Tuesday, July 13, 2010
Post Natal Depression and TCM- A patient’s story to wellness
Since I started ‘Fertile Body, Heart and Soul’ I have had many requests to write about Post Natal Depression (PND). Several times I have attempted to write a about it, however I really struggled to do this. This is because my blog is about my honesty insights and being genuine. I have not suffered from PND. Sure, I have had days where I feel down and out, but I can not begin to even pretend that this comes close to PND.
I didn’t want to write a blog pretending to know how a woman with this illness feels. However what I do know is this - TCM can offer amazing results for depression, especially that which occurs in the pregnancy, pre and post natal period.
I have thought long and hard about how to get the right information into this blog. After a great conversation with a patient last week, it dawned on me; who better to write my blog than somebody who had experienced PND first hand? So I asked her if she would be prepared to write about it for me. When she sent me through what she had written, I felt compelled to get this blog out as soon as possible. She really has a story to tell, and I am certain than many women will be able to relate to her experience as she tells it.
It is understood from a TCM perspective, that post natal depression often follows a traumatic birth, specifically that with significant blood loss. When I asked my patient of her birth and if it was traumatic, this is what she wrote:
I ended up having to be induced due to extremely high blood pressure, swelling and not feeling my baby move as much. I had to be very assertive as to my birth plan on entering hospital following the induction which was my first frustration. After my OB broke my waters, I suddenly had a drip in my arm pumping in hormones to bring on the labour and the contractions started hard and fast. Within about an hour the epidural started to wear off, I was fully dilated and I had an immense feeling of realization that this was it, I could feel my baby’s head and I needed to push. 45 minutes later, I was still pushing but was exhausted. The amount of intense pain I’d experienced that morning had just completely tired me out. I had been in a pain whirlwind. I was still pushing, but did say ‘just pull it out’ the next thing I know, my OB said ‘I’m going to give you a helping hand’, I was so close, but just couldn’t go that last push, so my baby was vacuum extraction. I had two stitches after a small episiotomy. Truth be told, looking back, I was angry with myself for ‘giving in’ at pushing, and not saying ‘no’ to the intervention. Why had I not been fitter to be able to push for longer, why hadn’t I prepared myself properly, why didn’t I say ‘wait, I don’t need help yet’? I probably could have pushed for longer. It left me feeling that for that moment, I was totally out of control. Everything just happened so quickly.
Post Natal Depression for this patient wasn’t immediately diagnosed. I suspect like many instances of PND, questioning of “is this really how I feel or is this normal?” probably played over and over again for her. As a new mother, it’s really difficult to know what is normal and what is not. I wanted to know at what point she realized that she wasn’t coping. Here is what she said:
I once heard someone describe PND as like wearing a veil. I have to say, with the benefit of full recovery and hindsight, I’d have to completely agree. There was no defining moment or realization of it for me. The early months of my motherhood experience were a complete nightmare. My baby was immensely unsettled, cried every waking moment and was generally very difficult. To top it all off I found breast feeding extremely challenging and wasn’t enjoying the experience at all. I remember the incredible amount of guilt I felt, about everything. Not being able to feed properly and having to resort to that terrible ‘devil food’; formula. How could I?! Not being able the settle my own baby; what was wrong with me? Above all I felt frustrated and a failure. Around 5 months after my baby was born, I went to my GP to complain that I was getting headaches every day (I am a migraine sufferer) and that I needed help to manage them. As a very thorough and insightful GP, she took one look at me and said “now tell me what’s really going on”. I burst out crying and couldn’t articulate how I was feeling. Everything was a struggle. Even though I was getting out of bed every day and kept to my routine of showering every morning when my baby had her morning sleep, just getting out of the house, getting the pram out of the boot of the car, putting a wash in the washing machine, tidying up the house, it all filled me with an immense feeling of despair, everything was just too hard. I had no motivation and am normally an extremely positive, energetic and motivated person; I felt gluggy, grey and sluggish. I literally lost my sense of self. That’s the only way to describe it. I hated not working and achieving, I disliked being stuck at home. My mothers group dissolved into nothing and I had no motivation to be the only one to salvage it. I felt alone, bored and fed up.
I am certain that many of you can relate to how this patient was feeling. I know when reading this, I feel a great amount of sympathy for her. At this point in her life, she really was at breaking point.
I started seeing a psychologist who diagnosed PND. I saw her every week, sometimes twice; it assisted, to a point. I put my baby into childcare one day a week a couple of months later as I wanted to get her ready for when I went back to work. During that month, I reached breaking point. The psych sessions weren’t working; I felt progress was slow and if anything I was feeling worse. My psych has since told me that she was thinking of ‘intervening’ in my treatment. As a first resort, she made an appointment for me to go back to my GP to get anti-depressants. I was failing at my own treatment; it was the last option, only option left and I was devastated. I cried through my appointment with my GP, I can’t even remember some of the information she gave me. The next day I took one of the pills. I hated that it had come to this, I was so adamant at the beginning that I didn’t want to take drugs. I immediately felt ill. One day, after lunch with a friend, I had what Oprah would call a ‘lightbulb’ moment. Why the hell had I not considered TCM and called Nat before? She had helped me through my pregnancy, had the advice when I was having problems with my baby…. Maybe she could help or would have some suggestions. I told her on the phone what had happened, where I was up to with my treatment and so on. She freed up an appointment to see me that day. Hurray! I didn’t have to take the drugs, there WAS another option! I almost felt stupid for not thinking about it in the beginning, but it never occurred to me that TCM could successfully treat PND.
TCM works well because it is based on an individual diagnosis. Two women suffering the same western medically diagnosed Post Natal Depression, will most likely be treated differently from a TCM perspective. The diagnosis is derived from symptoms and the patient’s own signs at presentation. This ensures the treatment becomes expressly tailored to each individual.
Seriously, I didn’t actually believe that I would feel any different from having acupuncture and taking the herbs. I am a skeptic, but knowing what my body is like (very sensitive) and how well it responds to TCM and knowing how professional Nat is, I knew I was in good hands, wouldn’t suffer any side effects (unlike the drugs) and that I had nothing to loose. After my first treatment I had the best night’s sleep in months. I actually felt rested. I suddenly started to feel like I was taking control. My decision not to take the anti-depressants and to assert myself in my own direction of TCM was a defining moment, definitely my turning point. I wasn’t going to let it control me or define me. I was taking charge! My psych was very interested in hearing about how I felt after my first treatment under TCM principles, and importantly was supportive and somewhat intrigued. I was definitely well on my way to recovery. I was realistic though, part of my recovery was also about my own attitude and I am a firm believer in the power of positivity (a very hard thing to achieve when you have depression). I thought myself better, fully supported by the herbs and acupuncture. I think I had around 4 treatments in total over about 3 months.
Like everything in life, each woman’s journey is different. Some are quick to feel better and others take a little longer. Support is a huge factor with any form of depression, especially for vulnerable new mothers. For this patient, her turning point was when she felt she had regained her control enough to continue on the path to better health.
My turning point was taking control, deciding that PND wouldn’t get the better of me and feeling really comfortable with my treatment choice.. TCM works for me, always had in the past and definitely did in supporting my recovery from PND.
This patient has offered so much of herself in telling her story. I’m so grateful that she was able to share her journey, because I am absolutely certain than many women will benefit from hearing it. Interestingly, I feel that the woman who will benefit most from reading her story is herself.
Posted by Nat Kringoudis Melbourne at 1:32 PM