PPPSS News & Events

What is Postpartum Depression? Could I have it?

By Rosemary Rukavina

 

What is Postpartum Depression?

Postpartum depression (PPD) is a major depressive disorder that affects 10 to 15 percent of women during or after pregnancy or adoption. Although PPD is most commonly associated with women, men can also experience PPD. Symptoms can include: sleeping and eating changes, concentration disturbances, exhaustion, anxiety, hopelessness, guilt, and thoughts of suicide. Women describe having a depressed mood and that they experience a loss of interest in things they were previously interested in. This potentially impairing condition is diagnosed by a physician, psychiatrist, or psychologist. Most nurses, social workers, and mental health professionals are also alert to the signs mentioned above and will make proper referrals.

Like many medical and mental health conditions the exact cause is unknown. However, many risk factors have been identified. A previous history of depression and anxiety, low self-esteem, and experiencing stressful life events (e.g., death, immigration) are a few. Other risks may be if the new baby has health complications or a difficult temperament. Finally, a lack of social support, a poor marital relationship, and not perceiving one’s needs being met can also contribute. Many other factors have been identified but these named here are the most commonly found.

Treatment for PPD is similar to the treatment for depression. However, some treatment programs have been tailored to meet the needs of the men and women who experience depression during this challenging stage of life. Medication, cognitive-behavioural therapy, individual therapy, group therapy, and psychoeducation are the most common modes of treatment. If you seek treatment with a mental health provider (e.g., psychologist, clinical counsellor) they may use other modalities to support you in your recovery, like mindfulness, hypnosis, or mind-body interventions.

Experiencing changes in mood after the addition of a baby to your family is experienced by many new parents. If you are concerned that your mood change is not a normal part of the adjustment, call the Pacific Post Partum Support Society support line or book an appointment with your family doctor.

*Source – Cline, K. M. C., & Decker, J. (2012). Journal of Health Psychology

 

Do I have Postpartum Depression?

Childbirth is commonly portrayed as a joyous time in a couple’s life. With the birth of a baby, families come together, love expands, and the hopes and promises of a new future unfold. The common feelings of overwhelm and anxiety, before and after childbirth, is a common experience for many individuals.

However, after a new member is added to a family, a negative mood and thought process can rob some women and men of their transition to parenthood. The thoughts and feelings that take over can be confusing. Confusion, guilt, and anxiety can make many suffer in silence as a result of not understanding what is going on or feeling shame in admitting that they are not living up to some standard of being a “good parent”.

It’s difficult to know that an experience is abnormal if you’ve never experienced it before; you have nothing to compare it to. Add exhaustion and disorientation to the mix and it becomes even more challenging to decide what is normal and what may be a potential concern. Symptoms to look for include: difficulties getting out of bed, thoughts that cause guilt or fear, or any on a wonderful list that Postpartum Progress has composed in “plain mama english“. It can be helpful to gauge whether it is important to see your family doctor about a symptom similar to the reasons you would see a doctor regarding a pregnancy symptom. It is just as important. Be certain to seek out your doctor or a mental health practitioner if the symptom persists or worsens. For more information on the postpartum journey, as well as to watch videos of several women’s personal experiences, please click here.

Kimberly’s Story

Story by Kimberly Daniels

 

A version of this essay originally appeared on Kimberly’s blog

I remember very clearly the day that I knew that I needed to reach out. I had seen a few “red flags” beforehand, recognizing the signs from working as a doula – but I was completely in denial that it was happening to me. It wasn’t until about six months into motherhood that I hit the wall, and it didn’t make any sense. I had everything I had ever wanted: a healthy baby, a supportive husband, and a new home in a beautiful town…and I hated it all. It was too much and too overwhelming to keep it all together.

Not many people realize that there can be intense anger in postpartum depression and anxiety. Knowing that those feelings are not generally in my nature it became clear that I needed help. My daughter needed so much of me; she didn’t sleep well and breastfed constantly. After months of being severely sleep deprived combined with my desire to do every part of motherhood “perfectly”, I was out of gas and I was barely holding on.

We had moved to Squamish in the cold grey dreary season, and I only knew a few of my husband’s friends, none of whom had young babies and so I became quite isolated in my own home. I had extremely high expectations of myself as mother. I had always had perfectionist tendencies and was used to being a highly functioning, independent and successful woman. And then this baby that I wanted so badly arrived and brought me to my knees. I didn’t cry a lot, instead I felt numb and hostile. It’s painful to even write those words in reference to my experience as a mother. “Numb” and “hostile” were not what I was supposed to be feeling. I was so fortunate to have friends in the birth community to talk to and connect with online. Still, it took me a long time to take the first step in asking for help because I was so ashamed. How could I, a birth professional, be “failing” at motherhood?! I felt like a fraud. I know now how distorted that thinking was, but at the time those feelings of shame were all encompassing. There were many factors that contributed to my postpartum depression… I had no family or friends living close by and being on mat-leave caused financial stress. My perfectionist tendencies came up full force and I felt unable to meet my own expectations. I was overwhelmed and extremely sleep deprived.

