Postpartum depression can last for years if untreated

CEDAR RAPIDS — After Nicole Vennie gave birth to her son, Christian, she was surprised at the rage she felt toward her husband and the obsessive anxiety she experienced over her baby's health.

She had two miscarriages before giving birth Christian.

'I thought, 'Nothing can happen to this one,'' Vennie recalled.

But she constantly would visualize horrifying things happening to him, such as getting into a car accident in which he would fly through the windshield, or falling down the stairs with him in her arms.

'I didn't know what it was,' she said, explaining she first blamed it on hormones. 'I kept it bottled up until there was just this giant explosion.'

But she also didn't know where to go for help.

Her mother suggested she talk with her OB-GYN. And her doctor told her to go to urgent care.

'I just wanted to scream,' she said.

It wasn't until Vennie started seeing Shannon Wilson, a licensed mental health counselor who specializes in postpartum depression, that she began to understand what was happening.

Postpartum depression affects 15 percent to 20 percent of new moms, making women feel intense irritability or anger, have excessive concerns over their new baby, lack focus and have trouble sleeping, Wilson said. Postpartum depression is different from 'baby blues,' which affects up to 80 percent of new mothers.

'The hormones go away. It's almost like a dump of hormones,' Wilson said. 'Your emotions are all of over the place. But that should subside after three weeks.

'If it's more than that, it's more clinical.'

Vennie now attends individual counseling sessions with Wilson as well as goes to a twice-monthly support group with other women struggling with the same anxieties and fears, which Wilson started in September.

Few resources

But Wilson and the others in her support group believe the community is lacking in resources, education and awareness.

'Doctors will mention (postpartum depression) when you have your baby — they'll tell you to watch out for it and tell you some things to look for,' said Sarah, another woman in the support group. 'But that's where they leave it.

'All of the information I found was through other moms or Google searches. Most women are funneled through hospitals — you think they'd offer more information.'

Sarah asked not to include her last name because of the nature of her job and the stigma associated with postpartum depression.

An Internet search of postpartum resources in Cedar Rapids yields few results — there's Wilson's support group, a UnityPoint Health-St. Luke's group and only a couple therapists.

But St. Luke's is working to reach more women, said Deb Oldakowsi, St. Luke's maternal child education coordinator, who added the hospital's strategy had evolved over the years.

The hospital used to have nurses refer new mothers who may need to be checked by Oldakowsi — a nurse with a social worker's license. She then would follow up with a phone call to see how the women were doing and adjusting, she said.

'But I wasn't getting that many referrals, and I knew the national statistics,' she said.

So last year the hospital implemented a universal postpartum-depression screening for all new mothers and now has a support group called New Beginnings: Adjusting to Motherhood.

'We designed it for women to attend any time during the first year after the birth of the baby,' Oldakowsi said.

The group covers a variety of topics, including changing relationships, returning to work and dealing with the transition into motherhood.

'You get emotional support,' she said. 'Sometimes family and friends will say, 'Why can't you snap out of it?' People don't understand you can't.'

Dealing with stigma

Experts say there are many reasons for this limited amount of resources. As with other mental health issues, postpartum depression is not often talked about. There also can be gaps in care, with OB-GYNs focusing on the physical health of the woman while she is pregnant, and pediatric physicians can be more concerned with the baby's health.

But there also is a huge stigma associated with postpartum depression.

The women involved in Wilson's support group said the pressure society throws on women to be 'good moms' as well as loving partners and efficient employees can be a lot to handle for any woman, even those not struggling with postpartum depression.

One adoptive mom said she was afraid to mention something was the matter for fear her baby would be taken away. It is not unusual for individuals who didn't give birth to the baby, such as fathers or adoptive mothers, to experience postpartum depression, Wilson noted, as caring for an infant can bring about hormonal changes and social changes.

There is also huge amounts of guilt that mothers can feel.

'You say I carried this baby for nine months. I want to be so thankful and happy,' Vennie said. 'But I'm so tired, and you feel so guilty that you're not just out-of-your-mind happy about it.'

Wilson, the mental health counselor, has spoken with doctors and chiropractors in the area to build relationships so they feel comfortable referring patients. But she said she's had a difficult time with it.

Women in Wilson's support group echoed similar sentiments, with many saying they had to seek out resources themselves and would have loved for their doctors to have picked up on the warning signs.

Sarah said her doctor was willing to prescribe anti-depressants, but she was afraid to take them because she didn't want to harm her baby, whom she still was breastfeeding. The prescription was safe, but her postpartum depression made her anxious.

'I filled the prescription but wouldn't take it because I was so paranoid,' she said. 'I wish I would have trusted my doctor.'

But she also believes women dealing with postpartum depression — which if left untreated, can affect women for years — need to learn ways to cope with their feelings in addition to taking medication.

Finding support

That lack of available resources also is something that Mike O'Hara, a psychology professor at the University of Iowa, and his team at the Iowa Depression and Clinical Research Center — which focuses on postpartum and pregnancy depression, the impact of maternal depression on children, mental health services research, and women's reproductive health — has turned its attention toward.

'One problem we have seen is that women, even if we identify postpartum depression, don't have available treatment options — there is some stigma, there are logistical problems, whether that be no child care or no transportation, they have no access to services,' O'Hara said. 'There are lots of barriers.'

For many years, the clinic focused on identifying risk factors and prevalence. For example, if a woman has battled depression or had problems with anxiety in the past, she is more likely to develop postpartum depression, he said.

In addition, women who had a stressful life event while pregnant, face financial challenges or have a stressful relationship with her partner can be more likely to undergo postpartum depression.

But O'Hara said it is difficult to predict who will deal with the mental illness. That's why it is important to have broad access to services.

The clinic has worked on several projects to see what type of treatment is effective as well as ways to deliver more care to women. It has teamed with the state to train professionals, such as nurses and case workers, who have direct contact with new mothers in areas with high infant mortality rates to treat and work with the women, as well as helped develop a program to deliver interventions in the neonatal intensive care unit, where babies are very sick and stress is high.

More recently, the clinic started a project targeting female veterans, O'Hara said. The online support group puts eight to 10 women together, allowing them to talk regularly about the problems they're facing, while being monitored by mental health professionals, he said, to see if a group setting can be beneficial.

It's that kind of communal support and sharing that the women in Wilson's group say helps the most.

'I have bared my soul about things that happened before we had the baby, family dynamics, my mother,' Sarah said. 'It helps normalize things.'

Seeking support?

New Beginnings: Adjusting to Motherhood

When — 4 to 5:30 p.m., Wednesdays

Where — Helen G. Nassif Women's and Children's Center, UnityPoint Health-St. Luke's Hospital, 1026 A Ave. NE, Cedar Rapids

Contact — (319) 369-7580

Pregnancy and Postpartum Wellness Support Group

When — 6 to 7:30 p.m., first and third Thursday of each month

Where — 1570 42nd St. NE, Cedar Rapids

Contact — (319) 313-2366