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It's a great blessing when a new mom with postpartum depression (PPD) is fortunate enough to be diagnosed early by a knowledgeable medical practitioner or therapist. But without guidance, it isn't always clear where the boundary between normal baby blues and PPD lies. As with any other illness, the quicker that PPD is identified and treated, the faster the woman will recover. Postpartum Depression For Dummies can help you begin the process of determining what's going on with you and give you a better idea of where you fall so that you can get yourself into proper treatment right away. The book covers all aspects of PPD, from its history and its origins to its effects on women and their families to the wide variety of treatments available--including conventional Western medicine, psychological therapy, alternative medical treatments, and self-care measures. Postpartum Depression For Dummies reveals: * Why some doctors may be hush-hush about PPD * How to distinguish between pregnancy hormone changes, "baby blues," and PPD * The difficulties of getting a proper diagnosis * The role and importance of a therapist * The benefits of medication for depression * Alternative treatments with a successful track record * How to find the right balance of psychological, medical, and alternative treatment * Ways you can help foster recovery * The nutrition you need to care for yourself properly * How to help your partner help you Postpartum Depression For Dummies also provides the additional resources you need--web sites, organizations, and further reading--to help avoid the unnecessary suffering caused by undiagnosed and untreated PPD and survive and thrive as a new mom.
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by Shoshana S. Bennett, PhD
Postpartum Depression For Dummies®
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Postpartum depression — possibly more than any other mental illness — is a very private pain. Private because you can’t believe you feel so empty and depressed at a time when you’re supposed to feel so happy and fulfilled. You’re afraid of appearing to be ungrateful, selfish, immature, or worse: A bad mother. So, you don’t want to confide in anyone.
I thought I was all these things and more. I wasted a lot of time and energy on self-blame, believing my depression was caused by a personal failure or weakness — or both.
Don’t do this to yourself. No one should have to go through that kind of anguish and humiliation. Accept the reality of PPD as an illness and recovery will be easier. Trust me. PPD is a mental illness, and mental illnesses have nothing to do with blame.
PPD doesn’t care how ready and willing you are to have a baby. It strikes without regard for age, race, education, or economic background. And it robs you — and your family — of what should be a joyful time. As a mother, you deserve to fully enjoy your new baby. Your baby deserves a healthy mother who can provide the love and care he or she needs.
Back in 1984, when I experienced the first of my two bouts with PPD, I had no idea what it was. It wasn’t something people talked about. I frantically searched every book about pregnancy and childbirth I could get my hands on for information about depression after giving birth. All I could find on the subject was a single paragraph that basically said “If your wife has postpartum depression, watch out! She’s likely to accuse you of having an affair!”
Thankfully, the dark ages are over. Postpartum Depression For Dummies does the groundwork to help you get through this insidious illness. Think of it as a survival guide that arms you with practical, easy-to-understand information so you can avoid being trapped in your private pain the way I was.
Mary Jo Codey Former First Lady of New Jersey
Shoshana S. Bennett, PhD, is a licensed psychologist who founded Postpartum Assistance for Mothers in 1987 after her second undiagnosed postpartum illness. Dr. Bennett is the immediate past president of Postpartum Support International and the past president of California’s state organization, Postpartum Health Alliance. She is a noted guest lecturer and keynote speaker, and her work has been the subject of numerous newspaper articles around the country.
Dr. Bennett has been a featured guest on national radio and television shows, including ABC’s 20/20. For years, her popular talk radio show Mom’s Health Matters was heard worldwide, and, like her current tele-classes, focused mainly on subjects pertaining to pregnancy, postpartum, and parenting. She’s also the coauthor of Beyond the Blues: A Guide to Understanding and Treating Prenatal and Postpartum Depression (Moodswings Press).
For 15 years prior to her current profession, Dr. Shoshana was a college instructor in the fields of special education, early childhood development, rehabilitation therapies, and psychology. In addition to three teaching credentials, she holds her second masters degree in psychology and a doctorate in clinical counseling.
Dr. Shoshana is available for speaking engagements, workshops, and telephone consultations. You can contact her through her Web site at www.postpartumdepressionhelp.com.
To my daughter, Elana, whose beautiful and persevering spirit not only survived, but is thriving despite my emotional absence for so many years. And to my son, Aaron, whose love of learning and passion for self-growth propels me to demand the best from myself.
