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Post Partum Depression Help

One of our readers emailed recently about her struggles with Post Partum Depression (PPD).  Do you have any professional recommendations for her; or experiences to share?

I am writing with the hope that some mamas will have some answers for me....

I am suffering from ppd - for the second time.  I am realizing that I have probably had a low level of depression for most of my life and it really shows during times of great stress (like having babies!)  It is definitely worse this time around (2nd babe) and my husband and I have decided to seek some help.

We have contacted a few folks but thought i'd put it to the umamas too.  Ladies, please share your experiences with me and help me to feel better about this situation.  I am trying to not feel like such a failure.  it is a challenge.  but the challenges of living with depression are far greater!

So, practitioners you like, safety of drugs & side effects.  I want to nurse my baby and don't want him to have drugs in his system.  Would acupuncture help?  I am currently taking, er, gulping, herbs and feel its not enough.

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I have seen Dr. Esther Lerman Freeman at OHSU. She's kind and thoughtful.

http://www.ohsu.edu/psychiatry/faculty/estherfreeman.htm

Good luck and best wishes to you.

I know through my work that people have found help through Wildwood Psychiatric Resource Center (they have a specialty in post partum depression) http://www.wildwoodpsych.com/ . You'd have to check what insurance they accept as there are some they don't (Oregon Health Plan, for instance). Another good resource is http://www.babybluesconnection.org/ . Best wishes to you. It's wonderful that you are seeking help.

Check out http://www.babybluesconnection.org/. They have a number you can call to speak with someone and support groups who meet locally on the east and west sides, during the day and in the evenings. You may want to check out more than one group to find a good fit. The facilitators of the groups have lots of info on herbs, etc. and are moms who have been there before. Sometimes just getting out of the house to go to the group made me feel better.

Some of the drugs are supposed to be safe while nursing, although I didn't feel that was the best option for me - especially w/o trying something less invasive to begin with.

I have Kaiser for insurance and although they offer counseling, they claimed to not have a group to cover this. With some perserverance, they finally referred me out to see Lori Cox on NE Broadway. I believe she's been mentioned on this site before.

Good luck to you and remember the sunny days are not too far ahead. I truly believe that helps a lot!

I love my Zoloft. That's all I can say. I was having a very, very hard time, to the point that my husband confessed that, when I didn't answer the phone right away, he wondered if I had hurt the kids. When I started on Zoloft, I started feeling better the first evening. I'm now taking 100 mg a day, and the difference is phenomenal. I feel like I have the energy and positive outlook to deal w/ my almost-2-year-old and my 6-month-old without so much anger. I don't know all the details, but I know that it is safe for breastfeeding (which I am). I don't have insurance, but with the Oregon Prescription Drug Program (google it to sign up), I can buy a 30 day supply at Fred Meyer for 8 bucks.

I wrote a similar post a while ago, but never sent it, in fear of being judged and or disliked. I think I am in a similar situation as you, where I have had a bit of depression all my life. I was ok with my first pregnancy, for the most part, but with #2, everything was worse. Now that my littlest is over 1 year, I'm starting to come out off the fog on my own, I think. I was suggested some herbs by my midwife, but never took them. I wish I had. I didn't do anything so I guess I don't have so much "advice" for you as I have sympathy and understanding and wanted you to know that you are NOT a failure. I felt the same way and it's only now that I am looking back that I can say it wasn't me.
I guess the things that have saved me and maybe brought me out of the "fog" are working out (I think the endorphins themselves are like a drug I need since I was an athlete ALL of my life), seeing a therapist just so I had someone to talk things out with (she also gave great advice and support), and figuring out better ways to discipline and parent my kids. Planning regular activities to get us all out of the house have also been helpful (as I'm a stay at home mom with 2 kids under that age of 3). Oh and joining a local moms group or contacting friends might also be helpful.

I do think you're on the right track and I hope the women here can help you more than I have.

I'm sure you are a wonderful mom! I wish you the very best.
If you are interested in chatting more, I would be happy to email with you personally: [email protected]

I also went on Zoloft shortly after the birth of my son. I have struggled with depression since my childhood and was on Prozac when I became pregnant. The hormones seemed to help me through the pregnancy and I was fine without the Prozac. Once my son was born, however, the baby blues hit pretty hard and I went to my primary physician immediately for Zoloft.

