When Dreams Crumble
By Chris Worthy
Copyright 2005 Palmetto Parent/Gannett

Virginia Williams dreamed of being of mother. She never expected her dreams to crumble around her, leaving her wracked with fear.    

           Williams had been married for about five years when Tyler, now 3, was conceived.

          “Needless to say, he was a very wanted baby,” Williams said.

          The pregnancy was easy, according to Williams. Even Tyler’s birth by Caesarean section was “a breeze.”

          Breastfeeding was difficult for Williams, a psychiatric nurse at Palmetto Health Baptist. Even before leaving the hospital, Williams became anxious, a condition that worsened when she realized that Tyler was showing symptoms of dehydration.

          “I started feeling really panicky,” she said. “Not just ‘new mom panicky,’ but really panicky.”

          Comforted by her pediatrician, Williams and her husband were able to take Tyler home. But search the family photo albums and you won’t find pictures of Williams leaving the hospital. Her mental state was already taking a turn for the worse.

          “I was such a wreck,” she said. “The first night at home, I just laid my head in my husband’s lap and cried.”

          Williams was spiraling into postpartum depression, a condition she had witnessed in patients she cared for, but one she never expected to hit so close to home.

          “They feel like they are the only ones,” Judy McKay, a psychiatrist in the Department of Neuropsychiatry at the USC School of Medicine, said. “There’s a lot of guilt, a lot of guilt.”

          Many new mothers experience the so-called “baby blues,” which often bring crying and fatigue.

          “The baby blues start about three days after the baby is born,” McKay said. “It’s usually completely gone by about a week.”

          Postpartum depression may begin anytime in the first year after baby’s birth. It is characterized by general symptoms of depression, McKay said.

          “Often, they are extremely tired,” McKay said. “The concentration goes down. They get overwhelmed easier. They might have trouble sleeping or they might sleep too much. They might lose their appetite or eat too much. Some of the symptoms mimic the symptoms of just being a mom.”

          But postpartum depression gradually gets worse.

          “About 20 percent of the baby blues can go on to be postpartum depression,” McKay said. “If it’s getting worse or it’s lasting two, three, four weeks—it’s very insidious. It’s very gradual.”

          Williams’ symptoms, characterized most prominently by anxiety, did grow worse. Her husband was able to take the first month off from work and the couple took turns caring for the baby.

          “I started getting panicky when it was my turn to take care of him,” Williams said. “My thoughts and feelings were so out of control.”

          Williams recalled the day when she sat on the floor clipping coupons, her infant son on the floor beside her.

          “I looked at the scissors and I looked at Tyler,” she said. “I didn’t have a feeling of hurting him, but I became terrified of having those feelings.”

          Williams quickly left the room and went to wash her face. When the intrusive thoughts continued, she immediately called a psychiatrist.

          “I had not bathed,” she said. “I had not eaten in days. He just looked at me and I started crying. He told me it would be okay and that he would get me through this.”

          With the help of her husband and parents, Williams had help caring for Tyler as her condition was gradually stabilized with medication.

           McKay said intrusive thoughts like those experienced by Williams are not uncommon with postpartum depression.

          “These are thoughts that aren’t psychotic, but they are afraid,” she said. “A mom going to the kitchen and the thought ‘what if the baby falls on the stove?’ Well, she wasn’t even near the stove. They aren’t suicidal or homicidal; they are just brief thoughts. ‘What if I stumble and fall with the baby?’ These intrusive thoughts cause even more anxiety. It’s so scary to have these thoughts.”

          McKay said postpartum depression differs from postpartum psychosis, a condition that can result in homicidal or suicidal acts.

          “(Psychosis) usually comes on extremely suddenly,” she said. “It is a psychiatric emergency. They might hear voices that tell them to hurt the baby. It’s different than intrusive thoughts. In psychosis they lose touch with reality. Psychosis usually comes on in the first couple of months. It progresses a lot faster.”

          McKay said postpartum psychosis is very uncommon but requires immediate intervention.

          Women who experience postpartum depression are often plagued by guilt about their own feelings.

          “This really catches them by surprise because they think they should feel happy,” McKay said. “They feel guilty and they don’t tell anybody because they think they aren’t supposed to. With depression, they need to realize that they’re not alone and there is treatment for it.”

          That treatment may include medication, therapy, or a combination of the two.

          Geoffrey Williams, manager of the counseling center at Palmetto Health Baptist, said talking to others is key. He, along with Virginia Williams and McKay, is an advocate of support groups for postpartum depression and is working toward the establishment of a morning group at Palmetto Health Baptist. An evening group meets monthly in the St. Andrews area.

          “It’s a safe place to go and talk about these things,” he said. “A support group is a place where you can go and express these things without judgment. It also provides a way of having an objective point of view about your functioning.”

          Virginia Williams said her experience as a psychiatric nurse provided some benefit in her own treatment, but hearing that she was not alone was even more important.

          “In my head, I knew it was out of my control, but that didn’t help,” she said. “When you have those feelings, there’s no explaining it. It absolutely defies reason. I really wanted this child. The more I talked about (the depression), the more people said, ‘I had it. I know someone who had it. Let me tell you my story.’ The more people who said, ‘I’ve been there. I’ve made it. You’re going to make it.’ That really made a difference.”

          Williams also credits her husband with helping her come through the depression.

          “My husband was very supportive,” she said. “He helped out more than he ever knew. He had never been around infants but he took care of Tyler like a champ. Just his being there helped.”

          Now three years later, Tyler is a bubbly preschooler and Williams seeks out opportunities to reach women in the midst of postpartum depression.

          “Tell somebody—your husband, your pastor, your OB-GYN,” she said. “Talk to somebody. There is help and you can get better.

          McKay agreed.

          “If you get postpartum depression, that does not mean you aren’t a good mother,” she said. “It’s just something that happens and we’re trying to figure out why, but they can get help.”

If you or someone you know has thoughts of harming herself or her baby, seek emergency medical help immediately. Contact a psychiatrist or go to the nearest emergency room. For additional information or help with postpartum depression, contact your obstetrician or local mental health center.

Information about postpartum depression support can be found online.

• The Ruth Rhoden Craven Foundation for Postpartum Depression Awareness was founded by South Carolina resident Helena Bradford. Her daughter, Ruth, ended her life when her baby was just over two months old. Ruth’s story, as well as support information, can be found at www.ppdsupport.org.

• Postpartum Support International (www.postpartum.net) provides lists of support groups and information for fathers and families.

• Depression After Delivery (www.depressionafterdelivery.com) provides extensive resources and information about postpartum depression.

The Postpartum Depression Support Group of the Midlands meets the third Tuesday of each month from 7-8:30 p.m. at Redeemer Lutheran Church, 525 St. Andrews Road, Columbia. There is no cost to attend. Fathers are invited. Childcare is available but please call ahead so organizers can plan for your child. For more information, call Judy McKay at 803-606-3244.