Erika .......

iVillage Member
Registered: 11-09-2001
Erika .......
7
Mon, 07-26-2004 - 8:42am
Hi - I can't find your original post here but can you go over something for me again? I found your last test results, which were TSH at 33. When did you first start feeling so bad? Was it during your pregnancy or right after? Hugs, Cathy
iVillage Member
Registered: 03-27-2003
In reply to: cathypem
Tue, 07-27-2004 - 10:29am
Cathy,

i started feeling bad a few months after my pg. at my 6 wk check up my thyroid was a .99 so they reduced my meds from .1-.075. then 1 month later my tsh was .0001 so they reduced my meds to .050. 4 wks later my tsh was 9.5 so they upped my meds back to .075. 2 wks later i was feeling soooo bad i insisted on another draw and my tsh was 63. my meds were upped again to .1. 2 wks later i was a 33. now just waiting to here again, altho i feel worse then i did whem my tsh was 63- but we are making a change in my antidepressant too (so that may be it too- it is so hard to tell since these symptoms overlap so much) thanks for being interested in me!

Erika

iVillage Member
Registered: 11-09-2001
In reply to: cathypem
Tue, 07-27-2004 - 10:51am
Hi Erika - What I guess I was wondering is how much of what you're feeling now is due to your pregnancy and whether or not post partum depression may play a factor because it is very common in women with thyroid conditions. I'll bet the combination of your pregnancy and your thyroid condition and all those fluctuations in hormones have really wrecked havoc on your system. I'm glad that you are taking an anti-depressent for now because that may be critical in your feeling well again. Is this your first baby? Because at about the same time that you were feeling bad is the time when all those hormones come into play after childbirth. It's just a tremendous "rush" of hormonal change. Dr. Arem's book, The Thyroid Solution has a long chapter on the relation of thyroid disease to the post partum period and depression. It may be worth getting. If I had the time - I could type the whole chapter out for you! :))) Hang in there! hugs, Cathy
iVillage Member
Registered: 03-27-2003
In reply to: cathypem
Tue, 07-27-2004 - 11:01am
Cathy-

i thought post partum started pretty soon after child birth? i also thought the symptoms were not wanting anything to do with your baby? i didn't start feeling this way until about 1 month ago- even tho my TSH was off. my baby is 6 months- so he would have been 4&1/2-5months old when i got like this? i thought PP started right away- PP blues leave with in a few wks. if the symptoms continue for months then they call it PP depression. maybe i am wrong about that- but i don't think it is PP. maybe it is. i just think it is my thyroid.

Erika

iVillage Member
Registered: 11-09-2001
In reply to: cathypem
Tue, 07-27-2004 - 1:43pm
I think they are both related. Perhaps the thyroid condition has made the other worse. Check out this site: http://www.mythyroid.com/postpartum_thyroiditis.htm

And look at this:

"Postpartum Depression

Symptoms

Most studies place the prevalence of postpartum depression to be between 10-15% of new mothers1,5,6,7. Studies have indicated that the hospitalization rates for depression are significantly higher during the first 90 days after delivery than for any other time within two years of pregnancy or delivery8, making this an especially vulnerable time for new mothers. Symptoms associated with postpartum depression are the same as those for major depression as defined by the American Psychiatric Association (see Table 1)9. The key critieria is that symptoms last most of the day, everyday, for at least two weeks. Although the DSM limits the definition of postpartum depression to symptoms occurring within 28 days of delivery, most experts agree that symptoms may develop later after delivery10. Two-thirds of these women experience the onset of these symptoms by 6 weeks postpartum; however, the definition for onset of postpartum depression varies widely (onset by 4 weeks to up to 12 months after delivery). In addition to the DSM-IV criteria, postpartum depression may be associated with unique feelings toward the new baby such as overly intense worries, lack of interest or fear of harming the baby. Feelings of anxiety and obsession also tend to be rather common and dominant11.

Table 1.

Criteria for Major Depressive Episode*

At least five of the following symptoms is present for a two-week period: (one symptom must be either 1) depressed mood or 2) loss of interest or pleasure)

Depressed mood most of the day, nearly every day

Markedly diminished interest or pleasure in all, or almost all, activities most of day, nearly every day

Significant weight loss (when not dieting) or weight gain, or change in appetite

Insomnia or hypersomnia, nearly every day

Psychomotor agitation or retardation nearly every day

Fatigue or loss of energy nearly every day

Feelings of worthlessness or excessive or inappropriate guilt nearly every day

Diminished ability to think or concentrate, or indecisiveness, nearly every day

Recurrent thoughts of death, suicidal ideation without specific plan, or suicide attempt or a specific plan for committing suicide

*Adapted from American Psychiatric Association 1994. Diagnostic Criteria from DSM-IV.



The following symptoms may be more diagnostic during the postpartum period. New mothers should seek help if they experience any of the following signs. Family or friends should also encourage new mothers to seek help if they notice:

strong feelings of sadness, anxiety, or irritability

emotional stress which interferes with taking care of self or family

tearfulness

trouble motivating oneself to do normal everyday tasks

diminished interest in food (or compulsive overeating)

diminished interest in self-grooming (dressing, bathing, fixing hair)

inability to sleep when tired or sleeping too much

trouble concentrating, making decisions, remembering things

loss of pleasure or interest in things which used to be fun or interesting

overly intense worries about the baby

lack of interest in the new baby

fear of harming the baby

thoughts of self-harm or suicide

Risk Factors

The risk for postpartum depression is higher in women with a personal or family history of mood disorders or depression during pregnancy1. These include:

history of prior postpartum depression

history of depression or bipolar disorder during or before pregnancy

history of severe PMS (premenstrual syndrome)

family history of depression or bipolar disorder

In addition, recent stressful events such as marital or partner discord, loss of loved one, and family illness also increase the likelihood of depressive illness10. Both biological and psychosocial factors contribute to the causes of postpartum depression. Some women may be sensitive to the tremendous change in hormones after childbirth12. Fluctuations in the concentration of estrogen, progesterone, gonadal hormones, prolactin, oxytocin, corticotropin releasing hormone, cortisol, norepinephrine, calcium, and beta endorphins have not been consistently found to be a direct cause for mood disturrbances in all women13. Some women may be sensitive to the changes in their environment. Often no single cause can be identified.

