Posted by My OB said WHAT?!?.
Jan
22
Posted by My OB said WHAT?!?.
“You Don’t Want To End Up Like That Woman In Texas Who Killed All 5 Of Her Children.”
“You don’t want to end up like that woman in Texas who killed all 5 of her children!” – Nurse practitioner to woman suffering from postpartum depression, while telling the mother that her only choice is to go on antidepressants.
There are 42 comments to this post.
You’re right. I’m reasonably confident NO ONE wants to end up like that. However, my choices are not a) flood my system with potentially dangerous mood-altering drugs or b) become a murderer. Can we actually discuss a variety of therapeutic options — counseling, hiring a mother’s helper, checking for vitamin deficiencies, light therapy, any number of holistic treatments, even inpatient mother-baby care — rather than jumping straight to Fix It With A Pill?
Ugh. This a pet peeve of mine. Don’t get me wrong, I’m not categorically opposed to antidepressants any more than I’m categorically opposed to antibiotics or hormonal birth control. But why has “medicine” come to mean “Problem? Fix It With A Pill!” rather than “find out what these symptoms are telling us about your overall health, and work to make your body healthier and stronger so it can repair itself, and if that’s not possible, consider treatment X, Y, or Z”?
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The topic of depression is a big one for me, with a strong personal and family history. I heard a speaker once who said (paraphrazing) that depression is a whole-being illness, affecting us physically, mentally, emotionally, and spiritually. He said the medical field tends to focus on the physical and emotional while ignoring the mental and spiritual, and religious organizations tend to focus on the mental and spiritual while ignoring the physical and emotional. Neither is doing a good job helping people because they’re not treating the whole being. I had to put in a lot of work in all areas of my being to overcome my depression, and while I still have relapses from time to time, I do my best to stay healthy in all areas.
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Jen Reply:
January 22nd, 2012 at 11:47 am (Quote)
That’s why the commercials for Abilify make me so angry. “75% of people taking antidepressants still have symptoms. They need to add abilify.” Or maybe they need to start treating their whole depression and not just the physical.
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The Deranged Housewife Reply:
January 22nd, 2012 at 2:38 pm (Quote)
Because 75 percent of people probably suffer from something else that makes depression a symptom, not the root cause. Other medical conditions, like hypothyroidism, can cause depression. So can things like Vitamin D deficiencies.
gah. 
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abba12 Reply:
January 22nd, 2012 at 3:42 pm (Quote)
THIS x100!
My husband and grandfather both suffer depression. We have discovered in both cases it is a direct result of sleep apnoea, my husband is getting help, unfortunately my grandad can’t get the help he needs because the stupid sleep lab test is absurd and he never got to sleep long enough for it to happen, however even he has found some strategies that help.
My husbands father has depression that, while not medically proven, I garuntee you is caused by vitamin deficiency. Their diet includes almost no vegetables.
My own father had depression that was a not a symptom but a condition of it’s own, however we know it was a direct result of his divorce and my mother taking the youngest children and disregarding the courts orders of contact and custody. In this case, it was appropriate to take antidepressants. In my opinion it’s the only case where they were needed. However, doctors perscribed them in all 4 before exploring any other options.
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racheleh Reply:
January 23rd, 2012 at 4:57 pm (Quote)
In my personal experience – sometimes you need to treat the symptoms before you are well enough to pursue the underlying physical stuff such as vitamin deficiency. (Which is usually a symptom of something else.) No one solution works for everyone.
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Rachel T Reply:
January 24th, 2012 at 12:37 pm (Quote)
You are absolutely right that sometimes drugs are great to stabilize a situation. Then, when a person is stable, they can begin to pursue more treatment avenues. For a friend’s depression drugs were great at first, giving him breathing room to get into therapy and really start to work on the underlying causes of his depression.
They are part of the treatment arsenal, not a silver bullet.
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Cat Reply:
January 22nd, 2012 at 3:53 pm (Quote)
Those commercials piss me off because Abilify has a side effect of DIABETES! I took it once for 6 months before my DD was born and it worked great. Then about a year and a half ago I tried it again and my blood sugars were through the roof. Luckily once I stopped it they stabilized.
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Jane Reply:
January 22nd, 2012 at 12:47 pm (Quote)
I agree about the whole person being affected. However…
In all fairness, religious institutions have no business offering medical advice. If I went to my priest talking about depression, I would hope he’d talk to me about my spiritual life and THEN say, “But really, you should also speak to your doctor, and maybe a nutritionist too.” Most religious organizations have no more medical expertise than doctors have spiritual expertise. 
