Phenomenology of postpartum depression

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Loss of control is the basic problem women grapple with when suffering from postpartum depression [29]. Mothers try to resolve this loss of control in a four-stage process as outlined in Fig. 19.1 [29, 30]. In the first stage, mothers are bombarded with horrifying anxiety, relentless obsessive thoughts, and difficulty concentrating. In the second stage, women feel that their normal selves are "gone." The women describe feeling "unreal," like they were just robots going through the motions caring for their infants. In this stage, women often isolate themselves and may begin to contemplate harming themselves. The third stage involves women strategizing ways to survive postpartum depression, including battling the health care system to get appropriate mental health treatment, prayer, and seeking solace in postpartum depression support groups. In the final stage, women finally regain control of their thoughts and emotions as their depression lifts. During this transition period, mothers describe having "good days" and "bad days"; however, when they wake up in the morning they never know what kind of a day it will be. As the postpartum depression lifts, mothers go through a mourning period

Stage 1 Encountering Terror

Stage 2 Dying of Self

Stage 3 Struggling to Survive

Stage 4 Regaining Control

Horrifying Anxiety Attacks

Stage 2 Dying of Self

Stage 3 Struggling to Survive

Stage 4 Regaining Control

Enveloping Fogginess

Alarming Unrealness

Contemplating & Attempting Self Destruction

Seeking Solace at Support Groups

Enveloping Fogginess

Alarming Unrealness

Contemplating & Attempting Self Destruction

Relentless Obsessive Thinking

Seeking Solace at Support Groups

Isolating

Praying

Oneself

Conditions Consequences

Strategies

Mourning of Lost Time

Consequences

Fig. 19.1. The four-stage process of "teetering on the edge." (Reprinted with permission from [29])

where they grieve over their lost time with their infants, which had been stolen from them by their depression. When mothers finally recover, they feel fragile and vulnerable and so they call their recovery a "guarded recovery."

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