Postpartum Depression

Patient Story: Postpartum Depression

Maya is a 32-year-old fit, vibrant lawyer. She had been married for more than two years and was expecting her first child, a baby boy. She had a history of depression and generalized anxiety disorder.

She had been doing well with a combination of medication and cognitive behavioral therapy (CBT) for many years. Maya had decided in the months leading up to getting pregnant that she wanted to be off medication and worked with her psychiatrist to carefully get off medication. She continued weekly therapy. She was mostly active, upbeat and cheerful during her pregnancy. She gave birth to a healthy 7.3-pound baby boy. After the delivery, she started to feel sad, overwhelmed and consistently tearful. She frequently felt irritable and on edge. This feeling persisted for the first 10 weeks after the baby was born. She had limited support—her parents were divorced and her mother was living in another state and helping her sister’s family as a full-time babysitter. Her in-laws were much older with numerous health complications and couldn’t help regularly.

Maya went to see her psychiatrist. She was quite tearful and felt she was a "failure as a mom." Her baby cried incessantly and she could barely get sleep. She struggled with getting the baby to latch during nursing and didn’t want to have to give him formula. She was upset that she had to "resort to getting an epidural, even having to get induced." She had been fixed on giving birth the "natural" way and was lamenting on how things didn't turn out the way she wanted. The baby had high level of bilirubin and had a bit of neonatal jaundice and she blamed herself for it. After being monitored in the NICU, he was sent home.

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Maya felt utterly incapable of soothing her baby and would get frustrated and tearful. She was so afraid of what she had learned about sudden infant death (SIDS), that she would barely allow herself to sleep. She felt that it was a constant race against the clock—with nursing, pumping and changing. She was always cleaning bottles and diapers. She felt horrified with how she looked. She had expected to wear pre-pregnancy clothes immediately after childbirth. She hadn't had a meal in peace or gotten her hair or nails done and couldn't even think about having sex with her husband. He tried to be supportive, but also felt overwhelmed by it all. He felt she was inconsolable and they both felt at a loss.

They went to see Maya’s psychiatrist as a couple and to get advice regarding her current mental state. They talked about a variety of tools, including CBT, incorporating 15-20 minutes of daily relaxation, mindfulness skills, hiring help, getting her mom to stay with her for a few weeks and other support. Her husband understood the urgency of the situation and offered to take time off work and to do some of the overnight feedings. Maya decided to get back on her previous antidepressant as it was extremely beneficial in the past. She also joined a new moms support group and continued CBT weekly therapy. Over the next few months, she was exercising more and getting more sleep and support and had significant improvement in mood and energy. She received some sleep training tips from her pediatrician as well.

Maya and her husband shared with her psychiatrist that they were feeling significantly better. They were excited to share that they found a series of self-help parenting books to be particularly helpful and had gotten some helpful tips from others in the mom’s group.

"Wow-it really does take a village to raise a child, doesn't it," Maya commented to her psychiatrist. They spoke about how in previous generations new couples could rely on extended family support and how that support often doesn’t exist now. Also, inaccurate beliefs, such as babies are easy and infancy should be a happy time for parents, add to stress, conflict and guilt. Being able to normalize the stress of adjusting to parenthood was extremely helpful for Maya and her husband.

More Personal Stories

A number of celebrities have publicly discussed their struggles with depression during and after pregnancy including Crissy Teigen, Brook Shields, Hayden Panettiere, Adele and Gwyneth Paltrow. Here are a few recent stories.

FEB 2017

Glamour magazine: Chrissy Teigen Opens Up for the First Time About Her Postpartum Depression

MAR 6, 2017

ABC News: Chrissy Teigen opens up about battle with postpartum depression

Excerpt from Brook Shields’ book “Down Came the Rain: My Journey Through Postpartum Depression”

2016

Vanity Fair: Adele, Queen of Hearts” (Story about Adele’s experience with peripartum depression.)

JAN 5, 2016

WAPO: Maternal depression: ‘If there’s no mama, there’s no baby’
By writer Joy Gabriel

“No one brings you casseroles and holds your hand when your brain gets sick, or calls you a survivor if you come out on the other side. But I am also a mother who made some harrowing decisions and fought desperately to take care of myself and my kids. I’m not ashamed that I took medication when I was pregnant. It saved my life. My only regret is that I didn’t have the wisdom to take care better care of myself sooner.”

(By Joy Gabriel, writing about her own experience with depression during pregnancy. She is a mother and writer living in New York.)

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