Been told I'm high-risk for PPD; lots of questions

overtonhayes · May 2012

(This is more about prenatal and postpartum depression, I suppose: this is my first baby, and she's not due until the end of July)

I guess I knew this was coming. I was diagnosed with depression and had a severe problem with self-harm and alcoholism when I was 15; then the depression returned again - along with an eating disorder - when I was 18. Lately I've just been low all of the time. I can't take joy in anything; I cry all of the time; I feel helpless; I feel like I'm not doing enough for this baby; I can't sleep at night; and I don't ever feel grateful for anything (I don't want to make this all about religion, but I'm big on thanking God for my blessings every night, and every week finding one thing to be thankful for that I normally overlook. Lately, I go to pray and I know I have so much to be thankful for, but I just can't feel it, so I just mumble "sorry" and give up).

I told my OB and she advised counselling. So far I've only had one counselling session. I don't know if it's standard for them to say "yep, you have prenatal depression!"/"actually, I think you're fine", but she wants to keep seeing me (I guess that's an indication she thinks there's a problem here?). She and my OB also mentioned that I should probably be put onto antidepressants as soon as the baby is born. So now I have questions, and I'd rather ask someone who's been through it...

1. Were you put on antidepressants immediately, instead of a more "let's see how you manage without first" approach? Is it common to do this?
2. Can I still breastfeed while on antidepressants?
3. Are there any side effects I should be aware of? (I won't care. I care more about being happy and healthy for my baby. I just want to be prepared)

And finally...
Does therapy really help? I can't get my head around my own thinking behind this one. I had therapy for the eating disorder, and not only did it really help me but I knew before I had it that it would. But for some reason I can't imagine how it would work with PPD. I mean, part of the therapy for the ED was to re-train the way I looked at myself. What is there to 're-train' in the case of PPD? I know that those who suffer from it still love and adore their children, so it's not "learn to love your child". I know it's not as simple as "look, you have a baby, just be happy!".
Sorry if I've phrased that badly, I'm not trying to offend anyone, or adhere to ridiculous misconceptions about PPD (in fact, it's because I know that they're misconceptions that I am confused).

redjetta22 · May 2012

I'm so sorry you're struggling with this. I had PPD after DS was born. I also have a history of depression and an eating disorder prior to pregnancy. I wasn't put on medication immediately after the birth, but in hindsight, I probably would have benefited from it. I remember my ob asking me about it before I was released from the hospital, but I said I wanted to see how it went. I didn't take an antidepressant while breastfeeding but I believe you can do both (I feel pretty certain my ob mentioned my Zoloft being ok for breastfeeding). I will say I struggled with breastfeeding and I have since wondered if I would have done better if my emotions had been in a better state earlier on. Breastfeeding caused a great deal of stress and I was extremely emotional. I think those emotions would have been there even without the problems breastfeeding... The depression was not situational, but I wish I had taken it more seriously early on rather than brushing it off as baby blues. Finally after about 3 months I went on meds. I was having irrational anxiety about perilous things happening to the baby, and my husband basically told me he thought I wasn't ok. I plan on speaking with my ob about meds a few weeks prior to the birth, just in case. Transitioning from pregnancy to new mom is stressful and hormones go absolutely bananas. I am so glad if you're dealing with depression at this point, you're being honest with yourself and trying to get some relief. Depression has "side effects" too so if medication can help, go for it. I think counseling can't possibly hurt and it can take some time to see benefits, but those benefits can be profound. I hope you'll chose to give it a try and give it some time. :-) I hope you find some relief soon, and I wish you a healthy and happy remainder of your pregnancy and baby!

frecks2112 · May 2012

My 2 cents:

Therapy can be helpful if the therapist can provide you with skills that you can implement when you need it.

My saving grace (for PPA) was to take a Mindfulness Based Stress Reduction class. You can look them up online depending on where you live. Look at Kaiser if you have a clinic nearby, you don't have to be member to take the classes.

I would say get on the medication right after your LO is born, and if you are feeling bad enough, you could just get on it now.

findingmyshoes · May 2012

I am in exactly your same boat, sister, just about a year ahead! For me, I started a therapist early, before I delivered, just so I wouldn't have to find one if I got really sick. There is more to PPD than just "I don't lveo my baby". Just like therapy for regular depression isn't "Just be happy", therapy for PPD isn't "love your baby".

For BF info, I would check out: https://postpartumprogress.com/what-psychiatric-medications-are-safe-during-breastfeeding. It is really thorough.

overtonhayes · June 2012

Thanks for your support, everyone. I just wanted to add an update and see if anyone has any additional thoughts on this.

