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Kathy's Story:
In Her Own Words
When I first got PPD and then got antepartum depression, I found that I didn't want to just read research papers and books and talk to doctors ... I wanted to hear from real women who had suffered through this and had survived. I wanted to know that I was going to get well and that I would eventually get my life back. The stories of real women helped me hang in there when I barely could.
As you no doubt know, PPD and antepartum
depression can strike different women in different ways. This is my experience with it -- but my
symptoms may not be exactly like yours and the medications that helped me may not work for you. This is
the tough thing about treating depression. The "cure" can be as unique as the individual. The main
point of me sharing my experiences with others is to give them hope and let them know they are not
alone.
I had had three children with no antepartum or postpartum depression. By the way, all of my pregnancies were planned and all my babies very much wanted. I did have the usual "baby blues" that more than 80 percent of new moms get -- the "weepies" around the second week. I had learned to even expect this and I had learned that the first 6 weeks or so with a new baby are always "challenging." I never expect them to be easy.
During my fourth pregnancy everything went fine. As usual, we eagerly anticipated the arrival of the baby and spent months planning for her to join us. I expected the first weeks to be difficult. However, I had a very helpful husband, a lovely home, older children eager to help with the baby ... and I wasn't anticipating any big problems. I had heard of postpartum depression, but to be honest, I thought it was something like a really bad case of the baby blues and probably was something that happened to women whose home life was not good, had little support, or didn't want their baby. It certainly couldn't happen to me!
Sydney Louise arrived perfectly healthy after a normal vaginal delivery weighing in at 9.0 pounds and 20.25 inches in length. It was November 11th, 1998. She was a relatively easy baby: no colic, not fussy, no problems. I was not well-educated about PPD and the signs and symptoms or I would have noticed that something was not quite right much earlier than I did. For example, I began to feel rather frantic when my husband wasn't home and it was getting dark. I began to obsess about getting back in shape and the baby sleeping through the night (and she wasn't even a month old!!!). I didn't feel a strong bond with the baby, and kept telling myself that all these things would improve over time.
On December 18th, 1998 I went to bed and woke up about 2:00 a.m. The baby was not awake. (As it was, she slept through that whole night.) At first, I told myself it was because I was used to getting up with the baby and that was why I woke up. Habit. However, I felt oddly "wired" ... like I had had too much coffee. I tried taking an Excedrin PM to fall back to sleep. It didn't work. I drank a beer. That didn't help. I took another Excedrin PM. I was up all night and for the next three days. I could not sleep at all. Things went from bad to worse within 24 hours. I knew that something was seriously wrong with me. I felt very anxious, frightened of everything, had near panic attacks, an aversion to the baby and severe OCD in the form of intrusive thinking. I felt as though I was going insane or going to collapse. It was a weekend so I didn't call my doctor. My husband suggested I go to the Internet and try and find out what might be happening to me.
As a regular at ParentsPlace it was one of the first places I investigated. It was there that I found the PPD board and the posts that I read told me right away that I had postpartum depression. I was so horrified that I put my head down on my keyboard and cried.
I spent the entire weekend trying to find out everything I could about PPD. I recalled my mother saying -- years before -- that my sister, Karen, was "having some problems" after she had had one of her babies. Is this what she meant? I called my sister and she confirmed that she had had PPD after the birth of her second and fifth babies. She has six children and always wanted a large family. If my sister, one of the most cheerful people I know, could have this then I suppose anyone could. She had not talked about it with anyone and that is why I didn't know. She does not live near me. After discussing the symptoms I was having (very much the same as my sister's) and talking to my mother, my mother realized that she had had PPD after she had had my sister in the early sixties. No one talked about it at that time and my mother never sought help ... just suffered through it ... afraid she'd lose her children if she told anyone.
First thing on Monday I called my OB and told them what was happening. They SHOULD have referred me to a psychiatrist right away. OBs are not trained to treat PPD and they have limited knowledge of the medications used to treat this disorder. Many women wind up being "mistreated" by their OBs. However, this was something I learned as time went on.
The nurse at the office told me that the OB had called in a prescription for Prozac for me and that if I took that I'd feel better by Christmas. HA! That still annoys me to this day. What total misinformation. Better in a few days! I was horrified that I would be taking a drug like Prozac. It made me feel ashamed and humiliated. Drugs to be "normal." However, the women on the PPD discussion board encouraged me and helped me get over my fears and so I took the Prozac.
