Postnatal Depression and anti-depressants
December 5, 2011 11:00 AM   Subscribe

Postnatal depression, advice and success stories, please.

My wife has been diagnosed with postnatal depression. I felt that something was up about two weeks ago, and as things spiralled downwards a GP has confirmed our suspicions. She's now on some sleeping tablets (temazepan) and an anti-depression (Citalopram, often sold axs Celeza). I am now off work on compassionate leave, and have taken over all night feeding, in addition to anything else she'll let me do.

It's only been a few days, but there's already been an improvement. I'm trying not to beat myself up too badly about dropping the ball and letting things get to this point, but I'm still a little scared, a little anxious, and a bit ignorant (baby is fine).

If any mefites would feel comfortable sharing any advice they think would be useful for a partner in this position I would be tremendously grateful. We're new to this, and I'm unsure of the best way to do things, and help things and make her feel better.

More specifically, I'm a little anxious about the Celexa. I'm trying to be positive, but going online I see a list of sideffects as long my arm, and people saying they never got back to "baseline" after taking SSRIs. I need to feel like we are doing the right thing here; I know it intellectual, but I need to feelit, you know what I mean? Wife is also seeing a therapist etc. Thank you.
posted by anonymous to Health & Fitness (11 answers total) 2 users marked this as a favorite
First off...
You didn't drop the ball!!

Your a loving husband who is very in tune with his wife and is doing his best to help her in life....

Depression is a tricky, horrible thing that is hard even for the personal involved to realize and understand.

IMHO (not a doctor, but play one on the internet) SSRIs are good for rebound, short term use like your GP has proscribed. I honestly would be more concerned for the baby's health than your wife's at this point... (Breastfed SSRIs!!!!)

If this seems like its going to continue for more than a month or so, I would highly consider having your GP refer her to an actual psychiatrist...

Your GP is most likely operating off conventional wisdom related to postnatal depression and his 'general' experience... A Psychiatrist can more closely look at your wife's brain/body chemistry and is potentially leading to the depression.

Best of luck... but honestly, this too will pass.... pregnancy does crazy things to the body, and it takes lil while to re-stabilize...
posted by anthroprose at 11:18 AM on December 5, 2011

Lots of people who begin to suffer depression never get back to the "baseline" of having never had depression. Drugs have nothing to do with it.

Please don't shame your wife for taking medication for this. Please don't take passing medical advice about breastfeeding and SSRIs from the internet, either. Find a doctor you can discuss it with - like your pediatrician and obstetrician.

I've seen people's lives saved by appropriate intervention in pospartum depression. It comes on so fast at such a hectic time, you guys have not dropped the ball.

Ask her what help and support is good for her, and do that. Keep talking, keep checking in with each other, and know that you may need to intervene again if she hits another rough spot. There's no one right way to do this.
posted by Lyn Never at 11:25 AM on December 5, 2011 [9 favorites]

Please do not feel that you have dropped the ball! You are getting care for your wife and have taken compassionate leave and that's *huge*.

Postnatal depression can sneak up on you, and it's even more insidious, I think, because you and your partner are are both likely feeling overwhelmed and anxious with the baby already, so it's natural to chalk up the postnatal stuff to exhaustion and hormones in the beginning and not realize how serious it is.

As far as the SSRIs go, I took medication after my first-born, went off them after about 6 months, and didn't have postnatal depression with my second, or take any medication again until after my hysterectomy, which was 8 years later. And I have a very strong family history of depression (siblings and parent).

There is really no way to tell for sure if your wife will need SSRIs forever or just temporarily. Leave that to the professionals to worry about. You can be your wife's advocate by making sure you know what the side effects of the meds are and keeping an eye out for them. You are more objective than she can be about that right now.

And please do not worry about breastfeeding the baby and the SSRIs and all that--if her doctor says she can do all that on her meds, fine. If not, that's what formula is for. Yes, I know, "breast is best", but what is really best for baby is to have a healthy Mom, full stop. My 16 year-old, 6'4" son was formula fed, and since it was the fashion back then, so was I, and so was my husband, and maybe even you and your wife. Your baby will be fine.

Also, if either of you have family that can help, take advantage of that and give them specific ways they can do so. Really. Ask them to run out for diapers, make some food you can just heat up, watch the baby for a while so you can get out of the house. You cannot care for your wife and child round the clock without it taking a toll on you, too.