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The Deranged Housewife Reply:
January 22nd, 2012 at 2:49 pm (Quote)
I think there are for many people, spiritual facets to their depression – in which case talking to a pastor or clergyman would be appropriate. I totally agree with Jen, though – a pastor can only do so much, at which point he needs to refer that person to clinical counseling. The two undoubtedly work well for many people.
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Jane Reply:
January 22nd, 2012 at 3:19 pm (Quote)
My thought is that a priest would be very much in the wrong to say “You know, in addition to reading the psalms and doing a holy hour, I think you should take Prozac. I’d recommend starting at a low dose and then working up to 40mg every day.”
EVERY profession should be willing to refer out to other professions. Every professional should know the limits of his competency.
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Details Reply:
January 22nd, 2012 at 3:13 pm (Quote)
Do we have a shortage of religious based hospitals? Have you never had a pastor, preist or rabbi come visit you while in the hospital? This really shouldn’t be a problem if they would al just work together. And I think the OB with the fear of delvering dead babies should sit down with the pastor, priest or rabbi and have a little talk! These people are out there, we just have a little trouble getting from point A to point B when everybody keeps telling us to take a pill.
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Jane Reply:
January 22nd, 2012 at 3:21 pm (Quote)
Actually, no, I never had a chaplain come visit me in the hospital *except* the one time I had made arrangements ahead of time because we knew the baby would die.
Working together is a lost art in the current American culture. It makes me very sad because depression *should* be treated as an interdisciplinary illness.
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Jade Reply:
January 22nd, 2012 at 5:26 pm (Quote)
I have never even heard of a religious person visiting people in hospital other than the dead or dieing.
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Rebecca Reply:
January 22nd, 2012 at 7:50 pm (Quote)
I had two Rabbis and a few members of the community visit me in the hospital when DD was born. Mom had at least a dozen visitors when she was in the hospital with pneumonia. I think it depends on the community and the religion you’re talking about.
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Stephanie P Reply:
January 23rd, 2012 at 4:28 am (Quote)
My births are a funny case for sure, and you can tell how rare it must be to have clergy visit! I had a monk and priest come after the birth of my second child, and for my fourth I had a priest (from the Vatican no less) come meet me and walk up with me to my recovery room. Nothing was wrong, but I had invited them. All three were close friends. These days unless you invite them, they won’t come. No one even asks you about religious observances required for the Sabbath if you give birth on the weekend.
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Details Reply:
January 23rd, 2012 at 7:02 am (Quote)
Well I’ve never had one come for a baby. But another time when I was sick I not only got a visit from my pastor at the Catholic hospital’s request, but I also got a visit from the pastor of the closest church of the same denomination. Apparently that chruch uses hospitalizations as an opportunity to get new members. I know our pastor visits the older folks everytime they check in. That is one thing that hospital is very good at. It seems to be part of the admissions process to notify the clergy.
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Jen Reply:
January 22nd, 2012 at 3:16 pm (Quote)
I absolutely agree. Sadly, there are some religious groups (including a subgroup in my own denomination) who believe depression is 100% spiritual, an attack of the devil, and that antidepressants mean you don’t trust God enough.
On the other hand, a doctor is not qualified to give spiritual advice, and perhaps suggesting a patient talk to their spiritual advisor might be a good idea during the course of treatment for depression along with meds and counselling. Sadly, many doctors do not think there is a connection between spiritual and physical health.
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Sigh. Andrea Yates had postpartum psychosis, not postpartum depression. Very different conditions. Please do not roam around loose telling your patients that every mother with PPD is at immediate risk for drowning her children, mmmkay?
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Kristy Reply:
January 22nd, 2012 at 12:46 pm (Quote)
This, this!! My midwife was the same way… at first she dismissed my concerns as ‘the baby blues’ then at the six week check up she jumped right to that look in her eyes where she was obviously convinced someone was gonna die at my house.
Fortunately my *lactation consultant* explained the three types/levels of depression. I had more than ‘the baby blues’ and less than postpartum *psychosis*.
I had PPD… with a large dose of postpartum *anxiety*. Zoloft *is* what worked for me at the time… but the inability of my midwife to understand the difference led her to push Prozac which is much less compatible with breastfeeding. At the time… difficulty with breastfeeding was *already* compounding my depression. I did *not* need her sabotaging me with what she had on hand instead of looking for something better because she panicked over missing my PPD earlier.
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I have bipolar disorder and was told the same thing after having both of my children – the only option is to take medication. I used them on and off for a while, but ultimately, I only felt disconnected and emotionless every time. Here I am 7 years after my first child, and they are both thriving, well-adjusted and amazing children…and I’ve been off medication for a few years. I’m sorry to the OP for being told such a thing. Not only is it insensitive, but it’s incorrect and NOT your only option.