Just as there were many pieces that contributed to my PPD/A, there were also many pieces to my healing. It started with a dear friend, and just being able to say the words to her “I am suffering, I need help” felt like such a huge relief. That friend listened to me sob and gently encouraged me to reach out to our local resources as well as to call Pacific Post Partum Support Society. This friend also connected me with another woman who had come through her own struggles with PPD/A. Hearing that woman, whom I had never met, saying “you are a good mom for reaching out” and “it will get better” was like being thrown a life-line that stopped me from slowly drowning. My husband was so incredibly supportive throughout; he has, and always will, have my back. He deserves a medal for what he had to deal with.

I remember filling out the Edinburgh Postnatal Depression Scale multiple times and after handing it over there was always a pause followed by an uncomfortable speech about medication. I scored high enough and actually admitted to having intrusive thoughts so there was no denying I needed help. I say speech rather than conversation because I never spoke; I just sat and thought about my preconceived ideas about medication. Did that mean I had to stop breastfeeding? ‘Cause I sure as hell wasn’t about to take away one of the only ways I felt connected to my daughter, she needed it as much as I did. I was worried about becoming addicted and being unable to feel emotions. I didn’t have access to a doctor I trusted so eventually I consulted with my brother-in-law, who is a pharmacist, about medication and my desire to continue breastfeeding. He gave me the information I needed to then be able to have a conversation and ask the right questions once I did find a care provider I trusted. With the assistance of two of our local public health nurses, I was also connected with Squamish Mental Health and Addictions Services where started cognitive behavioral therapy.

The first call to PPPSS left me with an incredible sense of relief. They immediately sent a package of information that helped me and my husband to understand and normalize what we were going through. PPPSS also runs peer support groups and so once a week I bundled up my daughter and drove into North Vancouver for what ended up being the most effective part of my healing – being amongst other women who were at different stages of their own journey and who understood what I was going through. As they told their stories I felt so relieved that I wasn’t the only one. Eventually I was able to share my story with the group. Our group facilitator, Kerry, is a genuinely sensitive and caring woman. I remember her voice being so soothing and I felt safe with her from the very first time we met. She understood the things that many others couldn’t. Being accepted without judgment, flaws and all, by Kerry and the other women in the group gave me hope that things could get better. And it did, it got so much better that a year later we decided to have another baby, a decision that, in the midst of PPD/A, I was certain would never happen.

It took awhile for me to be able to tell my family what was going on. I had spent a lot of energy trying to convince everyone I was enjoying motherhood, though I am sure I just was trying to convince myself. I remember driving back from a peer support group and getting a latte at the drive thru. Bean was sleeping in her car seat and I sat in my car, parked away from other vehicles, staring at my phone for about ten minutes before I dialed the first set of numbers I had ever committed to memory, my parents’ phone number. I could barely speak, my throat was tight and then the tears poured out with my words. I felt helpless and all I wanted was for my own mom to come scoop me up make it all better. I don’t hear my Dad’s emotions very often, but they were both audibly shaken. Not long after that phone call, flights were booked. Bean and I went to visit family; they held me and gave me space to grieve and heal. They replenished parts of me that only they could.

A growing number of families in Squamish live here without extended family. Having loving support around after the arrival of a new baby is, in my mind, essential. Without support we are left on our own to care for a brand new human and ourselves when we were never meant to be doing this alone. We are also a community of highly driven, highly functioning, athletic, goal oriented women. Once baby arrives and we are no longer the woman we were before baby and that can be devastating.

Something else I didn’t realize was how crucial self-care is to recovering from postpartum depression. Motherhood can sometimes feel like it’s all give. Self-care is a way to replenish and re-energize ourselves. Learning to set aside five minutes every day to do something like enjoying a cup of tea while it’s still warm, listening to soothing music or soaking in a warm bath, I was able to return to my daughter with a renewed sense of myself. If we expect to give of ourselves all day as mothers we really need to replenish ourselves.

If you think you are suffering with PPD/A, the sooner you reach out for help, the sooner it will get better. You are not a bad mom. You are not alone, and it will get better.

Kimberly is a DONA certified doula and has been a member of DONA International since 2009 and is a certified Hypnobabies Hypno-Doula. Kimberly is the founder and facilitator of Après Baby, a support group for new and expecting moms in the Squamish area. More information about the group, including meeting times and dates can be found on Kimberly’s website here. Supporting new mothers with breastfeeding is of special interest to Kimberly.

What is support?

“Courage doesn’t always roar. Sometimes courage is the quiet voice at the end of the day saying, ‘I will try again tomorrow.'”    

–Mary Anne Radmacher

Support is defined as bearing all or part of the weight of, or to hold up and give assistance to. Support is crucial to recovery from postpartum depression and anxiety. From family support, weekly support groups, telephone support, and online support, there are many places to reach out and connect with others who can help during the postpartum period. If one type doesn’t feel particularly helpful, we encourage you to continue trying different areas in order to find the right support for you.

