Unexpected Depression

After surviving a twin pregnancy, closely spaced children (four in three years) and a pregnancy during a Saudi Arabian summer, I thought that my fifth pregnancy wouldn't offer any surprises. I was wrong. I am a mother of six, an LLL Leader, and an active person both mentally and physically. But shortly after the birth of my sixth child, Isabel, I was laid low by postpartum depression. In retrospect I realize that I was suffering from a mild level of anxiety throughout my pregnancy, starting practically from conception, though at the time I didn't realize what was wrong. When I became unexpectedly pregnant with Isabel, we had been living in Saudi Arabia while working as contractors for the US government for about four-and-a-half years. I was somewhat ambivalent about having another child, a feeling which passed, I am happy to say.

A decision was made that I would have my baby in the United States as I had with my previous pregnancy, and I came back to stay with my parents. It was an ideal situation in many ways. Their house is large and comfortable, and I had plenty of help during the pregnancy. My son Aidan continued to nurse throughout my pregnancy. Then I developed gestational diabetes, and had to go on a rather restrictive diet. Isabel's birth was medicated and induced due to unforeseen complications. She weighed a scant 6 pounds, 11 ounces. My previous children had been larger, with the exception of the twins, who had been premature.

I rented a house in the USA until my husband was to come back from Saudi Arabia. At that time, we would begin house hunting and job hunting. However, three weeks after I had Isabel, I began having mild panic attacks and feelings of "unreality" would wash over me. I became anxious about someone breaking into the house at night and I barely slept. Even through all that, I was breastfeeding, and I believe that was critical to the relationship that Isabel and I share today.

When Isabel was about four-and-a-half months old, I began to have problems functioning. I would cry over nothing. I felt nothing. I remembered other postpartum times as being happy and filled with joy. Although I loved Isabel, I couldn't seem to muster up any emotions other than panic. I began feeling a tingling sensation that led me to become worried and preoccupied with my health. Soon I was overcome with the feeling that I was going to die. I couldn't eat, couldn't sleep, and worried all of the time. I remember waking up one morning and thinking that I would hang in there for five years, but that if I wasn't better, perhaps it would be better if I died. I felt that Isabel would remember me if she was five when I died. I would put Isabel and my three-year-old son, Aidan, in the stroller and walk for hours. Walking helped relieve some of the anxiety. I lost 35 pounds in just a couple of weeks. I became panicky about the kids if they weren't in sight. Several calls and visits to the doctors indicated that there was nothing wrong with me, no thyroid problems, no physical illness of any kind.

My father had been treated for a major depression several years before (he currently takes medication for bi-polar disorder). After seeing the anguish I was going through, he suggested that I go and see his psychiatrist. I was reluctant because I worried that the doctor would encourage me to wean Isabel. I felt as if that would severe the only link that I had to her emotionally and decided to forego treatment rather than wean her.

However, I did some research via Internet and other sources, and found out that some of the older antidepressant medications were considered compatible with breastfeeding and that studies indicated that the newer serotonin reuptake inhibitor medications were being used by breastfeeding mothers, too. I went to see the psychiatrist armed with information. At first, he suggested I wean my daughter, but when I explained what nursing meant to me, he suggested that I try an SSRI and continue nursing. I had a bad reaction to that medication, and needed to switch to another. My recovery has been gradual. It took about six weeks for the antidepressant to take effect, and I remember weeping for joy the morning I woke up and felt "normal." Not wonderful, not perfect, but just normal. I had minor setbacks after that, but for the most part it was a slow steady improvement. I have been symptom-free for almost a year now. With my doctor's supervision and encouragement, I am gradually reducing the amount of medication I am taking.

The most frustrating thing about having postpartum depression was the lack of support and information available for nursing mothers. The lack of regard that some doctors give breastfeeding and its importance to both mothers and infants is surprising. Although my doctor did not know much about breastfeeding initially, he has been willing to learn, and respects my daughter and me and our nursing relationship. I recently presented him with a copy of Medications and Mother's Milk (available from LLLI) by Dr. Thomas Hale. The statistics that I have seen indicate that as many as 30 percent of all women who give birth suffer from mild to severe depression after birth. Moderate to severe postpartum depression does not go away by itself and medical intervention is often needed. Breastfeeding mothers and care providers who help them need to become more aware of postpartum depression and learn it can be treated without interrupting the nursing relationship.

Page last edited Sun Oct 14 09:30:36 UTC 2007.