Meds help me tremendously. Without them, I get angry, frustrated, and easily overwhelmed. I find it difficult to do anything because I am overwhelmed with the thought of having to decide how/where to start. I feel like a crushing weight is lifted from my shoulder from the meds and I am able to function. I remain on my tried-and-true prozac and have come to the conclusion that this is something that I need to remain on, indefinitely.

I think that realizing how irritable and short fused I become with my son when I am not on medication has made it easier for me to take medication without concern for the stigma attached to medications.

I, too, am more than willing to chat 'off-line' if you have any additional questions.

I have had depression my entire adult life. After both babies, for a few months, it got worse. My obgyn had me on prozac. It is safe for baby and works well. When the baby was done breast feeding, I went on Welbutrin. I am happy with the result and it is true that you do not have any sexual side effects. This makes life much easier for you and your husband. Good Luck!

This is a long post, but I know how hopeless depression can feel, so I'm writing this in case something in it will help in some way: a doctor, a book, an article, or some specific little strategy that was helpful for me.

Like others have said, I think I have struggled with periods of depression most of my life, but I didn't realize it until I saw a professional during a severe depression during pregnancy. (I saw Dr. Marcia Kahn at the Women's Psychiatric Resource Center in Beaverton, 16110 SW Regatta Ln,
Phone: (503) 645-9444. I was referred to her by my ob/gyn in Portland.

Dr. Kahn recommended a book, which really helped me
"Women's Moods: What Every Women Must Know about Hormones, the Brain, and Emotional Health" by Deborah Sichel, Jeanne Watson Driscoll.
It is available at the Multnomah County Library, and can be reserved online at www.multcolib.org and sent to your branch library for pick-up. The book explained why women are more susceptible to depression, and detailed specific areas that can trigger depression if you have a genetic predisposition to it: including stress, diet, exercise, sleep, etc. (Of course, high levels of stress doesn't result in depression symptoms for everyone, but after reading the book I realized that many of the women in my mom's side of our family seem to have inherited this tendency. The book helped in identifying specific things I could do to prevent these episodes or keep them from snowballing.

Also, here's a link to an article about the effect of low seratonin on the brain. http://www.mental-health-matters.com/articles/print.php?artID=160 Seratonin was discussed in the "Women's Moods" book, which went into more depth by talking about foods that have tryptophan in them and can help elevate mood because trypthophan is a precursor to seratonin, or something like that.

I don't have advice about medication and everyone is different, but here are some of the things that have helped me function better during serious depression and also deal more effectively with low level depression:

- Always eat well, and look into foods that have tryptophan(?)/seratonin (turkey, almonds...
- Get enough sleep
- Exercise/Get out of house (sometimes it's just walking around the block)
- Minimize stress (often easier said than done)
- Plan a special stress reducer when needed, like a massage. I don't usually get massages, but occassionally it's worth the cost for the stress reduction benefits
- Have a routine, but a flexible routine that allows you to have fewer responsibilities, or avoid stressful situations during low times.
- when I get depressed, I try to accept that it's a low period and not let it spiral down due to feelings of guilt or low self-worth; basically I try to get through it by taking extra time for myself, and without berating myself for feeling useless, worthless, etc.
- Have a good support system (friends or family) who can give you slack (or help) when you need it. And don't feel pressured to stay friends with someone if you don't want to.
- Reject external expectations for yourself, your home, or your career, and decide what's best for you, your family, your life.

Seeing a professional really helped get and keep me on track toward creating a plan that worked for me. I haven't been back since my pregnancy depression but would if I needed to. Very often women who have severe depression during pregnancy also get post-partum depression, but somehow I lucked out and had only a very minor and short episode after the baby was born, or maybe the plan was effective enough to help keep it from recurring. I think breastfeeding helped too(the hormones), and when it was time to stop breastfeeding I did it slowly which I think also helped.

I also always remember that medication is out there if I need it, and sometimes during especially low periods I get close to making the decision to see a doctor for a prescription. One thing that worries me about it though is that medication works differently for different people. A close friend had some horrible side effects after she started taking medication, until they switched her to a different prescription. But I don't know how common it is to have problems like that, and I've gotten close to the point of being willing to risk it getting worse just to do something.