Three days of Prozac and I was doing worse than ever! I spent Christmas Day thinking I needed to be hospitalized. I couldn't even join my family to celebrate. I spent the day in my robe, near collapse. Again, I called the OB's office and they said they'd call me in an anti-anxiety agent, Xanax, and if I felt really bad I should take that. Now I was even more humiliated! They also told me I ought to find a psychiatrist. This put me in tears again. I felt like a total loser.
However, with the encouragement of the women on the PPD site, I made the appointment. The Xanax helped me very little and the Prozac seemed to do nothing for me. The psychiatrist I saw explained that it would take weeks for the Prozac to work and that the Xanax should be taken around the clock at regular intervals in order to better help my anxiety. He said I needed to stick with the Prozac. He also gave me Trazadone to sleep. I had diurnal insomnia. The Trazadone was a Godsend as at least. If nothing else, I slept well at night.
Seven weeks of Prozac and I was not much better at all. I also didn't think the psychiatrist I was seeing cared or was listening to me. I was keeping a journal of my symptoms and he didn't even seem interested in it. He just kept saying to stick it out awhile longer. Meanwhile, my life as I knew it was gone and I was missing out on my baby's first months. Every single day was a horrible nightmare and a huge struggle. This was the hardest thing I had ever been through and I was 40 years old and had certainly seen heartache and difficulty before. Nothing held a candle compared to this battle.
I decided to seek out another psychiatrist and went to the Depression After Delivery guide to find one who might specialize in PPD. I found one listed, about an hour from my home. I didn't care. I'd make the trip. He took me off of Prozac saying it was a poor choice to give to someone with my anxiety level. However, I also had severe OCD and I now know that only certain antidepressants help OCD and that I should have been put on one of those antidepressants first! He put me on Remeron. At first, my anxiety level went down .... and I was hopeful. Then, I began to experience depression in the classic sense. I felt very sad and felt like life was stupid and not at all worthwhile. I complained to the doctor and he raised the dose of Remeron. This made me feel very wired and nervous, and also, oddly enough, very angry. I felt a very scary inner rage. I called him and complained about this. He told me that I hadn't given it long enough -- I needed to stay on the drug longer. I waited seven more long days (it had now been one month on the Remeron) and felt no better. I called him again and he simply wanted me to stay on it even longer!
So much for that psychiatrist. I tried joining a support group here but I didn't think it was well-run. In my opinion, only people who have HAD PPD should run a support group for PPD. If you haven't had it, you haven't got a clue as to the hell it is. The gal who ran it was just that -- "clueless." However, I did benefit from trying the group. I met another woman there who had a son one week older than my baby and she was as sick and desperate and frustrated as I was. As an added blessing, she lived right near me! We have been fast friends ever since. It was a great help to have someone going through this with me. While at the meeting someone passed out the name and number of a doctor they had heard was great for treating PPD and really cared about the moms who had this. Both my new friend and I decided to give him a try.
I want to add that as the months passed I was busy reading everything I could, posting on the PPD board and seeking every way that I could to get well. I was beginning to think I never would get well or be "normal" again. It was now April and I had been sick since December.
The new doctor was a very kind, gentle person and totally different from the other doctors I was seeing. He wanted to try me on Serzone. Frankly, I spent one month on Serzone and it did absolutely nothing for me. He also wanted to try me on Neurontin, which also seemed to do nothing for me. He had me switch from Xanax to Klonopin as he said he found Xanax to be far more addicting, which is true. I was taking three times as much with the same result and it is a harder drug to wean off of. In the midst of this, weary of being sick for so long, I tried to take my own life. I just didn't think I could go on feeling like I was. I had run out of energy. My new doctor literally saved me by promising me I would get well and that he wouldn't give up until I was. He called me every single night. He saw me once a week. At the beginning of May he suggested we try Anafranil. I knew it was a good OCD drug and I was eager to try it. The first day I took it, things were better. Within one week, I was well. It was hard to believe I had ever been sick. This was an unusually fast response, but I have learned that a person usually can tell within a week or two (at the most) if the medication is really helping them. If a doctor keeps you on a medication for weeks on end, and you are not getting better, you probably need a different medication -- and a different doctor!
