It's time to update the quiz

[dampscribbler]

I need to go back one of these days to revisit my posts during Miss M's first year of life. I've recently seen a couple of them, and was pleased that they were actually fairly pleasant and reflective of the great things about having a baby. Because it should not be overlooked that having a baby is a great thing, and I was immensely enjoying my new daughter.

But.

I was also having a hell of a difficult time adjusting. I'll be exploring these experiences in the coming months -- I'm hoping to write some articles or possibly even a book about my experiences, and of course the process of training to work with expecting moms and new mothers (as well as watching my best friend go through it all, she's due in June) will require and inspire lots of reflection on my part. Some of it I'll share here, I imagine. To begin it, I'm currently researching the existing literature (at least that which is available online) regarding post-partum depression. What strikes me as I'm reading this stuff is that either (1) the experts really don't have a clue what it's like, or (2), what I had wasn't post-partum depression, but needs a name because it sure wasn't what I think of as healthy.

I'd love to have feedback from any parents (yes, dads included) regarding the following.

First, here is the quiz currently used as the "standard tool" to screen for post-partum depression.
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Edinburgh Postnatal Depression Scale (EPDS)

Taken from the British Journal of Psychiatry June, 1987, Vol. 150 by J.L. Cox, J.M. Holden, R. Sagovsky

As you have recently had a baby, we would like to know how you are feeling. Please UNDERLINE the answer which comes closest to how you have felt IN THE PAST 7 DAYS, not just how you feel today.

1. I have been able to laugh and see the funny side of things.

As much as I always could
Not quite so much now
Definitely not so much now
Not at all

2. I have looked forward with enjoyment to things.

As much as I ever did
Rather less than I used to
Definitely less than I used to
Hardly at all

3. * I have blamed myself unnecessarily when things went wrong.

Yes, most of the time
Yes, some of the time
Not very often
No, never

4. I have been anxious or worried for no good reason.

No, not at all
Hardly ever
Yes, sometimes
Yes, very often

5. * I have felt scared or panicky for not very good reason.

Yes, quite a lot
Yes, sometimes
No, not much
No, not at all

6. * Things have been getting on top of me.

Yes, most of the time I haven't been able to cope at all
Yes, sometimes I haven't been coping as well as usual
No, most of the time I have coped quite well
No, I have been coping as well as ever

7. * I have been so unhappy that I have had difficulty sleeping.

Yes, most of the time
Yes, sometimes
Not very often
No, not at all

8. * I have felt sad or miserable.

Yes, most of the time
Yes, quite often
Not very often
No, not at all

9. * I have been so unhappy that I have been crying.

Yes, most of the time
Yes, quite often
Only occasionally
No, never

10. * The thought of harming myself has occurred to me.

Yes, quite often
Sometimes
Hardly ever
Never

Response categories are scored 0, 1, 2, and 3 according to increased severity of the symptoms. Items marked with an asterisk are reverse scored (i.e. 3, 2, 1, and 0). The total score is calculated by adding together the scores for each of the ten items. A score of 12+ indicates the likelihood of depression, but not its severity. Users may reproduce the scale without further permission providing they respect copyright by quoting the names of the authors, the title and the source of the paper in all reproduced copies.
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Based on this quiz, I'd have probably scored a 10 or 11 (I even recall taking it at the time I was freaked out, and scoring below the level of concern then). But things were bad. So, I think it's time to re-design this 20 year-old quiz for today's mother. So, now, I give you:

Kristi’s totally non-expert post-partum depression quiz.

Please answer to the best of your recollection how often in the past week you've thought the following:
0= I’ve never thought this
1= About once
2= About 2-4 times
3= About 5-6 times
4= I think this daily or more often


1) I don’t know what to do

2) I’m so fucking tired

3) I don’t have anyone to ask for help

4) Nobody understands/will understand if I ask, anyway

5) Nobody wants to help me

6) I have such bad luck, all avenues for help are closed to me

7) The only help available costs money that I don’t want to/can’t spend

8) My child doesn’t care if I starve

9) I feel desperate

10) I’m incompetent

11) I don’t know how I will get through this

12) Jesusmotherfuckingsonofabitchchrist

13) It will be like this from now on

14) What if I get hurt/sick/die? (usually accompanied by mild to moderate panic, and/or tears)

15) What if the baby gets hurt/sick/dies? (ditto above)

Of a possible maximum score of 60, I would have scored a 54 on most days. How about you?
(PS - Number 12? Yeah, I thought that, or something equally foul, about once every 15 minutes, at many many times. I knew I was getting better at long last when I realized that I hadn't thought anything like that in over a week.)

Comments

[alikander.livejournal.com]

I remember the "official" scoring test, too. This one:

7. * I have been so unhappy that I have had difficulty sleeping.

Always made me laugh bitterly. If it read "I have been so unhappy because I have had difficulty sleeping (because some people can't go 90 minutes without breastmilk or 10 seconds without being held," then I would have said, "Damn straight, now shut the f**k up so I can sleep for five minutes, or use the bathroom if I'm lucky."

FWIW, at my lowest point (0-8 weeks pp) I probably scored around an 8 on the official test.

I like your test much better! I would have scored about a 30 on it. I expanded the "starve" question to include "pee/crap myself" and "smell like a hobo".

#13 was the biggie for me, there was no light at the end of the tunnel, and that made me despondent.

Btw, I've often made the point that the "fourth trimester" is much like torture and marine training, especially in the use of sleep deprivation. It breaks you down and rebuilds you as something else--a mom.

[dampscribbler.livejournal.com]

Good points, all! Yes, I need to explain (well, not to the moms, probably, but to someone) what's wrong with the questions in the official quiz, because as you point out, they just don't apply under the circumstances.

I think I had several very low points -- particularly right after each milestone at which everyone had said it would get better -- "oh, it's better after the first 6 months" (nope), "once you get through the first year, it gets better" (well, sorta, but not better enough). It was almost literally on her second birthday that I finally started to feel like a human being again.

Marine boot camp? Yes. Torture? Definitely yes. :) But it's hard to explain the constant dichotomy (if that's the right word) to someone who hasn't been through it -- how you can simultaneously be freaking out about your own stench while adoring the most beautiful big shiny eyes and pink button nose you've ever beheld in your life.