One more thing. When I'm depressed, I have a REALLY hard time making decisions, so I keep lists for when I need them:
1. For when I'm most depressed I have a list of things to do EVERY single day (a very short checklist of must do's just to stay on routine, and to keep me and the household afloat and things from piling up so much that it's hard to dig out of when I'm feeling better. For example, Get kids up by 7:30am, Meals, Dishes, Mail, Go outside, Tidy)
2. List of easy, fun, inexpensive kids activities.
3. List of super simple meals, and cheap take-out places. I even have a meal category for every night (for example, Monday=Fish night, then I just decide what to make within that category. Fish sticks and frozen french fries on a low night, or on a good night a nice salmon meal.)
4. List of Goals (This is not to feel pressured to do anything toward them every day, but it helps to remember the big picture and can be a reminder of things I've done to move toward those goals when I'm feeling like a complete failure)
5. Pre-printed grocery list, with "must have" items, like milk, in bold. Then I can just circle what I need and go, or occasionally I even order the groceries online and have them delivered.

My mama was depressed when I was growing up and would take out her anger and frustrations on me. It made me realize that one of the best things I can do as a mother is make sure I'm taking care of myself or getting help to do that. I don't let myself feel guilty anymore for taking time for myself, or lowering my standards in some areas to reduce stress (or getting a housecleaner for a few months), because I know that it's what I have to do to be a good mother. So I try to turn it around: I'm not failing at [fill in the blank] - I'm suceeding at raising a happy, healthy, well-adjusted child. I know some people can do everything, but I can't so I don't let that bother me.

p.s. Since lack of sleep can help trigger depression, our baby slept in our bed so nighttime feedings disrupted my sleep less.

I swear by my Zoloft. I have suffered from depression for most of my adult life. When I finally went on meds, it made a huge difference. Friends and family noticed alike - even those who didn't know I was taking something. When I got pregnant, I too was worried about the effects of the drugs on the baby, so I decided to stop. By about week 17, I had to go back on. It made the biggest difference! My OB and I decided that after I had the baby that we would up my dose(I was on 50 mg, now on 75 mg) to try and avoid ppd. I'm currently breastfeeding as well.

That said, I understand the need to try and do it without drugs. I struggled with feeling like a failure, that I couldn't fix myself. I was always scared, and didn't want to admit that I needed help. But looking back on it, I wish I had done it sooner - not only for myself, but for my friends and family.

I've done acupuncture, which is very relaxing and I highly recommend it just for some alone time to concentrate on yourself. Working out always helped me as well. Good luck and it will get better!

St. John's wort was a very effective herb for me for years. Doctors told me to avoid it during pregnancy, and the hormones kept me from needing it anyway, but I found European studies showing the only danger was from an appetite suppressant side effect I never experienced.

My years of depression lifted completely when I gave up dairy products. Apparently for some people, milk proteins can interfere with seratonin-melatonin regulation. A major diet change takes more energy than most post-partum women can spare, but it may be worth a try down the road.

Take it easy on yourself! You have wonderful strength and courage in reaching out for help.

First - please know that you are not alone! Having struggled with PPD myself, I know how lonely you can feel.

My PPD was made worse by sleep deprevation - so I encourage you to find ways to get more rest and take care of your own needs.

I tried accupuncture and it worked OK but not enough. I also worked for a long time with my therapist before deciding to take medication. I take prozac and have been happy with the results - and have continued to breastfeed.

My strongest suggestion though is to find a therapist or counselor who understands PPD and the pressures of motherhood. I highly recommend Dr. Britt Anderson
http://www.andersoncounseling.net/

I found her through the Baby Blues Connection - a great resource and very nice supportive helpline. They have a whole list of mental health professionals who understand PPD. Many of them will take insurance.

First - please know that you are not alone! Having struggled with PPD myself, I know how lonely you can feel.

My PPD was made worse by sleep deprevation - so I encourage you to find ways to get more rest and take care of your own needs.

I tried accupuncture and it worked OK but not enough. I also worked for a long time with my therapist before deciding to take medication. I take prozac and have been happy with the results - and have continued to breastfeed.

