postpartum

Understanding and living with depression

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Despite the multitude of resources and information available, as a person who has experienced depression in many forms and contexts, it is my experience that most people – even those who may have gone through a depressive period – don’t actually understand depression, it’s many forms, and how it manifests differently in different people.

The society I live in, and probably most modern societies, tends to pay lip service to acknowledging how debilitating and dangerous living with untreated depression can be while at the same time making receiving actual treatment of the type and duration needed virtually impossible to receive.

There’s an awareness and informational understanding that depression is physiological: hormonal and neurochemical, in nature. However, there is an impatience and stigma for those who are medicated to try to balance out the biochemistry. Those who find medications too difficult to stay on and slide back into symptoms after going off meds are looked down on and criticized, often treated as if they are responsible for their illness, “I don’t understand why she won’t stay on her meds. She just doesn’t care how she affects others. If she did, she’d stay on her meds. She’s just selfish and self-centered.”

Women experiencing postpartumn depression get judged and labeled as bad moms because they have fears and feelings, outside of their control, that society says no mom should ever have. When the truth is that, as human beings, we all have scary, negative thoughts that we don’t like to have, about even the ones we love the most. A woman experiencing postpartum depression just has less ability to filter, censor, and control those thoughts and feelings. She recognizes and understands on an instinctual level that those filters and control are fragile and absent and becomes even more anxious.

People in our society – I include my past (and sometimes present) self- have learned mental health terms, then use them as labels to criticize, demean, and judge others by. We stop seeing individual people and just try to assign the label so we can determine the appropriate amount and kind of time, attention, and care we should invest. We place unrealistic expectations on those experiencing depression, whether it is ourselves or others.

What follows is a list of various forms of depression that I or those I love and care about have gone through or are dealing with now. I have provided links and brief descriptions. It is my hope that the next time you or someone you know starts showing signs of depression, you will remember this and seek compassionate, empathetic responses, offering understanding and patience instead of platitudes, minimizing statements, and the attitude that they, or you should, “just get over it.”

Major Depressive Disorder, via the Mayo Clinic:

More than just a bout of the blues, depression isn’t a weakness, nor is it something that you can simply “snap out” of. Depression is a chronic illness that usually requires long-term treatment, like diabetes or high blood pressure.

Dysthymia, via Medline Plus:

The main symptom of dysthymia is a low, dark, or sad mood on most days for at least 2 years. In children and adolescents, the mood can be irritable instead of depressed and lasts for at least 1 year.

In addition, two or more of the following symptoms will be present almost all of the time that a person has dysthymia:

• Feelings of hopelessness
• Too little or too much sleep
• Low energy or fatigue
• Low self-esteem
• Poor appetite or overeating
• Poor concentration

People with dysthymia will often take a negative or discouraging view of themselves, their future, other people, and life events. Problems often seem more difficult to solve.

Bi-Polar Disorder, via MentalHelp.net:

a category of serious mood disorder that causes people to swing between extreme, severe and typically sustained mood states which deeply affect their energy levels, attitudes, behavior and general ability to function. Bipolar mood swings can damage relationships, impair job or school performance, and even result in suicide. Family and friends as well as affected people often become frustrated and upset over the severity of bipolar mood swings.

Cyclothymic Disorder, via PubMed Health:

Cyclothymic disorder is a mild form of bipolar disorder (manic depressive illness) in which a person has mood swings over a period of years that go from mild depression to emotional highs.

Think dysthymia with episodes of hypomania.

Postpartum Depression, via Web MD:

Postpartum depression is a serious illness that can occur in the first few months after childbirth. It also can happen after miscarriage and stillbirth.

Postpartum depression can make you feel very sad, hopeless, and worthless. You may have trouble caring for and bonding with your baby.

It is now recognized that “you can have postpartum depression any time in the first year postpartum.”


PMS/PMDD, via Psych Central:

For a woman to have premenstrual syndrome (PMS), the symptoms must be severe enough to interfere with her social or work life. Severe cases of PMS are diagnosed as premenstrual dysphoric disorder (PMDD). Symptoms of PMS and PMDD include those for depression as well as breast tenderness, headaches and joint and muscle pain.

Women who have a family or personal history of depression or postpartum depression are at higher risk for developing PMS or PMDD. PMDD affects five percent of menstruating women.

Seasonal Affective Disorder, via NAMI.org:

The symptoms of depression are very common. Some people experience these only at times of stress, while others may experience them regularly at certain times of the year. Seasonal affective disorder (SAD) is characterized by recurrent episodes of depression, usually in late fall and winter, alternating with periods of normal or high mood the rest of the year.

Atypical Depression, via Discovery Fit & Health:

it’s a very specific subset of the mental health disorder, with careful criteria for diagnosis. All “atypical” means here is that some of its symptoms are the opposite of what doctors had come to expect with depression.

Melancholic depression is what most people mean when they talk about being depressed. You can’t sleep, you can’t eat. You can’t concentrate on anything. And nothing seems to bring you out of it. Things that used to make you smile leave you feeling empty.

With atypical depression, some of those symptoms are reversed. Patients oversleep (hypersomnia), overeat (hyperphagy) and exhibit mood reactivity — they’re able to brighten up in response to happy news; it just doesn’t last long. Because of that latter quality, they may not even know they’re depressed. They may think that their baseline of depression is just how everyone feels.

They do know, however, that feeling like your limbs are so incredibly heavy that you can’t move is not normal. This symptom, leaden paralysis, is different from a lack of energy — it’s more like being physically anchored to your bed. With actual metal anchors.

Atypical depression tends to set in fairly early, in the teens and young adulthood, and it’s more common in women.

Situational Depression, via BeForLiving.com:

Situational depression, also known as reactive depression: This type of reaction is thought to be universal and frequently seen in patients who have had to cope with events of personal injustice, humiliation, frustration, and helplessness (Linden et. al., 2007). A stressful life event (SLE) can be events that would seem insignificant to others, however, to you the event was perceived as an offense to you. A feeling as if there has been a small pinch to your inner self. Any situation that leaves you feeling deflated and helpless can be considered as a SLE. When this happens, it is imperative that you ask yourself some difficult and honest questions.

When did I start to feel this way?

What was said or done that served as a precursor to my ill feelings?

Do I feel ashamed?

Do I feel embarrassed?

Do I feel humiliated?

Do I feel exposed?

Do I feel powerless?

In my research, I found that three of these depressions can also be exhibited with signs of psychosis, where the people experiencing them can also suffer hallucinations and delusions that can be dangerous and frightening for them and for those around them: major, bi-polar, and postpartum depression.

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I was first told I was experiencing depression in my early teens by a school counselor. I later received a diagnosis of dysthymia. I have had a couple of major depressive episodes and experienced postpartum depression after each of my three children were born. I recently realized that I do have periods of hypomania, PMDD, and SAD.

It seems that every year or two situations occur which trigger a situational depression that often coincides with or leads into one of these other forms of depression.

Lack of consistent access to treatment, incomplete/inaccurate diagnoses, and the subsequent treatments which may include medication have led to additional problems or issues. My own poor and incomplete understanding has played into exacerbation of symptoms at times. I have been afraid of judgment, stigma and how the assumptions and misunderstanding of others, especially those in positions of power and authority over my life, could and have impacted my life.

I’m doing better than I’ve done in many years. At least I’m more in tune with the symptoms and triggers. I’m more cognizant of my own thought processes and choices that can help manage the symptoms or make them more difficult to manage. Sometimes it’s a moment by moment daily struggle. Some days I feel like I’m done with the depression, only to be frustrated when the signs start popping up again.

I’m still here and I’m still fighting.

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