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Depression in the NICU May Not Be Depression At All

The rates of diagnosed depression are higher among NICU parents than non-NICU parents. However, often missed in the assessment for this diagnosis is that certain survival states lead to symptoms that look a lot like depression, but are not a mood-related problem. The NICU is a place where parents often live with an activated survival response, and when living like this indefinitely, they can experience symptoms that can be mistaken for clinical depression.

“When the human body lives with an active survival response for too long, the nervous 
system shifts into a dorsal vagal state that looks and feels a lot like depression. This state, however, is a survival mechanism to keep you safe and preserve resources while you’re facing a threat (the NICU) for an indeterminate amount of time. This biological mechanism could explain the high incidence of depression during and after a NICU stay.
– Parijat Deshpande

The body is under tremendous stress when functioning in this depression-like survival state. However, instead of experiencing this stress as hypervigilance, inability to sit still, overwhelming thoughts, etc., women (and their partners) experience it as feeling hopeless, helpless, disconnected & numbed out.

For many, traditional treatments for depression are not sufficient because the source of the symptoms is nervous system dysregulation that is focused on sustaining a whole-body state to keep you alive.

This cluster of symptoms that is often misdiagnosed for depression improve significantly when you take a somatic, trauma-informed approach to nervous system regulation. It can even reverse many chronic illnesses such as chronic pain and autoimmune diseases that are common experiences for NICU parents. 

Where to from here?

We recommend discussing this with your trauma-informed primary care provider, psychotherapist, or psychiatrist and review your options for somatic treatment modalities. We suggest identifying which somatic modality would be best for you and understanding why your care team is making their recommendations. 

The Ruvelle Experience has a library of specific question workflows to review with your care team, trauma-informed, neurobiological health education to review with them, and guidance on how to build a truly trauma-informed care team.  

You deserve a care team who understands what you’re going through and also who understands what your body is communicating while you’re in the NICU. With the widespread acceptance of telehealth and virtual care, it is possible to build this tight team for yourself.

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