In my first post I said I'd only had one therapy session so far. I've had another since then, so I've had two to date. I know it's still early days, but I just don't think that it's helping... Let me explain a little more, because I must sound like I'm thinking therapy is some miracle, overnight cure.

When I was in therapy for my eating disorder, I felt a difference right away. I don't know whether I just 'clicked' with that therapist better than this one or what, but from the very first session I walked away feeling different. I guess it's because there were actual thoughts to change, if that makes sense: I saw myself as fat and hideous, and from the very first session we worked on changing that. This time around, there are no thoughts to 'change', I just feel low all the time (there we go, that's how I should have put it in my first post!). A lot of the therapy for my ED went way, way back to issues with my family. That doesn't apply here, so there's nothing to work on in that sense.

In both sessions so far, my therapist has basically told me (nicely, of course) that I need to get out more. In fact, in my last session we ended up talking about DH and quilt-making for nearly half the session because I didn't even know what to talk about. I don't think that the therapist necessarily sees me as some bored housewife who just needs to go out and meet people, but that's how I feel during the sessions. I don't walk away at the end thinking "wow, I never thought of that" or "she's right, I do need to start focusing on X", I walk away thinking "eh". I walk away feeling like that horrible, old stereotype of the woman who is in therapy because she's bored.

So what do you think? Is that a warning sign that therapy isn't going to work, either in general or with this particular therapist? Or is it just early days?

Useonfire · June 2012

overtonhayes:
Thanks for your support, everyone. I just wanted to add an update and see if anyone has any additional thoughts on this.
In my first post I said I'd only had one therapy session so far. I've had another since then, so I've had two to date. I know it's still early days, but I just don't think that it's helping... Let me explain a little more, because I must sound like I'm thinking therapy is some miracle, overnight cure.
When I was in therapy for my eating disorder, I felt a difference right away. I don't know whether I just 'clicked' with that therapist better than this one or what, but from the very first session I walked away feeling different. I guess it's because there were actual thoughts to change, if that makes sense: I saw myself as fat and hideous, and from the very first session we worked on changing that. This time around, there are no thoughts to 'change', I just feel low all the time (there we go, that's how I should have put it in my first post!). A lot of the therapy for my ED went way, way back to issues with my family. That doesn't apply here, so there's nothing to work on in that sense.
In both sessions so far, my therapist has basically told me (nicely, of course) that I need to get out more. In fact, in my last session we ended up talking about DH and quilt-making for nearly half the session because I didn't even know what to talk about. I don't think that the therapist necessarily sees me as some bored housewife who just needs to go out and meet people, but that's how I feel during the sessions. I don't walk away at the end thinking "wow, I never thought of that" or "she's right, I do need to start focusing on X", I walk away thinking "eh". I walk away feeling like that horrible, old stereotype of the woman who is in therapy because she's bored.
So what do you think? Is that a warning sign that therapy isn't going to work, either in general or with this particular therapist? Or is it just early days?

If you talked about DH and quilt making for half the session, I'd say the therapist was happy to make money while you "chatted." That isn't therapy. Well, not good therapy anyway. Therapy sessions (particularly at the beginning) should be thought provoking, and insight seeking. If you don't feel like you are getting much out of it, then you aren't. I wouldn't give up on therapy, but I'd find someone who challenges you.

Just my 2 cents (I'm a licensed Psychotherapist).

Bride-hilda · June 2012

Hello.

I'm probably at risk too, since I'm pretty depressed right now, and before I got pregnant. I've been to therapy before for depression and anxiety, and it helped a TON. They use different strategies for different problems and diseases, and a good one will help. If yours isn't helping, find another one. Just don't give up.

overtonhayes · June 2012

Useonfire:
If you talked about DH and quilt making for half the session, I'd say the therapist was happy to make money while you "chatted." That isn't therapy. ... ..... I'd find someone who challenges you.
Just my 2 cents (I'm a licensed Psychotherapist).

I had a nagging feeling in the back of my mind about this. In your professional opinion (I mean that genuinely, not in a snarky way), should I give it a little more time with this therapist and see if things will 'click', or just try to find someone else now? My insurance only covers two therapists in my area, and she's one of them, so I'm not exactly spoiled for choice.

haleymay18 · June 2012

Have you considered placenta encapsulation? I did it after my second because I had severe (hospitalized because of it) ppd after my first.

Best decision I ever made.

Been told I'm high-risk for PPD; lots of questions

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