The remainder of that year was one of the best of my life. I had never been happier, and I had learned now to be very grateful for "normalcy" and good health and the all of the other "little" things. I enjoyed my daughter more than I had ever enjoyed a baby. In fact, I wanted another baby! However, I did NOT want to go through PPD again. I talked to my psychiatrist and did my own research, too. If a woman who has had PPD in the past goes back on the medication that worked for her within 24 hours of giving birth she has a 95 percent chance of NOT getting PPD again. If she doesn't, she has a 67 percent chance that she will. I decided that I wanted another baby and that I would simply go right back on Anafranil after the baby was born. Life throws us curveballs, however. I planned on staying on my medication for one full year as the experts suggest. Then I decided I would try to get pregnant. I was doing quite well on a low dose of Anafranil and no longer needed the Trazadone or Klonopin. I planned on going off the Anafranil in May of this year and then trying to conceive. Well, I got pregnant in January! I was on 50 mg of Anafranil at that time. I immediately called my doctor and was advised to go off the Anafranil right away. Anafranil is a very potent antidepressant and not considered to be one of the safer drugs during pregnancy.
For the first trimester I did pretty well. However, during week 18 of my pregnancy I was greatly saddened to feel my old PPD symptoms resurface. The symptoms were not as severe, but they were ruining the quality of my days, anyway. Now what would I do? I didn't want to take any medication while pregnant but I couldn't see living like this until the baby arrived! Then, I was also worried that if I didn't get a handle on my illness NOW ... what would happen when the baby got here?
I once again began researching everything. I spent five weeks finding as much information as I could on antepartum depression. I spoke to my OB and my psychiatrist. I called Teratogen Services in my state. I read every single archived message on the Pregnancy and Depression board at ParentsPlace. I wanted to meet real women who had had to take meds while pregnant and had had healthy babies. Eventually, I decided I wanted to take the medication and that my research showed that there was no higher incidence of miscarriage, stillbirth, birth defects and so on among women who took medication for depression than the general population.
The doctor put me on Zoloft. It was a hard road. The Zoloft took much longer to work than the Anafranil had. I got discouraged with it a lot, and I also found it made it impossible for me to fall asleep at night, so I needed to take 1 mg of Klonopin before bed in order to sleep. However, once I got to 125 mg of Zoloft I felt consistently good and my OCD was mild ... and tolerable. I decided not to go any higher with the dose because of being pregnant.
I also made the decision not to taper off of the medication prior to having the baby. I had researched this, and with my OB's blessing, decided that it was safe not to taper off. My daughter was born 4 days late on October 9th, 2000, weighing 11 pounds and measuring 22.25 inches! No blood sugar problems or anything else. No withdrawal symptoms from the medication I had taken. In fact, she is very laid-back and her Apgar scores were 8 and 9.
Immediately after she was born, I raised my Zoloft to 150 mg in hopes of kicking the rest of my OCD. After two weeks I could see it wasn't helping and I was having more problems with sweating and headaches. At this time, I am in the process of tapering off of the Zoloft and substituting in my old pal Anafranil. I just prefer it and with the Anafranil I have NO OCD. Other than mild OCD, though, I am doing great, sleeping well (as well as you can with a newborn) and have no anxiety or any signs that PPD will rear its ugly head again. Of course, I am 3 weeks and 4 days postpartum and do not consider myself totally out of the woods yet. I feel pretty good about making it through, though. I have done everything I can to keep the "monster" away.
An interesting side note to this is that my sister is expecting her seventh baby in early April and just recently has gotten antepartum depression, very much like I had, and this is her first time with this. She is on Zoloft and is slowly getting better. The genetic link in our family is very strong and seems to only affect us during pregnancy and postpartum. Between my sister and myself we have nine girls. We are hoping to see things change for our own daughters as it looks like the possibility of them going through this is very good. I write this to you to let you know that you are not alone. The journey is hard and dark. However, I was very, very sick and I did get well and go on to enjoy my life very much. I didn't think it would ever happen. I urge you to be very proactive in getting better. Don't settle for a doctor who isn't helping you or stay on a medication that doesn't make you feel 100 percent better. Fight for yourself and your life. As my doctor told me, no woman has PPD or antepartum depression forever. There is help out there. Some people get better sooner than others and find the right medication and doctor right off the bat. Some of us have to fight harder. Also, don't be afraid to take medication, even if you are pregnant. You owe it to yourself and those you love to get better and there is no shame in having to take a pill to get there. I had to learn that. The bottom line is getting well ... by whatever route.
My heart is with you...
Kathy Woltman (41)
