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Subject:
From:
Jennifer Tow <[log in to unmask]>
Reply To:
Lactation Information and Discussion <[log in to unmask]>
Date:
Mon, 29 May 2000 14:58:27 EDT
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In a message dated 5/29/0 11:57:20 AM, [log in to unmask] writes:

Kathy wrote:

<< I have a question about treatment of depression (general or post-partum)
with drugs when there are good reasons for the depression -- do these drugs
(Zoloft, Paxil, Prozac) work to elevate mood in people who are depressed for
good reason?  Like Corrine after her dad had a massive heart attack and one
of her roommates attempted suicide?  Or like my mother-in-law after her
wonderful husband died, or like my graduate student who has stage 2 breast
cancer?  Or are these drugs mostly helpful only if a person is depressed for
no apparent reason (like PPD, or just feeling really bad even when outwardly
everything is going well?). >>

I agree with Kathy that when women are brave enough to speak of such pain
(thank you, Corinne) then others are healed. But I also have the same
question. (More below.)

<<My graduate student was prescribed Paxil because she was "crying all the
time for no reason."  This is a 40 year old woman with three kids (ages
10-18), who was just diagnosed with stage 2 breast cancer on Christmas Eve,
had a bilateral mastectomy, half her lymph nodes involved, and is struggling
through nasty chemotherapy.  I told her she had two good reasons to cry --
breast cancer, and treatment for breast cancer, but that if the Paxil made
her feel even a little bit better, more power to her.  Still, I thought the
attitude of the oncologist who prescribed the Paxil was horrible.  :(>>

A new mother called me several years ago (referred by her day care) b/c she
was told by her OB (not even a therapist or psychiatrist was involved) that
she was suffering from depression. Her baby was 2 mos old and she had just
returned to work. She was crying all of the time and couldn't sleep, was
distracted and felt extremely sad and overwhelmed. She wanted to know if it
was safe to take the drugs and bf. Of course, I told her that it was, but we
talked for a long time.
    She was able to recognize that these "unexplained" bouts of crying began
several days before her return to work. She missed her baby terribly and felt
overwhelmed by her emotions. She struggled to communicate to her husband, who
felt she would just get over it in time. I suggested that bad feelings are
not necessarily best addressed by supressing them. Perhaps she could
structure her life differently. If not perhaps she could just accept that as
a mother she would not be comfortable leaving her children and she could just
honor these feelings. In any case, I suggested that a therapist might be
better qualified to diagnose depression.
    In the end, she chose to bf w/o the drugs. She felt that when she had
another child, her dh might find it too expensive for daycare and she could
stay home. *Miraculously*, she conceived twins while still nursing--way too
many babies to afford daycare for!
    My point is that for many people, there seems to be little exploration of
the source of the depression. And very little support in exploring negative
feelings, which may be normal in certain circumstances. We, as a culture, do
not like to deal w/ what is difficult, so we find ways to avoid it. This
cannot possibly benefit someone like Corinne, whose symptoms may be minimized
*or* someone like my client, whose symptoms may be maximized by others.
    Also, there are many natural approaches to managing depression. Last week
I heard a radio interview w/ an herbalist who became one to cure her own very
serious depression. (She had previousely used drugs). There is a great deal
of evidence suggesting counseling in nutrition (esp for those lacking sources
of essential fatty acids in the diet), herbs and homeopathy can heal
depression.
Jennifer Tow, IBCLC, CT, USA

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