Steps You Can Take
Treatment of PPD often requires counseling and medication that requires time to take effect. The process can be long and difficult. Below are steps you can take to facilitate recovery.
Recognize the Depression
Often it is the husband that is the first to realize that something is wrong. The Postpartum Support International website (www.postpartum.net) has an excellent description of Postpartum Mood Disorders that will help you to recognize the symptoms. Below are some first hand examples of depression and psychosis.
When our beautiful girl was born, it was the most amazing experience of my life. Bringing a real, fully alive, human being into the world is an amazing experience. The intense rush of emotions, the depth of our love, and the stress of it all just took us over. And so it was that the first couple of days and weeks were pretty much all about being amazed, adrenaline, and coping. There are no classes that can really teach you how to be a parent. So, you trust your instincts and what comes naturally. And it seemed to be working, or so we thought.
After being home for a couple of weeks, I began to notice that Mom was not quite herself. She just seemed very emotional about everything. She monitored and tracked everything about our little baby girl; her schedule, her sleeping, her playing, her eating habits, her diapers, her lack of diapers, etc. Mom seemed to cry constantly, was very anxious and, although one hears all the stories about no sleep, seemed to have major insomnia. Every decision was tough. What brand of diapers? When should she sleep? Was she hungry? What should we do about her diapers not being wet enough? It was at this time we realized that maybe it was a little tougher than we expected and that Mom might need some help.
(for complete story see Peter’s Story)
I remember when it took a turn for the worse. I still, to this day, have a hard time believing it happened to me. It started on a Friday morning when at the last minute Mom decided not to go on a business trip with me. And so, I left on the plane and Mom went to Grandpa’s house for the weekend. As we talked that weekend, Mom just kept talking about how tired she was and that she was trying to sleep but wasn’t able to. Each night grew worse, but I just thought she needed more sleep and all would be okay. The night before I came home from my trip, she finally got prescribed medication, but given her state, it did not help. In fact, at this point, it made things worse. On Sunday, when Mom picked me up at the Airport, crying, I knew something was not right. She was upset because the doctor had not called her back, but it was much deeper than that. I was just so happy to see my little girl, in the back seat, six weeks old, beaming, that I didn’t notice how bad it was. On the way home from the airport we stopped for a sandwich and I hoped that would make Mom feel better. After about 15 more minutes in the car, it all turned weird, scary and very out of control. Mom started talking funny, saying she could not handle this anymore and just wanted to die. She wanted out, wanted it to end. She began to roll the window down and threatened to jump out of the window while we were driving 65 miles per hour. Then she stared talking in strange voices and I didn’t know what to do.
(for complete story see Peter’s Story)
Depression with Suicidal Thoughts
For us, PPD came on very unexpectedly. After our daughter was born it seemed like everything was going great. I was very proud of how quickly Pam had settled into a routine of being a new mom. She took Jodi for daily walks, she was very successful breastfeeding, Jodi slept through the night after one month, and we were working together as new parents. The whole experience of having a baby was just how I had hoped it would be. Then things started to change.
It started when Jodi was about three months old and Pam was preparing to go back to her job as an electrical engineer. Unfortunately we had not planned out our day care arrangements very well and finding day care became very stessful. At the same time Jodi started to eat very little. Even though Jodi looked fine to everyone else Pam became very concerned. Efforts to get Jodi to drink out of a bottle ended in frustration and the stress of trying to breastfeed a baby that didn’t want to eat became very intense. She was unable to get a good nights sleep, even though the baby was sleeping through the night. I felt very frustrated because it seemed like there was nothing I could do to help. I wasn’t able to help with the feeding and I also couldn’t convince Pam that the baby was fine. Trips to the Pediatrician’s office also failed to reassure Pam that the baby was fine. It was almost as if she couldn’t believe anything that didn’t support her worrying.
At some point the normal concern that a mother has for her baby turned into a dark cloud that consumed Pam. She was unable to sleep and became almost obsessed with the babies eating habits. I became seriously concerned when I met Pam at the home of a lactation specialist. The Pam I saw there was not the confident, warm, cheerful person that I had known for the last ten years. The person I saw there was desperate for answers, exhausted, and different. The lactation specialist was very caring but only focused on the breastfeeeding and didn’t even mention depression. After our visit at the lactation specialist I started to think that maybe this is what PPD is about. I had no idea how to get help, except to call my mom and dad and have them come over the next day.
