Six Things That Can Affect How Quickly You’ll Recover from Postpartum Depression

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postpartum depression

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There is probably no question I am asked more often by moms suffering from perinatal mood or anxiety disorders than “How long will it take for me to get better?” Suffering moms are seeking the exact date when the box will be delivered to their door with their old self inside of it.

“Is it 4 months? 6 months? I heard so-and-so got better by 5 months postpartum, and I’m 10 months postpartum and I’m still miserable, so does this mean I’m a lost cause?”

I actually looked this up in my library of PPD books, and searched online, and couldn’t find a single citation of the exact amount of time it takes to recover from postpartum depression and related illnesses. That’s because there isn’t one! There are many different variables affecting how long it takes each person to get better.

This installment of the Postpartum Progress Six Things series will address six things that can affect your length of recovery from postpartum depression and other mental illnesses related to childbirth. I am hopeful that, armed with this information, you will be able to have a smoother road to recovery.

1. How long did you suffer from PPD before you reached out for treatment?

Most moms with postpartum depression will fully recover, especially if the illness is diagnosed and treated early. It stands to reason that the longer you wait to get help, the longer it may take for you to get better. Some research has found that the rapid remission of depressive symptoms is the most important predictor for the favorable long-term outcome of a depressive episode. (Scadoczky et al,Journal of Affective Disorders, 2004) In simpler words, the quicker you are treated, and the more effective the treatment is, the better result. So, ask yourself, when was it that you finally started on an effective treatment?

2. How severe is your illness?

The more severe your postpartum depression symptoms, the longer it may take for you to get better. A 2002 study found that more severe depression was associated with a decreased likelihood of early recovery. (Meyers et al,Archives of General Psychiatry, 2002) NOTICE, that doesn’t say decreased likelihood of recovery, just decreased likelihood of early recovery.

3. How effective is the treatment you have been using?

Some women receive treatment that isn’t particularly effective, so their illness doesn’t resolve. There are a variety of reasons why this might be the case. There are different kinds of therapies (cognitive behavioral therapy, dialectical behavioral therapy, interpersonal therapy, group therapy, etc.), and different kinds of medications (serotonin reuptake inhibitors, serotonin and norepinephrine reuptake inhibitors, tricyclics, antipsychotics, etc.), different kinds of alternative methods (light therapy, exercise, etc.) and even different kinds of support groups (new mom groups, PPD groups that allow moms to bring their babies, PPD groups that don’t allow babies, freewheeling groups and groups with specific agendas at each meeting). It has been proved time and time again that, in the arena of mental health, what works for one person does not always work for another.

In the book “This Isn’t What I Expected”, Karen Kleiman writes “If you haven’t met your goals or if you are actually getting worse instead of better, it is time to consider a change in treatment or a consultation …” If what you’ve been doing isn’t working, work with your healthcare professional to try something different. Don’t give up.

By the way, some people actually have treatment-resistant depression.According to the Mayo Clinic, you may have treatment-depression if standard treatments don’t help much or don’t help at all. It can be caused by significant emotional stress, not taking medications exactly as prescribed, or other underlying health problems you may have like thyroid disorder, heart problems or substance abuse. Another possibility, if you happen to be on meds, is that your body metabolizes medication more quickly or more slowly than most people. The Mayo Clinic states that you should make sure you’re being treated by a mental health professional (not just your regular doctor), be patient and be willing to try different methods of treatment. This may include different types of therapy, different medications, tryingasleep and exercise program, ornewer treatments like vagus nerve stimulation or trans-cranial magnetic stimulation.

4. How effective is thedoctor or therapist you are working with?

We sometimes make the mistake of assuming the people in the “white coats” know more than we do, so we go along and don’t speak up for ourselves when we know we aren’t getting better despite following the treatment recommendations. It could be that the doctor you’re working with has limited knowledge and experience in the area of perinatal mental health, and has already tried whatever method they know how to use. If you’re in therapy, perhaps the method they are using just doesn’t work for you or the therapist just isn’t a good fit for your personality. If you’re on medication, perhaps they’ve given you a sub-therapeutic dose, or something that has side effects that are hindering you, or something that flat out doesn’t work for you. This may be because they aren’t psychiatric specialists, or because they don’t know enough about the medications. Or, perhaps you are in a support group that just doesn’t make you feel comfortable or supported.

You MUST speak up about how you’re feeling and how the treatment plan you are on is, or is not, affecting your symptoms. You must talk about how you feel in the doctor’s or therapist’s office and whether you feel you are being heard and understood. If the healthcare professional you’re working with isn’t willing to try something else or isn’t willing to listen to you, there is another out there who will. Again, Kleiman writes “Treatment failure is not necessarily the fault of the therapist [or doctor]. ‘Good’ therapists often need to change treatment modalities or consider new options when [the treatment] doesn’t have the desired outcome.”

