Authors

  1. English, Jill MSN, ANP-BC, WCC

Article Content

DURING THE HOT summer months of 2012, I was expecting my first child, a baby boy. Before his arrival he was already the best thing that had happened to my husband and me. At the time, I was working full time and trying to complete a second master's degree in nursing. I was thrilled, excited, and very tired!

  
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During my OB-GYN appointments and prenatal classes I'd peruse the literature related to postpartum depression (PPD). As I skimmed through the warning signs, I remembered famous actresses who'd shed light on this particular disorder and spoken publicly about its challenges. Being so happy at that time, I thought to myself, how could I ever be sad?

 

Bringing baby home

Labor and delivery went well, but the baby-we named him Nicholas-had some minor complications that delayed his discharge. Eventually we went home and my husband went back to work.

 

Days with a baby were busy, but in a different way than I was used to. As the weeks went on, Nicholas and I bonded and I was in love. On my fifth week postpartum I read an article in a nursing journal about PPD and postpartum psychosis, but couldn't relate to how these women were feeling.

 

At my 6-week postpartum checkup, my OB-GYN practitioner and I discussed restarting birth control, and I filled out a PPD checklist. I chuckled to myself thinking, let me just check these boxes and leave; I'm fine. Sure I had some baby blues, but I'd expected that and I was able to take care of Nicholas without any daytime help.

 

Within a few weeks, the babysitter we'd planned on for months bailed and left us stranded with no childcare option. We placed our home on the market and 2-hour notices for showings had me frantically trying to clean up the house. As friends and family called I'd always say, "Things are great! Things are fine." But I started to get more anxious. How did moms juggle all these responsibilities?

 

One night I woke up in the middle of the night sobbing for no reason. My husband tried to comfort me, but I couldn't explain what was wrong. I felt such a deep sadness.

 

By mid-weekend, I didn't feel safe with Nicholas. It didn't make sense to me-I'd fed him, changed him, and bathed him independently for months, but now I was hesitant and afraid. I wanted my husband to be there with me all the time. I felt the need to run, get of the house, escape. I called friends who were nurses to see how I could prevent PPD. They encouraged sunlight and walking or outdoor activity to help. I did these things but the anxiety and fear didn't go away.

 

Reaching out

One day I was driving home from my mother's house and suddenly felt scared to drive; I wondered if I was losing my mind. When I got home I sat down with my husband and cried. I told him how I'd been feeling, and we decided to call a local PPD hotline. The voice on the other line encouraged me to go to a crisis center. Although it seemed drastic, I did feel "in crisis."

 

The "crisis center" was a hospital ED. We sat there for hours, and the only test performed was a urine drug screen. I repeated to multiple healthcare providers that I thought I had PPD and they just looked at me and smiled.

 

After many hours, we were approached by a psychologist, who asked if I wanted inpatient therapy. I really didn't, but what was my choice? The psychologist thought I was safe to go home and see my primary care physician next day. I didn't get any medication, but I did get reassurance.

 

Getting better

At the appointment the next day, my primary care physician recommended an antidepressant and reassured me that things would be OK. I was encouraged by the way she treated me by reassuring, listening, and not judging me.

 

I thought about the mothers I'd heard about in the news who took their own lives or the lives of their children and wondered if they'd had PPD. Were they ill but unable to reach out? I thought about how brave some women were to speak out about this disorder because I didn't want to tell a soul how I was feeling. How did they have the courage?

 

I started taking an antidepressant and let close family and friends support me. I started to feel better as time went on. Every day was a little easier.

 

My husband was amazing. He understood PPD and worked to help me feel safe and see the positive. He reminded me that one day this would all be an afterthought. I found a babysitter and went back to work. I improved in time.

 

It took me 4 months to finally open up about PPD and my experience. Finding the confidence to talk to others has really put it in perspective and let me focus on the amazing son I love so dearly.

 

Having PPD is nothing to be ashamed of, and the only way to get better is to break the silence. The literature on PPD focuses on identifying the signs and symptoms but offers little information about treatment modalities. Psychosocial therapy and antidepressants are regarded as optimal interventions for PPD,1 and both helped me. If everyone felt more comfortable about discussing PPD, we could do a better job of helping new mothers get through this difficult time.

 

REFERENCE

 

1. McCoy S. Postpartum depression: an essential overview for the practitioner. South Med J. 2011;104(2):128-132. [Context Link]