As seen in OC Parenting Magazine

When Mom's Crying Won't Stop

Tips for Dealing with Postpartum Depression

By Jeanne Michele, PhD   

Mary Hargrove was a 36-year-old successful manager in an international firm when she became pregnant. She studied business in college and graduated at the top of her class. Mary met her husband Tom at a corporate sponsored event, and she was drawn to his humor and quick wit. Two years later they married. They decided to wait to have a baby until both were well established in their careers and they could afford to buy a home.  

 Everything in Mary’s adult life seemed to be moving in the right direction. She had met a great man and her career rewarded her hard work and effort. Mary put 100 percent of herself into everything she did and it seemed to be paying off. Mary and Tom saved money for over a year and decided that they close enough to their financial goals to begin working towards starting a family. Within six months, Mary was pregnant. She experienced some morning sickness, which subsided by the end of her first trimester. Labor was a bit long, but Mary made it through with Tom by her side.

Tom and Mary had a beautiful and healthy baby girl. When Mary arrived home from the hospital she was feeling a bit weepy. She attributed her sadness to something called the “baby blues” which she heard was a common and temporary occurrence after delivering a baby. As time went on, instead of getting better, her crying became more frequent and her feelings more intense. During what she thought would be the happiest time of her life, Mary just felt guilty and ashamed. She really wasn’t even sure she wanted to be a mother. When did all of this happen? Why couldn’t she just turn off the crying and be happy?

At first she tried to hide her sadness from her husband. Tom noticed that Mary wasn’t acting like herself. He spoke with some of the dads at work who told him it was probably due to lack of sleep. Wanting desperately to be supportive, Tom told Mary he would wake up and feed the baby during the night. This meant that Mary, who was nursing, would have to learn how to use a breast pump. She didn’t relish the idea and was therefore resistant to Tom’s offers, telling him that she could handle it and would try sleeping when the baby took her naps.

One day when Tom came home from work he found Mary huddled in a corner of the bed crying uncontrollably. The baby was asleep and Mary was sobbing. He tried to comfort his wife and yet she told him she just wanted to be left alone. By this time she had managed to pump enough milk to take care of several feedings so Tom said he would take care of the baby.

Feeling helpless and worried about his wife Tom called Mary’s OB/GYN. This is when they first learned about a condition called Postpartum Depression (PPD). Tom vaguely recalled hearing something in the news recently about a clash between Tom Cruise and Brooke Shields he thought was related to the illness. At this point, he decided to do some research of his own.

Mothers, who experience postpartum depression, frequently do so in shame and silence. During a time when everyone is supposed to be thrilled with their new “bundle of joy,” mothers who suffer with PPD often feel isolated and alone. The isolation is typically self-imposed as these mothers tend to pull away from family and friends whom they fear will not understand the debilitating nature of a depression that they “have no reason to feel” during what “should be” one of the happiest times of their lives.

The illness impacts fathers as well. Feelings of helplessness and frustration abound. Fathers want to be supportive, and may do whatever they can to help with both household duties and infant care. I have witnessed many husbands become much more involved with their new babies during this time. Men who may have initially been intimidated at the prospect of caring for a crying infant, feeling that women naturally know how to better handle such a situation, are forced to take a much more active role in the face of PPD. Their support plays a vital role in assisting moms and babies through this very challenging time.

PPD is different from the ‘Baby Blues,’ which show up as feelings of sadness and typically occur and disappear within the first week or so following delivery. A woman suffering from Postpartum Depression, however, experiences a range of symptoms with a much longer duration. Symptoms may occur up to one year following delivery, or may occur during the last few months of pregnancy, and may include any combination of the following:

The Symptons
• Sadness, Hopelessness, Depression                   • Poor Concentration, Confusion
• Feelings of Guilt, Inadequacy                           • Over Concern for the Baby
• Uncontrollable Crying                                       • Memory Loss 
• Extreme Sensitivity, Irritability                        • Fear of Harming Self or Baby               
• Intrusive/Repetitive Thoughts                           • Fatigue / Exhaustion                                  
• Lack of Interest in the Baby                             • Intense Anxiety or Fear                       
• Appetite and Sleep Disturbance                        • Rapid Breathing, Fast Heart Rate         
• Lack of Interest in Sex                                    • Shaking, Dizziness                 

Some women feel more anxious than depressed, and some feel a mixture of both. It is common to develop obsessive thinking, which is indicated by the presence of intrusive thoughts, which are difficult to stop.

The good news is, PPD is very treatable. Brooke Shield’s personal expose and book Down Came the Rain: My Journey through Postpartum Depression, has helped to bring the condition out of the closet and alleviate the guilt and shame that has been associated with PPD. There are many good books available on the subject. One of my favorites for moms is, This Isn’t What I Expected: Overcoming Postpartum Depression, by Kleiman and Raskin. Hit the Ground Crawling, by Greg Bishop, is a tremendous resource for new fathers.

Men typically thrive on fixing things and can tend to experience feelings of great helplessness dealing with a condition they don’t understand. While there are no quick fixes, here are a few ideas on how dads can help:

Helpful Hints for Dad   

• Be Patient - Encourage Her to Talk, Listen without Judgment
• Help Around the House or Arrange for Someone Else to Help with Chores
• She May Lose Interest in Sex for a Time —Don’t Take it Personally, Offer Affection without Pressuring Her for Sex 
• Help Set Limits on Visits From Family and Friends
• Encourage Her to Get Out of the House with and without Baby
• Accept Offers from Reliable Sources to Baby-Sit (This May be Tough for Her at First, Be Patiently Persistent)
• Take Care Of Yourself –Spend Some Time Doing Things That Re-Energize You, Talk to Someone When You are Feeling Overwhelmed
• Tell Her You Love Her. Women Are Vulnerable After the Birth of a Child and Can Feel UnSexy and Unlovable. They Need to Know You Are Not Going to Leave.

The Quicker the illness is diagnosed and treatment begins, the easier it is to resolve. So, where do you turn for help?

The Ideal Treatment Plan includes:

• OB/GYN or M.D. is a Great First Resource (To Rule Out Causes Like Thyroid Conditions)
• Psychotherapy is Key (To Work Through Issues and Challenges Which Arise)
• Psychiatric Evaluation (Medication is Sometimes Needed for Up to One Year After Diagnosis to Help Stabilize the Condition and Alleviate Symptoms)
• Participation in a PPD Support Group

Early intervention helps the family stabilize more quickly. Don’t be embarrassed to reach out for help. Contact your OB/GYN if you are unsure about your symptoms. Referral to a psychotherapist is a great way to begin recovery. Ask if she has experience in working with PPD. Know that the condition is temporary and with help you can all move through this.

You may be wondering about Tom and Mary. Mary made an appointment with her OB/GYN who ruled out physical causes. She then was referred to a psychotherapist who helped her identify and work through some underlying personal challenges. Due to the severity for her condition she took anti-depressants for approximately nine months, which helped to stabilize her moods. Mary, Tom and baby Jen are now feeling great and continuing their wonderful journey together.

(Tom and Mary are not actual patients. The above story represents a composite picture of a family experiencing Postpartum Depression. Any similarities to actual families are purely coincidental.)