Hello. Welcome back to another exciting episode of, “What to do when you have dropped your basket.”
What is “dropping your basket”? I’m glad you asked.
Often, it is nothing more than being weepy and dysphoric, not enjoying things you once did. It can also manifest as:
2. Obsessiveness / OCD. OCD can sometimes be just obsessiveness without compulsions, and hand-washing and tidiness are not the only signs. Trust me; I know. Look for fear/concern over toxins, frequent thoughts of the baby being hurt or something being wrong with her, checking things over and over even though you just checked them, even words, phrases, or music repeating themselves in your head. OCD can focus on numbers, textures, certain rhythms.
3. Outbursts of anger, even episodes of violence (including punching walls, throwing things, and kicking holes in the cupboards).
4. Anxiety, memory problems, feelings of emptiness, losing interest in things that you used to find pleasurable
There are surely more. Some would suggest that this cornucopia of symptoms might better be called something else. Postpartum syndrome?
In any event, clearly the usual question of “do you feel sad and not want to get out of bed in the morning” doesn’t really cut it as a diagnostic tool.
But let’s say you already know. Let’s imagine that you’ve struggled with depression throughout your life, so you know you are more at risk for severe PPD, and you kinda know what it looks like.
What do you do?
There are many options available. I would have to say that the top five solutions are all occupied by the words “find support.” Whether this means help at home with children, meals, or housework, or a friend who is a good listener, or a therapist of some kind – do it. Do it all. Don’t keep quiet. Now, that said – I am the quiet sort. No one has any idea just how far down I had sunk. In fact, I think depression feeds on itself and postpartum depression has its own unique brand of vicious cycle. We are mothers. We are supposed to be able to do this thing, right? So when we can’t, we feel awful about ourselves. This feeling awful makes everything worse. When you believe you are an epic FAIL as a parent, why in the world would you want to advertise?
So more than just seeking out help and support for yourself, it’s important that you have the people closest to you understand what to look for. Have them ask you how long it’s been since you showered (but please don’t ask me how long – not today). Schedule someone to come over once a week for a standing date, no matter how little you feel like being social. If that person knows they are there to make sure you are okay, they will be respectful of your limits. Sleep. Exercise. Eat right. You know the drill.
If these things don’t work, then what?
We are lucky to live in a time when medications for depression are so much better than they used to be. SSRIs are excellent medications for dealing with depression, anxiety, anger and OCD. Some are better at handling some things than others, so have this discussion with your physician. And most are safe to varying degrees, particularly Zoloft. For the best resource available on medication use during pregnancy, I recommend Dr. Thomas W. Hale’s book, Medications and Mothers Milk: A Manual of Lactational Pharmacology. He discusses many of the medications used for depression and how they can affect your baby and you. The book is often available through a local La Leche League group lending library (LLLLLL??), and there are discussion forums on his website. Be forewarned, however, that consumer questions are not accepted and many of the forums essentially tell you to read the book.
If the first line of antidepressants don’t work for you, what should you do?
If breastfeeding is well established and your baby is a little older, there are more options. But what if you have tried some of the stronger medications, and it looks like your only option is to wean and break out the big guns or continue to struggle? How do you make that choice?
My baby is twenty months old. I nursed my last child to the age of three. I really never expected to do that, but somehow you just get caught up in things. He had emotional and behavioral issues which made parenting him extremely difficult, and breastfeeding was my ace in the hole. I admit it – I’m lazy. I wanted an easy way to get this child to sleep at the end of my grueling days, and nursing was like slipping him a mickey. His eyes would even roll back in his head as he went on the nod. Now my little Beckett is pretty addicted to it, too. And he is my last baby. Once I wean him, I will never share that bond with another one, which is sort of depression-inducing on its own, for me.
So I find myself weighing the seriousness of my depression with my knowledge that I might have to sever the breastfeeding relationship. It’s a sucky place to be. And the worst part of it is, it’s a selfish position. My mental health being stable is so much more of an influence over my almost-two-year-old than a few more months of breastfeeding. But I don’t want to feel I sacrificed that relationship for nothing, since trying a new medication is always a crap shoot.
I also struggle with the issue of judgment, both from myself and others. There has been so much talk over the last couple of weeks about breastfeeding in public and working. There’s The Case Against Breastfeeding by Hanna Rosin, and an excellent rebuttal by PhD in Parenting. Then there are posts about when to give up and even about nursing another woman’s child. It seems not too many of us can straddle that middle ground all that well. Or maybe it just doesn’t make good blog.
I began writing this thinking I would have some resolution at the end. And I hate to leave anyone without solving the problem, least of all myself. But no one really knows all that much. In the end, it’s about weighing the pros and cons and making an informed choice, much like anything else having to do with parenting. Seek out people who have been through it. Keep talking and asking questions. Even if it’s too late for us to have real answers, maybe our daughters will.
Tomorrow on Blogher: why I’m such a know-it-all when it comes to depression.