I think we should all have our 4th kid first. It would make things so much easier.
I was called last night about a woman, 7 days postpartum, who seemed to be in an emotional crisis and they were looking for a PP doula. They lived about 70 miles away. After talking to the woman's mom (forevermore known as grandma/gma), I felt it would be good to go and see her because the gma seemed to be in some denial about how serious it was, the things she was saying.
I got there and sat with the new mom for about an hour, talking to her, and she had been having feelings of dying, feelings of the baby dying (but not by her), anxiety to beat the band, and major insomnia.
Clinical postpartum depression doesn't usually hit for at least 4-6 weeks postpartum, so if this woman was this sick at one week out, she REALLY needs help. With talking, she admits to having anxiety for years, never treated. Time to be treated, I told her.
The family is very holistic. Their pantry and fridge was like being in Whole Foods or Trader Joe's. The gma was distraught about her daughter taking meds, helping herself feel better that it might not be forever. I encouraged the gma to stay in the here and now and to Let's Get Through Today sort of thing.
The mom was making plans for the baby should she be hospitalized. She wants gma to take the baby and spoke a lot about how she did not want the dad to have the child. Dad, apparently, is struggling himself, by being an insensitive oaf. On purpose? Hard to tell.
I spoke in-depth about this "going away" feeling and it seemed to help.
PPD is so painful.