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Kathy seemed to be restless as she was moving her hands and feet quite a bit -- another sign that is quite common in postnatal depressive patients. I also noted that there seemed to be some kind of anxiety in Kathy and the anxiety seemed to really be present when we talked specifically about the baby. She seemed hopeless as well in that she repeatedly stated that she feels that she can't do anything right. Anxiety over not knowing exactly how to do things as a first time mother are quite common (Dalton & Holton 2001, p. 45), however, Kathy's anxiety seems to be much more than just that. She reported that her focus had been quite scattered (not being able to focus for more than a minute) and that she is constantly worrying about Molly and her health and safety because of her own lack of concentration. She was worried that she would get distracted and something would happen to Molly. Again, I reiterated that those feelings and being so tired after pregnancy were very common (Kleiman 1994, p. 3).
I inquired about Kathy's family history of mental illness and she stated that there was no history of mental illness in her family. She admitted to seeing a counselor when she was in high school because she worried all the time, but other than that she never sought help from a counselor. I asked Kathy if the way she was worrying now about the baby was along the same lines of how she worried when she was back in high school. Kathy said that she was worrying a bit more now than she did back then and, of course, about different things, but she recalls being overly concerned about everything in high school and the feelings are similar. Kathy states that she even worries about worrying.
I asked Kathy if she had been using any alcohol or drugs. Kathy states that she has not used alcohol since becoming pregnant with Molly...
I asked her if she ever thought about suicide and she took a pause before finally answering that her daughter Molly "would be better off without me." I asked Kathy if she had ever harmed herself or if she thought about harming herself and she said she had never and she didn't think about it. Kathy's pause gave me reason to worry a bit, however, I do believe that she will not harm herself. I asked Kathy if she could give me her word that she would not and she agreed. She said that she did not want to die and that she wanted to be a good mother and wife and that she was just having a hard time getting the emotional energy to do both those things.
I covered most of the bases in terms of Kathy's interview in asking about family history, emotional support in terms of friends and family, finances, and whether drugs or alcohol were involved. Kathy seems like she has all the pieces there in order to recover from postnatal depression, but she will be seeing her medical doctor to see if there is anything that she can be doing (I suggested some vitamins and physical exercise as well as journaling about her feelings) to help her feel a bit better.
References
Aiken, C. 2000. Surviving postnatal depression: At home, no one hears you scream. (1st
edition). Jessica Kingsley Publishers.
Dalton, K. & Holton, W. 2001. Depression after childbirth: How to recognize, treat, and prevent postnatal depression. (4th edition). New York: Oxford University Press.
Kleiman, K. 1994. This isn't what I expected: Overcoming postpartum depression. (1st
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