My strongest suggestion though is to find a therapist or counselor who understands PPD and the pressures of motherhood. I highly recommend Dr. Britt Anderson
http://www.andersoncounseling.net/

I found her through the Baby Blues Connection - a great resource and very nice supportive helpline. They have a whole list of mental health professionals who understand PPD. Many of them will take insurance.

There are sooooo many women out there who've been through this. As you can probably see here, just by telling people about it you'll find that many of us mama's can tell you about how hard it is & how we survived it.
I went through a depression after my first daughter was born. I didn't have any health insurance but my daughter's pediatrician asked the right question & got me into a few free visits with a social worker at OHSU. Fortunately our finances sent me back to work shortly thereafter & I found an opening for a community garden plot (it was May) so between lots of sunshine & shovelling & an amazingly friendly group at work I pulled out of it.
With my second it wasn't so easy--there were just so many more stressful situations going on just at the same time that I don't think I had a chance but to be back yelling at my 2 year old, crying behind the door, hating my husband, etc. This time I had Kaiser & I finally impressed upon them the urgency of my situation & got a referral to a great psychologist. I also spent a month going to acupuncture & chiropractic therapy (Mychell Vincent at Elements in Clackamas is WOW!). Now my husband and I are in counselling--undoing damage that I think was done while I was being depressed. And, frankly, I am very relieved that I got a tubal ligation with the birth of my last child because I don't think our relationship could withstand another pregnancy/postpartum and I hate to think of the years of my life that I lose to just not feeling well.
Another thing that came of the psychologist, he helped me get a handle on my relationship with my 2 year old. She had been acting out in an attempt to get my attention & it would crescendo until I yelled at her or otherwise made her cry. It made me so angry! But when you're angry with a toddler you kind of have to repress it--leading to more feelings of helplessness & depression. All I did was start to use timeout as a discipline tool and figure out a good bedtime routine. Now she understands that when I ask her to do something (pick up toys, hold my hand to cross the street...) she is expected to comply; and she does what I ask most of the time. So now I enjoy being with her and I can express my love and affection much more because we're not fighting all the time.

I, too, am on zoloft, which is generally thought to be least transferred between mama and baby in pregnancy and through breastfeeding. the other thing I do that I don't think has been mentioned is take a lot of cod liver oil, which is supposed to help, especially with regulating moods through pregnancy and afterwards. my midwife suggested carlson's cod liver oil, it comes in a big bottle and can be lemon flavored. in her opinion the only way to get enough of it is to take it straight, rather than in the little capsules. I've found that mixing it into a little orange juice is the easiest way to get it down. and it's great for babies' developing brains as well!

i have struggled with serious depressive episodes both pre-pregnancy, while pregnant, and postpartum, and i think the previous posters have already given some great advice. you are absolutely not a failure -- you are a mama who is very wise in seeking help and support!

i second the recommendation of baby blues connection. their meetings are a fantastic resource, as are their peer counselors. they also have a resource guide in print and on their website which lists psychiatrists and therapists who specialize in, or work, with PPD issues, and i've had very good luck with the practitioners on that list.

i would also gently encourage you not to cross meds off your list completely, because they can make a tremendous difference. not saying you have to take them to resolve the issue, but sometimes i think people shy away from them unecessarily due to understandable fear about side effects for themselves or their babies. i was on zoloft during pregnancy and while nursing without any issues, and i found that going on meds was a key factor in my being able to enjoy and cope with the stresses of new parenthood. (my daughter is almost two, and i'm now off meds, so it can potentially be a temporary measure.)

best of luck to you, mama, and kudos to you for having the guts and wisom to reach out!

i have struggled with serious depressive episodes both pre-pregnancy, while pregnant, and postpartum, and i think the previous posters have already given some great advice. you are absolutely not a failure -- you are a mama who is very wise in seeking help and support!

i second the recommendation of baby blues connection. their meetings are a fantastic resource, as are their peer counselors. they also have a resource guide in print and on their website which lists psychiatrists and therapists who specialize in, or work, with PPD issues, and i've had very good luck with the practitioners on that list.

i would also gently encourage you not to cross meds off your list completely, because they can make a tremendous difference. not saying you have to take them to resolve the issue, but sometimes i think people shy away from them unecessarily due to understandable fear about side effects for themselves or their babies. i was on zoloft during pregnancy and while nursing without any issues, and i found that going on meds was a key factor in my being able to enjoy and cope with the stresses of new parenthood. (my daughter is almost two, and i'm now off meds, so it can potentially be a temporary measure.)

best of luck to you, mama, and kudos to you for having the guts and wisom to reach out!

