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Postpartum Depression

PPD or Grief?
By Karen Kleiman, MSW
Karen KleimanQ. I suffered PPD with my first son. I denied it for more or less a year. I had sleeping troubles, eating fluctuations, and erratic emotions. When I fell pregnant with my second baby, I had a smooth pregnancy and was seeing a psychiatrist up until I had my little girl. I was on Luvox for a short time well before my second pregnancy and ceased it probably two months before conceiving. Then my baby girl died of SIDS. Its been two months since then, and my doctor is having trouble diagnosing me with PPD obviously because of the grief symptoms, but suggests I am prone to get it if I have had it a first time. Right now I am feeling really depressed, last night I wanted to die (but know ultimately I could never carry it out), and I've had trouble sleeping since my daughter died. I have panic attacks at night when I think about the day she died, sometimes I can't understand why I am here on earth, and lately life doesn't seem worth living, when deep down I know that I am happy with life, and I love my son to bits and my husband and I have a wonderful relationship. I have erratic emotions. I was put back on Luvox and only on half a tablet (which may need review). I guess this is really hard because grief encompasses so many of the same feelings and symptoms. But I just wondered if you had any thoughts about this . . . or any advice.

A. I'm so very sorry. What an unimaginable pain. Most of us mothers cannot bear to think of such an excruciating loss. My heart goes out to you.

Now, what does this mean in terms of PPD? It means it makes it more complicated, to be sure. But within the parameters of "normal" grieving, I would say that you are "entitled" to a mourning process before we would label it PPD and it doesn't really matter, does it? Either way, it's clear that your symptoms of depression and anxiety are directly related to this horrible loss and either way, if the grief is complicated (with symptoms of suicidal thoughts or self-destructive behaviors or a significant amount of non-functioning) then it needs to be treated. Because EVEN IF you have EVERY REASON to be depressed, this doesn't mean the depression isn't real and requires professional attention. I suspect the Luvox you are taking may need to be increased to get you through this, especially if you are having thoughts of wondering why you are here.

You are here because because your wonderful son loves you and your wonderful husband needs you here. I know it's hard to make sense out of this and I can't imagine how you find the strength to get through each day. But somehow, you have found it, and the memory of your sweet daughter will give you the strength to keep moving forward.

Make sure you take care of yourself during this incredibly difficult time. Do whatever you have to do to get through this. The medication will help. Therapy will help. Time will help. Hugging and loving your family will help. Talk about your daughter. Love her. Love your son. Be good to yourself.

I wish you the best and please let us know if there is anything we can do to ease this pain for you . . .

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