Postpartum depression

  1. [FONT=Arial Narrow] Has anyone ever come across a patient that was experiencing pp depression? What were your clues that the pt. may have been suffering?
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  2. 14 Comments

  3. by   LizzyL&DRN
    I can't say i've ever come across a pt suffering due to the fact we don't see them for long in the hospital. Maybe 2-4 days max on our floor then they d/c home. Anyway, I only experienced the PP Blues after my first child. I just couldn't stop crying. Never been like that before.
    Anyway back to your question:
    I think clues to look for as far PP Depression goes are, poor bonding with child, feelings of hurting themself or the child(not that she would express these feelings to you), maybe poor eating habits, poor bonding with family and/or FOB. The chances you will see these signs while mom is inpatient I think are unlikely. Therefore its important to offer this type of teaching upon discharge. Its important mom knows the difference between normal and abnormal PP feelings.
  4. by   midwife2b
    About 80% of all new mothers experience some "baby blues"; feelings of sadness, emotional outbursts, teary times. These blues are considered normal for the first 10-14 days postpartum. If they continue past 2 weeks, or are so severe as to cause difficulties with bonding or family relations, our patients are asked to come in for an evaluation. I've seen quite a few who benefitted from this early intervention and had great outcomes.
    This is one of the reasons why our midwifery service has a 2 week appointment for postpartum: to distinguish blues from depression, and to work on any breastfeeding problems.
  5. by   mommy2boys
    I had PPD after both of my babies. I felt like I COULDN'T do anything right and that I was going to hurt (ie drop it or hurt it bathing it etc, not harming the baby on purpose) the baby by being a bad mom. I couldn't sleep and was very moody.

    With my first son my OB noticed the change w/ me and spoke to me about it. I just thought it was normal "baby blues" but it lasted longer than it should. I was on anti depressents for 6 months and felt tons better. With my second son, I was put on anti depressents right after birth to help avoid PPD. They helped and I was only on them for a few months and it helped me tons again.

    For me the best course of treatment was medication and extra help around the house. My treatment may not have worked for everyone, but it helped me a lot.

    Erin
  6. by   CHATSDALE
    pp depression [as opposed to pp psychosis] usually resolves itself as the hormones return to normal, if not med will help..
    frequently the new mom is not really aware of the depression she needs a famly member to step in and encourage her to talk with md sometimes family members think that all they have to is say 'SNAP OUT OF IT'
  7. by   mitchsmom
    Here is one page (I'm sure there are many) about PPD, & there is also a quiz there that moms can take (I think it is based on the Edinburgh Postnatal Depression Scale, at least it is mentioned there):
    http://kellymom.com/ppd/index.html
  8. by   bignursenancy
    The Edinburg is one of the best Pp depression scales out there. "We just finished a 3 month survey on every pp patient. It is truly amazing at how many have just the baby blues and are able to pull out of it. Others can become quite ill. I would suggest going to the site above and look at the test. It is a simple test made on a 6th grade level (it says anyway)
    Nancy
  9. by   tusnchargers
    [font='times new roman']my sister-in-law went through post-partum depression with her first child. she would cry out of nowhere, feel overwhelmed, and stressed out. i would try to help out her out in any way i can with chores around the house, running errands, or anything that would not take away from her bonding with her child. i researched on post-partum depression and found out that a mother who is suffering postpartum depression could affect her ability to parent. she may lack energy, have trouble concentrating, be irritable, and not be able to meet her child’s needs for love and affection. as a result, she may feel guilty and lose confidence in herself as a mother, which can worsen the depression. i read that researchers believe that postpartum depression can affect the infant by causing delays in language development, problems with emotional bonding to others, behavioral problems, lower activity levels, sleep problems, and distress. it helps if the father or another caregiver can assist in meeting the needs of the baby and other children in the family while mom is depressed. [font='times new roman']a mother’s depression can affect her baby’s development, so getting treatment is important for both the mother and baby. [font='times new roman']depression not only hurts the mother, but also affects her family as well. nurses should provide education on postpartum depression because it can happen to any new mom.
  10. by   BSNtobe2009
    I was so emotional to the point of complete detachment from my child...I highly suspect that it was because she was a preemie born by c-section. I felt like I had surgery, but I had an overwhelming feeling that I didn't really have a baby and they just rolled up an isolette and said, "Oh, this one...belongs to you."

    The day I left the hospital, I felt like I could just go home and not go back and that sounds HORRIBLE...that is a hard thing to admit.

    I really think I was afraid to get attached to her because I was so scared she was going to die. However, I now understand that post-traumatic stress syndrome is most-likely what I was going through and it lasted for MONTHS.

    I cried at everything...when I couldn't find a sock that matched, over things I saw on TV...even a dead rabbit on the side of the road...I was constantly overwhelmed with emotion.

    My daughter and I have since bonded but it took almost 1 1/2 years before that happened.

    I felt so incredibly robbed of the entire birthing process..very jealous of two close friends that had babies while mine was in the hospital and got to bring their babies straight home.

    The only "remnant" that is left is now I can't watch a baby being born, whether real or fictional, on TV without welling up in tears.

    I'm not much on celebrity books, but "Down Came The Rain" by Brooke Shields was about the only account of PPD that I had ever read that was EXACTLY what I was feeling....and very, very afraid to admit to anyone.

    Everyone keeps telling you how lucky you are...but it's sad when all you can focus on was what went wrong.

