I think i have ppd. What happens now?

[texmati]

I think I have ppd. I think i've been battling depression for some time know. I'm so sick of living this way... I"m ready to seek more 'medicalized help;' but i"m worried as to what will happen when I do.

A few practioners have suggested getting on SSRI's for me in the past... but we never got much past the suggestion. I wasn't ready.

I have a few questions, that I was hoping somone could answer...

Is the medication addictive? Is it expensive? what can I take that wont affect my bf daughter? Will i have to be on it for ever? how does it work?

Are they just a perscription, or do I need to go back and see my dr at regular intervals?

[FischK]

Sorry to hear you're suffering from PPD. I'll try to answer your questions as much as I can, but I suggest that you get in touch with your midwife/OB/PCP about this asap.

1. The medication is not addictive in the traditional sense. However, it changes your body chemistry because it addresses a chemical imbalance in your brain. This means, a) it'll take some time for your body to get used to it and for the medication to be fully effective and b) you have to wean your body of the medication and you can't just stop cold turkey because that causes some unpleasant side effects. 

2. Many antidepressants are available as generic drugs, making it less expensive to take them. Always ask you doctor if there's a generic version of the med and if so to prescribe that instead of the brand name. Most insurances also cover antidepressants - I believe mental health riders have become illegal.

3. Zoloft is safe for breastfeeding mothers and their children because it does not secret into the breastmilk. This is not true for all SSRI's, though.

4. Most people don't take SSRI's forever but get off them when they've felt better for a while. Often it is a good idea to combine SSRI's and therapy because it allows you to not only feel better but to work through some of the underlying psychological issues causing the depression.

5. SSRIs work by changing the way your brain processes a certain chemical, serotonin. Serotonin is linked to depression. If you google it, you'll find more detailed info.

6. Your doctor will most likely want to see you a few times as you begin taking SSRIs to make sure that you're tolerating the medication well and that you're at the most effective dose. Then, they will probably want to see you once in a while (every 3-6 months) to make sure that things continue to be ok. Your doctor may also want to supervise weaning the SSRI.

I hope this answers your questions. Good luck.

[texmati]

thanks so much for your respnse... it really, really really helps. I don't have anyone to talk to about this, an dI DETEST taking meds. But I feel at the point where it's irresponsible of me to keep throwing days, months, years of my life away due to depression. I've tried alot, although not consistantly.

Unfortunetly, cost is an issue. I'll need to talk to both my  pcp and insurance to see how much all this will cost. of course... today has been a good day compared to yesterday's abysmal one. Depression is such a tricky thing.

I am going to research this, but wanted to ask the question here (and this may be a dumb one) but is there any test to see if there is an actual chemical imbalance with me? I'd feel so much better if I knew that it wasn't just a string of bad days, yk?

[chaoticzenmom]

Is your PPD more chemical or because of a living situation.  When I saw it was you, my first thought was to wonder if your MIL had moved back in.  You can't medicate a bad living situation.  I had PPD/anxiety, but a large part of it was that I had postpartum thyroiditis.  Have you had your thyroid and vit. levels checked?  

[texmati]

nope. she's still out, although she did visit this weekend (and it was bad).

I haven't had any of  those checks... in fact, I'm going over the budget, and I don't think I'll be able to make this happen on this insurance plan... We *do* have insurance-- which I am greatful for, but we will end up paying out of pocket for these visits. It would be better to wait until next year.

[FischK]

Originally Posted by texmati 

nope. she's still out, although she did visit this weekend (and it was bad).

I haven't had any of  those checks... in fact, I'm going over the budget, and I don't think I'll be able to make this happen on this insurance plan... We *do* have insurance-- which I am greatful for, but we will end up paying out of pocket for these visits. It would be better to wait until next year.

It should not be that expensive in the end. There are mental health clinics and organizations that offer services for free or on a sliding scale; they exist virtually everywhere. Your PCP may be able to point you in the right direction, and your PCP may also be able to work something out with you, like checking up over the phone or something. Generic ADs are not that expensive. If I remember correctly a 30-day supply should cost around $10-20. I understand money being tight, but it is important that you deal with the depression before it gets any worse.

