Where do I start finding a loved one help with undiagnosed depression?

March 1, 2013 10:25 AM

I need to find my partner some help with ongoing depression symptoms that she has been suffering from for a decade but has deepened recently.

My partner is pregnant with our second child, she is the primary care giver for our first child, a toddler. Her depression is not diagnosed at this point but we've been struggling with something on and off over the last 10 years. At this point the stress of being a stay at home mom with a toddler and the pregnancy is overwhelming her, and we've talked about it and both agree that we need to at least explore a therapeutic/medical approach to the problem. We are also looking at things like pre school for the toddler and other options to ease the load on her day to day.

We are fortunate, we have comprehensive health insurance, we can afford a private therapist out of pocket if it comes down to it. We have supportive family, I just don't know where to begin, should we talk to her regular doctor? How do you find someone to talk to about this? Geographically we're located in the US.

posted by anonymous to health & fitness (8 answers total)

We have supportive family, I just don't know where to begin, should we talk to her regular doctor?

Yes. Get a referral and a diagnosis to start. It may take her a couple of cracks to find a therapist that she gels with/a style of therapy that works for her, but your doctor should have a couple that they can recommend on hand.
posted by Rodrigo Lamaitre at 10:30 AM on March 1

You can ask for a referral from a doctor, either your GP or her OB/GYN.

I googled my specific issue (disordered eating) and found a great thereapist.

If you have Mental Health coverage through insurance, go there first to see who's in network. Then narrow down from there.

Also, many doctors are the first stop for diagnosing depression, etc. My GP discussed my anxiety with me and prescribed my meds. Since your wife is pregnant, her first stop should be her OB/GYN.

Therapists are one of those things, you have to go a few times to see if you click, if you do great! If not, you keep looking until you find one you like.
posted by Ruthless Bunny at 10:30 AM on March 1

The medical help is an amazing step but if she is expressing feeling overwhelmed you can immediately take steps to help her. Get the toddler into preschool and arrange the transportation back and forth so it is one less thing for her. Have a cleaning service come in weekly, drop the laundry off and at a wash and fold service, get healthy home-cooked meals delivered, have the family babysit evenings and weekends. It is far, far easier to take these small steps now instead of helping her if she falls in the pit. She needs concrete support beyond medication and a weekly appointment.
posted by saucysault at 10:38 AM on March 1 [2 favorites]

In addition to the doctor and therapist appointments, she should try some other things that are safe during pregnancy that may help. Yoga can be helpful and many places now have prenatal yoga. Schedule some prenatal massages. Also daily exercise can help if her GYN OB is okay with that. Doing these things, plus having a break from her daily life may help a lot. If you have family who can watch the toddler a few times a week for a few hours that would be perfect.

Getting enough sleep is also really important, and I know, not an easy thing when you are pregnant and have a toddler. Maybe even having a sitter so she can easily get a nap in sometimes.
posted by maxg94 at 10:42 AM on March 1

A psychiatrist or OB/Gyn is more likely to have a good sense of psychiatric medications that are safe during pregnancy than a GP, so I'd start with one of those. If she wants to try therapy before or instead of medications, you can also just call up a therapist and make an appointment.
posted by jaguar at 11:43 AM on March 1

If she wants to try therapy before or instead of medications, you can also just call up a therapist and make an appointment

Jaguar's link goes to Psychology Today's therapist/psychiatrist provider directory which is indeed an excellent resource. You can email the issue in to the provider and they can call you knowing something of the background, or you can just call. You can also sort by specialty, insurance, etc.

Personally I had a terrible experience talking to my regular doctor about depression and had better luck just going through the directory. If you have insurance that doesn't require referrals, you might want to go that way. However, I know my experience isn't universal.
posted by sweetkid at 12:01 PM on March 1

I would recommend contacting her OB/Gyn sooner rather than later. There has been a huge effort recently to train these providers to recognize and give support/referrals/education etc about pregnancy-related and post-partum anxiety and depression. They will be able to guide you to local resources and can act as part of the team making sure her care and the baby's care are coordinated. You don't have to wait for a regular appointment. I would recommend giving their nurse's line a call and ask for assistance.
posted by goggie at 12:35 PM on March 1

I was in therapy at the time that I got pregnant a second time and I continued that. But when I was hospitalized for being suicidal during that pregnancy, I said something to my sister like "I am looking forward to sleeping and reading a magazine uninterrupted" and she said something like "You don't need to be hospitalized. You need a vacation."

So I will Nth suggestions like get a maid. It may be just as effective and carry less emotional baggage than therapy (which she can also do -- this extra help can still make her feel less stigmatized, less like a failure, even if she also goes to therapy). Framing problems as "you have too much on your plate and need and deserve extra help during this challenging time" is usually psychologically healthier than blaming everything on someone's "issue," whatever that issue happens to be.

Also, make sure she is sleeping enough. A friend with three kids under the age of five insisted on taking my monster two year old overnight when I was six months pregnant because I looked so exhausted. It made the whole rest of my pregnancy easier to have uninterrupted sleep until noon just once.

I am not biologically inclined to depression. For me, if depression persists for three days, it is almost always anemia. I was severely anemic during my first pregnancy. They put me on massive iron supplements. Have them draw blood and see if she needs extra, extra nutrition while pregnant.
posted by Michele in California at 4:26 PM on March 1