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Antepartum Depression: Just as Real And Scary as Postpartum Depression

 
We’ve all heard of postpartum depression. A lot of us have known someone with postpartum depression. It’s those weeks, and sometimes months, after a woman has delivered her baby that trigger depression and anxiety. Little do people know, postpartum depression has a sister that is rarely talked about and sometimes, unknown. This is called antepartum depression. 
 
Allow me to break this down just a bit. Ante is a latin term that means before. Partum refers to the delivery phase of the pregnancy. Depression has many definitions, so we will define it here as an overwhelming feelings of sadness. Therefore, antepartum depression means depression that happens before you deliver your baby. In other words, it is depression while you are pregnant.
 
I was first introduced to antepartum depression when I was pregnant with my third child. In my years of practice, I had worked with several pregnant mothers that described feeling down and blue. We worked through the depression, but I never named it or did a great deal of research on it. During my third pregnancy, I was very sick. Days of sickness turned into weeks. The weeks turned into months. It turned out that my entire pregnancy, I was extremely sick. After feeling sick for weeks on end, I started feeling depressed. My desire to do things that usually brought me happiness seemed unimportant. My energy was incredibly low. I had a hard time getting out with friends and family because I didn’t feel up to it. For weeks, I complained that I didn’t feel like my normal self. 
 
After some time, I set out to find more information about antepartum depression. Realizing that it is a real problem that many women struggle with made me feel a lot better. I started naming it, talking to people about it, and taking steps to make myself feel better. This did not come easily and took me a long time to do. In fact, while I was diligent about doing all of those things, I still feel that my depression lasted until I delivered my daughter. However, talking about it and getting the help I needed really made all of the difference in the world.
 
What are the symptoms of Antepartum Depression?
 
The symptoms of antepartum depression are very similar to depression outside of pregnancy. This include but are not limited to:
-Feelings of worthlessness
-Feelings of guilt
-Persistent sadness
-Anxiety
-Change in sleep (sleeping more or less than usual)
-Change in eating habits
-Change in desire to do things that once brought happiness
-Thoughts of hurting yourself
-Thoughts of suicide
 
What can I do to treat my antepartum depression?
 
-Psychotherapy is one of the best tools to use when dealing with antepartum depression. A therapist can help guide you through your thoughts, feelings, and help give you solutions to work through them
-Medication is another route to take. This has implications on your baby and you will want to talk in depth with your medical provider. There are some medications that are safer to take while pregnant. 
-Herbal supplements are another option. Again, talk to your doctor about what he/she feels is best for you and your pregnancy. There are several herbal treatments that can help.
-Foot zoning was a major help while I was dealing with antepartum depression. It eased my sickness and helped me feel more centered with my thoughts and feelings. 
-Exercise is the last thing you want to to when pregnant (and depressed) but it is truly one of the best things you can do. Even walking around the block will release endorphins that will help your mood. 
-Eating a balanced and healthy diet will be beneficial for you physically and mentally during your pregnancy.
-Sleeping and getting enough rest is essential during this time. 
 
If you are suffering from Antepartum Depression, please know you are not alone! Thousands of women suffer from this on a daily basis. Share this blog post with someone you feel needs to hear about this. Antepartum depression is rarely talked about and needs to be an active conversation with women who are expecting babies. If you need further help, please call Wasatch Family Therapy. There are kind and professional therapists here to help you through this difficult time.
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Ask Julie: How Do I Stop Feeling Depressed, Angry, and Irritable?

[dropcap]Q: [/dropcap]I was diagnosed with depression and anxiety a little more than a year ago, (although I have been feeling this way for a really long time.) I feel like I’m angry all the time. I want to be happy, but sometimes I feel like the anger is just always there. I have a wonderful husband and family and am happy with them, but I just cannot seem to shake this feeling. The littlest things bother me to where I can hold a grudge. I feel like I’m irritable a lot of the time, and sometimes, I feel as though I could just scream at any moment. Other times, I just feel like crying. I would really appreciate some feedback about this and maybe some type of mental exercises that I can do to start controlling all this built-up anger before it gets any worse.

[dropcap]A: [/dropcap]Thank you for writing in. You said you were diagnosed with depression and anxiety but I’m curious if you’re being treated for it currently? If you are on any type of medication, I suggest that you talk with your health care provider and make sure that the dosage and medication is actually helping. Please watch the video for the complete answer.

Take good care of yourself!

Julie Hanks, LCSW

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Mormons and Mental Health Therapy: KSL Radio Interview

Mormons & Mental Health KSL RadioWasatch Family Therapy’s Julie Hanks, LCSW, Clair Mellenthin, LCSW, and colleague Sue Beuhner, LCSW talk with KSL Newsradio’s Amanda Dickson on a special LDS Conference edition of “A Woman’s View” program.

Scroll down to listen to the podcast.