Getting Screened for Hypothyroidism

Thyroid hormone may be very low in 6% of women after birth due to a postpartum autoimmune thyroiditis. Women with low thyroid levels suffer from many of the identical symptoms as depression such as fatigue, mood swings, appetite/weight changes, sleep changes and feeling sad. It is advisable to get a thyroid hormone level test for any of these symptoms and prior to commencement of depression treatment18. If a woman is hypothyroid, the symptoms resolve readily with thyroid replacement therapy. However, the co-existence of both thyroiditis and depression should also be entertained if there is not a prompt improvement of symptoms

Treatment

Antidepressants are very effective in the treatment for postpartum depression. If the new mother has used antidepressants in the past successfully, then that same antidepressant should be prescribed in the postpartum period. The selective serotonin-reuptake inhibitors (SSRIs) are most commonly used because of their ease of administration, few serious side effects and low risk of fatality in case of overdose. Treatment is usually continued for six to twelve months after full remission of symptoms. All psychotropic medications are secreted into breast milk. Serum levels in infants who were exposed to fluoxetine, sertraline and paroxetine while breast-feeding revealed only trace or negligible amounts of the parent compounds or their metabolites.24,25,26 Paroxetine was not found in the plasma of exposed infants that were breastfed26. More importantly, there were no treatment side effects observed in the infants. As expected, recent studies show that venlafaxine also appears to have a similar safety profile and be equally effective as earlier studies SSRIs in the treatment of postpartum depression27. Although more studies are needed, the probability of adverse effects appears small. For moderate to severe depression, antidepressants are usually necessary. However, for mild depression, professional counseling such as interpersonal psychotherapy or cognitive-behavioral therapy may be all that is necessary in the treatment of postpartum depression28,29. Including the spouse in treatment decisions as well as securing household help for the new mother are also seen as important components in therapy by most providers.

Conclusion

The successful of treatment for postpartum depression is dependent on an awareness of the commonality of the disorder, getting women screened, and prompt initiation of therapy. Since depression occurs across all age, race, ethnic and economic groups, every new mother should be screened and educated about postpartum depression. The postpartum checkup and routine well-baby visits are an opportune time for obstetricians and pediatricians to discuss and screen for depression. Other individuals or organizations in the community who have contact with new mothers such as daycare providers and lactation consultants, can also help in the screening effort. Treatment for this disorder usually requires medication (most commonly antidepressants) but counseling alone may benefit some women who have only mild symptoms. Increased recognition, diagnosis and treatment of postpartum depression will improve the health and well being of new mothers and their families. "

Me again - It seems worth looking into to make the connection. Did you see that list of symptoms? So many overlap with hypothyroidism. Even if you don't have a clear clinical diagnosis of post partum depression, it seems pretty clear that this is a very difficult time for you because of the birth of your baby, the depression and your thyroid. What do you think? Cathy

iVillage Member
Registered: 03-27-2003
In reply to: cathypem
Tue, 07-27-2004 - 9:34pm
yes, i do see the overlap. the confusing part to me is that i do not have any of these symptoms:

In addition to the DSM-IV criteria, postpartum depression may be associated with unique feelings toward the new baby such as overly intense worries, lack of interest or fear of harming the baby. Feelings of anxiety and obsession also tend to be rather common and dominant11.

i definetely have the depressive symptoms- no doubt about that! but these i don't think so. the worries i have are valid as he has been sick. but i am depressed and at this point it is affecting my rlhsp with baby... but also with everyone else in my life as well. it is hard to say as it all overlaps. it will be easier to know when i get my test results back and start on a *therapeutic* level of thryoid meds. cuz right now what i am on is not cutting it. what do you think? am i missing something?

Erika

iVillage Member
Registered: 11-09-2001
In reply to: cathypem
Wed, 07-28-2004 - 11:29pm
Hi Erika - sorry about the post partum thing. I thought that you had alot of the same symptoms of each = fatigue, weepeiness, depression. I didn't realize that you don't!! How are you doing on your third - soon to be fourth! - day off. Cathy :)


Edited 7/28/2004 11:30 pm ET ET by cl-cathypem
iVillage Member
Registered: 03-27-2003
In reply to: cathypem
Thu, 07-29-2004 - 11:13am
oh you don't need to apologize at all. i have had the nurse at my PCP dr. ask me the same thing. it is a normal thing to think after just having a baby and being depressed. i think i am depressed- but i was depressed way b4 even getting pg. in fact i took an antidepressant through out my pg. but the interesting thing here- is i was diagnosed hypo 2 wks before i found out i was pg. so, i am still trying to figure out how much of the depression is *depression* or just my thyroid. i know that puts me at greater risk for PP but i think the key issue that differentiates reg. depression from PP are the feelings of not wanting anything to do with baby, feeling like you might harm baby etc. and i do not have any of that.

i am doing ok. i have kept myself busy seeing friends and stuff. today will be my only day just staying in the house and piddling!

Erika