I am especially grateful to the following people:
My children, who continue to be my best teachers — about being a mother and about remembering what is important.
My wonderful clients, who, by allowing me the gift of helping them recover, give my own suffering with postpartum depression a purpose and meaning.
My husband, who was the smiling, upbeat parent for our babies when I was ill and who has always supported me in pursuing my mission to pioneer in the field of postpartum depression.
My sisters, who encouraged me throughout the process of writing Postpartum Depression For Dummies by frequently checking in with love and care.
My dad, who has been an inspiration and role model, for expecting excellence in all my pursuits. And my mom (I miss her dearly), who showed me what unconditional love is all about.
My research assistant Laura Strathman Hulka, who checked facts and produced whatever obscure pieces of information I needed with lightning speed and thoroughness. And the enlightened editors at Wiley for understanding how important it is to add this topic into the For Dummies series and for helping me to bring the book to fruition: Jacky Sach, Tracy Boggier, Kristin DeMint, and Jessica Smith. Also, a big thank-you to Marlene P. Freeman, MD, who served as the technical reviewer of this book and lent her expertise to make sure I covered everything important for you to know.
We’re proud of this book; please send us your comments through our Dummies online registration form located at www.dummies.com/register/.
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Title
Introduction
About This Book
Conventions Used in This Book
What You’re Not to Read
Foolish Assumptions
How This Book Is Organized
Icons Used In This Book
Where to Go from Here
Part I : Bringing Postpartum Depression into the Light: What It’s All About
Chapter 1: The Big Adjustment: Welcome to Motherhood
The Reality of Motherhood: Let Bootie Camp Begin!
The Reality of Postpartum Depression (PPD)
Debunking Denial: A Glimpse from Yours Truly
When Depression Begins in Pregnancy
A Brief Overview of Treating and Recovering from PPD
Before You Begin, Take Some Hope for the Journey
Chapter 2: These Ain’t No Baby Blues: PPD, Up Close and Personal
Baby Blues: Cute Name for a Crummy Time
When the Misty Blues Turn to Darker Hues
Considering Special Situations Where PPD May Be on the Horizon
Extending beyond Biological Moms: PPD in Dads and Adoptive Moms
Chapter 3: You Mean There’s More? Five Related Postpartum Disorders
Penciling in Some Lines: A Quick Comparison of Mood Disorders
When Fear Strikes: Panic Disorder
Facing the Aftermath: Post-Traumatic Stress Disorder
Breaking the Cycle: Handling Obsessive-Compulsive Disorder (OCD)
Riding the Emotional See-Saw: Bipolar Disorder
Immediate Attention Needed: Psychosis
Part II : The Three Little Letters: PPD and You
Chapter 4: Looking Within: Is PPD Your Big Bad Wolf?
Facing the Beast Head-On: Tuning In to Your Emotions
Minding Your Mentality: A Look at Self-Talk and Dark Thoughts
Watching for Warning Signs of the Physical Kind
Evaluating Your Postpartum Slump
Chapter 5: A Professional Assessment: What’s Huffing and Puffing at Your Mind’s Door?
The Difficulties of the Diagnosis
Taking a Pre-Assessment: The Edinburgh Postnatal Depression Scale
Receiving a Competent Professional Assessment
Reacting to Your Diagnosis
Chapter 6: Seeking Out a Therapist to Keep Your Proverbial House Standing
Understanding the Role and Importance of a Therapist
Finding the Motivation to Go to Therapy: Demolishing Mental Blockades
Seeking Help When You Suspect You Have PPD
Finding the Right Therapist for You
Choosing a Licensed Therapist
Paying for Therapy: Don’t Shortchange Yourself
Locating a Therapist or Counselor
Assessing the Therapist You’ve Chosen
Part III : Diagnosis Confirmed: Looking at the Treatment Options for PPD
Chapter 7: Venting Your Mind and Heart: Psychological Treatment
Knowing What to Expect From Therapy
Making the Most of Therapy
Ending Therapy and Staying Healthy
Attending Groups
Chapter 8: Counteracting a Chemical Cause: Medical Treatments
Recognizing the Benefits of Medication on Depression
Who You Gonna Call? A Psychiatrist, That’s Who
Addressing Concerns about Taking Prescribed Meds
Specific Types of Medical Treatments for PPD
Understanding the Fact that Finding the Right Med(s) Is a Process
Side Effects: You Can’t Always Get Just What You Want
Knowing When to Begin Med Therapy
Chapter 9: All Things Natural: Alternative Treatments
Introducing the World of Alternative Treatments
Alternative Treatments that Make the Cut for Their Success
Alternative Treatments that May Add a Bit of Benefit
Administering Alternative Treatments: You and a Pro
Searching for Other Alternative Treatments: Be on Guard!