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Ask A Therapist: Feeling Depressed, Angry, And Irritable

I was diagnosed with depression and anxiety a little more than a year ago, although I have been feeling this way for a really long time. I feel like I’m angry all the time. I want to be happy, but sometimes I feel like the anger is just always there. I have a wonderful husband and family and am happy with them, but I just cannot seem to shake this feeling. The littlest things bother me to where I can hold a grudge. I feel like I’m irritable a lot of the time and sometimes, I feel as though I could just scream at any moment. Other times, I just feel like crying. I would really appreciate some feedback about this and maybe some type of mental exercises that I can do to start controlling all this built up anger before it gets any worse.

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Ask A Therapist: I Get Serious Anxiety Before Therapy

I do therapy over the phone, and my stomach gets really hard and tight before I call my therapist. I get a ton of other physical symptoms, including muscle tension, diarrhea, tightness in my chest, shallow breathing, nausea, etc. I’ve talked it over with him, as I think it might be a transference thing, but it’s getting to the point of not being okay. I’ve had nervousness with other men, particularly doctors and people in an authoritative position, but I’ve never had it this bad. The kind of therapy I do is based on primal theory as well as other things, but it also makes it very hard for me to feel my feelings when I get so nervous around him. I don’t really want to switch therapists right now, but I would appreciate any suggestions!

A: Thank you for writing in with your question. What you’re describing sounds like a panic attack. Please talk to your therapist about possibly making some shifts in treatment, like meeting face to face instead of talking by phone, or getting a medication evaluation. While therapy is often uncomfortable, my concern is that your anxiety may be so overwhelming that it is getting in the way of your progress. Watch the video below for my complete response.

Take good care of yourself!
Julie Hanks, LCSW

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Ask A Therapist: Depressed, Anxious, and Socially Awkward

Q: I don’t remember a time in my life where I’ve been totally happy but for the past approximately 2 years i have been extremely depressed as a result of my social anxiety and loneliness. I have always found social situations ‘awkward’, in fact the last time I remember frequently leaving my house for social reasons was when I was about 13. I then became more and more of a recluse from there on, i went out with my friends less and less outside of school, then upon leaving school i stopped doing things with my friends more and more until the point where i have not left my house for social reasons for about 2/3 years. I no longer have any friends and although my family is nice and supportive they cannot provide me with what I need. I have not spoken to anyone in person about my problems, I simply can’t. My parents will just tell me to go to a doctor. Doctors will just prescribe me with a drug that I don’t want. I don’t feel a psychiatrist can help me. I’ve become extremely lonely and depressed. My self esteem is extremely low and although I’m not a bad looking person I simply cannot accept my imperfections, no matter how hard I’ve tried. I feel I am in so deep that I cannot make a recovery. I cannot throw myself into social activities to make friends because of my social anxiety. I no longer find anything enjoyable and nothing at all interests me, this leaves me with the motivation to try nothing. I feel like I’m in a corner with no way out, every possible path I need to take to fix myself, I cant bring myself to walk down whether its my self esteem, depression or social anxiety stopping me. I hate it and I hate the person I am, I’m so sad it hurts. I feel so lost and lonely I cry randomly, its pathetic. There is no reason why I should feel like this, I’ve had a very normal life without any trauma, this only makes me feel guilty for the way I am. Guilt I don’t deserve to feel when there’s so many more out there in far worse situations.

I just want to live my life and be happy, but I truly believe I will never get there. Sometimes I feel like giving my life and donating what i have to give someone else a shot at life. Someone who can appreciate life.

I have read a lot of advice online about people in similar situations to myself but what are my options when the things I need to do to fix myself, I simply cannot bring myself to do?

A: Thanks so much for writing in and reaching out for help. I have seen many clients in my therapy office who express similar feelings of hopelessness, worthlessness, focus on their own imperfections, and have extreme guilt for feeling so sad and lonely because they’ve had a “pretty normal life.” It sounds to me like you are suffering from severe depression and anxiety that are keeping you in a downward spiral, unable to reach out for help. The good news is you have reached out on this forum, so I am very hopeful that you can reach out in other areas.

I urge you to talk to your parents and ask them for help. You said you haven’t talked to your parents because they will tell you to go to a doctor. If they love and care about you they will tell you to go to a doctor or a therapist because that’s the right thing to do when a family member is ill. I suggest that you keep an open mind about medication. While it doesn’t need to be the first course of treatment, it can definitely be a helpful tool in treatment. Ask your doctor for a psychotherapist referral as individual psychotherapy can be very effective. Often, a combination of medication and psychotherapy can be effective in treating depression and anxiety.

In order to experience some change in your life and find happiness you will need to take some action, even if you don’t want to, and even if it’s a small one – like talking to your parents about how hopeless you feel. You can do it. It sounds to me like what you’re experiencing isn’t really “you” but is mental illness clouding your thoughts and feelings. You can have more satisfaction and joy in living than what you’re experiencing.

Take good care of yourself!

Julie Hanks, LCSW

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Ask The Therapist: Psychiatrist Talks To Mom And Ignores Me

Q: I have bipolar disorder, along with ADHD and OCD. Recently, I have started going to see a psychiatrist about my issue. But when I go to her, I feel as though she doesn’t ask ME how I am, she asks my mother. There are so many issues I need to tell her, but I simply do not feel like I can. I am worried about myself. All I want to do is lay in bed. Please, tell me what I need to do to tell her about my issues. I tried writing them down to tell her, but I did  get the chance, because she only had a 2min session with me, after talking to my mother. Help!

