Possible late-onset PPD and questions (long) — The Bump
Postpartum Depression

Possible late-onset PPD and questions (long)

Let me start by saying I am new to this board and I'm not even sure if I belong here but I am pretty desparate for answers. LO is about to have his 2nd birthday and I also suffered a M/C in early march of this year. I have always been mostly even-tempered (except for normal monthly PMS type emotions) and have always had an optimistic, happy personality. I am blessed with a DH and child that I adore and I love my life. I have experienced some minor anxiety since LO was born that has come and gone roughly once a month and had stayed very manageable and Ive never needed medication or anything. 

I then experienced anxiety a couple weeks ago that has completely taken me over. I have seen my dr and she gave me something for the anxiety and feels very strongly that a lot of this is hormone related. I started back on BCP last month and bled through the entire first pack (sorry tmi). She wants me to take the anxiety meds until feel back to normal. The thoughts and fears caused by the anxiety are so irrational and I know they are but they are still crippling. Since starting the medicine the anxiety has stayed at bay with the exception of an occasional flair of it a couple times a day. I can't seem to get rid of the negativity and irrational thoughts. 

 My questions are these: have any of you heard of PPD coming on this long after LO was born? Also, dr says if I start on an antidepressant I have to stay on it for 6 months even if I feel better. Has anyone ever been told this by your dr? I am still a ball of emotions even though the anxious feeling has gone away but the thoughts and fears still linger. Any thoughts or advice is grateful appreciated. It is so nice to know I have a place to go for support besides my DH. Part of my concern is that this literally came over me in a flash like a wave. 

 TIA! 

Married my love 6/27/09 Conceived 09/09, LO born 6/17/10 TTC #2 since 12/11, BFP 2/22/12, m/c 3/2/12 @4w Stopped TTC for now. Photobucket Lilypie Second Birthday tickers

Re: Possible late-onset PPD and questions (long)

  • Ok I'm not a doctor, so this is all just my understanding from having dealt with a pretty serious case of PPD/PPA after my son was born. I also experienced an early miscarriage when DS was 18 months old.

    I think a clinical diagnosis of PPD/PPA is within a year of the birth. After that it would just be considered a clinical depression or maybe generalized anxiety. With that said- what is the difference really? If you have debilitating anxiety, you certainly need treatment. The treatment I received immediately following the birth of my son is the same thing you will get 2 years out. Most often a combination of medication and cognitive behavioral therapy is recommended. Your doctor might give you a long term medication- SSRI (Zoloft, Lexapro) and a med for panic attacks- benzo (Ativan, Xanax). There are variations and different things work for different people, but they usually they start there. 

    To address your specific questions:

    I don't think it is PPD related to your first pregnancy. Your body has probably regulated in 2 years (unless you were breastfeeding for those 2 years). And your loss was early so those pregnancy hormones shouldn't have caused a hormonal shift that great. If anything, my best guess is that it is related to your new BCP. The bleeding is normal. I had that too after I started back on BC after my M/C. I also experienced an increase in my anxiety and depression. I had been really good for a long time. Starting BC mixed with the emotional aspect of a miscarriage was a really hard adjustment. I think that's really normal.

    As far as the length of time you stay on an antidepressant- your Dr. is right. First of all it can take 2-6 weeks for the medication to start working well. That's generally why they give you something like Xanax to get by until it kicks in. Then you will start feeling better slowly. That doesn't mean you don't need the meds anymore. It means they're working! If you go off them too quickly you can experience rebound depression/anxiety and end up in a worse place than were you started.

     I might question your doctor about your BCP and if it could be related. It might not be the case at all, but with no history of mood disorders, its worth asking I think. The timing just seems like it could be related. Best of luck to you and sorry for your loss.  

    PCOS dx 2008 | BFP #1 2/26/2009 with Metformin
    Owen Matthew 11/1/2009 4lbs 10oz 16.5in
    Born 5 weeks early by C/S | Severe Pre-Eclampsia
    BFP #2 5/1/2011 | M/C @ 7 weeks | D&C 5/25/2011
    TTC #2 | HSG Clear | SA 2% Morph otherwise great
    3 failed Femara/TI cycles moving on to IUI
  • I was diagnosed with PPA, PPOCD at 15 months PP. BUT, in talking with my Dr, that's just when I got the diagnosis, I had both issues since my LO was born, they just went undiagnosed. 

    Given what you've described, not feeling anxious until just recently, it seems more related to something hormonal or external (life change? new job? worry about finances? new house?).  Also, hormonal shifts, especially nearer to your period can increase anxiety feelings, I know i have more anxious thoughts and feelings near my period. 

    My Dr said to stay on my Anti-depressant for 6-12 months, which will make you less likely to relapse.  I know people feel very apprehensive about meds, but it really turned my life around, and I needed it. 

    I preach about this on the board a lot, so please just take it as another possible option, but I really got a lot out of a Mindfulness Based Stress Reduction class that I took. It really has helped me manage my anxiety without medication. 

    <a href="http://lilypie.com/"><img src="http://lb2f.lilypie.com/4B2Um7.png" width="400" height="80" border="0" alt="Lilypie Second Birthday tickers" /></a>
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  • I agree with the PP. without any previous medical history of having anxiety or depression i would blame a hormonal imbalance....possibly caused by your bc.  I experienced this earlier this year and it was crippling. I was very scared because I didn't know what was going on with my mind and body and when I heard it was anxiety/depression i thought that was crazy considering I had no siginificant life changes going on that would cause me to feel that way. I then figured out (thanks to my sister) that this could be caused by the new bc that i had just started. I quit as soon as I figured it out but by then I was already on medication. THank goodness for medication! I don't know how I could have gone on without it.  I then found out I was pregnant and weaned off the medication and have been fine ever since. Talk to your gyn about switching your bc...espeically if its causing such havoc in your life. I know they tell you to try it out for 3 months, but if its making this much difference in your moods in the beginning I can only imagine it getting worse.   Best of luck to you and know that there is a light at the end of the tunnel. You are not alone.....and this will not last forever. :)

     


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