There’s a Variety of Flavors under the PPD Umbrella: Thriving after PPD w/anxiety & OCD?

By Diane Ashton, LSW

Chances are, when someone mentions postpartum depression, images of antidepressant television ads come to mind, with a woman talking about how she can’t get out of bed, how she feels sad and that depression hurts.  Or perhaps horrible news stories flash to mind.  It’s understandable that it’s the rare mother who would want to be associated with that stigma.

Fortunately, the variety of pregnancy and postpartum disorders are more and more recognized, and with that, the stigma diminishes.  Here’s the quick list:

  • Pregnancy and/or Postpartum Depression
  • Pregnancy and/or Postpartum Anxiety
  • Pregnancy and/or Postpartum Panic
  • Pregnancy and/or Postpartum Obsessive Compulsive Disorder (OCD) (scary thoughts)
  • Postpartum Post Traumatic Stress Disorder (PTSD)
  • Postpartum Psychosis (rare [1 or 2 per 1000 births], but serious)

As someone who experienced postpartum anxiety with OCD, I didn’t find the proper name for that difficult time until about 5 years afterwards.  Oprah had Marie Osmond on her show, and they were talking about some book Marie wrote, “Behind the Smile; My Journey out of Postpartum Depression.”  Five minutes later I was on the internet in a discussion forum reading stuff from women who said things about their experiences that resonated with mine.  Oprah “diagnosed” me. I was thrilled!  It had a name!

So far here in Hawaii, women are usually diagnosed with “PPD”.  At the PPD Support Hawaii support group though, women identify with the other flavors too–anxiety, panic, OCD and PTSD.  Actually, the majority seems to have one of the anxiety types, and/or PTSD versus the cant’-get-out-of-bed depression.  In fact, the name, “PPD” makes it harder to find help when one doesn’t feel down or depressed.

One of the latest varieties under the umbrella to finally be recognized officially is postpartum PTSD.  PTSD is most-often associated with war and the trauma of facing battle.  But anytime a person perceives a threat to their own life or that of a loved one, PTSD can be an appropriate fit.

Many women who end up with an emergency Caesarian section get PTSD.  It may be all the rush-rush-rush and hush-hush-hush of a white-faced medical team racing down the hallway with mom-to-be on a gurney or a stern-sounding statement from the doctor saying something about the cord being around baby’s neck and “we could lose him/her” that pushes mom’s brain over the edge into a nightmare.  Maybe during the c-section she lost a ton of blood and the doctors scared her about her own life and survival (who will raise my baby!!!).  Or even, something about baby seems drastically wrong.  The cord.  Being blue. Not responding and breathing right away.  There are so many things that can sound horrendously scary when one is so vulnerably stuck on a rolling bed with white coat-wearing professionals all around.  Perhaps the woman opted to bypass an epidural, gets an emergency c-section but has no memory of the actual birth—just the rush down the hall and flurry of stressed out doctors.  Did she actually have the baby yet?  Is that really her baby?  How can she know?  What happened?  WHY?

From the women I’ve talked with, who have endured birth-related PTSD, many seem to have a stuck moment in time that they cannot easily get away from.  It’s a glaring, frozen time period, so bright that it’s hard to look at closely, at all really, especially for any length of time.

Tiny peeks back at what happened, over time, in a safe and validating environment can help alleviate the “charge” that some unexpected reminder, or trigger, can elicit.  A trigger could be something as simple as driving past the hospital where the birth took place.  It could be the smells experienced at the birth, the noise, or any number of things somehow tied to the event that triggers flashes of the violent or traumatic memory.  As long as it was perceived as such, that is the woman’s truth.

Recognition of the condition as a birth-related event can help, and can help for finding appropriate treatment.  While postpartum PTSD is under the umbrella of PPD, finding a PTSD therapist who understands birth trauma can be yet another challenge.  Sometimes talking to peers with similar feelings can be a good option, or “as good as it gets.”  A prescription for an antidepressant, while appropriate in many other situations, isn’t necessarily the treatment for PTSD related to child-birth.

To find out more about any of the mentioned conditions or talk with someone who understands, see the links below.  PPD Support Hawaii offers a warm line (call you back within 24 hours), as does Postpartum Support International (PSI).  PSI also has a free Wednesday “Chat with an Expert” for women every week.  There’s also men’s chat on Mondays—the first Monday of the month.

There is just no reason to suffer.  All of the varieties under the PPD umbrella are very treatable.  You’re not alone, you didn’t cause your condition, and with help you will be well again.

Resources: PPD Support Hawaii Postpartum Support International Most widely read blog on postpartum mood issues. Trauma and Birth Stress

originally posted at The Birth Lounge, 8/28/11. Mahalo!
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