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View Full Version : Postpartum Depression: How It Presents Itself



jannawrites
09-22-2008, 11:01 PM
I'm thinking, particularly, about cases that have gone undiagnosed.

How does the mother's affliction present itself? What can happen to alert the family - especially the husband - to the fact that something's just not right?

I do plan to research the topic online, but wanted any first- or second-hand opinions/experiences.

Thanks!

ETA: Do symptoms generally occur over an extended period of time, say, over several weeks where things seem off? Or can it seem like a sudden exacerbation, with seeming normalcy one day and a glaring change the next?

Skyraven
09-23-2008, 02:41 AM
lack of attachment to the child. Mom refuses to have anything to do with the child. The mom loses interest in things that she used to enjoy before or during pregnancy. Depression of any form last a while. It doesn't happen from one day to the next.

BarbaraKE
09-23-2008, 03:53 AM
There are actually different types of depression after childbirth.

One is 'postpartum blues' (aka 'baby blues'). This is a "mild, transient condition that affects more than 70% of U.S. women who have given birth". It "begins in the first week and usually lasts no longer than two weeks". "It is characterized by insomnia, irritability, fatigue, tearfulness, mood instability, and anxiety".

A second is 'postpartum depression'. "A woman experiencing PPD shows less interest in her surroundings and a loss of her usual emotional response toward her family. Even though she cares for the infant in a loving manner, she is unable to feel pleasure or love." She does not experience 'mood swings', this is a persistent depressed state. It usually starts 2-4 weeks after birth and affects 15-20% of women.

The third is 'postpartum psychosis'. This generally surfaces within 3 months of birth. "Symptoms of postpartum psychosis include sleep disturbances, confusion, agitation, irritability, hallucinations, delusions, and the possibility that the mother may kill herself or the infant".

(Everything in quotes taken from 'Foundation of Maternal-Newborn Nursing', Fourth Edition, published 2006.

illiterwrite
09-23-2008, 04:26 AM
I think a lot of the time, PPD goes undiagnosed because it starts out as the baby blues and just never goes away. I'm pretty sure I had PPD after the birth of my daughter but didn't recognize it until a year or more had gone by. I was just constantly tired, snappy, cried a lot, and found the whole thing extremely difficult. My husband at one point stuck a card from a psychiatrist/psychologist in our bedroom mirror, and I ripped it up. I blamed it all on a "difficult" baby (colic) and thought I wasn't cut out to be a mother.

Entropy Perk
09-23-2008, 08:02 AM
Different women show it differently and some hide it better than others. A tight relationship between the woman and other people, can often find them seeing something is very wrong, before she understands it (her mother, husband, sister, best friend).

If a woman hides it well and just "snaps" one day, it can seem to others, that it came out of nowhere, but that wouldn't be true. If a woman has good support groups (close knit mothers groups, friends, family), she can talk about it and often will listen, if other mothers show sympathy and understanding about PPD and she will usually go get help, because they encourage it.

Alerts, she isn't handling things; Doesn't seem to want to leave the house much. Has little interest in activity. Hands her baby off to other people ALL the time.

Some others are; Was going to breastfeed, changes mind and refuses to discuss it. Starts doing sleep training (CIO) when baby is a few weeks old. Doesn't want to talk about the birth. Changes the subject when people come over to talk about the baby.

Some that are not; Blows off cleaning the house to play and stare at baby. Won't let other people hold baby. Wears the same clothes, jammies, for 3 days in a row and doesn't seem to notice it. Orders pizza every night, so she can sit and stare at the baby rather than cook. Refuse to leave her baby. Sleeps with her baby. Talks about nothing else, but her baby. Seems fully preoccupied, with poo or lackthereof.

When PPD is not PPD, but PTSD; A Bad Birth/Traumatic Birth can cause a woman to actually have PTSD not PPD. Some, might end up with both. If a woman is being treated for PPD and its not working, look to her birth story. The answer, is probably there. If she has PTSD, then yes, she can just snap one day.

