SIL has PPD and refuses treatment

[blondekids]

My sister in law has been dealing with PPD for the past year and refuses to comply with any treatments. She's lost weight, doesn't sleep, and it's really contributing to serious marital problems with my brother (who's not very supportive to begin with but her depression makes the situation worse).

Anyway, the doctor prescribed something and she took one pill before she went to work one day and it made her sleepy (it had sedative properties and should have been taken at night) so she stopped it. She promised to go back and did and the doctor prescribed Zoloft and she told me she'd take it for 6 weeks. Well, i just found out she stopped taking it after a week for no apparent reason. She hates medications of any kind, and I don't think she would go for any "natural" remedies.

Is there anything I can tell her? She snaps a lot (yelling) and I am worried so much about my 1 year old niece. I think she realizes that she is depressed but blames so much of it on my brother (not helping her around the house) but I think if she were less depressed then their relationship would be better off.

Any advice would be so helpful.
Thanks.

[anothermama]

Mental illness of ANY kind is so stigmatized in our culture.......I know many women who deal with different kinds of depression issues and don't want to be on meds.

I think maybe you could try to reinforce to her that people can more tell somethings wrong with her when shes NOT on her meds as opposed to when she is. She also may need encouragement that she needs to give things a try.......maybe she needs to set ACTUAL goals for being on a med. For example, she needs to make a deal with herself and her husband that she'll get the Zoloft filled and be on it for 12 days before make a choice on if she'll go off it or not. Solid goals help. Lastly, I dont know your relationship with her, but you may be able to get kind of "tough" on her and say "Look....do you want things to change? Do you WANT to be happier? Because things won't magically change with NO action on your part. You have to take some sort of action to help the situation". Or something along those lines.

And......as for the meds.......I understand......I was completely unwilling to go to a doctor and get drugged up.........but a mama here suggested St Johns Wort, which you can get at Target these days....and it worked wonders for me. She might be willing to try it since its a more mainstream herb.

[waiting4baby]

Depression is so, so, hard on a marriage - coupled with a new child and uncooperative spouse (or one who doesn't quite know what to do) makes for a bad combination.

Would your SIL consider counseling with her husband? When I was depressed, my dh could do nothing right in my opinion. He's a sweetheart, but he really didn't know how to deal with me. Perhaps counseling with both of them would help - husband could learn how to help SIL and how his actions negatively affect her healing, SIL could learn how to help herself and how she is in ultimate control of this process, and both could learn the negative affect their failure to deal with this has on their child. For me, talking about my depression with a counselor was twice as helpful as the antidepressants.

I'm so sorry you are observing this. It's hard to see the people you care about crash and burn . . . but, ultimately, the best you can do is offer your hand and help and hope they take it. You could offer to babysit during all of their counseling sessions.

Good luck!!

[Jish]

The hard thing can be that depression can slowly creep in so that one doesn't know how bad they are until they are feeling better again. Meds can take up to six weeks for some people to really start noticing a difference, though most people I know start to notice a difference in two or or three weeks, though the full effect may not come for a few months. The key about antidepressants is that one needs to be on them for at least six months and up to a year to get the brain chemistry straightened out. Just because you feel great and like your old self at two months doesn't mean that your brain chemistry is back on track. It takes longer to get the brain to do the work on it's own, so to speak.

Perhaps you could find some information about depression online and share it with her. One thing to remember is that depression isn't a "weakness" like many people seem to think. It is a chemical imbalance in the brain. It can be triggered by any number of things from post tramatic stress disorder, a stressfull time or simply sleep deprivation (as was my situation.) It also can run in families (yup, this is me again.) You wouldn't tell an insulin dependent diabetic to suck it up, that they don't need meds. The same thing should go for this chemical imbalance. She needs help to get her brain chemistry back on track. Yes, some people will come out of depression on their own, but it can take months or years for it to happen, and for many, it won't happen on it's own and they will either suffer for seek help.

I was very frustrated and angry when I first started meds because I felt like a failure that I couldn't be myself without popping a pill every morning. After I researched depression I began to feel more positive and not view it as a negative, life long sentance. I was on an SSRI for nine months and have now been medication free for a year and a half. I got pregnant after stopping meds and now have a nine month old and feel great. I'm at the point where if I feel it creeping back in I can step up my exercise program and get back ontrack. If there ever comes a time where I can't control it myself, I will gladly go back on meds.

The important thing to know is that meds aren't a quick fix. It's not like popping a pain pill and you feel better a half hour later. It will take weeks. Also, there are typically side effects the first few weeks ranging from insomnia, sleepiness, nausea, vivid dreams, appetite changes among some of the more common ones. These typically subside within the first month.

I hope that you are able to help her and that she gets help soon. I know that my depression was so hard on my dh who had to watch me go through it. It's painful to see people you love suffering.

[blondekids]

thanks everyone. I think I do need to get tougher with her, I've just been afraid that she won't talk to me anymore. My husband said I just need to do it and not worry about it. Thank you so much for sharing your personal experiences. I will pass on all of your advice to her. They've given me a lot of encouragement.

