Victoria Jelinek

The Baby Diaries 21

Depression is melancholy minus its charms…Susan Sontag

Depression picHaving a baby triggers a heap of emotions both good and bad – pleasure, joy, enthusiasm, apprehension, anxiety, and, often, depression. Yes, that’s right. I’m daring to talk about the elephant in the room. The one that Brits don’t generally like to talk about and Americans talk too much about. When Brits talk about depression, their views often reflect their ignorance and outdated myths (or repression): it’s a sign of “weakness,” it’s self-indulgent, and one needs to keep their “chin up,” be positive, and all that. One thoughtless English ‘friend’ recently said to me, “Oh, I simply don’t have the luxury of depression!”

Regarding depression following the birth of a baby, rest assured it’s a complication of birth, not narcissism or an inadequacy on the part of the mother. It can happen a week or two after giving birth, it can happen a year after giving birth, or it can happen after nursing stops. Experts no longer regard depression’s cause as being purely physical, circumstantial, or emotional, but, rather, a combination of reasons. Physically speaking, after a woman gives birth, there’s a dramatic drop in hormones (estrogen and progesterone), and other hormones produced by the thyroid also drop sharply. There are changes in blood volume and pressure. Changes to the metabolism and the immune system. The mother’s lifestyle and emotional circumstances also can prompt depression. Perhaps the baby is demanding. Maybe there are other siblings. Perhaps she has difficulty breast-feeding. Or there’s a lack of personal and practical support. Her body changes, she feels less attractive. She struggles with her sense of identity as she feels a loss of control and independence.

The most common form of depression is called “the baby blues.” This lasts for a week or two, and causes the new mom to be moody, anxious, irritable, tearful, and unable to concentrate (though what new mother doesn’t feel this?). The second type is called “postpartum depression.” Symptoms include a loss of appetite, insomnia, intense irritability and anger. Overwhelming fatigue. No interest in sex. No sense of joy in life. Feelings of shame, guilt, and inadequacy. Severe mood swings. Withdrawal from friends and family. Thoughts of harming oneself or one’s baby. Difficulty bonding with the baby. The third type, and the most severe type of postpartum depression, is called “Postpartum Psychosis.” Symptoms include confusion, disorientation, hallucinations, delusions, paranoia, and serious consideration about harming yourself or your baby.

As mentioned, there has historically been a stigma to speaking about depression, so one is understandably reluctant and embarrassed to talk about it. But it is important for your own health, as well as your baby’s health, to talk to your doctor (in the first instance) about any combination of the aforementioned symptoms you may feel. Left untreated, each of these depressions can become more severe in nature and can lead to a chronic depressive disorder. Even when they’re treated, there’s an increase in a woman’s risk for future episodes of severe depression. Also, left untreated, the depression will affect your child negatively: studies show that the children of mothers with untreated postpartum depression have an increased likelihood of developing behavioral problems, such as sleeping and eating disorders, hyperactivity, temper tantrums, delays in learning development, language, and socialization skills.

The good news? It’s not your fault if you’re feeling depressed. And, contrary to the US, where doctors are so used to people asking for help with depression that there is an inadvertent “business as usual” approach, and contrary to the UK, where the whole “keep calm and carry on” myths prevail (it’s ironic to me that this British slogan was first used during WWII, and Winston Churchill was depressive and quite open about this fact), and one must beg for help with depression, the French are incredibly sympathetic, and they believe in a comprehensive approach. One that incorporates modern medicine, such as anti-depressants and sleeping pills, as well as holistic care such as acupuncture, meditation, vitamins, and yoga. So, if you’re feeling bad, and you suspect that you may be depressed, go talk to your local French doctor and read up on the maladie. Discover what it entails and how common it really is – you’ll be surprised at how much better you feel afterward, if only by learning that you are not unique in your feelings after all.

The Pregnancy Diaries – 20

“Who has fully realized that history is not contained in thick books but lives in our very blood?” Carl Jung

My brother had a pulmonary embolism last week. It’s a blood clot in the lung that can cause sudden death. I’d be so sad if something were to happen to him that I don’t even want to think about that. Apparently, he had chest pain and shortness of breath. He wasn’t even going to the go to the doctor, just went to bed to lie down, but thank goodness for his wife who insisted that he go to the hospital immediately. He’s fine now, but he’ll be on medication for life and he has to have his blood levels checked regularly.

So, he calls me to tell me about all of this after he’s been in the hospital. I panicked by his call ‘cause he never calls, thinking that a call from him meant something horrific had happened to someone in our family. I wasn’t too far off base. Anyway. He tells me that he has a Factor II mutation in his blood. It’s what our father had, too. Before they discovered this, however, he’d been discussing his family history with the specialist, and one of the questions the specialist asked him is whether there’s any history of miscarriage in our immediate family. Of course. There’s me. The specialist tells my brother that a hereditary Factor II Mutation could be the cause of my previous miscarriages and I must get it checked out with a specialist so that something can be done to protect my current pregnancy and my life after the baby is born.

I’m scared. I’ve started to feel “safe” in this pregnancy. No more bleeding. No abnormal pain. Things must be okay, right? But even as I feel nervous about whether I have this mutation and it means there may be problems with this pregnancy, or later for me, I must admit I also feel a sense of relief because this may explain why I’ve repeatedly miscarried and I believe knowing is better than not knowing — I have a very hard time with the oft French phrase from doctors ‘c’est comme ca.’ My brother sent me the report and screening. It’s hard to understand. Words such as “mutation (G20210A) in the Factor II (prothrombin) gene,” and “in pregnant patients with placental abruptions and fetal growth restrictions,” (though everything looks good on my ultrasounds!). Something about testing for “R506Q (Leiden) mutation in the Factor V gene,” and “plasma homocysteine levels.” I took the results of my brother’s exam and the specialist’s report to my doctor who then referred me to a specialist in Annecy. The reports are in English, though, and the specialist in Annecy doesn’t speak English, so my doctor in Chamonix wrote a letter outlining everything and giving the gist of the problem. I’ve investigated it online now, too, and I’ve written a load of questions in French. Likely my grammar will be all off and the doctor will think I’m stupid, but the point is to find out whether I have this science-fiction sounding mutation or not, and whether there’s a risk for my baby. I must admit there are times like this that I really wish that I were in an English-speaking country or that I spoke fluent French…it’s bad enough to try to figure this kind of a thing out with an English-speaking medical system. To try to understand it in French and how the whole system works on top of that, is another thing altogether. Intimidating. That said, the French medical system thus far has been amazing for me; it’s immediate and responsive; comprehensive to the point of sometimes seeming overly careful (and all paid for by my taxes! It ain’t like that in the states). I think I’m in good hands…