Deb Kinnard
09-23-2008, 04:58 PM
The hospital in which I work screens new moms for depression using a simple paper quiz. If they score high enough, intervention follows. The quiz is "graded" (for lack of a better word) on something called the Edinburgh scale. Suggest you google it to find out exactly what it is.

jannawrites
09-23-2008, 06:43 PM
<snip>

If a woman hides it well and just "snaps" one day, it can seem to others, that it came out of nowhere, but that wouldn't be true. <snip>




In my character's case, she wouldn't have exhibited any behaviors her husband noticed... until she "snaps" and he realizes, in retrospect, there were red flags he should have seen.

But by the time this happens, the baby is 3 years old. Is this a feasible situation? Is there anything that says it - the culmination of it all - couldn't happen three years later?

I should say... my inspiration for this story came from a circumstance I've seen lived out, where the mother abandoned her family and responsibilities, etc., and the husband thought it all stemmed from a never-diagnosed case of PPD.

Entropy Perk
09-23-2008, 09:29 PM
Yes, a woman can have PPD for that long...sorta. I would think, that would be a case of PPD that developed into full blown, clinical depression though. You need to look at how depression acts itself out though and tailor the characters actions around it. Some people, show depression only by self-harm, others withdraw, others climb into bed and don't get out, some hide self-destructive behaviors (gambling, affairs, drinking, drugs).

I would also tell you to look at PTSD, where it fits into birthing. Since that illness has triggers, it could be the woman was having trouble she could hide and then one day, something triggered a PTSD cycle, and she up and took off.

There are a lot of online resources and studies about PPD , go into more detail about manifestations.

WendyNYC
09-23-2008, 09:37 PM
[quote=jannawrites;2779635]In my character's case, she wouldn't have exhibited any behaviors her husband noticed... until she "snaps" and he realizes, in retrospect, there were red flags he should have seen.

But by the time this happens, the baby is 3 years old. Is this a feasible situation? Is there anything that says it - the culmination of it all - couldn't happen three years later?

[quote]

You might want to think about postpartum anxiety as well. That's something that might be easier to hide and could lead to someone snapping.

Since many new mothers are naturally anxious about the safety of their children, it could be easier to miss.

illiterwrite
09-23-2008, 10:47 PM
When PPD is not PPD, but PTSD; A Bad Birth/Traumatic Birth can cause a woman to actually have PTSD not PPD. Some, might end up with both. If a woman is being treated for PPD and its not working, look to her birth story. The answer, is probably there. If she has PTSD, then yes, she can just snap one day.

I had no idea you could get PTSD from a bad birthing experience. Now I'm curious. How does PTSD differ from PPD? I had what I considered a bad birth that was rather traumatic (for me & my husband).

Entropy Perk
09-24-2008, 10:32 AM
PPD is a hormonal driven depressive state, whereas PTSD is caused by an experience that leaves the person traumatized (the top 3 events contenders are; an assault, being put into physical danger, or seeing someone killed or severely injured) Where a traumatic birth fits into this area are under assault or physical danger.

I'll try not be overly graphic in explaining that (I can be, if asked for further example). Was the woman bullied or threatened during labor? Did she become frightened and her fears belittled or dismissed by staff? Was she told her baby was in danger due to her choices? Was her baby taken from her by staff and she not told what was going on or allowed to see it? Was she left, alone and frightened in recovery with no answers as to the state of her baby? Was her husband bullied or pushed around by staff? Did she appeal to him for help and he didn't know what to do and so did nothing? Did he go along with staff, despite her appeals for him to help her? Did he stand by and do nothing, when staff hurt her and she cried for them to stop? Were his questions or concern ignored and belittled by staff?

Often, what the average person thinks is "normal" about labor, is anything but. The delicate hormonal state of the women leaves her very, very vulnerable and easy to push around in order to suit hospital policy rather than what is actually happening during the birth. When the things I mentioned above happen to her during that state, it can send shock waves through her system, overloading her ability to process or handle the added stress. The end result, is PTSD.

Google: birth related PTSD. there are quite a few articles, groups and websites that discuss this in detail, with case histories and women telling stories of what is known as, "birth rape". *that phrase may shock some, but I will stand by it as a valid one and yes, if asked, I will tell you why.