Chapter 10: Creating a Comprehensive Treatment Plan
The Three Components: Finding the Right Balance for You
Conventional Therapy or Alternative? A Quick Comparison
Coordinating the Plan
Adding Professionals to Your Treatment Team
Getting Your Team Members to Huddle
As You Go through Treatment . . .
Ah, the Good Stuff: Dealing with Insurance
Part IV : Traveling the Road to Recovery
Chapter 11: Getting the Most Out of Your Treatment
Recognizing the Stages of Recovery
Keeping the Faith: Ways to Foster Recovery
Chapter 12: Setting the Supermom Cape Aside: Caring For Yourself
Eat and Drink Your Heart Out, Baby! (The Healthy Way, of Course)
Making Sure You Get Some Winks
Shakin’ It for Your Love
Taking Regular Breaks
Staying Social
Creating a Positive Ambience
Giving Yourself Permission to Set Limits
Structuring Your Day
Knowing It’s Okay to Lighten Your Load
Chapter 13: Coping with Your Feelings
Learning to Ride the Waves
Facing Your Feelings Head On
Boosting Your Self-Esteem
Knowing What You Can and Can’t Control
Responding to Others Honestly (But Appropriately!)
Forcing Yourself to Laugh
Chapter 14: Finding Somebod(ies) to Lean On
Emerging from under the Sheets
Diversifying Your Support Team
Explaining Your Depression to Others
Finding a Healthy Balance between Support and Self-Sufficiency
Chapter 15: Helping Your Partner Help You
Understanding Your Partner’s Role in the Battle
Dealing with Your Partner When You Want to Be Left Alone
Communicating Effectively on a Regular Basis
Seeing a Therapist Together: Benefiting from an Extra Set of Brains
Getting Support when Friends and Family Make You Feel Worse
Sharing Responsibilities
Watering Your Relationship and Letting It Grow
Chapter 16: Helping the One You Love: A Chapter for Family, Friends, and Partners
Reacting in a Healthy, Helpful Way
Getting Information if Depression Is Foreign to You
Thickening Your Skin: Not Taking Things Personally
Caring for Yourself . . .
Keeping Kindness in Your Countenance
Putting Your Love into Action
When PPD Escalates: Recognizing the Warning Signs of Suicide
Practicing Sensitivity: Knowing What’s Okay and Not Okay to Say
Part V : Moving Beyond PPD
Chapter 17: Delight at the End of the Tunnel: Emerging with a New Sense of Self
Looking Back: Build Yourself Up, Buttercup
Taking Back the Reigns
Feeling Like Yourself . . . Or Even Better
Chapter 18: Deciding Whether to Have Another Baby
First Things First: Assessing Your Intentions
Making an Informed Decision, Sans Fear
Planning Ahead if You Decide to Pass Go
Trusting Your Decisions
Part VI : The Part of Tens
Chapter 19: Ten Common Fantasies about Motherhood
This Should Be the Happiest Time in My Life
I Should Be Able to Do Everything Myself
I Shouldn’t Need Breaks
My Life Won’t Change That Much
My Needs Shouldn’t Matter
Bonding Happens Immediately at Birth
Breastfeeding Is Natural, So It Should Come Easily
Mothering Is Instinctual
I Should Feel Satisfied Being a Stay-at-Home Mom
My Baby Will Be My Companion
Chapter 20: Ten Thoughts to Focus on Throughout the Day
PPD Is an Illness, Not a Weakness
Seeking Help is Courageous
I’m a Good Mom
PPD is Temporary — I Will Recover
It’s Important That I Take Care of Myself
I’m Doing the Best I Can
I’m Practicing Love toward Myself
I’m Surrounding Myself with Positives
PPD Isn’t My Fault
I’m Not Alone
Appendix: Resources
Web Sites
Support Numbers
International Organizations
Further Reading
M y family and I are survivors of my two life-threatening encounters with postpartum depression (PPD). After realizing that what I had been suffering from had a name and that it was unnecessary for my family and I to suffer for years, I vowed to myself that I would never let another woman go through this devastation if I could help it. It became my life’s mission to educate women, their families, and health professionals about this affliction. When I started coming out of my second round of PPD in 1987, I began running PPD support groups out of my Northern California living room. (Up until that point, I taught special education and early childhood development at local community colleges.)