I was on Lexapro for about a year for PPD and then Zoloft and just want to offer my experience. I was underwhelmed by the results. I didn't feel thhhaaatt much better. I was expecting more. I also suffered through some, what became unacceptable, side effects... Nausea, trouble sleeping and an occasionally sort of fogginess. So, the meds aren't for everyone. I have been told that the body can take up to 2 years to recover from pregnancy. My best advice to is strive for a superbly healthy diet, get as much rest as you can any way you can, keep the communication open and real, let go of any guilt, reach out to friends and family to hang out and/or talk REGULARLY. Some people also have great results with acupuncture, I did not. I think my body just took it's time getting back to normal. It was very overwhelming! Just keep working with your Dr. toward finding what combination of lifestyle, med, acupuncture, diet, exercise, etc. will work for you.

Something will work and you will feel better eventually.

Please do not feel like a failure! Instead, give yourself lots of credit for recognizing that you need to take care of yourself.

I had PPD after the birth of my first (and only). It took me a few months to realize that I was just not myself anymore, and it was more than just being sleep deprived (though that didn't help!) and getting used to life with a baby. I decided to take Zoloft for three months, just to get me over the hump, and I am SO glad that I did. It made a huge difference. I was comfortable that it was safe to use while breastfeeding and also decided that the risks of maternal depression outweighted any risks of taking an antidepressant. But if you're really not comfortable with the meds, I've heard that fish oil and B vitamins can help, and there are other good suggestions in other posts.

I also started seeing Laurie Cox at Motheroots on NE Broadway, and she has been an amazing source of support. Several of the other names here were also given to me as referrals, so I think you've got lots of good options to pursue.

Please don't feel like you are alone. As the many responses here indicate, you definitely are not. Take good care.

One of the things that helps me the most when I start to sink into a depressive period is to tell myself over and over again, "It's a chemical imbalance." It's hard to really get your head around that, and believe it. But it isn't just a mood - it's a real, chemical phenomenon that's occurring in your brain and body. This helps me lift some of the shame/embarassment and also to see a light at the end of the tunnel. So many things can trigger it! It's very hard to take that leap to get help, for some reason ... I know. You're doing a great job.

I have one piece of advice. Make sure that you carefully monitor your responses to any drugs, if you try them. Some primary family doctors don't have the experience to really monitor the effects or see the warning signs if you aren't responding positively, so if you have the means to see a professional, prescribing psychiatrist - do it. They have more current information and know what to look for. I had a bad reaction to Lexapro, but Effexor worked miracles. (Though I don't know if it's OK for breastfeeding.)

And if you don't choose to try drugs at this point, get LOTS of sleep, including daytime naps, if at all possible!

I love that you all are talking about this and the support in not feeling alone helps! I had ppd with both kids and both times began taking Lexapro with fantastic results. I also recommend Gaby Donnell at Motheroots. She is fantastic and I've heard that Laurie Cox is as well.

I am happy to see so many great ideas about healthy diets, getting rest, time alone, etc. However, when I was at my lowest I literally did not feel like going out without my baby, or even with my baby. I didn't feel like eating anything but comfort food, had no energy to think about what was healthy or not. I didn't have a single lick of energy to exercise-it was tough enough to shower, much less work myself up to go out and walk or, even worse, go to the gym. So, obviously: eat right and exercise and get plenty of rest. But, know that there are other ways to feel better and then you can do all those things more easily.

Good luck and you will feel better.

It looks like you've gotten some great advice here, but I wanted to chime in my support for you and what you're going through -- you are in no way a failure and by speaking up and finding the care and support that you need, you are doing what's best for you and your baby -- you are being a good mom! I experienced ppd with both my children and I'll tell you that my recovery was remarkably different with my second because I sought help. An excellent resource here in Portland is baby blues connection. I know it's already been mentioned in these comments, but I wanted to call attention to it again because it's a great place to find answers and resources.

