Postpartum Depression: Navigating Emotions and Treatment Challenges

Postpartum depression

Hello, doctor.
I am experiencing postpartum depression.
My husband and I do not live together, and every time I see him, I feel like he has another family outside, and that my child and I are the third party.
I feel that when I go out with him, no matter how genuine he sounds, I still agree with him, but when I am alone afterward, I keep telling myself that everything is fake.
Every day, my mind is torn between what is real and what is not.
My husband has very little understanding of depression; even if he tries to learn, I feel that in his mind, depression is just an excuse.
He once told me that someone said people who talk about wanting to commit suicide won't actually do it, and that the psychiatric medications I take are just like gastric lavage.
Ever since I heard these things, my emotions have become increasingly volatile.
Recently, I have found it hard to control my emotions; I used to never resort to violence, but now when my emotions flare up, I easily lash out.
Thoughts of wanting him and the child to die, or for me to die, have crossed my mind.
I have already switched doctors three times, but I want to change doctors again.
The reason for switching is that I suddenly find myself unable to trust the doctor for no apparent reason.
I haven't engaged in self-harming behaviors for over a month, but these behaviors have started to resurface in the past few days.
I am afraid to tell anyone and don’t want anyone to know, so I choose to do it in places covered by my clothing.
I have to take seven pills before bed in one go, and seeing the medication makes me feel really exhausted.
Even after taking so many pills, it still takes two to three hours for me to fall asleep, and I can only sleep for five or six hours.
I wish I could just finish all the medication in one day and not have to continue taking it.
Everyone says that I am not that serious; can I start to slowly taper off the medication?

Zi, 20~29 year old female. Ask Date: 2016/01/11

Dr. Zhong Mingxun reply Psychiatry

Hello! Your situation is truly concerning.
It seems that your emotions are difficult to control, leading to impulsive actions and self-harming behaviors, which are manifestations of the overwhelming emotions you are currently experiencing.
For your own well-being and that of your child, if possible, you should consider a short-term inpatient treatment.
However, in the long term, your biggest issue appears to be a lack of trust in others, which can repeatedly cause difficulties in your close relationships.
I encourage you to try to trust a consistent therapist.
Although you may sometimes feel uncertain about this therapist, it is important not to change therapists frequently, as this will help you address the issue of trust in relationships.
If possible, you should consider engaging in long-term psychotherapy.

Reply Date: 2016/01/11

More Info

Postpartum depression (PPD) is a serious mental health condition that can affect new mothers, and it often goes unrecognized or misunderstood. Your feelings of isolation, distrust, and emotional turmoil are significant and warrant immediate attention. It’s crucial to understand that PPD is not merely a phase or a sign of weakness; it is a medical condition that can have profound effects on both the mother and the child.

From your description, it seems you are experiencing a range of distressing symptoms, including feelings of worthlessness, emotional instability, and even thoughts of self-harm or harm to others. These thoughts can be alarming and indicate that you are in a state of crisis. It’s important to take these feelings seriously and seek help from a qualified mental health professional.

Your concerns about your husband’s understanding of depression are also valid. Many people have misconceptions about mental health, and it can be incredibly isolating when your partner does not fully grasp the severity of your condition. It might be beneficial for both of you to attend a session with a mental health professional who can provide education about PPD and its implications. This could help bridge the gap in understanding and foster a supportive environment for your recovery.

Switching doctors frequently can be a sign of your struggle to find the right support. While it’s essential to feel comfortable with your healthcare provider, it’s also important to establish a therapeutic relationship that allows for continuity of care. Trust is a critical component of effective treatment, and building that trust takes time. If you find yourself feeling distrustful, consider discussing these feelings openly with your current provider. They may be able to address your concerns and help you feel more secure in the treatment process.

Regarding medication, it’s understandable to feel overwhelmed by the number of pills you are taking and the side effects you are experiencing. However, it’s crucial not to stop or reduce your medication without consulting your doctor first. Abruptly stopping medication can lead to withdrawal symptoms and a potential worsening of your condition. Instead, have an open conversation with your doctor about your desire to taper off the medication. They can help you create a safe and effective plan to reduce your dosage if appropriate.

In addition to medication, therapy can be a powerful tool in managing PPD. Cognitive-behavioral therapy (CBT) and interpersonal therapy (IPT) are two evidence-based approaches that can help you process your emotions, develop coping strategies, and improve your relationships. Engaging in therapy can also provide a safe space to express your feelings without judgment.

Lastly, consider reaching out to support groups for new mothers experiencing similar challenges. Connecting with others who understand what you are going through can provide comfort and reduce feelings of isolation. Many communities offer resources for new mothers, including peer support groups, which can be invaluable in your recovery journey.

In summary, postpartum depression is a serious condition that requires appropriate treatment and support. It’s essential to communicate openly with your healthcare providers, seek therapy, and consider joining support groups. Remember, you are not alone in this journey, and there is help available to guide you toward recovery. Your well-being is paramount, not just for you but also for your child.

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