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Jennifer had this to say,
Jan 22, 2012 @ 12:34 pm (Quote)
This is horrible. Possibly one of the most irresponsible statements I’ve ever heard. Like a mom with PPD needs to be made to feel any *more* guilty or *more* paranoid about her condition. It takes A LOT for someone with PPD to even reach out to a healthcare provider, I know from experience. I got the brush-off from my OB when I tried to bring it up at my 6-week checkup. I was still crying multiple times a day and I knew it was more than the baby blues. It took me until 8 months postpartum before I made an appointment with my family practice doc, who, thankfully, was great about it.
OP, I hope you were able to get the help you needed.
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In addition to what others have said, there is also the problem of antidepressants actually causing worse depression and even suicidal thoughts and tendencies. I know that happened to me after I had my first. My husband deployed to Iraq six weeks after he was born and I had real bad depression. The antidepressants just made things so much worse. The only thing I have found that works for me is St. John’s Wort, a natural herbal supplement. (it’s a flower ground up and turned into a pill)
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Teri had this to say,
Jan 22, 2012 @ 1:44 pm (Quote)
I have PPD and I was lucky enough that my doctor was very good about it. He offered to put me on anti depressents but was very understanding of my worries. We agreed on a low dose of meds and regular visits to check how I’m doing mentally and physically. He asks me every visit if I want to change the dose or stay the same or even come off them and is ready to refer me to counselling if n when I feel I want/need it.
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Oh, this one is disturbing on so many levels. The case she referred to was NOT PPD! A woman suffering from PPD is already feeling confused and jittery. Why make it worse by leading her to believe that PPD would cause her to drown her child(ren)? That’s just so wrong. And while a lot of women are benefited from anti-depressants and there is NOTHING wrong with taking them, it also isn’t the “only” option. I’m of the opinion that anyone started on antidepressants for any reason should also attend counseling sessions for a little while. Not necessarily long term, but a little while. I know not everyone agrees with me about that but it is something I feel very strongly about. Don’t just throw a pill at the problem and expect it to go away.
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This is one of the main reasons I DIDN’T go to the doctor when I thought I might have PPD. I was afraid they would start shoving pills down my throat again. I don’t react well to anti-depressants at ALL. And they have NEVER helped with my depression in the past.
I mean, my doctor was pill happy to begin with, she gave me percoset for sciatica pain while I was pregnant…
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antidepressants didn’t help me. they reduced the anxiety but didnt make me less angry, bitchy, or, well, depressed! what DID help was supplementing with a couple amino acids (tryptophan being the most critical). I did other things too like vit d, fish oils, and watching nutrition, but the aminos were key! The book I read to figure out which ones I needed was called The Mood Cure and I absolutely recommend it for anyone looking for an alternative to antidepressants!
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Yes, it was awful. Not only did the nurse tell me this awful thing (which had nothing to do with me since Yates and I had different diagnoses), but she told me I had to choose between breastfeeding and possibly murdering my child or quitting breastfeeding immediately and taking pills. She did not tell me my medication had side effects, or that there was a suicide risk attached to the medication.
After three years of switching around medications and seeing a therapist, I finally saw a naturopath. I never knew there was more to depression than ‘serotonin’. I had hormone issues and also pyroluria. Pyroluria usually strikes during life-changing stressful times (like having a baby!) and does not respond well to drugs. After months of suffering with pyroluria, my hormones finally followed suit with led to the depression.
I’m almost completely off the drugs now and doing ok (not great, but ok–I have a lot of work to do fixing what those drugs did to me).
The only thing that nurse practitioner offered me was drugs and a thyroid test. How narrow her view of depression was! There were soo many more things she should have done–a full hormone panel, a kryptopyrrole test, a histamine test, a vitamin D level!
Don’t take after me–get yourself to a naturopath the MOMENT you suspect PPD. Only a naturopath can tell you, for sure, if you really need a prescription medication. In my state (Oregon), they can even prescribe them if necessary.
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Ellen Reply:
January 23rd, 2012 at 6:35 pm (Quote)
“Pyroluria” is not a widely accepted condition, and, as Wikipedia points out, “studies have either failed to detect hemopyrrole and kryptopyrrole in the urine of normal controls and schizophrenics, or found no correlation between these chemicals and mental illness.” I’m not really surprised that an NP wouldn’t be well-informed about an alternative theory which lacks solid research support.