And I know you are scared, but really, you will get through this okay. Many women suffer from Postnatal depression and though it is a serious condition, the horror stories you hear about women actually hurting their babies are very much NOT the norm, and that's WHY you hear about them.

Breathe. It gets better, I promise.
posted by misha at 11:53 AM on December 5, 2011 [2 favorites]

people saying they never got back to "baseline" after taking SSRIs

I've never heard that, and I've taken SSRIs for PPD. They saved my life, I suspect, plus you can breastfeed while taking some of them. I was the mom, not the dad, so I don't know it from that point of view, but it sounds like you're doing the right stuff.

Good for you for being involved, and good for your wife for looking after herself.
posted by The corpse in the library at 11:57 AM on December 5, 2011

People's experiences are very different, so please take mine with a grain of salt.

I had postpartum depression with all three of my children. With my first, it was the worst. It was bad. I would spend all day thinking about ways to off myself. I never slept. I was wound so tight knowing at any moment that the baby would wake up that I never could get myself to sleep. On top of that my first never slept. She was this alert up-all-the-time thing. I wanted to scratch everyone's eyes out who advised me to "sleep when the baby sleeps."

I finally went to my Dr. who prescribed Celexa. I took one and got pretty much every single side-effect listed. Who knew constipation and diarrhea could could happen at the same time!? The side effects coupled with my depression were just unbearable. So, I didn't take any more Celexa. Interestingly, at this time, my daughter slept through the night THREE nights in a row. And holy crap I was a new person. Doctor wanted to prescribe Prozac, which I never got filled. Instead I figured that getting sleep was most likely a better option FOR ME.

I think my postpartum depression was caused by two things:

1. Severe lack of sleep
2. The frustration of not being able to do anything during the day because I was so tired and because I was taking care of this wakeful child.

Both of these things were so very overwhelming to me. But I learned how vital sleep is to me for my mental health. To this day, having a rough night almost immediately spirals me into depression and suicidal thoughts. I'm very careful with my sleep and I take it seriously. Also, being unproductive in my day makes me feel like utter crap. I don't want someone else to do it, I want to do it. I want to feel like I accomplished something during my day, so having my husband do all the chores made me feel worse. It's a strange thing being so tired I can't do anything and then feeling like crap because I didn't get anything done that day.

Things that really helped me:

~knowing that it was okay to bottle feed my kid so that I could get some uninterrupted sleep (this was a very hard one for me). Dad could then get up at night, feed the baby, and I was okay to sleep through it all. misha says it perfectly up thread, "Yes, I know, "breast is best", but what is really best for baby is to have a healthy Mom, full stop."

~giving myself some small tasks that could be accomplished throughout the day. Tasks that would give me a feeling of accomplishment.

These are things that helped me. It may be different for your wife. I'm an advocate of anything and everything that will help your wife get through this.

You're doing a great thing. But, remember to take care of yourself too.
posted by Sassyfras at 12:03 PM on December 5, 2011 [2 favorites]

I would say you are already doing a wonderful job supporting your wife. PPD is such a difficult thing to get through but to have your partner there to help is so fantastic. For me, the return to "normalcy" really helped me - including sleep and being able to do my things more often like reading or just eating a meal at a leisurely pace.

It also helped me to know that my partner could take over if things got really hairy. For a while there, he was afraid to hold the baby which really put a crimp in the taking over part of the equation. Once he got over that, I didn't feel guilty about asking him to help.

Also, just listen to what she has to say, no matter how out-there, crazy, bizarre it may seem. She is down the rabbit hole and experiencing some crazy stuff, so to be able to talk about it with a loved one without judgment will be so helpful.

Nthing taking care of yourself too. Try to get someone to come and watch the baby for a few hours so you can both have some couple time. Date nights were initiated for us and it made a great big difference.
posted by Leezie at 12:10 PM on December 5, 2011

I forgot to mention that I've been on Celexa, Prozac and Zoloft. The Zoloft was for PPD since I was still nursing. That was a HUGE mistake, I later realized. It made things much worse. The thing about SSRIs, though, is that each person will react to them differently. Zoloft caused me physical issues and made me more depressed, not less. When I switched back to the Prozac (and stopped nursing) I felt so much better.
posted by Leezie at 12:12 PM on December 5, 2011

All I can add is, I didn't treat my PPD with SSRIs, and never really felt normal again until 6 years later, when I did treat my now-chronic depression. I am closer to normal now than I have been since years before I got pregnant.