(for complete story see John’s Story)
Help Her Recognize the Depression
One of the biggest challenges many men face is getting their wives to recognize that they are suffering from depression. Often women reject their husbands, children, family, and friends, and still do not realize they have a serious problem. Some women refuse to talk to their husbands and blame them for all their problems. Some go so far as to send their children to other countries, file for divorce, get restraining orders, or have extramarital affairs. This creates tremendous strain on the relationship and separating the person from the depression is very difficult. The depression may cause her to say and do things that are very hurtful to you and others. The challenge is getting her the help she needs to recover without getting upset at her.
Here are some suggestions for how you may get her to realize she needs help:
· If she is not speaking to you, or doesn’t trust you, communicate your concerns with her family and friends. Try to find someone that she does trust and let them help you. Let them know how concerned you are about her and encourage them to learn about PPD.
· Share with her the information that you are finding out about depression.
· Ask her about her sleeping, eating, thoughts, etc. Let her know that you are concerned her and help her see that PPD is a physiological condition as well as a mental condition.
· Many famous people have had PPD and she may be able to relate to someone she admires like Princess Diana, or Marie Osmond. Help break down the stigma of depression.
· PPD is very common and there is a good chance that someone you know has recovered from PPD. Be open with the people around you and try to find someone with firsthand experience that can talk to your wife.
There are two very clear indications of a crisis situation that requires immediate action:
· Your Wife Is A Danger To Herself
· Your Wife Is A Danger To Others
We cannot stress enough how important it is for you to act quickly and decisively. Any reservations you may feel about getting help are far outweighed by the risk posed to your family. Your options are:
· Call 911
· Drive to a Doctor’s Office (Not Recommended)
Each of these options will probably lead to hospitalization. Hospitalization can be a traumatic experience but the advantages far outweigh the disadvantages. Follow the link to read more about what to expect during hospitalization.
Below are some examples of crisis situations that required immediate action.
“John, I don’t want to do this anymore…..Do what?….Keep living….What about the baby?…..I’ll take her with me.”
“One morning Eve came into the bedroom carrying a knife and saying we should all ‘go’”
“So, I called Mom’s sister (she’s a twin) and asked her to talk on the cell phone. Mom started talking into the cell phone telling her sister that she loved her and to take care of her daughter once she was gone. It was so scary for me, and I just went into auto-pilot. I raced us home, put my little girl at the neighbor’s house, and took Mom home. She was hallucinating and out of control. Fortunately for me, Mom had reached out two weeks before to a Post-Partum specialist. This was a life-saver for me. I called her and she explained to me what was happening, how these kinds of things can happen. She talked me through what I needed to do, offered her complete support for me, and was able to calm me down so that I could do handle the situation. After a couple of hours, I realized I could not calm Mom down, and so I called 911. The police, the fire trucks, the EMC, the neighbors, all showed up. It was decided that Mom just needed rest and since there was a prescription at the pharmacy, we decided to use that to help her get some sleep. So we tried that, but at 2am, Mom woke up and was still in the same situation. Sleep had not helped. We gave her some more of the medication, and hoped that in the morning all would be okay. But it wasn’t.
The next morning we decided that she would have to go to the hospital. This was a very difficult experience. Emergency rooms at Hospitals are not the greatest place for this type of situation. They do not work with a lot of post-partum mothers that need special help. It was at this point that I realized Mom was hanging on for her life. And it’s at this point that as Fathers and Husbands we need to be strong, make sure we have our support network in place, and get as much help as we can.”
Depending on the severity of the depression, you may need to play a critical role in creating and implementing the treatment plan for your wife. While you will be relying on professional doctors and counselors for the specifics of the plan, you may be in the best position to observe the results and provide feedback to the professionals. Your wife may not be capable of making appointments, keeping appointments, understanding instructions, and following through. The doctors may not be able to get a good understanding of her condition without your input and evaluation. Your active participation can greatly help her recovery.
Traditional treatment of Postpartum Depression most often involves a combination of medication and counseling. Your wife may be visiting an OB/GYN, a psychiatrist, a psychologist, a lactation consultant, as well as other all at the same time. She may need your help coordinating all the different appointments and understanding how they all interact. It’s very rare for all the specialists to communicate and keep in mind the whole patient.
Any medical doctor can prescribe medication for depression, however it is typically prescribed by a psychiatrist. For many women, finding a good psychiatrist is an important step towards recovery. The best way to locate a good psychiatrist sensitive to the needs of PPD women is through referrals from a local PPD support group. Visit www.postpartum.net to locate the support group nearest you. If there is no support group near you, ask doctors you know and trust for referrals. For first hand experiences of good and bad psychiatrist visit this link: psychiatrists.
General practitioners, gynecologist and other medical doctors can also prescribe anti-depressant medication. While it is generally recommended to see a psychiatrist, if you have a good doctor, he/she may be the best able to treat you wife as a whole person, rather then just focusing on the depression.