Depression can develop during pregnancy and the months following birth. There are factors that increase the risk: sadness, exhaustion from sleep deprivation, and the complex feelings associated with having a child with special needs all contribute to the risk of depression. If the baby is in the intensive care unit the parents are exposed to additional trauma as they witness the conditions of other babies on the unit, not just their own.
Literature advises that a period of depression is normal but if it continues, it may become clinical depression that needs to be treated. Can you tolerate a little sadness for 2 weeks? What if it lingers for 4 weeks?
What does depression look like? It may not be what you expect. Sadness and tears are the most common signs of depression. Some other signs of depression are:
irrational responses to minor annoyances,
sleep disturbances (too little/too much),
difficulty concentrating or feeling overwhelmed,
feelings of inadequacy,
inability to laugh or feel pleasure
withdrawal from family or friends
thoughts of harming the baby or thoughts of suicide
poor weight gain in the newborn infant.
Family and friends may call it bitchiness, anger, or hyperactivity and not identify it as depression.
What should you do if you think you (or your partner) have depression? Ask for help. Let your family know that you have some of the symptoms listed above. Talk about your concern with your physician. Treatment is available from your OB or primary care physician but your physician may not know you well enough to recognize your depression.
Unfortunately, the person who needs help is the least likely to ask for help. Knowing your risk for depression (history of depression, stress such as a high risk pregnancy or special needs infant) will help you and your family to notice the symptoms early. Successful treatments include medication with or without counseling. Additional help at home will ease the burdens of care and reduce isolation. It may take a few trials before the medication that is right for you is found. Be sure to let your physicians know you have had depression, especially for future pregnancies.
And let us not forget the father. He may also suffer from sleep deprivation, feeling left out, overwhelmed, or confused by the demands of his new or expanded role as parent and housekeeper. He may respond with anger or impatience. He will need to be included in the treatment and healing process.
Post partum depression frequently goes undiagnosed. I am sorry to say that is has happened that a mother confides months later that she was in fact depressed. And WE (the professionals taking care of her baby) did not notice it. When we see the mom AFTER she has recovered (and she will recover) it is as though we are meeting her for the first time.
No one is more expert than a mother who has experienced depression. Here we have the privilege of hearing directly from a mother who was diagnosed prenatally with a child who had a cleft lip and cleft palate.
One mother’s story:
“Hearing the news that our first baby was going to be born with cleft lip and palate was hard and puzzling; after the shock, we worked hard to find the team that will take care of our baby, to learn more about what was coming up for us as parents and to get mentally ready, we had all the love from our family and friends, and at nine months, we felt stronger and ready for the challenge.
Two years later, I know that there was not reading, education, or love that would have prevented me from having post-partum depression. Depression is something that happens, I was not looking for it, but in retrospect, there were many risk factors, being the sensation of having a “no perfect baby” the worst one. Social pressure to be smart, thin, rich, successful and of course having gorgeous kids is just toxic.
I was so sleep deprived, taking care of our baby was, as with any baby, a 24/7 job, but unfortunately, I was mostly alone, my husband worked, we do not have any family here, and the feeding, plus the molding routine, plus the pumping, plus cleaning the pumping hardware, cut my resting time down to a few minutes, then the cycle repeated again, and it was like that for 3 months. Around 6 weeks postpartum I asked my OBGYN about post-partum depression, unfortunately, I was disregarded as a busy mom with normal post-partum blues. After the lip closure when my baby was 11 weeks old, things got easier, but the depression had settled in already. I was extremely intolerant and moody, felt guilty about everything: stopping the milk pumping, gaining weight instead of losing it, feeling tired and upset; my husband’s sadness and exhaustion was obvious as well, but I just neglected his emotions, I could barely keep mine under poor control. I felt completely incapable of feeling happy or even trying to untangle my life. The spiral just kept on spinning and when my baby was 8 months old, I was suicidal.
It has taken 2 years of therapy for us to recover, it has been a roller coaster kind of process, but we are out of the worst part. We are stronger as individuals, as a couple and as a family.
These are the things that I have clear now, took me years to elaborate them, but sharing them with other parents makes me feel that the experience was worth it:
1. My son IS perfect, he always was and I am proud of him, and I should have posted pictures of him as he was born and voice my pride without social fear.
2. I am The Best Mom for my son, I should have given myself credit for feeding, molding, pumping, washing and not sleeping. I actually am a bad a$$ mom and you too!!
3. I would without fear ask for real help, I would say, please come and help us. If family is not an option, I would have hired a nanny from day one to help at least to wash and take care of the baby while I sleep for a few hours.
4. I would be much more sympathetic to my husband’s feelings. Men are much more pragmatic than women and all this emotional madness is overwhelming for them. My love for this man is the reason why my baby is here, in the first place.
5. I strongly feel that all moms of babies with special needs, should have professional evaluation before and after delivery to monitor for post-partum depression. Prenatal couple’s counseling would also be extremely helpful.
6. My family is precious and I will not let depression destroy us. However, once depressed you can’t rationalize this, so talk to your family and close friends about it, because they can help you to identify warning signs.
7. And finally, remember, crises are temporary, everything will be better, just be prepared.”