ETA: There are also women's clinics that offer reduced or free services which could also help you deal with this asap. 

[chaoticzenmom]

What are your symptoms?  Why do you suspect ppd?  Maybe we can brainstorm some ideas.  Thyroid tests are pretty cheap.  The dr's visit (100), the test (50) and the meds (10 for 3 months) or if it's anti-thyroid meds, a little less.  

[HeliMom]

 I don't know much about taking medications for PPD, but I just wanted to extend my support to you. I think the meds are worth a try, and this is coming from a lady who hates medications with a passion ( at least for myself anyways). PPD is so insidious. I suffered from it with my first and there were some very scary moments, and even though I knew I shouldn't feel ashamed of being angry/depressed, I still was. If meds can help you it's worth it.   I do think you should supplement medication with therapy,  sunlight, sleep, good diet and exercise.  Staying inside all day, not getting enough sleep, eating poorly, and being sedentary can really exacerbate PPD.  Even if you can't get out of the house, or eat better, or get more sleep, I found it helpful to remind myself that things seemed even bleaker because I was lacking those things. Sometimes the rationalization kept the edge off my spiraling freak outs.  I also chanted to my self that "this moment is not forever"  Again these things didn't make the PPD go away, but it did stay my hand from doing things I'd later regret.

I'm sorry I couldn't be helpful on the medical or financial side of things. I just wanted you to know that you are not alone.

[texmati]

Thank you so much fo rthis post-- I do feel like my lifestyle is exacerbating things; but I simply seem stuck. I wish I had more time to post now but I have to go.

I will check back in this thread with my symptoms etc at the next nap.

Originally Posted by HeliMom 

 I don't know much about taking medications for PPD, but I just wanted to extend my support to you. I think the meds are worth a try, and this is coming from a lady who hates medications with a passion ( at least for myself anyways). PPD is so insidious. I suffered from it with my first and there were some very scary moments, and even though I knew I shouldn't feel ashamed of being angry/depressed, I still was. If meds can help you it's worth it.   I do think you should supplement medication with therapy,  sunlight, sleep, good diet and exercise.  Staying inside all day, not getting enough sleep, eating poorly, and being sedentary can really exacerbate PPD.  Even if you can't get out of the house, or eat better, or get more sleep, I found it helpful to remind myself that things seemed even bleaker because I was lacking those things. Sometimes the rationalization kept the edge off my spiraling freak outs.  I also chanted to my self that "this moment is not forever"  Again these things didn't make the PPD go away, but it did stay my hand from doing things I'd later regret.

I'm sorry I couldn't be helpful on the medical or financial side of things. I just wanted you to know that you are not alone.

[texmati]

Edited by texmati - 6/13/11 at 9:04pm

[FischK]

It's the last bit that is most worrisome and that leads me to repeat that you should really go see someone. Have you checked if there's community supported mental health or women's health clinics in your vicinity? They will provide services at cheaper rates than your PCP.

[texmati]

Is it possible that this could be caused by lack of sleep? I talked to my husband about it, and he was saying i should make a decision in a week when I've gotten more sleep (averaging 3-4 hours every day this week).

I will look into  he community supported clinics. I'm not crazy about my pcp, but maybe I can talk to my ob even though I'm so far out from birth?

Edited by texmati - 6/10/11 at 9:14am

[IsaIsa]

Sleep can contribute, but from what you've written I believe it is ppd. I know the first step can be hard, but you'll feel better just knowing you have a plan. The anger and suicidal thoughts are terrible and also very typical of ppd. Don't wait! Get help now! Only you can decide if you want to take the meds, but I would really recommend getting to a counselor or group immediately. Talking this over with professionals and those who are also experiencing it will make all of the difference. I can only speak for myself, but it is a process to recover from ppd. It's not overnight. Getting a plan together and finding support can get you on the right track. Good luck! Sending strength and peace your way!

