Highlights
Case Study 4: Maya (Perinatal depression)
Maya is a 32-year-old married lawyer. She had a history of depression and generalized anxiety disorder. She had been doing well with a combination of medication and
psychological therapy for many years. Maya and her husband decided to begin their family, and Maya decided in the months leading up to getting pregnant that she wanted to be off her antidepressants. She worked with her psychiatrist to carefully cease medication and continued weekly therapy. She was mostly active, upbeat and cheerful during her pregnancy. She gave birth to a healthy 3.5-kilogram baby boy. After the delivery, she started to feel sad, overwhelmed and consistently tearful. She frequently felt irritable and on edge. This feeling persisted for the first 10 weeks after the baby was born. She had limited support—her parents were divorced, and her mother was living in another state and helping her sister’s family as a full-time babysitter. Her in-laws were much older with numerous health complications and couldn’t help regularly.
Maya went to see her psychiatrist. She was quite tearful and felt she was a "failure”as a mother. Her baby cried incessantly, and she could barely get sleep. She struggled with getting the baby to latch during nursing and didn’t want to have to give him formula. She was upset that she had to "resort to getting an epidural, even having to get induced." She had been fixed on giving birth the "natural" way and was lamenting on how things didn't turn out the way she wanted. The baby had high level of bilirubin and had a bit of neonatal\ jaundice and she blamed herself for it. After being monitored in the NICU, he was sent home. Maya felt utterly incapable of soothing her baby and would get frustrated and tearful. She was so afraid of what she had learned about sudden infant death (SIDS), that she would barely allow herself to sleep. She felt that it was a constant race against the clock—with nursing, pumping and changing. She was always cleaning bottles and diapers. She felt horrified with how she looked. She had expected to wear pre-pregnancy clothes immediately after childbirth. She hadnt had a meal in peace or gotten her hair or nails done and couldnt even think about having sex with her husband. He tried to be supportive, but also felt overwhelmed by it all. He felt she was inconsolable and they both felt at a loss.
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