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For some women with postpartum depression or anxiety, the thought of taking medication feels terrible. Even if their symptoms are severe and incapacitating.

This may be due to a variety of reasons, such as 1) fear of stigma, 2) prior negative experience with medications, 3) concern about side effects, 4) fear of being labeled crazy, 5) fear of not being in control of your life, 6) feeling that medications make you powerless or weak and not able to handle this yourself, 7) fear that medication could make things worse, 8) shame over your illness 9) feeling that taking medication makes you a failure somehow.

However:

  • You have the right to feel good.
  • You do not need anyone's permission or endorsement for the choices you make to feel better.

Fortunately, current medications are generally well tolerated, even at higher doses. If you are wondering whether medication would be helpful for your symptoms or not, below is a list of symptoms that are associated with a positive response to medication. The symptoms on this list are biologic in nature, which is why they respond well to the biologic intervention. 

If you are experiencing any of these symptoms, you might want to discuss this with your healthcare provider.

Symptoms Associated with Positive Response to Medication*

  • Significant weight loss (beyond that expected after childbirth)
  • Depression worse in the morning (diurnal variation)
  • Agitation
  • Inability to get out of bed or sleeping all day
  • Extreme indecisiveness (e.g., it takes an hour to decide what to wear in the morning)
  • Waking often in the middle of the night, even when the baby is asleep
  • Suicidal thoughts
  • Medication helped you in the past during a similar episode
  • Clear-cut change in your personality
  • Severe irritability, with frequent loss of control over temper or outbursts at loved ones when you previously had good control
  • A blood relative of yours was helped by medication for depression
  • Panic attacks
  • Symptoms never go away—you never feel happy or take pleasure in life, all day, every day
  • Horrifying thoughts or images
  • Hallucinations or delusions

I hope this helps make the decision a bit easier for you. 

Remember to do what you need to do to take care of yourself. Talk to someone who is informed and who understands.

*Adapted from This Isn't What I Expected by Kleiman & Raskin (Da Capo Press)

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