[brackin]

I've been where you are.  All it entailed for me was a call to my OB's office, a description of my symptoms to the nurse, and they prescribed low-dose generic Zoloft (sertraline) for me (I'd researched the best option for nursing moms, which sertraline definitely is, with the very lowest transfer rate).  It helped within days and it is not expensive.  Hugs to you, mama, and hope you feel better soon.

[texmati]

really? they didn't require an office visit? How far out pp were you?

IDK... My husband is so against it. He'll support me, but I just feel nervous making this change...

[insidevoice]

They really SHOULD request an office visit, and you should seek counseling in addition to meds because the combination will have the best outcome for you.

I remember the rage so well.  It is completely unlike me, normally, but the rage is what scared me most.  I was never in a position where I felt like hurting a child, but my husband and myself?  I had to take off sometimes just to go for a drive and escape.  I was so irrationally angry at my husband for not being able to fix everything with a magic wand.   

Once I did get the help, I felt better within a few weeks and was back to feeling like myself within about three months.  

Sure, the sleep deprivation can contribute, but it sounds like your DH is minimizing what you are experiencing.  This is something a couple hours of sleep won't fix. 

[brackin]

They didn't require an office visit, but my OB was/is someone I've known for a long time, who knows me very well, as does the nurse.  He knew I would know the meds, my situation, etc.  I understand not wanting to take meds--I'm that person, for sure.  But it was SO worth it in this situation, to me.  I was also going along on almost no sleep, but I realized I had a touch of postpartum anxiety as well as ppd (it's hard to find info on pp anxiety--it's much less well-known, but fairly common), and I found that that was a contributing factor to my sleep deprivation/quality--a truly vicious cycle.  

If you decide to try medication, you can start with the lowest dose.  That way, it doesn't feel like such a huge step to take.  If it works at that dosage and you don't experience side effects, great. If not, you re-evaluate.  

I think talking to a professional can really help, if you can find a way to fit that into your budget.  

ETA:  I think I was 2-3 weeks postpartum.

[waiting2bemommy]

I know I'm late to this thread, but wanted to say that I have taken both Prozac and Zoloft with good results. I felt better with the Prozac but I was also more consistent with it. I tend to forget to take the pills every day.....I think it's my subconscious not really wanting to take the meds. I, like you, HATE medicines.

I have the exact same symptoms.....lack of motivation, excessively "tired" and not wanting to do anything. I will get up, put a few dishes in the sink, and feel like I need a break. Logically I'm thinking, "seriously? You haven't DONE anything" but I'm drawn back to the computer or the couch or bed. Irritability, and being oversensitive/enraged are also very scary. I have had several times recently where I wanted to hit SO or even, God forbid one of the kids.

 http://www.infantrisk.com/ This is Dr. Hale's new website, and he now has a free number that you can call for an honest look at all your options for medications while pregnant and/or breastfeeding. I also have ADD and although I can function unmedicated, when it combines with depression it is unbearable. I always was told that there was nothing I could do for it while nursing. but I called the number and discovered that I have options.

The medication will take a while to work, but when you get the right one you will know because it will feel like the fog has lifted.

I'm so sorry your dh is minimizing it. My SO is a suck it up kinda guy, too, but I've learned to insist on things that affect my well being and once he saw the difference medicine made he shut up quick. I don't think it should be anyone else's decision but yours, because you are the one suffering.

[texmati]

I'm sorry for not responding earlier... Just in case anyone is wondering... I finally called a few minutes ago. It's going to be 1 visit now, then a month from now, then every 3 months for aslong as I"m taking it. The nurse said that some patients come in and say that it's like night and day...I hope so.

I'm so, so, so, so very tired. I feel old; and I no longer feel certain that I'm going to snap out of it. It's been nearly 5 years.  I want to thank everyone who responded, I never would have called if it weren't for this community. I feel like the place is going downhill... but MDC has been a huge support in my life for many years.

[Mosaic]

{{hug}} I'm sorry I didn't see this earlier. I was like you: severely depressed for a long time, avoided meds for a long long time, until I finally gave up and tried them. To say it was like night and day is a gross understatement. Within two weeks, I was bawling my eyes out, only this time it was because I felt like myself again. I hope the same is true for you!