothes after I'd been out before picking him up, made DH & older DD & DS change their clothes when they came in every day.

Anyway, like I told DH, my thought processes have changed. I can't process things like I used to... meaning, now when I hear/read about something tragic, I immediately start to think about the different things that could happen to my children. Like, after that youtube video that dramatized the car wreck caused by texting while driving, I was scared to death to drive w/ the children in the car. Older DS has asthma, & I was so worried he would catch flu & end up in the hospital, I would have to choose between being in the hospital w/ him or being at home w/ the baby. Even after we got our flu vaccines, I still felt crazy. When my older kids had something at their school, I felt so anxious/panicky the entire time I was there. I've lost some friends because I quit socializing after he was born.

And the thing is, I'm not depressed. I just feel anxious/panicky & scared to death something is going to happen to him or older DS & DD.

Anyway, sorry this is so long & didn't mean to hijack the thread! Just wondering if anyone else has any experience w/ this & wondering if these crazy-panicky feelings will go away eventually...

 

[Lisa loves Pooh]

Wendy--I have heard of it, but I unfortunately do not know much about it.

My dd9 had a period of severe anxiety and it got so bad that we did have to medicate her. We had her with a psychiatrist and they gave her an anti-depressant and it worked well enough to take the edge off. My dd wasn't depressed by any stretch of the imagination--but her anxiety was just too much.

We did eventually ween off the meds and as she matures, she isn't anywhere near as anxious as she was--so we just take a wait and see approach.

Just wanted to comment--b/c some anxiety can be treated with anti-depressants and it isn't normal to be constantly on edge and worrying.

I do know there are also anti-anxiety drugs. But if you are nursing, that may not be compatible.

The thoughts you are having are irrational of course--and sometimes therapy can help--but if part of the problem is leaving your son, it would be difficult to see a counselor in that case.

I had anxiety pre-kids--and was able to do...Congnitive Behavioral Therapy. My case was not bad enough to require meds and the therapy was successful. The Psycologist described the process as kind of a remapping of your brain--that usually you react to a scenario in this way....and through a grueling process of documentation, you learn a better way to react and over time, you eventually react in the more rational way and thus not have anxiety over it.

Definitely seek assistance--anxiety can worsen with time. I'm not sure how old your son is now---but you've had it gone on long enough that it is safer to seek help to get it taken care of.

 

[vettechick99]

I'm sorry he brushed you off. My OB takes PPD very seriously. He asks me every single visit how I feel mentally/emotionally. Asks me if I feel like I want to hurt someone (which sometimes my answer is yes j/k)

Seriously though, I would go back and tell your OB you know your body and this isn't right. You had it once before. There are several meds that will get you over this hump.

You may also want to go back on the pill. The pill has always been able to regulate my hormones well.

Congrats on the baby!!

 

[Normangirls]

Oh, and I forgot:

(had the baby Feb 9th)

CONGRATULATIONS!!!

with this baby

GOOD LUCK!!!

When my last baby

GOOD LUCK!!! (O.K., there was no quote to use, but I saw your siggie!)

I just had DS #2 on Monday

CONGRATULATIONS!!!

 

[Normangirls]

And one more...

Congrats on the baby!!

Good luck (per your siggie!)!


DISers really are fertile bunch, huh?

 

[Katie's Butterflies]

My friend had PPD. Thankfully, 2 weeks ago she finally went to a competent therapist & physciatrist. She was immediately put on meds. Now, I have my friend back. For the past year, she has been depressed, suicidal, paranoid, anxious, and just not herself. It was taking a toll on everyone. (her, her family, her friends etc) Unfortunately, her doctor pretty much ignored all of her worries and she was embarrassed to speak with her about some of her symptoms, so it went untreated for too long. It had been getting worse, but now, thanks to the counseling and meds, she is starting to become her old self again.

Wendy- This friend also had severe anxiety similar to yours, plus the depression. She was worried to take her son anywhere because of germs and constantly worried someone would abduct him or harm him in some way. She was a nervous wreck. She is now on anti-anxiety medication and feeling much better. She can now sleep and actually run errands without worrying so much about her son. (She still worries about him, but not to the point of panic attacks )