Tuesday, June 11, 2019

Coping with postpartum depression

by Kim Vargas, LCSW

Jessica walked into my office in a sundress with her hair and makeup done. [For the purposes of illustrating key points, a fictitious client has been created.] She smiled and spoke in a calm, warm tone. Had I not had a phone conversation with her the day before where she detailed her reasons for making the appointment, I would never have guessed that this woman was suffering deeply. To look at Jessica, you would wouldn’t have known that she was terrified to be alone with her baby; that she wasn’t sleeping at all because she was so anxious that her baby would stop breathing if he wasn’t constantly monitored; that she felt hopeless and filled with despair almost all of the time; that she sometimes wondered if her baby would be better off without her; that she spent most of the day crying as soon as her partner left for the workday. To look at Jessica, you would never have known she was in the throes of postpartum depression.

Jessica’s mother told her that she was just suffering from the baby blues, and that all new moms go through a tough stretch. Her mom told her she just needed to get out of the house more, spend time in the sun, and pull herself together. For three months after her son was born, Jessica suffered in silence, and told herself that she was a terrible mom for not feeling joyful about her new baby. She was fearful that her baby would be taken away if she revealed the truth, so she made sure to act upbeat at her six week postpartum check-up.
As it turned out, Jessica was one of the 1 in 7 women who struggle with postpartum depression.
Luckily, Jessica had a sister-in-law who had previously suffered from postpartum depression (PPD), and knew to ask Jessica important questions about her mood and coping. Had that not been the case, Jessica could easily have fallen into the 50% of women who are never diagnosed (and consequently never get help) with postpartum mood disorders.
Women suffering from untreated PPD are more likely to develop Major Depressive Disorder down the road. They may have more difficulty bonding with their baby. These moms often have lower self esteem. Their babies may experience language delays, have more difficulty with self regulation, and experience depression themselves later in childhood.
Postpartum depression is more likely to occur in parents with a baby who spends time in the NICU, parents who experience complications at birth, parents with a history of depression, parents with a high needs infant, and/or parents with a lack of social, emotion, and financial supports.
It is worth noting that it is not only biological mothers that suffer from PPD. 1 in 10 fathers experience depression in the postpartum period. Adoptive and foster parents are also at risk. Because these parents did not give birth to the child, they sometimes feel unjustified in their depression, and are therefore unlikely to mention the feelings to anyone.
The good news is that there are many wonderful options for treatment and healing. Many parents find immediate relief in working with a therapist trained in postpartum issues. These professionals can validate and normalize the thoughts and feelings, make concrete suggestions for behavioral modifications, and assist new parents in finding resources to help manage new parenthood. Sometimes just being “allowed” to say the deepest, darkest thoughts and fears in a confidential setting lifts a tremendous burden.
Many women find that talking to their doctor about their mood enables the doctor to prescribe medication that helps manage the feelings. Doctors knowledgeable in postpartum issues may be able to prescribe a medication that is compatible with breast feeding, as that is often a concern for new parents.
Support groups offer an opportunity to connect with other new parents in a safe setting filled with individuals at a similar life stage. Sometimes parents benefit from hearing someone else speak a familiar thought, feeling, or fear. Likewise, joining local baby-centric activities connects new parents to each other, and offers a structured activity outside of the house. For breastfeeding mothers, attending a breastfeeding support group and/or getting the support of a lactation consultant can be extremely beneficial in making the breastfeeding process smoother and more comfortable, physically and emotionally.
Asking for help from friends, family, and/or paid professionals, especially in the very beginning, can go a long way toward allowing the new parents to heal. Because lack of sleep is often a contributing factor to postpartum depression, having someone else wake up with the baby some of the time may improve mood quickly.
The bottom line is that there is an extraordinary amount of help, support, and resources for people suffering from postpartum issues. Because postpartum mood disorders can develop any time during pregnancy, and up to a year following the birth of a child, it is imperative to know the signs and symptoms, and to seek help immediately.

Kim Vargas, LCSW has been a psychotherapist for over 19 years. She specializes in working with individuals and couples navigating the various stages of parenthood (including the journey to become parents). She is especially passionate about working with new parents surrounding issues of postpartum depression, anxiety, and identity. Kim can be reached at kimvargastherapy@gmail.com or 267-568-7846.