Q&A: PPD after weaning toddler?

And back to something more serious leading into the weekend...

Jeanne writes:

"I really want to know if anyone has dealt with symptoms of postpartum depression after weaning. I've tried to do some research and have come up with very little. I definitely didn't see it coming, and actually assumed things would really get back to "normal" after we weaned, so it's all a bit confusing.

My daughter turned 2 in May, and she nursed for the last time right around the 4th of July. For the months leading up to and after her birthday, she was only nursing after waking up in the morning and after waking up from her nap in the afternoon. Toward the end, we very slowly went from those two sessions (which were already brief) to only nursing in the morning, to nothing. So we were both ready for this chapter to end, and if anything, she and I are even closer now than we were before we weaned.

But ever since then, I've felt so down. The kind of down that I can't control, where I know I can't just give myself a pep talk or go out and be active and it'll be okay. Looking back, it's gotten worse as time has gone by. This has all been accompanied by poor sleep, bad headaches at least once a day, bone-tired feeling, lack of appetite...and now it just feels like an accomplishment if I get showered and get us out for a little bit during the day. What I'm grateful for is that I still want to be a mom (definitely didn't feel that way on my relatively few mild postpartum days) and am having so much fun with my little girl. It's just everything else - (patient) husband, housework, friends, spirituality - that I'm just not into right now.

In consultation with my midwives, I went back on a regular birth control pill about a year ago, even though I was still nursing when I went back on. The thought at the time was that I'd had really bad breakthrough bleeding on the progesterone-only pill and with depo provera shots, and since my daughter was eating solids very regularly at 15 months, she wasn't getting a majority of her nutrients from nursing. And I didn't think at the time that we'd nurse much longer, but we went for almost a whole year beyond that!

I'm sure that with the decrease in hormones from lactation, plus the pill hormones, plus whatever else, is all contributing. I just had never heard anyone talk about such an ordeal and would love to know if others struggled and what they did to help themselves."

I've definitely heard of women suffering from some PPD after weaning, and whenever I get questions about weaning I make sure to warn the woman that she may suffer a dip in hormones that could throw her into some PPD. That combined with the hormonal stuff of being on the pill is undoubtedly what threw you into PPD.

Some of my readers may disagree with me, but it seems to me that most of the other things in your life are pretty stable right now, you're not having any hidden emotional issues, and you're dealing well enough to be able to experiment with some ways to get out of the PPD without having to go on meds. I don't have anything against meds for women who really need them to manage, but it does take anywhere from a few days to a few weeks for them to kick in, and depending on which one you're taking you can have truly a nightmarish time getting off them (Effexor is the worst one I know about). So if you're not in crisis mode, I'd see if you can kick your hormones back into place without the meds first. I'd make sure you're doing three things:

* In her The Big Book of Birth (my review here), Erica Lyon cites a study that showed that a 15-minute massage every day prevented PPD as well as meds did in newly postpartum women. I'd say it's worth a try. If your partner doesn't know how you're feeling, definitely 'fess up, and when he asks what he can do to help, ask him for a 15-20 minute massage every day. He'll probably be thrilled to do it, because it's something physical and concrete that he can do (many men love that). It sounds like you're feeling some distance from him right now, and a short period of nonsexual touch every day from him could help bring you closer together without any real pressure on either of you to "do something about it."

* Make sure you're forcing yourself to do 15-20 minutes of exercise a day. If you've got a T-Tapp DVD, put it in and actually press "play" and just do the Basic Workout Plus. T-Tapp is definitely a mood enhancer. (If you want to start with T-Tapp, read Summer's great summary of how to start and what video to start with here.) If you're not a T-Tapper, climb stairs for 15 minutes, or dance around the living room for 15 minutes, or (if it's cool enough where you live) go for a brisk walk for 15 minutes.

* And make sure you're taking Omega 3 supplements, either fish oil or flax seed oil, every day. At least 1200 mg a day if you can.

If you're hitting your hormonal mood problem with the trifecta of massage, exercise, and Omega 3s, you should start to feel better in a week. If you're not feeling better after two weeks, ask your midwives for help, because you might need to have your thyroid tested or look for other physical explanations for your mood.

In the long run, you might consider non-hormonal birth control. It's not for everyone, but the fertility awareness method/natural family planning method has a high reliability rate when all the rules are followed by a motivated couple. For the basics on FAM, read Toni Weschler's Taking Charge of Your Fertility. (Yeah, I know those of you who've gone through infertility are rolling your eyes, but for people without fertility problems, TCOYF is a revelation about how your cycle works and how you can use your cycle to prevent or achieve pregnancy.) Giving your body a break from the hormones might help it regulate itself and get you back into a better frame of mind.

Did anyone else suffer from PPD after weaning? How long did it last? Did you treat it or did it just pass?