After making my vow to help other women and their families, I went back to school and earned a second master’s degree and a PhD. Then, fueled by my passion, I went on to become licensed as a clinical psychologist. Not counting the telephone classes I have led, since 1987 I have assisted over 15,000 women in dealing with and recovering from PPD.
My guiding star for two decades now has been identifying and treating women with PPD as quickly as possible so they could begin to once again enjoy their lives and families. So, when the wise and competent folks behind the For Dummies series approached me to write this book, I jumped at the chance. I knew that such a book would reach many more women than I could personally assist. And with this book, I hoped that women and their families wouldn’t have to unnecessarily suffer for years — like I and my family did — from undiagnosed and untreated PPD.
This book is intended for anyone who has PPD or thinks that he or she knows someone who has it. This includes women who have recently given birth, as well as their partners, family members, and friends. It’s also a great resource for pregnant women, couples, and family members of pregnant women. In short, this book is meant for any women (and their friends and families) who may be at risk for PPD, which can be as many as one out of every five women who give birth.
However, this book isn’t meant to be a medical textbook. Instead, like all ForDummies books, this one’s meant to be an easily accessible and digestible guide that, no matter what page you turn to, can be immediately put to practical use. Even though this book isn’t meant to be a textbook, my hope is that medical and mental health professionals will pick it up and benefit from what’s inside (especially those who don’t really believe in PPD).
The primary goal behind this book, then, is to enable you to understand the nature of PPD, and to help those suffering from it to recover as quickly and effectively as possible. I want you to know what to expect from PPD, including how this illness tends to behave, what the general treatments look like, and how to proceed through the recovery process. Although recovery can happen quickly, it won’t be overnight, so I want you to have reasonable expectations about what’s likely and what’s possible.
To help you navigate easily through this book (because I know how scrambled your mind can feel when you have PPD), I set up a few conventions that I use consistently throughout the book:
Anytime I want to highlight new words or terms that I define in the text, I italicize them.
Boldfaced text is used to indicate the action part of numbered steps and the keywords of a bulleted list.
I use monofont for Web sites and e-mail addresses.
When this book was printed, some Web addresses may have needed to break across two lines of text. If you come across these instances, rest assured that I haven’t put in any extra characters (such as hyphens) to indicate the break. So, when using one of these Web addresses, just type in exactly what you see in this book, pretending as if the line break doesn’t exist.
You’ll also notice that I refer to a mom’s partner quite often throughout the book. As much as possible, I used the gender-neutral reference because I fully understand the fact that nowadays many couples are same-sex parents (and a good number of the couples I’ve counseled are same-sex parents). Sometimes, though, being politically correct is extremely tedious in writing, so in those cases, I used the masculine form — please note that this usage was only a technicality, though, and I in no way am leaving anyone out of the picture.
Finally, if I tell you that a client or some other person told me something, you can be sure that it’s exactly what he or she told me. Unlike some books discussing mental health issues, I don’t use composites of clients — pulling a little bit from Client A’s history, a little bit from what Client B told me, and a little bit from what I read in a journal — to illustrate a point. If I tell you that something happened to a client, it really happened.
Everything in this book has value — otherwise, I wouldn’t have written it or included it. However, you may want to skip over some parts of the book, especially if you’re pressed for time or don’t have a need for certain types of technical or detailed information. Helpful but unnecessary information is usually denoted by a Technical Stuff icon or is highlighted in its own separate sidebar, which will be shaded gray.
Similarly, keep an eye out for my personal experiences, which I highlight with the Anecdote icon. This icon flags information that’s extremely helpful and useful, but nonessential to your understanding of PPD.
