postpartum depression

webbiedebbie · Oct 13, 2003

I, too, would be interested to hear what other PP nurses are doing. In my unit, we give the moms information in a booklet. If they have a history of PP depression, they are seen by the discharge planner. I'm sorry to say that I don't really know what they go into with them. Most of our time is spent teaching moms about pericare, breastfeeding, baby care, etc.

From personal experience, I had a touch of PP depression twice. For the first one (my second child), I hid it from the nurses. For the second one, (my third child) I only saw the nurses once a shift, and they never brought the subject up. I struggled at home with it. Thank God, it didn't develop into something worse for me! (I wasn't a nurse when I had my children).

renerian, BSN, RN · Oct 13, 2003

I have no post partum experience other than my own on depression. Would that help?

renerian

wannaknow · Oct 13, 2003

Thank-you for taking the time to reply. Yes, it could be helpful if you would assist me on some of the areas you felt there was not enough input by the nurses or if you felt the nurses did a great deal to help you through it. My paper is on the views of the effects and treatments of postpartum depression. Whether their is enough resources and training to help mom and baby, or perhaps if the outcome was not as good, how do the nurses maintain and help focus to ensure the road to good health and acceptance? I am needing both outside and inside views on what people view the nurses roles are and how far they should go, and if there is a gray area that is neither understood by mom or nurse how could the gap be lessened? Anything you have to say in these areas would be greatly appreciated!! Thanks again.

Long Term Care Columnist / Guide · Oct 13, 2003

I don't think postpartum depression was even recognized back when I was having kids, and the youngest is only 12, so it's fairly new as a diagnosis, if not as a phenomenon. I was one of those who got worse with each child, until the last one when I really thought I was losing my mind. I had these horrible fantasies about harming the baby or allowing him to be harmed in some way, although I never even came close to acting them out like that poor woman in Texas who drowned all five of her kids. It scared me so, and made me feel soooooo guilty, that I pushed all the feelings way down deep inside---how could I even THINK of hurting this baby, whom I loved more than life? People would think I was crazy........so for more than a year I lived with the fantasies, the fear, and the guilt, and prayed for the strength to keep it all bottled up.

I didn't know then that I was suffering from a form of postpartum psychosis, or that there was help for it. All I knew was that I was a terrible mother for even thinking about these things, even though I couldn't control my thoughts or stop seeing the mental pictures that appalled, and yet fascinated me, much like an auto wreck that you just can't help gawking at.

When I first heard about this, years later when I was in nursing school, the relief was so incredible it was almost tangible. I remember thinking "THAT'S IT!"---I wasn't a bad person, I'd only been sick.......and both my son and I were damned lucky I'd stopped at merely thinking about harming him. I'd had postpartum depression with all four of the previous kids, and it had gotten worse with each one, but I hadn't crossed over into a psychotic state until the last. I still thank God we never had another one, if only for that reason!

Now, of course, we know more about this phenomenon, and it's possible to talk about it and get it treated without feeling like the worst person on earth. This is the first time I've actually told anyone about my experiences.......I'd hinted about it with my sister once, a few years ago, but even she doesn't know how ill I was, or how close I came to committing suicide because I was so afraid I'd hurt my son. We lived about 500 feet away from the railroad tracks back then, and more than once I thought about going out there and just lying down in front of an oncoming train.

It would have been so quick........but I couldn't do it.

Now I'm glad I can talk about it. No woman should have to live with the kind of guilt I did, or feel so bad about herself that she wants to die. Postpartum depression and psychosis are treatable, and I hope you will help continue to spread the good news, wannaknow!

renerian, BSN, RN · Oct 13, 2003

I know my kids are all older as well. Four in college and one high schooler. I had my second and came home having a child not quite 2 at home, hubby could not get off work. Had no help. I remember being very depressed and crying as the baby was colicy and never slept just cried ALOT. I called the Dr. and the nurse and Dr. both said, to bad get over it.

renerian

Josie K · Oct 13, 2003

In the UK, Health Visitors screen new mothers for PND ideally at the 8 week check-up, or between 7-9 weeks, using the EPDNS (Edinburgh Postnatal Depression Scale), and a standardised interview.

Mothers who score 14 and above will receive invite to PND group, or 4-6 home visits @one per week for supportive intervention inc., evaluation and investigation of other treatments, such as antidepressant therapy.

See British Journal of Psychiatry. June 87. Vol. 150 by by J.L. Cox.

J.M.Holden. R. Sagovsky.

Also try www,wellmother.com.

renerian, BSN, RN · Oct 13, 2003

Wow Josie that is nice! renerian

wannaknow · Oct 14, 2003

wow!!! you are sure an amazing woman mjlrn97!!! Your insight is helpful to me as I'm sure it will be to others. It's a wonderful feeling to be able to speak freely about the things that scare us. My first child was stillborn, and I didn't suffer post-partum depression, but it was a very hard issue to come to terms with. I think that a lot of people are unaware of how difficult child bearing

really is. You never hear of the other side of the fence. I'm very gald things turned out well for you. I have two children now but my second was a twin and one passed away also. I'm considered a high risk pregnancy, and we were told we could probably never carry a girl. I'm glad to say they were wrong. There is so much fear in talking about the feelings surrounding trauma. But I'm sure glad there are people out there like you that let them now its ok. We all have things to face and its so much easier when we are aware we are not alone. thanks again and best wishes to you and your family. Your strenght is a wonderful gift!!!

wannaknow · Oct 14, 2003

Thanks Josie!!! I can defintely put this information to good use!!

wannaknow · Oct 14, 2003

hi renerian, I hope times have changed since you had that experience. It's very crass to be told such unfeeling words. I hope you had support from someone else. Those are the exact sentiments that make mother's feel they are strange. When I lost my first child and went in to have my post natal checkup (not quite sure what it is called?) I was asked if I was brestfeeding?! This was very disturbing to me because she had my chart in her hand and I knew right away that she hadn't even bothered to open it. Sometimes we are made to feel very insignificant around doctors and nurses. Thank goodness not all are like the ones we ran into!!! We can put our experiences to good use though. Helps us and others remember that each patient is an individual, and cases and needs vary and to not overlook this!!!

Thanks for letting me know this. There are still a lot of gaps in patient/dotor/nurse communication!!!