Good luck to you and take care!

just commenting to reassure you that you are not alone, and that you will be ok. PPD completely floored me when my son was born about 8 months ago. i tried to deal with it on my own, and then with the help of a naturopath. but then i just spiraled completely out of control. i had unrelenting anxiety and could not sleep no matter how well the baby was or wasn't sleeping. i had to seek medical help, i knew there was no other choice at that point.

i strongly recommend Diane Solomon, who I found through Baby Blues Connection. She is a psychiatric mental health nurse practitioner, and a midwife. she has been such a help to me. her office is near central library.

and zoloft (along with ativan in the beginning of my treatment) has basically saved my life. i went from not being sure that i could survive another day to being mostly fine - sleeping great, happily taking care of my baby boy every day. i was really hesitant of starting an antidepressant. i didn't want to need that medication, but i now know that its ok to need it.

and i can't say enough great things about the folks at Baby Blues Connection. those women picked me up and comforted me week after week for months. we are so lucky to have that resource here. i doubt most other cities are so fortunate. please don't hesitate to take advantage of that resource! i promise you won't regret it.

remember that this is temporary, and it is not your fault.

dear friends,

thank you so very very much for all of your suggestions and thoughtful posts. knowing these encouraging words are just for me is really helpful.

my husband and i are working toward a solid plan that includes many of the things suggested. it is mainly down to his ability to help me balance this life with two in the areas of sleep, exercise and alone time, so that is part of the discussion. you should know (because i know how loyal the mamas are!) he is beyond willing.

has anyone heard of amino acid therapy? good results? any results?

thanks again mamas. i am taking all of this very much to heart. and best wishes to the many other mamas who i know are reading this post and suffering too (maybe silently and alone). get some help (right ladies?!) you're not alone.

I just wanted to ask: do you think most of these practioners take insurance? Has anyone ever tried to access services without insurance and know how much it could cost?

Yes, most take insurance, so it just depends on who is in your network and your mental health coverage, which can be different from primary care. My therapist charges $100/session.

hey anon-

i know there are some therapists that can see you on a sliding scale if you do not have insurance. again, i think contacting Baby Blues Connection would be your best help for finding these practitioners. My insurance (Blue cross) covers 80% of mental health visits, so i think i end up paying $25/session.

please don't let worries about finances stop you from getting the help you need to feel better. the money part will work itself out later, it is more important for you and your family that you receive the care you need.

I'm an Urban Mama's reader and also a psychotherapist who works with individuals struggling with postpartum depression and I've been following this thread. People experience the postpartum period in many different ways and it can be an incredibly difficult and isolating time. Please know that there is help available to you if you are suffering. I and many other practitioners in Portland are available and have experience treating postpartum depression and I'd be happy to help you get hooked up with someone who can help. Many therapists accept insurance and/or work on a sliding scale. Feel free to contact me at [email protected]

I am a Naturopathic Doctor and I am treating PPD. I became interested in It from my own experience after the birth of my son Santiago. Since then I have been studing the hormonal changes and nutritional deficiencies that affect new mothers and I have developed treatment plans to support them through this. I use laboratory tests to see how the changes in the female hormones, thyroid hormones, neurotransmitters, and adrenal hormones so I can get a clear picture of the mother’s physiology, these allows me to prescribe Aminoacids to help balancing the brain chemistry. I also use herbs, nutritional supplements and diet to support the biochemical paths. Call me if you want more information on how these treatments can help.
I hope the best for you and your family.
Adriana Azcarate-Ferbel
503-230-0458
http://www.sellwoodnaturalhealth.com

just so you know, William Temple House does 12 sessions of therapy for about $5-10 per session. it doesn't take all that long to get from waiting list to therapist. the reason it is so cheap is that the therapist you see is a grad student at PSU. they are located on NW HOYT & 18th.

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I'd like to talk with any mamas who have experienced postpartum anxiety (as distinct from or perhaps along with postpartum depression) for an article on the subject. I went through it about 8 years ago and find that there is still more information out there on depression than anxiety. Lisasaurus, if you are out there, I'd love to talk with you. [email protected]

How do you ask a question on this site about postpartum depression?

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