Finally, if you’re the one going through PPD, you may want to skip Chapter 16, which is intended for friends, family members, and partners of new moms suffering from PPD. On the other hand, you may actually find it useful to read about things from the perspective of those who love and know you best.
As any author does, I had some assumptions in my mind about you, the likely reader of this book, as I was writing it. By putting forth the following assumptions, I hope you’ll feel liberated to make the best possible use of the material in this book:
A lot of you have either been diagnosed with PPD or think that you may have PPD (or you’re a family member or friend of someone who has it or who may have it).
If you’re pretty sure you have PPD, you’re willing to talk to a qualified medical or mental health practitioner as soon as you can, and in any case, you won’t make any kinds of major life changes or start with any kinds of medications (especially illegally obtained ones) without consulting a practitioner.
You want to understand more about PPD, and you want an inside look at this all-too-common disorder from a trained psychology professional and from someone who intimately knows what you or your loved one is going through.
You want to know that there’s hope and light at the end of the tunnel. But, having said that, I also assume that you’re ready to do what it takes to reach that light.
This book is divided into six parts to help you find information quickly and easily — whether you need general info on PPD or specific info on a certain treatment. The following sections give you a brief overview of the six parts.
Motherhood is challenging even without a mood disorder. So, in this part, I help you out by discussing the normal transitions of motherhood and then move into the basics of postpartum depression — who gets it and why and how you can tell the difference between the baby blues and PPD. I also describe the other five postpartum mood disorders so you can identify where you’re at in the mix.
After you’ve identified what you’re experiencing, you can use this part to tune in to your thoughts and start turning the negative into the positive. Here in this part, I discuss the importance of seeing a competent professional, how and where to find one, the different types of therapists to pick from, and what to expect when you go to see one. Because hearing a diagnosis of PPD can provoke a wide variety of reactions, I mention many of them so that you can be prepared (or have something to identify with if you’ve already been there and done that).
In this part, I answer all your questions regarding treatment — whether you want to know about psychological, medical, or alternative treatments. For example, because there are four different types of groups that you might join for support, it’s helpful knowing what to expect from each so you can choose well. Then I take you on a tour of medical and alternative treatments, including medications and herbs that are considered safe with breastfeeding. Finally, I round out the part with a chapter that shows you how to create a comprehensive plan for recovery.
Hopefully by the time you reach this part you’re seeing a wonderful therapist. Here, I show you how to maximize your treatment to speed things along. I include a number of self-help tips as well — for example, eating specific foods, understanding the good and bad ways to exercise, and knowing how to let go of unrealistic expectations. Because emotional and physical support is so important to a new mom who’s suffering from PPD, I also give you ideas about who to lean on, and I outline how to help your partner (if you have one) help you. The last chapter in this part is specifically written for the family and friends of the woman suffering with PPD.
When all of your hard work has paid off and you’ve made it to the other side of the dark PPD tunnel, you’re ready for specific suggestions on how to adjust back into your life — your new life. If you’re contemplating having another baby in the future, I give you healthy ways to approach this important decision, including all the pros and cons. Plus, I show you the best way to develop a plan that will ensure a positive outcome (if you decide to go forward).
In this part, which is great for quick and practical pieces of information, you can check out the most common fantasies of motherhood (see which ones you believed in before becoming a mom!). I also include a list of my favorite empowering thoughts to help you get through your day.
Throughout this book, I use icons in the margins to quickly relay certain types of information to you. Here are the icons you’ll see and a short description of each.
When you see this icon, you’ll know that I’m disclosing personal information regarding my own journey (or my patients’ journeys) through this devastating illness to illustrate a particular point.
These reminders highlight the information that’s good to jot down on your pad of notes (or that’s just good to keep in mind as you go down the road to recovery).
I use this icon to flag a piece of interesting, but nonessential, information, such as the results of research or an experiment.
This icon points out useful tidbits and practical advice.
Because this icon alerts you when you need to be particularly careful about something, don’t skip these icons!
This book is written in a modular style, which means you can flip to any chapter and get a great deal of value from it without having read the chapters before it. However, for some of you — especially those in the medical or mental health professions, or those who have a friend or family member who may have PPD but who isn’t in crisis — reading this book from start to finish will provide the most value. Otherwise, if you know what topic you’re looking for, take a glance at the index or table of contents to find out where to find it.
