“John….I don’t want to do this anymore.”… “Do what?”…“Keep living”. That was my introduction to the world of Post-Partum Depression (PPD). Like most people I had heard about PPD, but I had no idea how serious it was. I certainly never thought that my wife would ever lose hope to the point that she wanted to end her life. I also had no idea how to get help. Nothing in my life has come close to causing as much worry, anger, frustration, despair, and fear as dealing with PPD.
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.
The next morning is when Pam woke me up and said she “didn’t want to do this anymore”. I will never forget that morning for as long as I live. Nothing in my life prepared me to hear those words for the woman I loved so much. Nothing had prepared me to deal with how quickly our wonderful life with our new baby had spiraled down into thoughts of suicide. It felt like it just couldn’t be happening.
After calming Pam down that morning I set up an appointment with her primary care doctor. Her doctor was a very caring man who spent some time with her asking a few questions and examining her. He asked me to leave during Pam’s exam so I was unable to tell him the details of what happened, and Pam didn’t tell him she was suicidal. After the exam he sent her on her way to get some blood tests. No medications, no referrals to a psychiatrist, no advice on what to do. Looking back I think things may have turned out differently if I had stayed in the exam room and told him the whole story.
That evening Pam was looking better and my parents were there to help with Jodi. Jodi wasn’t eating much but I was hoping that the worst was over. The next morning was a repeat of the previous day only worse. This time Pam had gone out to the car and sat there considering driving it into an embankment with Jodi inside. Her reasoning was that if she took herself and Jodi it would be easier for me. It was much more difficult to calm her down this time and out of desperation I decided to take her to the emergency room for help. At the emergency room I was overcome with a feeling of loss and cried for the first time in many years. It felt like the life that we had built together was falling apart.
The emergency room was poorly suited to deal with the situation. After the usual long wait and shuffling between rooms, Pam talked to a psychiatrist in a sterile exam room. The examining psychiatrist was an older man with a very serious demeanor. He asked a few questions and then told us how concerned he was about us, in a very clinical manner. There was no compassion, no reassuring words, no attempt to make it easier for us. More waiting, and then a very burly intern came and escorted us to the Behavioral Health ward of the hospital. At this point we had no idea what was going on.
The primary purpose of the Behavioral Health ward of a hospital is to prevent people with suicidal thoughts from caring out those thoughts. As a result the hospital must take several precautions that can seem degrading. The ward was locked so patients could not get out, Pam had to remove her shoe laces, all her possessions were searched, she could not use any electrical devices with a cord, and her privacy was very limited. Once someone like a doctor determines that a person is suicidal and potentially a danger to others he can have that person retained at the hospital for up to 72 hours.
We were totally unprepared for this type of “care”. I became very angry at the hospital and staff, feeling like we had been betrayed. I came for some help and now my wife was being locked up against her will with a bunch of depressed people. When I was told her attending physician wouldn’t talk to her or me until the next day I became even more angry. Of course this anger did nothing to help the situation or get my wife the help she needed. On the other hand, I did have a feeling that at least Pam would be safe and I could go home knowing she couldn’t harm Jodi.
The next day Pam was looking much better. She had gotten some sleep and looked more relaxed. My mom had gotten Jodi to start taking formula so much of the stress of feeding had been reduced. I had started to think that what Pam really needed was just a little time away from the baby and a good nights sleep. The doctor visited her and she told him she did not want to take any medication that wasn’t absolutely necessary. He gave her something to help her sleep but that was it. While I was very relieved that she was doing much better, I did notice that she was very suspicious of all the people at the hospital. At the time I thought it was normal because I wasn’t happy with them either, in retrospect though I think it was another symptom of the depression.
Being convinced that all Pam really needed was a good nights sleep and time away from the baby I then devoted all my energies into getting her out of the hospital. I was very confrontational with her doctor and started to pursue legal means to get her out. After the 72 hour hold her doctor extended the hold for another 3 days. We decided to appeal to a judge and the doctor finally lifted the hold and allowed us to discharge Pam against his recommendations. I felt like we had won a victory. However, in the back of my mind things still didn’t seem right. Pam was still very suspicious of everyone and very concerned about Jodi’s eating. I knew that Pam still needed help, I was just convinced she could get better help away from the hospital.
The first night she was home Pam looked great. She was rested, enjoyed being with the baby, and we had a great night. The next morning the dark cloud returned. Again she wanted to kill herself and the baby. This time I was desperate to get her better help without going to the hospital. I just felt like I couldn’t deal with facing all the people in the hospital again.
We called our pediatrician and got a recommendation for a psychiatrist and was able to get an appointment that afternoon. When we walked into his office there was a totally different attitude toward us then at the hospital. The doctored just listened. He allowed us, mostly myself, to explain our whole ordeal. He allowed me to express a lot of the anger and frustration I had about the situation. He then patiently explained the nature of depression and how Seratonin levels in the brain effect mood. He continually reassured us that Pam would get better. He explained what medications he was prescribing and what the effects would be of each. He allowed us to ask lots of questions. He was compassionate and caring. Suddenly I felt like we had someone on our side helping us to heal Pam, rather then a system treating her like a criminal. It was a huge turning point for us.
Pam’s doctor prescribed Zoloft and Lithium to help with the depression, and Klonopin to help her relax and sleep. The Klonopin helped Pam to finally get some sleep, however she remained depressed for a couple of weeks. I remember how frustrating it was to do things together that we used to enjoy and have them being no fun at all. Mornings were the worst, it was very difficult to get her out of bed. However after a few weeks things started to improve significantly. After about a month she stopped taking Klonopin but remained on Zoloft for 6 months. During that time she returned to work part time as an electrical engineer and got back to being the wonderful mother that she started out being. She had very few side effects from the medications and I credit them with saving her life. I also credit her doctor with taking the time to explain things to us so that we could understand what was happening and know that there was hope.
Two years later the birth of our second child became another crisis for us. Ben was born with a heart defect that required major surgery when he was 4 days old. Pam did wonderfully through the entire ordeal. She was a fantastic mother going to the hospital everyday, dealing with seeing our baby with 20 tubes in his body, and not giving up hope. However, when it became time to go back to work again she began to fall back into depression. This time we knew what to look for and got treatment right away. She went back on Zoloft for another 6 months and the depression cleared up within a few weeks. Equipped with the experience from our previous episode we were able to avoid much of the pain and suffering.
Dealing with PPD was my first real exposure to the fragility of life. Even though I was 30 when the first depression occurred, in many ways PPD forced be to grow up. Suddenly I was caring for not just myself, but also my wife and baby. My view of how my life was going to go was shaken. I had to confront my fears, my frustrations, and my disappointments and carry on. I found new strength and confidence that has stayed with me through other serious problems.