And since no one else has pointed it out...dads can get their own version of PPD too. New babies are stressful, life changes are stressful. We understand this with deaths, but not births. Both can be just as hard on our brains, though, and set off depressions.

Get help for yourself too if you need it.
posted by emjaybee at 1:26 PM on December 5, 2011

> I honestly would be more concerned for the baby's health than your wife's at this point... (Breastfed SSRIs!!!!)

This is terrible, verging on dangerous, advice.

from: Using Antidepressants in Breastfeeding Mothers:
... breastfeeding should be supported fully and not interrupted by mom's needs for medication; and that treatment of postpartum depression can be accomplished relatively safely in breastfeeding mothers. So, in his consideration, moms should continue breastfeeding and should get drug treatment as needed for depression.

I am five weeks postpartum and feeling fine, though less so at 3 a.m. when very sleep-deprived. But I can see, with scary clarity, how shit can go sideways with a new baby in the house. Things you can do:
- When she goes down a rabbit hole (ymmv, but mine tends to be: I will never have gainful employment again! I am wasting my life!) listen, reflect back what she's saying, and show that you empathize. Try not to point out immediately that what she's saying is obviously false/weird/out of left field. Feeling inexplicably awful and then being told that you're wrong is frustrating in itself. Don't try to have a debate about her irrational fears and thoughts.
- Do the laundry. All the laundry. Promptly. And without commentary.
- Stuff like doing the laundry helps maintain normalcy hygiene: If the baby spits up on her shirt, she should change her shirt. This requires that she has a clean shirt. Thinking Why bother to change, he's just going to spit up again in 15 minutes is a dark path. Likewise, make sure she gets a chance to shower every day. Again, you may not be even getting out of the house, but showering -- to clean off baby spit-up, breastmilk, your lunch that you dropped on yourself when you tried to eat while rocking the baby, formula -- feels good.
- Produce regular meals, whether you cook them or acquire them. Do not make her think of or ask for meals. If she is breastfeeding, she will be especially hungry, and either way, hunger makes you feel wonky.
-When the baby cries, and the baby will cry, don't whisk the baby from her automatically. You may be trying to help, but in reality, it seems like you don't think she's competent. Ask if she needs anything, let her do her soothing things, be there to take the baby, offer to get a glass of water for her or a swaddling blanket or a pacifier. But don't do the typical dude thing where you try to swoop in and save the day.

Because here's the thing:
Your wife, and I would hazard to say this goes for all new moms, wants to feel like supermom. This PPD diagnosis has almost certainly chipped away some of her confidence, and it's your job to help give that back. You will be recognized for your heroic dadly and husbandly achievements some other time, but right now, your focus should be on what a great mom your wife is. Give her that gift.

Going along with that: Do not obsess over the Celexa. Stop reading horror stories online. Let your wife figure out how it makes her feel; you can neither control how she feels or fully understand how she feels. Do the other stuff, the chores and making the house run. If you are unable to stop worrying about whether the Celexa is the right or the wrong thing for her to be taking, talk about your feelings with a therapist. I'm serious. There's no shame in getting help for yourself too.
posted by purpleclover at 2:17 PM on December 5, 2011 [8 favorites]

Let your wife figure out how it makes her feel;

This is so important. Different drugs do different things to different people; don't look out for, assume or fear the worst. People in this thread will tell you Celexa saved their lives. People in this thread will tell you Celexa was the worst trip they ever took. All that matters is how your wife tells you she feels taking it. Which is, hopefully and most likely, better.

And don't worry too much right now about how things are going to be After. You guys just had a baby; everything is going to be different in some pretty fundamental ways pretty much forever. You are on your way to finding a new normal, with or without the drugs.

I have never had PPD. But I can tell you a partner who expressed displeasure and a sort of provincial mistrust of drugs I really, really needed to be taking made me not want to take the drugs I really, really needed to take because I didn't want to disappoint anyone else. To this day, I resent that person. Your wife has made a decision for her fundamental well-being; dig deep and cheerlead for her here. Tell her she's brave to take these steps and that you... tell her that you love her for doing this for all of you.
posted by DarlingBri at 6:59 PM on December 5, 2011 [1 favorite]

Rather than listen to unhelpful vague worry from internet commenters about your child's health with regards to medication you wife is taking, look at some real data here from the National Institutes of Health.

Good for you for working with your wife and helping her through this. Taking daily care of an infant is difficult in the best of situations, and having a partner willing to help you through the dark days is priceless.
posted by chiababe at 8:48 PM on December 5, 2011 [1 favorite]

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