07/29/2014 05:23 EDT | Updated 09/28/2014 05:59 EDT

What Postpartum Nurses Won't Tell you about Postpartum Depression

Although I have dealt with depression since I was a teenager, the devouring feelings of worthlessness, loneliness, and devastation became savage and gripping after the birth of my first child. What I didn't know then was that I was suffering from Postpartum Depression, and what I do know now is that I never got better. For 18 years I dragged my weary soul through moments that most mothers cherish.

Fortunately, finally, teaching new mothers about Postpartum Depression occurs on postpartum units regularly now. Explaining the difference between postpartum blues and postpartum depression is on a checklist of topics that I, as a postpartum nurse, review with my patients and their families before they head off down the hospital corridor; sweet smelling newborn strapped securely in the car seat; a car seat they are very familiar with because they've actually taken a class prior to delivering their baby, about car seat safety.

This is the part of my time with my new mothers and their families that I feel is the most important. I want them to really hear this part. I want them to listen to this, their ears as perked up to my discourse as they were when they were learning how to strap a floppy doll into a car seat.

In order to maintain professional boundaries, however, this is what I tell them:

"A few days to a few weeks after you get home, you may develop the blues. This is a time when your hormones are going crazy. Postpartum blues is normal. You can usually shake it off with a shower or a coffee date.

If you have postpartum depression, you won't feel better after your shower. In fact, you may not even care to shower. You may not even want to get out of bed. Consistently gloomy days in which you find yourself unable and unwilling to do much more than the basics to care for your baby or yourself is postpartum depression.

Often other family members will notice that something is just not right with you. Dad, if you see that your spouse is not herself, and perhaps has not been for several months after the birth of this baby, you need to find the courage to remind her of this discussion. She will need help. And mom, if you have thoughts of self-harm or thoughts of harming your baby, it is imperative that you call your physician who will be able to provide you with supports and medication if it is necessary."

As a mother who suffered from PPD with all four of my kids, and in order to refrain from unprofessionalism, this is what I don't tell my patients:

"Days, week, and months in which you are physically and mentally exhausted are normal. But 6/8/10/18 months later, waking up every single morning with a feeling of gloom and dread at the day ahead is not normal.

Becoming frustrated when your child has been crying for 13 hours in a row is normal. But muttering over and over, "I don't like this baby I don't like this baby I don't like this baby," is not normal.

Wishing the day would end so you can pull the covers over your head, and never come out is normal. But wishing this every single day for months and years following the birth of your child or children, is not normal.

Placing your baby in the crib so you can have a quick breather and a cry is normal. But placing your baby in the crib every day while you grip a pillow over your head and sob for hours, is not normal.

Bad days are expected. But bad days that linger into bad months and bad years, where all you do is wish that you could leave the house and never come back is not normal.

Wishing you had never had a child, and immediately regretting the wish, is normal. Asking a friend or family member to care for baby for a few days is normal. But picturing yourself throwing your baby against the wall and imagining him/her slowly sliding down like a blob of jelly is not normal.

Going out for milk by yourself so you can have a "mommy break" is normal. However, contemplating driving past your house after you've picked up the milk, in order to speed your minivan into a brick wall is not normal.

If you should experience any or all of the scenarios I have described, please don't wait to seek help quickly. What I did not know is that this is PPD, and I was not alone. What I also didn't know is that there are people who will not judge you, and who are trained at helping to heal you. Please always remember this.

But of course, I don't say that because...well, because it's not socially acceptable.


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