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Victoria Reply:
January 23rd, 2012 at 7:03 pm (Quote)
Actually, pyroluria is very solid with a lot of studies backing it up. Wikipedia? Really? Why not try webMD while you’re at it! lol
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Holly Reply:
February 6th, 2012 at 4:41 pm (Quote)
Wikipedia is NEVER an acceptable resource for information or in a debate. It is not monitored, it is not a medical site, it is community moderated. Anyone on the internet can go in at any point and time and change items on any subject. Please, look into other resources to back up your opinion or to research anything you are looking into.
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Ellen Reply:
February 6th, 2012 at 7:01 pm (Quote)
Oh, come on. Immediately after that sentence is a series of footnotes to studies in peer-reviewed medical journals. Would you prefer I cut and paste the full list of references instead of just summarizing them?
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Ellen Reply:
February 6th, 2012 at 7:10 pm (Quote)
Should you actually want to look at those references (unless they have somehow been poisoned by being mentioned in a Wikipedia article), here they are:
Holman, Paul (July 1995). “Pyridoxine – Vitamin B-6″ (PDF). Journal of Australian College of Nutritional & Environmental Medicine 14 (1): 5–16. Archived from the original on 2007-05-08. Retrieved 2007-04-19.
Cruz, R; Vogel, WH (1978). “Pyroluria: a poor marker in chronic schizophrenia”. The American journal of psychiatry 135 (10): 1239–40. PMID 696910.
Gendler, PL; Duhan, HA; Rapoport, H (1978). “Hemopyrrole and kryptopyrrole are absent from the urine of schizophrenics and normal persons”. Clinical chemistry 24 (2): 230–3. PMID 627053.
Jacobson, SJ; Rapoport, H; Ellman, GL (1975). “The nonoccurrence of hemo- and kryptopyrrole in urine of schizophrenics”. Biological Psychiatry 10 (1): 91–3. PMID 1120177.
Gorchein, A (1980). “Urine concentration of 3-ethyl-5-hydroxy-4,5-dimethyl-delta 3-pyrrolin-2-one (‘mauve factor’) is not causally related to schizophrenia or to acute intermittent porphyria”. Clinical science (London, England : 1979) 58 (6): 469–76. PMID 7428279.
Vaughan, K.; McConaghy, N. (1999). “Megavitamin and dietary treatment in schizophrenia: a randomised, controlled trial”. The Australian and New Zealand journal of psychiatry 33 (1): 84–88. doi:10.1046/j.1440-1614.1999.00527.x. PMID 10197889.
National Library for Health (2005-10-05). “What is pyroluria, is it an accepted clinical entity and what are the treatment?”. Archived from the original on 2007-02-11. [And here's a link for that: http://web.archive.org/web/20070211000315/http://www.clinicalanswers.nhs.uk/index.cfm?question=1208. The answer here, from the British National Library for Health, says "If pyroluria is a condition it does not to have been accepted to any extent."]
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SculptorAlison Reply:
February 13th, 2012 at 11:19 am (Quote)
Did the OP mention anything about schizophrenia? Pyroluria is a real condition. This a case of a problem that can be “treated” with pharma so the simple solution (B6 ad zinc supplementation) is ignored because it won’t bring anyone big bucks.
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Because that’s what women with depression require of their medical care providers: no options, threats, and nightmare scenarios. Depressed moms NEVER feel guilty for their own depression, NEVER feel helpless, NEVER feel like bad moms, and are just so eager to seek help that they won’t possibly be put off by the idea that the nurse thinks they’re a maniac and a danger to their own baby.
[/sarcasm OFF]
*sigh*
To the OP: I’m sorry. You were seeking help BECAUSE you wanted not to have horrible things happen. The NP had no right to try bullying you into the only option she knew about or the option which was fastest and easiest for her practice. I hope you were able to get the help you needed.
It’s a shame this nurse practitioner had never heard about the modern and unusual treatment for PPD called “counseling.”
**double sigh**
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Jane Reply:
January 22nd, 2012 at 10:33 am Jane(Quote)
I just looked it up, and Andrea Yates was on antidepressant drugs when she murdered her children. So this nurse was wrong in even more ways than I thought. :-b
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LG Reply:
January 22nd, 2012 at 10:36 am LG(Quote)
*facepalm*
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Kasondra Reply:
January 22nd, 2012 at 4:20 pm Kasondra(Quote)
Yates wasn’t suffering from PPD. She had post partum psychosis…complete with hearing voices and other delusions. She was also under constant emotional abuse by her husband and pastor (the PASTOR and his wife basically put in her head that her kids would be better off without her and that she was sending them to hell)
Ugh.
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