Postpartum depression: a psychologist gets personal

Postpartum depression - mom with baby
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I’ve always loved baby’s sweet smell and innocent gummy smiles. As a teen, when I babysat, I couldn’t wait for parents to leave so I could be in charge. Years later, my husband, Bill, grew so tired of me pointing out yet another pink-faced cutie that he laid down the law: Unless there’s something distinguishable about a baby, I’m not looking at it. This didn’t deter me.

For me, pregnancy was easy compared to becoming a mother

I was in graduate school earning my Ph.D. in clinical psychology when I had my first child. The pregnancy was easy. Bill and I were on a tight budget, but life was really good. Until it wasn’t.

The day I went into labor, there was a shortage of anesthesiologists at the hospital. After hours of laboring in excruciating pain, my doctor (Dr. Stork, no joke) informed me that she had no other choice but to conduct an emergency caesarean.

Like Prissy in Gone with the Wind, Bill and I knew nothin’ ‘bout birthin’ babies. We also knew close to nothin’ about postpartum depression (PPD). For example, I didn’t know that first time mothers who experienced unplanned cesarean sections (like me) were at an increased risk for PPD. I didn’t know that while 80% of new mothers experience the “baby blues,” only 20% experience PPD. I didn’t know that if symptoms of the baby blues persist beyond 4 weeks, mothers should be assessed for PPD. (Here’s a great article with more detailed information about the differences between the baby blues and PPD.)

The symptoms of postpartum depression I struggled with and tried to hide

While everyone’s symptoms of PPD are different, I experienced the following:

  • Panic and irrational fear (e.g., I was afraid of being alone with the baby)
  • Chronic insomnia (my inability to sleep started right after my son was born)
  • Loss of appetite (my disinterest in food started in the hospital)
  • Weight loss
  • Crying spells out of nowhere (e.g., such as while setting the table for dinner)
  • Loss of confidence (e.g., I doubted myself and struggled to make basic decisions)

But, unless you knew me well, you may not have suspected anything. I felt an enormous pressure to present as a stoic, natural mother who loved motherhood. The harsh critic in me reminded me that I had it way easier than many new mothers too.

Yet on the inside, motherhood felt everything but natural. My throat ached from suppressing a constant urge to burst into tears. Even with training in psychology, I was at a loss for how to fix it or even what to do.

What led me to seek help, and the lessons I learned while doing it

When my son William was about 16-months-old, we flew to Texas to visit my father. As Dad and I rinsed our dishes after dinner, he commented on my skinny arms. “Tillie, you’ve gotta eat girl. Go get yourself a bowl of ice-cream. Eeeeat.” Tears welled in my eyes as I confessed that I hadn’t felt hungry since William was born. “I just don’t feel good,” I repeated, leaning into my dad at the sink. He insisted that I meet with his “psychiiiiatrist” before William and I flew home.

Lesson 1: Tell someone you trust how you’re feeling

My willingness to spill the beans to my father about my mental health was the first turning point in my postpartum depression journey. Here’s why:

  • Getting real with my dad required me to get real with myself.
  • Sharing the truth with my dad took a huge weight off of my shoulders.
  • Telling my father the truth gave him permission to offer help. I had been protecting my family, but they didn’t need to be protected. I did. Dad reached out more and visited more, which was great. That support is exactly what you need with postpartum depression.

Lesson 2: Make an appointment with a specialized mental-health professional

My second turning point with postpartum depression was scheduling time with a mental-health professional. As I mentioned earlier, my dad facilitated an appointment with his psychiatrist. I had started with a general practitioner (GP) for my symptoms and was prescribed medication. If I could go back in time, here’s why I would do it differently.

  • I had seen at least three different GPs since my son was born to share my concerns about my insomnia and irrational fear. They each prescribed similar medications, one of which worsened my symptoms significantly.
  • Psychiatrists or other mental-health professionals can offer more specific advice for PPD.
  • Providers who specialize in psychiatric medication management (e.g., psychiatric nurse practitioners) have a lot more experience with prescribing mental health medications than general practitioners (GPs). I started feeling like the old me within a few weeks of beginning the new medication, which was a such a relief.
  • The psychiatrist conducted a more specialized clinical interview than my family care practitioner. He also shared that he never would have recommended the second or third medication based on my response to the first. He also knew my family history, given his previous relationship with my father, which was an added bonus.

Lesson 3: Make an appointment with a psychologist experienced in postpartum depression

But you’re a licensed psychologist. Yes, I am. However, for me, it was important to connect with a psychologist who specialized in postpartum depression. Though my story didn’t unfold here first, I often wonder if I would’ve needed medication had I done this step earlier. To anyone hesitant to seek help, I’d like to say that “talking it out” about my PPD helped me tremendously.

  • I learned a lot about PPD, which changed my view of myself as a mother. In therapy, my psychologist helped me creative a more accurate, supportive narrative.
  • My psychologist helped me understand the relationship between my fear during my traumatic delivery of my son and my fear as a new mother. Once I understood this, I felt less afraid, which helped me heal.
  • I learned new coping strategies with Cognitive Behavioral Therapy (CBT) and other therapy techniques, such as guided imagery, to help me cope with stress.

What I hope others will learn from my postpartum depression experience

  • Don’t suffer in silence. Tell your loved ones that you need their support.
  • If you are feeling depressed and anxious for more than two weeks after you become a parent, schedule an appointment with a mental- health professional, such as a psychologist, who has experience with PPD. Please note: If I had begun working with a psychologist earlier, I may not have needed to see a psychiatrist.
  •  If psychotherapy is insufficient in treating your PPD symptoms, schedule an appointment with a psychiatrist or other prescribing specialist, such as a psychiatric nurse practitioner.

If you’re struggling with postpartum depression, seek help and feel hopeful. One positive from my PPD is my never-ending gratitude for my mental health, my ability to sleep and enjoy food, and my increased awareness about PPD.

Katherine Quie, Ph.D, L.P.
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