[mamamoo]

I just wanted to say that an unsupportive parnter definately adds to the situation...ask me how I know. Maybe you should talk to your brother too.

[pilesoflaundry]

Originally Posted by mamamoo

I just wanted to say that an unsupportive parnter definately adds to the situation...ask me how I know. Maybe you should talk to your brother too.

ITA with this, not only is my dh not helpful so it's all on my shoulders he isn't very supportive. When I tell him I'm at the end of my rope and really need a break he just gives me a hug and says "you're fine" like patting a dog on the head and walking away kwim? He doesn't offer to help or to give me the break that I need and he isn't a very good listener when I need to talk.

good luck helping your sil!

[kirei]

Originally Posted by blondekids

thanks everyone. I think I do need to get tougher with her, I've just been afraid that she won't talk to me anymore. My husband said I just need to do it and not worry about it. Thank you so much for sharing your personal experiences. I will pass on all of your advice to her. They've given me a lot of encouragement.

I just wanted to add something here -- be really careful about being tough with her. This is coming from someone who's been depressed for 4 years.... and I know that someone being tough with me could potentially make me feel more alone. Keep in mind that depression [of any kind] can be very debilitating -- its possible that she just feels completely overwhelmed by herself, and everything around her. It's really hard for me to get help. My anxiety has gotten a lot worse recently, and I've been stressed over everything. I need to see a counselor, but I feel so overwhelmed and frustrated about finding one. I feel like I want someone to hold my hand and walk me through it.. -- kinda ridiculous, I know. But the whole thing is really scary.

I don't know your SIL, so maybe I'm way off. Just be really careful. Someone being tough with me could do a lot of damage. I really DO want to get better, I'm just scared and overwhelmed. In fact, I'm hard enough on myself, that the last thing I need is everyone else being that way too. Heh.

I think I had more to say but I'm falling asleep! I hope your SIL can get the help she needs. It's wonderful that you're concerned enough to try to help her.

[greensmile]

There are a lot of reasons someone may not want to take meds. The more you push the more resistent she may get. It doesn't help to have the attitude that her behavior is a problem that can be medicated away, rather than she is a person who needs compassion and support. If she has other conditions than simple depression it can escalate into mania or worse. She needs a evaluation by a psychatrist, follow up counseling, household help and daily coaching. A tall order, but valuable.

[MsMoMpls]

Rather than "tough" I might try..."Wow, you seem really stressed, you seem really irritable, you seem really hopeless..." She needs to figure out if it is depression or not. Meds are not the only answer- try looking for a support group like through www.postpartum.net They have some wonderful handouts as well, and information for Dads. I suggest talking to your brother as well- the first year after a new baby is very hard on marriage, so is depression. If they don't get on top of this, they will destroy their marriage before they get the help that they both clearly need.

[Mothra]

I got a really bad feeling reading your posts, blondekids. How do you know that she is truly clinically depressed and not just having a hard time because your brother isn't helping her? That is an awfully big judgement to make on someone. Taking care of kids without help from a partner would make me irritable and cranky, too. It also makes me really uncomfortable to hear about someone being pressured to take a medication they do not want to take. Unless you have some kind of court appointed authority over her, I don't think you should be asking someone to "promise" you that they will take anti-deppresants.

From what you described, it sounds like she needs a supportive partner-- that doesn't come in a pill. In your situation, I would ask her what she needs instead of telling her. Ask her if she needs help with the baby, help with the house, if she wants to go out for coffee. Pushing someone in a situation like this is just not the best way to deal with the situation, especially when you don't know everything that is going on.

[blondekids]

Thanks for responding everyone. I haven't really said much to her because I don't want to push anything, KWIM. Unfortunately, I don't live close enough to help her with much and the times when I go over there she doesn't want anyone to help with anything related to the house or the baby (very obsessive compulsive about how she does things). I think there's a lot of signs of her being depressed, like the weight loss, insomnia, i recently found out she drinks at least 2 beers/night when she comes home from work (she told me), she snaps very easily at the smallest things, she doesn't take any pictures of the baby ("i don't have time"), and the entire conversation on the phone is negative thoughts "she kept me up all night, she has a snotty nose, she won't keep her hands out of the dog dish" I don't hear "she's the most beautiful thing, she's so much fun, guess what she did today" kind of stuff, ever. You're right in that a pill won't solve her problems with my brother, but they might help her relax a little. My niece isn't old enough to understand yet but I am sure she can feel the tension in my SIL. At this point, I've kind of said to myself I'll be there to listen to her and try and make her smile about something good but I'm not sure there's much else I can do with her or my brother, unfortunately they are either going to be miserable for the rest of their lives or they'll end up getting a divorce (BTW i've suggested support groups, psychiatrist or family therapy).

Thanks for talking about it with me. It gets frustrating to see this happen but not sure there's much I can really do other than listen when she needs to talk.