Trigger Warning: This post contains a brief mention of suicidal ideation. If you are suffering from suicidal thoughts, please talk with someone from the Suicide Prevention LifeLine at 1-800-273-8255 or www.suicidepreventionlifeline.org.
Postpartum depression is a special kind of hell. You’ve been told that the time with your newborn is fleeting and magical. That you should be bonding with your baby. That every mother has the blues, so there shouldn’t be anything wrong with you.
But postpartum depression is not fleeting or magical. It interrupts the bond with your baby and leaves you a compromised mess. And it’s not just the typical blues “every” mother gets; if you have postpartum depression, there is definitely something wrong.
May is National Maternal Depression month. The awareness month is intended to acknowledge the seriousness of depression and psychosis during and after pregnancy. Studies show that up to 20% of mothers suffer from some form of depression in the postpartum period.
And you know what they say: “when Mama ain’t happy, ain’t nobody happy.” The damage that can be dealt to families when a mother suffers from depression or psychosis is tremendous.
Symptoms of Postpartum Depression and Psychosis
Postpartum depression symptoms can show up anytime within the first year, though most tend to show up soon after your baby’s birth. If you or your loved ones are feeling three or more of these symptoms, call your doctor right away.
Symptoms of postpartum depression can include:
- Persistent sadness or anxiety
- Irritability or anger, especially for no reason
- Sleeping too much
- Changes in eating patterns, either too much or too little
- Mood swings
- A lack of ability to focus
- Changes in memory (can’t remember things)
- Feelings of worthlessness
- Suicidal thoughts
- Anhedonia – Lack of pleasure in usually enjoyable activities
- Isolating yourself
- Feelings of hopelessness
- Unexplained aches, pains, or illness
- Interrupted bond with the baby
Postpartum psychosis, however, usually shows up within 2 weeks of the birth. The most significant risk factors for postpartum psychosis are a family history of bipolar disorder or a previous psychotic episode.
Symptoms of postpartum psychosis can include:
- Delusions or strange beliefs
- Auditory or visual hallucinations
- Enormous irritability
- Feeling pressured to go, go, go all the time
- High energy
- Inability to sleep, or decreased need for sleep
- Extreme mood swings that cycle quickly
- Inability to communicate at times
Postpartum psychosis is a serious disorder of the mind. Women who experience postpartum psychosis die by suicide 5% of the time and kill their infants 4% of the time. The psychosis causes delusions and hallucinations to feel real and compelling. They are often religious. Postpartum psychosis requires immediate treatment. If you or a loved one are feeling any of these symptoms, head to your nearest emergency room.
After my son was born, I suffered a postpartum psychotic break and committed myself to a mental hospital, where I was diagnosed with bipolar I disorder. I later wrote a book about the experience. After I recovered from the break, a manic episode with psychotic features, I suffered postpartum depression.
By the two-and-a-half year mark, I was writing daily suicide notes and making plans to die. It wasn’t until I weaned my son and took lithium that the clouds parted. My full recovery took a long time after that, but I was able to recover. I have since had a second child with no ill effects.
But if you have postpartum depression, how do you cope with it? Read on for 9 practical tips from a woman who’s been there.
Tip #1: Get Professional Help
Postpartum depression is a beast that screams for professional help. If you don’t already have a treatment team including a therapist, psychiatrist, and a primary care physician, then make the effort to get one.
(For a post on getting a psychiatric evaluation, click here. For a post on how to start seeing a therapist, click here.)
I know calling and vetting doctors at a time when you can barely hold your head above water sounds about as appealing as sticking your hand into a box of tarantulas. But trust me: the sooner you get help, the better off you’ll be. If you have a friend or a partner willing to support you, delegate the task of finding doctors and making appointments to your helpers.
A therapist can teach you coping skills to better handle your depressive episode. And a psychiatrist can prescribe you medication which can improve your mood and anxiety tremendously. And your primary care physician can give you referrals to a therapist and a psychiatrist.
If you don’t have a primary care physician, go to urgent care or call Postpartum Support International at 1-800-944-4773. Their website, postpartum.net, enables you to find local resources to get treatment, and support groups for new moms like you. You can also ask your ob-gyn if the hospital in which you delivered offers services to treat postpartum depression.
Tip #2: Take Your Medications
If you’ve been prescribed medication, then do take it. There’s no shame in using the tools that you’ve been given specifically to help you.
I know that you may not feel an effect for a couple of weeks, and the first medication may not even work the way you want it to, but I promise, if you stick with them, your meds will help. Stay the course. Work with your psychiatrist (see tip #1) to find the right combination of medication to help you.