Sometimes, though, you may have just gone to the wrong person. That’s okay. You have every right to make a change. Here’s a list of postpartum depression and anxiety specialists, and here’s a list of national and local postpartum depression support organizations that will know who to recommend in your area.

5. What is your current life situation and how may it be affecting your recovery?

Getting professional help is crucial, but your doctor or therapist can’t come home with you and ensure that your environment is the right one for recovery. If you are in a situation where the people around you are not supportive or you’re not getting any help so that you can have rest and good nutrition, this could slow down your process. If your partner, for instance, doesn’t believe postpartum depression or anxiety or psychosis are real, or isn’t willing to help you get the right amount of sleep or give you help around the house, the resulting stress of that can make it harder for you to get better faster. A study on the role of support from family and friends in recovery from major depression found that emotional support is significantly associated with depression outcome. (Nasser, Acta Scandinavia Psyciatrica, 2004)

As much as you can, reach out to those who are supportive when you need to talk. Ask your most reliable and encouraging family members or friends to pitch in, or maybe reach out to a local moms group or PPD support group for help. If you can’t find local help, you can at least find virtual emotional support from people who know what you’re going through here at Postpartum Progress or at places like Postpartum Support International or the #PPDChat on Twitter.

6. What have you been doing to follow your treatment plan and take care of yourself?

In the end, no doctor can make you show up for appointments. Therapy will fail if you don’t open up to your therapist and aren’t willing to try some of the coping techniques your counselor suggests you try. No medication will work if you don’t take it. No support group will help if you don’t attend. Poor sleep and lack of nutrition can prevent anybody from being healthy. Remember that you need to take a key role in your recovery process. I know it’s hard. I know you feel like crap. I also know that you candig deep down and do this. Taking care of yourself and making your health a priority is the best gift you can give to both you and your baby.

One final note: Once you start to feel better, and you will, the Mayo Clinic suggests that “It’s important to continue treatment after you begin to feel better … Stopping treatment too early may only lead to a relapse.”

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  1. Um, yeah, this is SO freaking true. I'm more than a year postpartum, but still suffering from time to time. BUT, I've been through 2 moves, 1 to a new city, 1 job change (about to be 2), crazy travel situations badly timed during moves, a hellish commute, a major illness, sick baby x4 or 5, 7 therapist and 6 psychiatrist changes, and more. If I didn't have PPD before, I'd probably have it from my life circumstances anyway. But, I've learned to be gentle with myself and do what I need to do to feel better, whether that's relying on someone else to help me or taking medication. I no longer feel bad about it and know that I'm going to help myself cope/improve as a result. Eventually my life chaos will calm and so will I. :-)

  2. It is SO fantastic that you not only recognize that these were majorly stressful things but also that you need to be kind to yourself and realize this is a process and it takes time! Wonderful!

  3. I was diagnosed early (6 weeks PP) and it was truly a blessing. I was able to start treatment immedietly. I was on Zoloft for almost 8 months before weaning off recently. I'm not sure when (or if) I will be ready to stop counseling, but I know the place I am now is so much better than it was last September. I'm not healed, but I'm getting better.

  4. Thank you for posting this. I am 31 weeks tomorrow, and I want to be as informed as possible on the topic. I struggle with anxiety so I know I may be at risk. I look forward to following this blog whether or not I suffer because I can't think of a more worthy way to support women.
    Jenna
    momofmanyhats.blogspot.com

    • Wonderful article and thread!! I also suffer from anxiety and I am bipolar. I am 26 weeks pregnant and I fear that I will have some sort of PPD/PPOCD. I have been reading up on sites like this one, and it does make me feel better. I feel better educated about this illness, and I’ll make sure I’m prepared for it with my OB GYN and psychiatrist. Also, I’m going to set up therapy sessions. Thanks a zillion and keep pressing on. God bless! Xoxo.

  5. Hear Hear! I'm a PPD survivor who also has a lot of dealings with PPD moms (some diagnosed, some not).
    I've had so many experiences with people who are rushing to end treatment the first time they have a good day. I don't quite understand the instinct, "Hey this is working so I should STOP DOING IT." Really? But it happens so often. And it's such a shame.
    And I also second the point about taking time to care for yourself. It's so hard to carve out "me" time when you have a baby but even a few hours a week make such a difference! I used to go to Starbucks by myself and read the paper. $5 plus 2 hours of alone time = priceless.
    Really good information!