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Ask A Therapist: I’m Not Happy. I Want To Be Rich And Famous!

Q: I just cant seem to be happy. Im married and have a baby. I work, have a house, car, family and friends. but nothing pleases me. I want to be famous/rich/popular. When I was younger I wanted to be a actress/singer/writer/director but nothing became of it. I just seem can’t to please myself. I know I sound spoiled and selfish because I have been gifted and beautiful life, but nothing seems to make me happy. Please Help.

A: Please get a screening for depression from a mental health professional. Sometimes even mild depression can make a full life feel unfulfilling and empty. The good news is that depression is very treatable through psychotherapy, medication, or a combination of the two.

You may also want to consider pursuing additional creative outlets. Your dreams of expressing yourself through acting, producing, etc. may be a signal that you have some gifts in this area that deserve attention.  While becoming rich and famous is a rare occurrence, pursuing creative outlets can provide an emotional richness and joy to life that may be missing in your current life.  Look for opportunities in your community to do what you love in the creative arts and see if that boosts your enjoyment of your life.

I can relate from personal experience to the need to express and create. As a performing songwriter, when I feel an emptiness in my own life, I usually sit down at the piano, or pick up a guitar to discover more joy and meaning again. Please write back and let me know how your mental health screening goes, and share what opportunities you can find to express yourself creatively.

Take good care of yourself!

Julie Hanks, LCSW

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Ask A Therapist: How Do I Know If I Still Need Therapy?

Q: I am a married woman of 24 years with 3 grown children.  I have had a pretty rough past and struggled with mental illness most of my life.  I grew up in a very dysfunctional violent family with an alcoholic parent.  I was abused and neglected.  I attempted suicide at the age of 17.  Through the years I buried my past and attempted to live a normal life.  I did not have an identity, I did what everyone wanted of me, and even believed the beliefs of the people around me. I was an empty shell being filled up by other people.  I had another breakdown in 1999 and attempted suicide again.  That is when I began therapy.  It took me a realy long time to open up to my therapist.  It seemed I got much worse before I got better.  I began cutting and binge eating became  a huge problem.  I had always coped with food but now it brought my weight up to 322lbs.

As the years went by, and with medication I began to slowly deal with issues and start to rise out of my depression.  I trusted my therapist and told her things I would never tell another soul.  I was getting better and I decided to improve my life. I had gastric bypass to lose weight and in the past year I have lost over 120lbs.  I was using good coping skills and having more rational thoughts.   Unfortunately my bones suffered from the weight and degenerative bone desease.  This past October I had a total hip replacement and this past February I had a total knee replacement. It has not been 2 months yet and it has been a slow painful recovery.

My therapist retired this past December.  I do not have a regular one yet, although I did meet with one just one time to feel it out.  I am unsure if I need to stay in therapy.  I have been in it for a very long time and although I am better than ever before, I still have depression and dysfunctional thoughts.  I am still on medication, Wellbutrin, Lexapro and Neurontin for mood disorder.  I have been labeled as PTSD and BPD. I am starting to binge eat again and I am afraid the gastric bypass will be worthless to me someday.  I do not want to gain all that weight back as I could hardly move then.  I feel very sad that my therapist retired and I feel pretty lost right now. Is it normal to be in a therapy program for as long as I have been? Do some people stay in therapy all of their life?  I feel that I will never get out of this dysfunctional rut. Is there hope for me? I am very tired and very afraid to live this way.  I just want relief and to feel a bit of satisfaction in how I live.  I appreciated any input.
Thank you 🙂

A: What a brave women you are to have faced your past trauma and to have actively sought treatment to move toward a healthier and happier life. I can’t imagine how difficult it must be to have your therapist retire after working so hard to develop enough trust to open up and share things you’ve never shared with anyone else. It is very normal to feel lost, sad, and to grieve the loss of this therapeutic relationship, just as you would if you said goodbye to a close friend or family member. I imagine that finding a new therapist and developing that trust again is a scary thing to consider, but a necessary one.

Some health problems, like diabetes, are chronic and require lifelong attention, management, and treatment, while others are acute, like strep throat, and generally require one course of antibiotics. Mental illness can be conceptualized in a similar way. Your mental health history, your history of abuse and neglect, and your psychological symptoms seem to fall in the chronic category. It is common for individuals with severe childhood abuse and neglect to be in treatment on and off throughout life to help manage the emotional and psychological consequences of the early experiences.

Your continued struggles with dysfunctional thoughts, depressive symptoms, and binge eating suggest that you need to get back into therapy to maintain the progress you’ve made and to continue to develop coping skills and insight. You may in be in treatment throughout the rest of your life. If that’s what you need to continue to move forward, to manage your symptoms, and continue to create the life you want, then that is nothing to be ashamed of.  You deserve to have nurturing and support.

Take good care of yourself!

Julie Hanks, LCSW

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