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Katherine is author of the blog Postpartum Progress, and a writer for Babble's Strollerderby. She has also been syndicated on BlogHer. You can follow...
 
 
 
 

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The Six Stages of Postpartum Depression

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Recovering from postpartum depression is, unfortunately, a pretty unwieldy process to get through. It's not like you can take antibiotics and ten days later you're all set and ready to go. The process of recognizing, getting treated for and recovering from postpartum depression can take months and months and sometimes years.

Yes, I know. That completely sucks.

I was thinking about the experience of going through PPD as seen through the lens of the famed "5 Stages of Grief," the process people go through when dealing with grief and tragedy. Developed by Elisabeth Kubler-Ross, a Swiss psychiatrist who wrote the book On Death and Dying, the stages are:

1. Denial

2. Anger

3. Bargaining

4. Depression

5. Acceptance

Per Wikipedia, "Kübler-Ross originally applied these stages to people suffering from terminal illness, [but] later, to any form of catastrophic personal loss (job, income, freedom). This may also include significant life events such as the death of a loved one, divorce, drug addiction, the onset of a disease or chronic illness, an infertility diagnosis, as well many tragedies and disasters."

Could we look at the process of going through postpartum depression and postpartum anxiety in a similar way? I think so.

1. Denial: This must be what new motherhood is like. I'll be alright. It can't be postpartum depression, because I'm not mentally ill. I'm sure it will wear off soon. I just need more sleep.

2. Anger: Nobody understands what I'm going through. Why me?! This is supposed to be a time of joy. I don't deserve this. I don't want to have to take medication. I don't want to go to therapy. I shouldn't have to call a doctor. This is not fair.

3. Bargaining: If I just exercise more and eat better I'll be fine. If I could just get to the point where the baby sleeps through the night, I'll be okay. If I get closer to God and pray more, this will surely go away.

4. Depression: I should just leave my family. I'm bringing everyone down. They all would be better off without me. My poor baby doesn't deserve a mother like this. I'll never get better so there's no point in going on.

5. Acceptance: What's happening to me isn't normal and I can't ignore it anymore. It's not my fault. It is okay for me to talk to a doctor. It's okay for me to ask for help. I can take medication or go to therapy or do whatever is necessary for my health and that of my family.

When it comes to PPD, I'd have to add another stage. The stage that comes after acceptance, after the treatment, after the time when you start feeling better but aren't 100%. I call it the post-traumatic stress disorder, or PTSD stage because even after a year of getting treated and getting better it took me another year just to get over the trauma of what I went through.

6. PTSD: I still worry that PPD will return. I'm constantly looking over my shoulder. Every time I feel bad I'm convinced that I've gone back there. I feel like I've lost a lot of confidence in myself and I don't know if I'll ever get it back. I worry I hurt my child in the long-term because of how I was when he was a baby.

It takes a while, but you'll get past the PTSD too. At that point, finally, you reach complete recovery. You are able to experience the joy of motherhood. You are able to believe that you are truly over PPD. You feel the love that was always there, buried by PPD, for your child, and you trust that you are better and that you are a good mom.

Kubler-Ross believed that not everyone would necessarily experience all the stages of grief in the exact same order or even have all of them. She felt that most people would go through at least two of the five stages, and that it was possible to switch back and forth between them. I imagine the same is true for postpartum depression.

My favorite part of the Wikipedia entry on the five stages of grief is something I want you to consider carefully. To make a point, I've replaced the word "grief" with "postpartum depression":

"Significantly, people experiencing (or caretakers observing) the stages

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unachicana 5 pts

I'm a grandmother now. I have one granddaughter. She's twelve now, my precious, beloved granddaughter, whom I adore. I still recall going through postpartum depression after my first born. I knew something was wrong, but I had never heard of postpartum depression. That was in 1967. I know, the "dark ages". I happened to see a Redbook magazine on the magazine stand at the grocery store, as I stood in line with my grocery cart. I saw the words "Postpartum Depression" on the cover. I knew right then and there what was wrong with me. I bought the magazine and read the article. That was the only "help" I got for it. It helped me to know there was a name for how I felt, and that it was "normal" to feel like this after childbirth. I didn't experience it after my second child.

However, after my divorce, leaving a thirteen year marriage, I began psychotherapy for clinical depression.

I suspect child birth triggers depression in a woman who is susceptible to depression. I don't know, but that's how it seems to me.

I also hate the label "mental illness" when referring to depression, because it's emotional, not mental, even though one does affect the other. But there is a world of difference between mental and emotional, how one perceives as opposed to how one feels. I wish a distinction was made between the two. That's just my humble opinion.

Anyway, it took me more than twenty years of therapy before I learned there is a name for how my mother behaves, which gave me clarity and validation, and I found the path to healing: she's a pathological narcissist. That's an untreatable personality disorder. But that's a subject for a different blog.

Dawn 5 pts

I wasn't diagnosed until my child was three...which meant I became increasingly detached, moving from wanting and planning to kill her into terrible sustained clinical depression.

I had to mourn her infancy as I recovered, eventually having to forgive myself and look forward with her.

Fear of a second - and possibly more terrible PPD episode - was one of the many reasons we decided to not have a second child. I had already been told that I would have to stay on anti-depressants, it was too risky to have me be un-medicated in a 2nd pregnancy.

Finally - and for me, this was key - was accepting that depression was PART of me. I couldn't run from it. I couldn't pretend it was simply an isolated incidence brought on by hormones. I needed to be alert and vocal about my own mental health needs. Since my initial diagnosis in 2001, I have had at least 4 clinical depressions and one manic- depressive phase( brought on by a bad mix of meds).

Being proactive with my own mental health and open about my struggles is the best gift I can give my daughter.

If she struggles (and statistically, she is at higher risk) then she will have had an example of a Mom who tried to not keep all the monsters in the closet. Maybe she will get the three years of her child's life I feel I lost with her.