    I now realize, from reading other stories on preemies, how lucky my daughter was...and that is the driving force to my choosing to be a nurse and working with preemies for a career. I want to focus that energy into something positive.
  11. by   ElvishDNP
    I had PPD myself but not in the hospital. I was emotional the first couple days but not to the point of it being worrisome. I agree c the posters who say we're not likely to see it in the hospital because people are there for such a short stay.

    Mine was bad. I went undxed for about 4 months while working fulltime and trying to keep up breastfeeding/pumping and maintain a house. It was the worst thing I've ever been through. I never felt like I wanted to hurt my son but often felt that for me, it would be easier to die than to live. I had a plan and all. My son's PNP (with whom I also worked) pointed out to me that I was depressed and needed to get help. I did and was on Zoloft for about a year. I have been med-free for about 8 months. I was fortunate to have the support of friends and family and my wonderful husband who stuck by.

    I make real sure I go over with all my new moms (and their SO's) the signs of baby blues/PPD/psychosis. I especially make sure the SO knows what to look for because so often we know that we feel bad but don't know what to call it. I let my moms know that if they feel all these things, they are NOT alone, there IS help, and there IS hope. And then I tell them (a short version of) my story, not for pity, but to make the point that it happens to real people and it doesn't mean you're crazy.

    I wish someone had done that for me while I was in the hospital. Where I am now, we automatically order a SW consult if mom has a hx depression, PP or otherwise.
  12. by   missninaRN
    I had PPD with both of my babies but never received treatement for it. The idea that I could be depressed was just impossible for us to admit at that time, although I had all of the symtpoms. I was anxious, fearful, weepy, and paranoid that I inadvertantly would harm the baby or that something terrible would happen to him/her. I was convinced that I was going insane, but when I told my husband that I needed help, he said I was fine, or that I was just tired.
    I guess it gradually went away, though years later I did seek treatment for clinical depression. It was then that I learned that leaving PPD (or any depression) untreated increases the likelihood that there will be a reoccurrence.
    Our decision to only have two children was based mainly on my history of PPD.
    Last edit by missninaRN on Dec 11, '06
  13. by   angchick
    Hello Im not a nurse but Im an aspiring one but I just had a baby girl 3 weeks ago and my blues started in the hospital the second day I was there when my husband couldnt stay with me b/c he had to go home to be with our 2 year old son. I guess I just felt alone and I sat there and cried and cried. When they brought the baby to me I couldnt put her down (I guess it was for comfort) so I stayed up all night and never got any rest. Finally when a nurse came in at 3 in the morning to check on the baby she caught me crying and talked with me. I had bad ppd with my first son and I was sooo fearful I would have it with my daughter which when I came home I did and Im now on zoloft which has helped me soo much. Mine started in the hospital and one nurse realized it and helped me alot. I misse out on my sons first 3 months of his life due to the ppd and I didnt want that to happen this time around. When I went to the doctor for my two week check up I just sat there and cried and cried and they gave me my meds and I feel like myself again and I can care for both of my children with no worries. I do plan on having two more and I know to get help so it doesnt get out of control
    Last edit by angchick on Dec 11, '06
  14. by   HvnSntRN
    I experienced PPD with my first child - I had no idea that there was anything wrong with me. Yes, I was not my usual self, but there were many other things happening that exacerbated the stress, and I attributed my emotional state to those changes: I quit the job I had at the time to be at home FT with my child, we moved three times by the time he was 2 years old (one move was an 800 mile move to another province), and part of me just assumed that this was my "welcome to motherhood" and that I was having a problem transitioning from being "me", to being almost wholly responsible for my child. I felt guilty for wanting to have time to myself, and my circle of friends reinforced that by implying that to have time to myself would be "selfish". It took until after my son's THIRD birthday to feel like myself again. I would not wish that experience on anyone.

    With my second child, five years later (yes, I was terrified that it would happen again) nothing like that happened. It was night and day. That's when I realized that something had gone dreadfully wrong with the first postpartum period.

    What is it they say about tempting fate?? We had our third 17 months later, and I had clues during the third trimester that things were going to hell - at about 33 weeks I started having panic attacks and started obsessing about the baby's gender, terrified that if I had a boy I would get PPD again; I wanted the pregnancy to "go away" - I didn't want to see the baby, hold the baby, or even name the baby. About the same time, we went through a stretch where it seemed like every week there was another crisis. Our car broke down, the washing machine flooded the basement, I had difficulty remembering things and concentrating. I brought it up with our doctor and he flagged my chart for possible crisis intervention. Finally when the baby arrived, things were peachy until about 6 weeks postpartum. I remember very clearly making a pot of macaroni and cheese for dinner, the kids were demanding attention, the baby was crying, my husband couldn't understand why the house was upside down and the laundry wasn't done. I had never felt so overwhelmed and out of control in my life. I felt like an animal in a trap - with an overpowering urge to escape. It took every ounce of energy I had to get up in the morning, and I was sleep deprived beyond belief. I would cry for no reason at all. I felt worthless. I felt like a fraud. I felt like I had nobody in the entire world who could understand what I was feeling. I didn't want to commit suicide, but I did want to "disappear" and never be seen or heard from again.

    My doctor referred me to a psychiatrist who specialized in treating women with PPD. I started on meds and stayed on them for about a year and a half. It took time, and a great deal of support, but I got better, and started nursing school when my youngest was two years old. I'm the go-to person on my Mother Baby Unit when it comes to PPD. I've done in-services for staff, and for students at the Nursing School, as well as spoken at prenatal classes. Last year I was on the Review Committee for a professional publication about PPD. I helped get a local support group off the ground too, and make sure all my patients and their partners hear about PPD before they go home.

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