#personalexperience

SSRIs literally saved her life.

The difference to her personality was profound: the woman I knew and loved came back.

Was it a societal structure and support issue? No. She had support from myself, our families, our GP and a psychologist. My work provided me with paid time off to manage it. We had no financial concerns; she had 12 months of legally protected maternity leave with the first 6 months fully paid.

She was ill and the medication worked.

All that being said, if you want spiritual support go to your church, you shouldn't be getting that from your OB or pediatrician.

If you think PPD (or any other form of depression) is "brain chemistry" on the same level and getting hungry or horny you grossly misunderstand what depression is at a fundamental level.

The serotonin imbalance hypothesis of depression, widespread as it is in popular culture, has actually been pretty thoroughly debunked at this point[1]. We know that SSRIs do have a therapeutic effect, but it seems their effect is oddly enough unrelated to serotonin levels.

What they seem to do is mask the depressive symptoms to the point where you're given a sporting chance to "behave" less depressed, which is what seems to be the most effective treatment. It's fairly analogous to how painkillers can cure back pain by permitting you to move around more.

Not acting like you're depressed is the real cure, which is of course very cruel, because as anyone who has had a depressive episode will attest to, just getting out of bed may be a struggle.

[1] https://www.nature.com/articles/s41380-022-01661-0

This seems like a weak criticism. You're vaguely referring to some other hypothetical solution that may or may not exist.

There may be a case for a two-pronged approach, but why complain about the prong that just got approved?

It can also be mother’s problem and nobodies fault.

Knowing how there is a much larger silent group who is reading and might disagree with you, or how your words will actually do harm to deny a mother what she may be going through.

It's up to you, but I hope you read the below with an open mind and eyes.

Isolation in a pandemic CAN make PPD worse.

The rates of PPD during the pandemic WERE much higher, and from what the data is saying more intense.

Imagine: Becoming a mother alone in a hospital room, without a single woman figure in the family who exists and would have been present otherwise is very easily a magnifier and amplifier of any conditions. Some mothers had to enter the hospital for weeks before birth alone from complications.

No visitors allowed, or only one. No support people allowed. Hospitals also had shut down most of the pre-natal and ante-partum programs and check-ins with dieticians, other parents to be, etc.

It was pretty much solitary confinement, and dismissal of it for those parents who went through it is pretty surprising since you seem to be an authority on what does or doesn't make PPD symptoms or experiences worse. It just kind of shows how out of touch your position might actually be.

So, onto the logical proof of explaining something that will only exist once science has studied it for your logical brain.

1) "Pandemic isolation is leading to more postpartum depression, anxiety. Everything that we tell postpartum women to do, like connect to other people, get out of the house, establish a routine, they can’t do that.”

https://www.today.com/parents/covid-19-pandemic-leads-more-p...

2) "A third of new moms had postpartum depression during early COVID.

People who delivered babies during the pandemic also reported more distress and anxiety. ... One in three new people who had babies in the beginning of the pandemic experienced postpartum depression – potentially triple pre-pandemic levels – while one in five had major depressive symptoms, according to research led by the University of Michigan School of Nursing and Michigan Medicine."

https://www.michiganmedicine.org/health-lab/third-new-moms-h...

3) "New moms, experts worry about postpartum depression during COVID-19 as services cut back Many in-person services now being offered by phone, video or have been cancelled altogether"

https://www.cbc.ca/news/canada/windsor/postpartum-depression...

4) "Women who lack social support after the birth of a baby are more likely to develop postpartum depression."

https://bmcpregnancychildbirth.biomedcentral.com/articles/10...

5) "We believe the present study to be the first to demonstrate that fewer supportive persons during pregnancy is a predictor for postpartum depression. This finding points to the benefits of early intervention to increase the number of support providers for pregnant women19."

I hope this helps with undertaking a search yourself to learn more about PPD.

As an aside, it's questionable if there's a reason you feel it's acceptable to harshly dismissing the words of strangers as harshly as you might with your own inner dialogue? The world's eyes and ears are not a toilet for you.

As for support structures having nothing to do with PPD, I can only speak to what I've witnessed and what the doctors in our lives have pointed out.

Since you weren't there, and it might not exist for you unless you can understand it, it's pretty easy to search for topics on the internet these days.

They're saying we should make sure expecting mothers are well informed on the effects pregnancy and birth has on their body. Not give them unrealistic expectations that pregnancy will be easy and that everything will go back to being the same after they give birth. A miss match in expectations can help drive someone into depression. Prevention by supporting new mother's.

I think they go too far though. Everyone's situation is different not all depression is preventable, many people need SSRI and other oral treatments. But let's not throw strawmen around.

That's exactly what they are saying. "If these women just had more support they wouldn't be depressed".

That's not how postpartum depression works at all.

Do you really think that expectant mothers are so naive as to think that pregnancy and birth and keeping a newborn alive will be easy?

> Anything we can do to treat it, even partially, is worth doing.

A very dangerous attitude if one is concerned with a human body. You don't have any idea what is going on and you going to throw in something with side effects of hitting a poor woman with a brick in a face.

Just be a man, be there and help her to get thru it. Birth is not a newest fab of 2023. It was around since the dawn of man (citation required). And for hundreds of thousands of years one would not use drugs. Suddenly we are going to change it. I beg you.

It's like re-writing a perfectly working golang server in NextJS just cause you love microservices.

Write the micro services in Go lol.

But yeah I agree to some point. We medicate far too fast and easily these days. Half these drugs have insane side effects, and yet people shit on shrooms. At least I won’t die from blood clots or some random shit.

And this is exactly with this line of thinking that you get everyone including kids on antidepressant

i wonder how other countries cope without all that shit.

There’s no shame in taking antidepressants. Some of us have brains that don’t work quite right and we should have more options than “cope” or self terminate.

We’re in 3 groups, we have a private therapist for this, and if it’s anything like last time there will be another light switch at 4-6 weeks where she is suddenly back to normal. This pill is another layer of support, and a necessary one so new moms with PPD can bond with their baby, and so their partner doesn’t have to manage a two year old full time during the day and a feeding every other hour at night.

I think your care and concern is well founded, it sounds like your heart is in the right place, but I think you should re-think this take.

This comment is no different than telling a depressed person "you have no reason to be depressed, so cheer up". Plenty of women with strong support networks get postpartum depression.

I don’t know enough to speak intelligently about the underlying biology, but an interesting theory I heard from someone more knowledgeable than me is that the sudden drop in progesterone - which tamps down neuroinflammation - sends the microglia (immune cells of the brain) into overdrive which results in rapid destruction of neural tissue which is experienced by the patient as profound feelings of unhappiness / depression. This is not unlike the runaway inflammatory response that kills people with COVID — which is why dexamethosone (an immunosuppressant) reduces mortality.

Any if it is? We surely can't solve every, or even most societal issue that causes it.

You can continue to support improvements to the societal issues of the world while still supporting pharmaceutical interventions for those who need it right now.

Typical HN upvoted bullshit from people who are trying to be contrarian to every fucking good thing that's done.

Not to mention that this is the best case scenario. Unfortunately deliveries of non-alive babies carry the same postpartum problems, without the joy of life

https://www.japantimes.co.jp/news/2023/03/31/national/child-...