If you’re a new mom or a soon-to-be mom, you’ll probably want to start with Chapter 1 because here new mom issues are truthfully stated, myths are busted, and the facts about PPD being a real illness are presented. If you have PPD, or think that you might, and you’re feeling desperate for information, skip to Chapter 2, where I give you the lowdown on PPD.
Here’s your first tip: If you’re reading this book because you think you have PPD, before reading on, you may want to grab a pad of paper and a special pen or highlighter so that you can take notes and do the various exercises suggested throughout the book. Use this pad and pen as often as you like — and as often as you can — and refer to your notes frequently to see just how far you’ve progressed. If at any time you find the book overwhelming, just put it down. And only pick it up when you’re ready to start reading again. Or, when you’re ready, you can have someone else read it to you.
In some cases, Postpartum Depression For Dummies may be all that you need to recover from PPD. For most women, however, psychotherapy and perhaps medical treatment will enable a much faster and more effective recovery. What’s most important for you to know, however, is that if you follow the suggestions in this book and get proper help, you’ll indeed recover fully and completely from your postpartum crisis. Keep the faith, and read on!
In this part . . .
Motherhood is an adjustment for any new mom, whether or not she has a postpartum mood disorder. So, this part gives you the lowdown on what to expect (consider this a friendly reminder if you’ve already been through the experience). I also discuss the difference between the baby blues and postpartum depression (PPD). Finally, I give you an overview of the six different kinds of postpartum disorders that can afflict a new mom.
The lowdown on motherhood
Straight talk about PPD
The costs of denial
Depression and pregnancy
Treatment options for PPD
The reasons to stay hopeful
Even if you’re not hearing the “sound of music” as you read these words, it makes sense to start at the very beginning. And the very beginning, for purposes of this book — and for human life as we know it —is none other than motherhood. Yes, motherhood, that mythic time of life when everything goes according to plan, everyone is always happy, and things just couldn’t be better.
Or, at least, that’s what popular culture repeatedly implies. (Just last night I saw a commercial with a smiling, drop-dead gorgeous new mom bathing her infant and saying, “I never thought the love of my life would be bald and short.”) But as anyone who has ever given birth or grappled with the demands of that new human life can tell you, this Shangri-La version of motherhood is more of an ideal than a realistic view of what to expect. This isn’t to say that you won’t also occasionally experience incredible joy and have peak experiences that would make the Dalai Lama jealous. On top of the usual busting of unrealistic expectations of motherhood, postpartum depression (PPD) adds a heavy layer. To be assaulted with PPD is a huge disappointment, to say the least — more of a shock, devastation, and feeling of failure to most.
Lesen Sie weiter in der vollständigen Ausgabe!
Lesen Sie weiter in der vollständigen Ausgabe!
Lesen Sie weiter in der vollständigen Ausgabe!
Lesen Sie weiter in der vollständigen Ausgabe!
Lesen Sie weiter in der vollständigen Ausgabe!
Lesen Sie weiter in der vollständigen Ausgabe!
Lesen Sie weiter in der vollständigen Ausgabe!
Lesen Sie weiter in der vollständigen Ausgabe!
Lesen Sie weiter in der vollständigen Ausgabe!
Lesen Sie weiter in der vollständigen Ausgabe!
Lesen Sie weiter in der vollständigen Ausgabe!
Lesen Sie weiter in der vollständigen Ausgabe!
Lesen Sie weiter in der vollständigen Ausgabe!
Lesen Sie weiter in der vollständigen Ausgabe!
Lesen Sie weiter in der vollständigen Ausgabe!
Lesen Sie weiter in der vollständigen Ausgabe!
Lesen Sie weiter in der vollständigen Ausgabe!
Lesen Sie weiter in der vollständigen Ausgabe!
Lesen Sie weiter in der vollständigen Ausgabe!
Lesen Sie weiter in der vollständigen Ausgabe!
Lesen Sie weiter in der vollständigen Ausgabe!
Lesen Sie weiter in der vollständigen Ausgabe!
Lesen Sie weiter in der vollständigen Ausgabe!
Lesen Sie weiter in der vollständigen Ausgabe!
Lesen Sie weiter in der vollständigen Ausgabe!