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Postpartum Depression

Prevent PPD From Recurring
By Karen Kleiman, MSW
Karen KleimanQ. I had my son (first and only child) after a virtually perfect and utterly uneventful pregnancy. He was born via unplanned c-section due to failure to progress and fetal distress. The second night in the hospital after he was born and everyone had gone home and he had been taken to the nursery until the next feeding, I began to cry uncontrollably in my room. I remember feeling utterly out of control and sadder than I could ever remember feeling and it scared me. These feelings lasted for months. When he was three months old, we moved to a new city (away from family and friends) and that drastic change started many of those feelings all over again. As I look back now, I think that I probably had undiagnosed PPD. I am wondering about the chances that I will have a repeat of this when I have another baby? It scares me because I really don't want to go through that again, especially now that I am far away from my mother and others who were so supportive and helpful after I had Thomas. Is there anything that can be done to help prevent PPD from recurring?

A. I can understand your concern about a recurrence of PPD; let me see if I can reassure you. First of all, the statistics for a repeat episode of PPD are 50/50. That means, once you've experienced PPD, you are 50% more likely to get it again. But I like to point out that you are just as likely not to get it again, if you know what I mean!

The one advantage women who have had PPD have is, they have the awareness and insight to enable them to seek out resources and support should they get it again. Although it's a bit premature to go through the details of "what you should do", here's a general guideline:

  1. Sit down with support people and determine what helped you through the last time and what didn't help. What plans can be made to alter things so you can feel most prepared.

  2. Discuss your concerns with your doctor and them him/her know you feel you are at risk. This is important information for them to have.

  3. Make sure to take care of your physical self during pregnancy, eat well, rest, exercise, TLC.

  4. Get informed. Find out what resources are available for support.

  5. Make sure you have adequate support at home during the postpartum period. Who will be there to help? What kind of help will you need? For how long?

  6. If you already have a therapist, touch base with them and "prepare" by outlining your concerns. I like to meet with women who are at risk for PPD at least once during their pregnancy, usually with their husbands so we can design a postpartum plan and help them feel more in control of the situation. I have them fill out a pregnancy support plan so they have all the information in front of them, should the time come that they don't feel well.

You are right that being further away from your family won't help. But it doesn't necessarily mean that you will feel bad. Distant family members can sometimes offer more (and better) support than those too close! It just means you may have to work a bit harder to get the hands on help you may need.

Hope this helps!

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