Work.
Well, that's where I am now, as I am most Thursdays. Today hasn't been a bad Thursday, as Thursdays go; still, I'm with Arthur Dent: "This must be Thursday. I never could get the hang of Thursdays."
Thursday tends to be a busy day on the average L&D unit. Lots of scheduled cesareans and inductions: the physicians reason that the vaginal deliveries will go home Friday, or possibly Saturday; they reason that, if the former, they'll see them tomorrow, and if not, well, they can leave a prescription on the chart for pain medication and let whomever is covering for the weekend worry about it. The cesareans will stay the weekend and leave Monday-- maybe Sunday, but again, that's for the on call colleague to decide.
Today the inductions have gone slow-- only one vag birth so far to be admitted to us in mother/baby. Another apparently failed the Friedman Curve an hour ago and was sectioned, so the next shift will have a fresh surgery to contend with. Other days they fly, and babies seem to pop out right, left, and sideways! It's my Friday-- ie, the last day I'm scheduled to work this week-- and I'm grateful it's been a relatively quiet one, for once.
Since it's been a calmer sort of day, I was able to put the finishing touches on an inservice I've got to present on postpartum depression. Here's a quote from the informational letter we'll be giving patients:
Up to 80% of new mothers feel stressed or cry easily after having a baby. This is commonly referred to as "baby blues." These feelings are normal and usually resolve in a few weeks. Postpartum depression is a mood disorder that affects a high percentage of women-- as many as 1 in every 8-- anytime in the first year after their child is born, or after a miscarriage or stillbirth. In the United States, about 400,000 women-- roughly 1 in 650-- may develop postpartum depression each year. A significant number of these will go undiagnosed, and may suffer needlessly...
Postpartum depression is, in my humble opinion, no joke (unlike Tom Cruise, who is!). I essentially lost the first year of my older son's life due to undiagnosed major depression and post-traumatic stress related to a traumatic delivery. The public is woefully undereducated on this topic; even in this day and age, new mothers are handed the unfeeling line, "What's to be depressed about? You just had a beautiful baby!" and worse, ""Get over it!" It's not that simple, as any mother who's tried to cope with the demands of a new infant and the realities of a dark depression can attest. Sure, good nutrition and excellent support will help alleviate the symptoms, but I hate to tell you, they're not a panacea. Sometimes-- much as it may gall me to admit it-- medication is indicated.
I've never had much luck with talk therapy-- I hate going through the ordeal of finding a therapist, meeting him or her, weeping my way through an intake appointment, reciting my woes and stresses and (loooooong) history of depression, and basically reiterating the whole boring saga of how I arrived at this particular point. I feel guilty about inflicting myself on counselors-- no one wants to listen to the baggage I have to offload, even if they are getting paid for it! Medication is safely private-- you can't induce ennui in a capsule of fluoxetine. Of course, your more conscientious physicians will insist that you return periodically to re-up your prescription, although in my experience it's largely a formality. Ideally, one should work with one's care provider vis-a-vis follow-ups, the monitoring of lab values, etc; if your doctor doesn't offer, it's recommended-- if not, indeed, imperative-- that you insist on regular assessments yourself. No matter what they tell you, all medications have side effects; it's best to be aware of them and proactive about addressing them as they arise.
In my experience, whatever the unpleasant symptoms associated with the antidepressants I've personally tried (Prozac, Zoloft, Wellbutrin), they were peanuts compared to the black pit of despair I inhabited after my son's arrival into the world in July 2002. I went to bed every night with the distinct hope that I wouldn't wake up. I cringe to admit that now-- I adored my sweet baby, but I firmly believed I was no good to him whatsoever and he would be immeasurably better off without such a useless mother.
I wouldn't wish that hell on anyone. I stayed there entirely too long, unable to escape the sucking despair. Finally I managed to drag myself to a family practice physician, who prescribed Zoloft, then Prozac. After long weeks, it worked-- I realized I no longer hoped for death. I flirted with guilt for awhile-- why couldn't I be strong enough to get by without the meds?-- but I let that go. The medication allowed me to function again, as a mother and as a human being. I could get up in the morning. I could (and did) breastfeed my child on demand-- and he didn't grow an extra head, or suffer any other setbacks that I've noticed in the intervening years. For me, it was worth it. Do I wish I hadn't had that mess to deal with? Certainly. Am I thrilled that, for me, it appears that antidepressants are an ongoing part of life? Not so much. But my kids have a (mostly) functional mother, and for that reason, I'm okay with it.
I wouldn't wish that hell on anyone. I stayed there entirely too long, unable to escape the sucking despair. Finally I managed to drag myself to a family practice physician, who prescribed Zoloft, then Prozac. After long weeks, it worked-- I realized I no longer hoped for death. I flirted with guilt for awhile-- why couldn't I be strong enough to get by without the meds?-- but I let that go. The medication allowed me to function again, as a mother and as a human being. I could get up in the morning. I could (and did) breastfeed my child on demand-- and he didn't grow an extra head, or suffer any other setbacks that I've noticed in the intervening years. For me, it was worth it. Do I wish I hadn't had that mess to deal with? Certainly. Am I thrilled that, for me, it appears that antidepressants are an ongoing part of life? Not so much. But my kids have a (mostly) functional mother, and for that reason, I'm okay with it.
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