Don’t stop taking them abruptly, as they aren’t designed for that, and you will suffer withdrawal symptoms. For a post on what to do if you run out of medication, click here.
You can pull through this. You just need to be patient–and take your meds as prescribed. Give medication a chance, and you’ll be well on your way to recovery.
Tip #3: Practice Self-care
Practice self-care. A lot of people think self-care ideas are limited to bubble baths and painting their nails. But that’s just not true.
Self-care is taking responsibility for your physical and mental well-being. That’s it.
Try to get enough sleep during the week, eat a healthy diet, drink plenty of water, exercise, and spend some time outside and with other people.
Practicing self-care on a daily basis is difficult. It’s the box of tarantulas problem again. But taking care of yourself will help your depression lift.
Tip #4: Lean on Your Friends
If there was ever a time to lean on your friends, this is it.
Tap into your social network and ask for support during a time when you might be feeling vulnerable. Give your friends a call and ask them to listen to your worries, or join an online support group. If you have a church or social organization, see if someone would be willing to set up a meal train for you. Ask your friends or family to come watch the baby so you can get some life-saving sleep.
Sometimes asking for help is the hardest part of being down and out. Pride is a stumbling block. But there’s no shame in asking for help if you really need it. If you’re depressed, you’re really suffering, and you need the aid of others. Lean on your friends.
Tip #5: Journal, Journal, Journal
When faced with overwhelming feelings, you need to express yourself. Don’t stuff your worries, thinking they’ll go away. You’ll only succeed in making them bigger and harder to overcome.
If motherhood is not what you envisioned, write about how unfair this new normal is. Journal your concerns about your baby. Write down your dreams.
Talking to someone also helps. Reach out to your friends (tip #4) and speak with them about your fears.
However, if you have a rare disorder called hypergraphia, the compulsion to write, then try to avoid writing. During my postpartum psychosis, I suffered from hypergraphia, and was compelled to write multiple to-do lists with hundreds of items each. I filled up a journal my husband bought me on the day of my son’s birth within a week.
If you are suffering from hypergraphia, it is even more imperative that you seek treatment (tip #1).
Tip #6: Breastfeed… But Only if You Can and Want To
Studies have shown that mothers who breastfed for two to four months were less likely to suffer postpartum depression. But for mothers who couldn’t or didn’t want to breastfeed and felt pressure to do so, their depressive symptoms were worse.
If you can and want to breastfeed, then do so. You may feel the benefits.
But if you can’t breastfeed or don’t want to, then don’t, and don’t feel shame. You are doing a wonderful job feeding your baby regardless of how you feed them. Ignore judgmental people, and do what’s best for you. What’s best for you is best for your baby.
For a post on which common antidepressants and antipsychotics are safe to take while breastfeeding, click here.
Tip #7: Schedule Me-time
Anyone juggling the demands of a newborn needs me-time. This is doubly true if you’re depressed. Lean on your friends (tip #4) to watch the baby so you can get out for a walk, take a nap, and practice self-care.
If you can’t bear to be separated from your baby, just try for twenty minutes. You can be alone for twenty minutes. That’s enough time to squeeze in a yoga or meditation session, or read a couple chapters of a book.
You need time off to function as an adult. Losing your identity to the vast maw of motherhood is a real concern. Schedule me-time.
Tip #8: Cry
After the postpartum period, your body is flush with hormones. One of the ways to rebalance your hormonal imbalance is to cry. Our bodies secrete hormones through our tears.
Don’t be afraid of tears. Embrace them. Sometimes, if you give yourself over to a good cry, it can be cleansing.
Tip #9: Practice Infant Massage
Infant massage has a whole host of benefits. The baby’s sleep may improve. Rubbing infants down stimulates growth hormone in underweight babies, and helps all babies’ stomachs. And infant massage also helps the pain of teething.
Most importantly, performing regular infant massage can help you bond with your baby. When you’re depressed, bonding with your newborn can be extremely difficult. Connecting with your baby through your hands may help.
Postpartum depression doesn’t have to last forever. If you get professional help, take your medications, practice self-care, lean on your friends, journal your feelings, breastfeed (but only if you can and want to), schedule me-time, cry, and practice infant massage, then you’ll be well on your way to recovery.
You don’t have to do all of these tips. Pick and choose the ones that are most appealing. But if you do any of them, do the first: get professional help.
Postpartum depression is a serious condition which requires the aid of doctors. And postpartum psychosis is a medical emergency.
Don’t be afraid to reach out. Trust your instincts. If you feel that something is wrong, then do take the first steps to care for yourself.
I wish you well in your journey.
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