  6. Hi – I went through post-partum psychosis before there was a name for it. 1981- could not think a whole thought after my second baby was born (13 mos.after baby 1.) I got help and have 3 great adult kids! Advice- -get psychatriic Help!Saved me.. saved baby 2 and made possible baby #3 (who will be a Dr. soon!)Hope and help throug God…

  7. My youngest daughter has always been the center of attention in every situation. She always said she didn’t really want kids because they require too much work and attention. Her husband wanted them so she agreed to have them. She had a little bit of the baby blues with her first son and her husband became the primary care giver to the child. When she had her second she had severe PPD. It got so bad that her therapist said she should not be alone with the children. She slept all day and was up all night. She cried for no reason at all and would take off on long walks without telling anyone. We worried so much for her. We footed the therapist bill, her diapers and formula for a year, and countless hours of babysitting and overnight stays. She shut us out. The only texts or calls we would get would be from them would say they needed more diaers or formula or money. Our funds are drained. I am drained. It has been well over a year and a half and she still will not take care of her own children. If her husband has to work or they want a date night they ask me or his parents to take care for the children. Her facebook page shows no pictures of her children nor does she ever mention them in her posts. It is as though it is still just her and her husband. Pictures of them kissing, on date nights and vacations….but no children. It hurts me to no end to think my child does not care for her children. Her husband just texted me and asked if I could babysit this weekend. I am in such a bind. It is extremely inconvienent for me this weekend yet I don’t feel I can say no. When does this end? There are times I wonder if she is just taking advantage of the PPD and using it so she does not have to have the responsibility of her children. I feel awful just saying that but it is affecting me in more ways than I can say. She still stays up late at night and sleeps during the day. She never has her children alone, she says she can’t. She will not even pick them up from daycare because she’ll have to be alone with them. She says she’ll like her kids when they are old enough to care for themselves. I do not know how long that will take. I feel so broken. Has anyone had a similar experience? Can anyone offer the light at the end of this tunnel?

  8. Pingback: What Postpartum Depression Recovery DOES NOT Look Like

  9. Great article! I’m dealing with PPOCD for the second time. I dealt with intrusive thoughts in 2005 when my first baby was 6 months old. My third baby was born in December and I worried about dealing with it the entire time I was pregnant. I didn’t leave the hospital without a Zoloft prescription but apparently not enough. After 6 weeks of keeping my intrusive thought to myself I decided to let my husband and the psychologist that I saw 9 years ago know that I was freaking out. At one point I was asking my husband to take me to the hospital. The psychologist did increase my Zoloft prescription. From my prior experience, I know I will heal eventually but right now my heart hurts and I can’t wait for this to go away. I feel like I’m robbing myself of these first few amazing months with my sweet baby. I just want to be able to be in the house with her without counting down the number of hours until my older children or my husband get home.

    • I know it’s awful Mary Catherine, and I’m so sorry you have to deal with this. You’re doing all the right things, though, by asking for and accepting help. Keep in contact with your doctor so that he or she knows how you are doing and if you treatment plan is working. You will get better.

      • Great article. I am a first time mom almost 11 months postpartum and was in denial about my PPD because I wanted to breastfeed And was told I would have to stop if I took an antidepressant. I breastfed/pumped my daughter for 7 months. At month 8 the suicidal thoughts and crying spells didn’t go away so I saw a therapist and started celexa. When I had my daughter last July I went through several major transitions in life. I quit my stressful job at 4 months pregnant, built a house, my mother was hospitalized and couldn’t travel so only my husband was at the hospital during the birth. My water broke 2 days after moving into our new home and I had to have a c section. One week after the delivery my dad had bypass surgery. And i found out i have scoliosis, osteoarthiritis, and a bulging disc in my back.I went back to work fulltime after only 8 weeks and was blamed for my work not being done while I was out on maternity leave so I was given a strict deadline to catch up. Now my aunt just passed away from cancer, my uncle her husband was also diagnosed with an agressive cancer, my mom is 51 on oxygen so she still cant travel, my dad was just hospitalized with a blood infection and my baby is sick with a cold. I have a few health issues myself and I haven’t honored myself enough to take care of me. Oh and my marriage is not doing well so there is no intimacy. I think the only reason I am surviving is due to my type A get it done personality and the counselor I have had for several years. I am not healed but I’ve come a long way.

  10. My son is now two I got diagnoized with postnatal depression wen my son was 8 weeks old he’s now 3 months off being two I have moved house and had to move doctors and they stopped my medication for postnatal and said I have a thirod problem I keep going back and saying I still feel the same as I did when I had my son I have to live everyday as it comes as I cnt remember what I did yesterday who I spoke to or seen it’s so scared and lonely I don’t hear voices I just feel high or low drift of in to day dreams tierd constantly an my main worry is am I ever going to come out off this I missed the loud bubbly outgoing now I’m none of this when I’m round people I carnt keep up with convos as I just keep drifting off in to my own little bubble if you like if anyone has experienced this please get in touch I’m 27 with 4 children an never gone tho this with my 3 girls was just my boy