Treating Postpartum Depression (and depression in general)

Hello!  Did you think I'd forgotten about this blog?  I haven't!  Now that my experience with PPD/PPA is mostly in hindsight, I've had a few more thoughts I've wanted to share, but it's been difficult to find the time because I've been extremely busy with work lately.  (I'm still a SAHM, but I work from home for my employer on an hourly basis, which means a lot of nights and weekends lately.)

In my experience, I struggled with two different types of depression.  These are not clinical categories, but just what I experienced.

1. The type of depression that hits you for no apparent cause.  You wake up, and before any thought has entered your mind, or before you are even fully conscious, you have a sinking feeling in your stomach.  You physically can't get out of bed.  You don't want to face the day, but there's no (obvious) reason behind it.
2. The type of depression or anxiety that is thought-based.  You think things like, I'm a terrible mom, or I'm a bad person, or No one likes me, or My life is pointless.

Sometimes, of course, I'd feel a mixture of the two.  I'd have panic attacks for "no reason," but I knew that my anxiety about my in-laws moving nearby was the overarching cause, even if I was not actively thinking about it at the moment.

So here's the thing, depression can have both physical (chemical or hormonal imbalance) and thought-based causes.  Medication can help with the first type, and therapy can help with the second.  A lot of times, the most effective treatment is a combination of the two because most people, like myself, don't just experience one or the other.

On medication - talk to your doctor about it.   You don't have to go to a psychiatrist; any family practice doctor can prescribe antidepressants.  However, I'm guessing a psychiatrist might be more helpful if you are struggling with something more than depression, like postpartum OCD or intrusive thoughts.  If you're hesitant to try medication, you could try St. Johns Wort or other natural remedies first.

On thoughts - One thing I've read over and over in the depression literature is that depression is not caused by emotions but by thoughts.  Eg: Sad -> Depressed doesn't tell the whole story.  It takes courage, but if you force yourself to figure out why you feel sad, you will usually find a thought lurking in there that caused the sadness.  Eg: I'm a bad mom -> Sad/frustrated -> Depressed.  Studies have shown that brain chemistry can cause depression, leading to negative thoughts, but that the opposite is also true: changing your thought patterns can actually change your brain chemistry.  (Don't ask me to cite any references...this is a personal blog, not a Wiki article!...just Google it.)  

So what to do about those thoughts?  Cognitive-behavioral therapy (CBT) is a systematic and widely accepted form of therapy to address these negative thoughts and has been proven in clinical studies to be just as effective as medication in some cases.  If you are thinking of going to a counselor, please look for one who uses a systematic approach, such as CBT, rather than just someone who uses "talk therapy."  You can also do CBT on yourself by following the exercises in the book Feeling Good by Dr. David Burns.  (Don't say it won't work until you've actually tried it.  Really - take a pen and paper and do the exercises, even if they seem too simplistic or that they won't work on you.)  It's supposed to work for not only depression and anxiety but also OCD.  You can also try a free, online program that walks you through the steps at https://moodgym.anu.edu.au.  Again, you really need to be committed to providing honest and detailed answers to some of their questions to expect it to work.  If you're too embarrassed to be completely honest with the online format, then stick with the book and pen and paper at home.

Sadly, one of the biggest barriers to treatment of depression is oftentimes the person herself.  If your trigger thought is, "I'm a bad mom," then of course you won't want to do any silly exercises to make yourself feel like a good mom because you don't think it's true.  It's a vicious cycle that the lie that makes you feel bad in the first place (eg: I'm a bad mom) is what keeps you from getting the treatment you need.  Unfortunately, you are the only one who can decide that you're ready to feel better.  But when you're ready, you'll know it!

Well, I hope this post has been helpful.  I'm not sure if I'll have time to blog in the new year, so I tried to pack as much helpful info in this post as possible.  If you're in need of other resources, please check out postpartumprogress.org.  It has a ton of resources and articles, as well as links to other personal blogs on PPD/PPA.

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Mental health and faith

People with mental health struggles (depression, panic attacks, OCD, etc.) are often encouraged to pray for God's healing in their struggles.  Pray for joy instead of depression.  Pray for peace instead of anxiety.  Pray for trust instead of fear.  I completely agree that we should pray to God for healing and grace in these areas.

Image: graur razvan ionut / FreeDigitalPhotos.net

However, our focus is often on how our faith can positively impact our mental health struggles, and we don't often discuss how our mental health struggles impact our faith.  PPD and intrusive thoughts, specifically, were destructive to my faith.

The scary thoughts I was having on a daily basis forced me to confront "the problem of evil" in a very personal way.  As soon as I gave birth to my first child, I knew that I would do anything to protect her from fear or harm.  So why did God not protect us from all the fear and harm in this world?  Instead of helping me to understand God's unconditional love, having a child actually made me question it.

Happiest robot on the block.

The problem of evil has been one of God's PR problems for a long time, and I know what the correct Christian responses are to these questions.  But sometimes knowing the correct answers don't keep your heart from asking the questions.  Hint:  The correct answers have something to do with "free will" and "It's not about me, it's about God's glory."  Call me crazy, but I'd rather be a happy, little robot than to live in a world full of broken people with free will.  (Unfortunately, have yet to find proof that this world is actually all about me.)

My faith struggles resulted in something that I hope no other Christian has to experience.  I started to fear that God would punish me for my thoughts.  I would lie there at night having waking nightmares about terrible things happening to me or my baby, and I would think, "God is going to punish me for having these fears by making these things come true."  I wanted to fly away, to hide my thoughts from God, but I knew I could not.  Writing these words, I am filled with a deep sense of sadness for how a relationship that was supposed to bring light to my life actually filled me with a dark and dreadful fear.

Although the intrusive thoughts have lessened, they awakened in me an awareness of evil and resulting fear that I have not been able to shake.  The apostle John wrote, "There is no fear in love.  But perfect love drives out fear, because fear has to do with punishment.  The one who fears is not made perfect in love."  Oh how I long for the day of my perfection!


Droid Image: Ben Jacobson

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