Telephone support is one of the many services offered here at Pacific Post Partum Support Society. We are so lucky to have experienced postpartum counsellors available to offer support, information, and referrals to mothers and their families. For me, this service was particularly beneficial, as I felt more comfortable sharing my thoughts and feelings over the phone, as opposed to face-to-face. It seemed to offer an anonymity that felt comforting and free of judgment. Speaking to someone who had experienced PPD/A and understood what I was going through and what I was feeling was an integral part of my recovery. I came to rely on the weekly phone calls to check-in, and looked forward to hearing the voice on the other end of the line asking how I was doing. After the birth of my daughter, I felt I had lost myself. My days, and all of my attention, were now occupied by this new baby I was responsible for. Having someone call to check-in on me, particularly while I was feeling so low and anxious, felt incredible. I also didn’t feel the need to put on my “happy face” and pretend that things were great, or were improving, when they weren’t. I could be completely honest. Please click here to read more information about this service, as well as our contact numbers and hours of operation.

One question that frequently comes up is how to handle support that is not wanted or not helpful. Well-meaning friends and family may try many things to help during this time. PPPSS offers many services for supporters – please click here to access these. These are great resources for people who want to help but aren’t sure how. I wrote a previous post in September 2014 about the support I received during my PPD/A from family and friends. For me, when I was at my worst I was not able to figure out or voice what kind of support I needed, therefore it was important that my husband was able to speak on my behalf and communicate with others about what was and wasn’t helpful. When trying to adjust to life with a new baby while also dealing with PPD/A, it can be difficult, if not impossible, to recognize exactly what help you need. For this, a friend, family member, Doctor, counsellor, any advocate whatsoever is particularly helpful.

To read previous posts regarding support, please click on the links below:

Online support

PPPSS Telephone Support

Support from family and friends

The Mother Load

Image by https://www.flickr.com/photos/girlontheles/

Image by https://www.flickr.com/photos/girlontheles/

CBC Doc Zone recently aired a documentary called The Motherload. While it doesn’t deal directly with postpartum depression and anxiety, it does take a long hard look at the context within which North American women are working as mothers. It focuses on mothers who are also working outside the home and shines a light on the intense pressures that come from juggling family and career. Watching the documentary is extremely enlightening when it comes to pinpointing the environmental factors that can contribute to PPD/A. For instance, it’s obvious that the women in the documentary are suffering from an extreme lack of self-care, sleep deprivation, and the negative effects of the Good Mother Myth (what the documentary makers call the Mommy Mystique). The documentary is well worth a watch for those wanting to learn more about where things need to change in order for parents to be healthy and maintain balance in their lives.

If you’re in Canada you can view the entire documentary here:

http://www.cbc.ca/doczone/episodes/motherload

Self care over the holidays

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By Andrea Paterson

I remember Christmas as a child as a time of extraordinary magic. Even now when the lights go up and the carols begin I experience an almost unbearable excitement. I also see that the magic associated with the holidays has hard working magicians behind it. Parents, and often mothers in particular, have a heavy burden to bear during the holiday season. Creating a winter wonderland is no easy task and being faced with a laundry list of chores, visits, decorating, hosting, cooking, gift wrapping, shopping, and weaving the mystery and mythology that makes the holidays special for our children can take a serious toll. For those parents who are suffering from postpartum depression and anxiety the holidays can be downright daunting.

Self care is a key component of the healing process promoted by the Pacific Post Partum Support Society, and during the holidays it is especially important to return to some basic self care practices to get you through. Here are some tips for making it through the season in one piece, and perhaps even getting a chance to enjoy it!

  1. My group facilitator at PPPSS, Shealagh, gave us some simple but profound advice when it came to event planning—Plan the event but not the outcome. I have tried to make this a personal mantra. We often get caught up in our expectations. We want to see the joy on someone’s face when they open our gift; we want our family dinners to be a perfect scene of domestic bliss; we want to host a party that people remember for years to come. But in reality we can’t control the outcome of our carefully laid plans. Things go wrong, plans change at the last minute, and sometimes things go better than expected. The key thing is to let go of our expectations, make the best plans we can, hope for the best and then let what happens happen. It’s an exercise in mindfulness where the goal is to take what comes in the moment for what it is, without judgement, and without comparing to an imagined ideal. It’s an excellent practice for the holidays.
  2. Don’t expect people to read your mind. We want our friends, family, and partners to know exactly what we need or want in any given moment. We expect partners especially to be able to pick out a perfect gift and know what to do to make the holidays special for us. The problem is that it can set us up for disappointment when they, in fact, have no idea what will make us happy. It’s not always realistic to expect a partner or other family member to know what we want or need the most, so as part of your self care practice you can try outright telling them! Try picking one thing that would really make your holiday special. Maybe it’s having a family snow shoe outing. Maybe its getting a particular gift, or finding time to watch a treasured holiday movie. Whatever it is, just ask for it and then enjoy it thoroughly without being resentful that you had to spell it out. Our loved ones aren’t mind readers, as much as we wish they were.
  3. Be sure to take some time out to be alone and enjoy the aspects of the holidays that are most wondrous for you. I make sure to head out to the craft fairs and Christmas markets (without my child!) every year. Go somewhere alone. Sit in a coffee shop with some apple cider and a book. The holidays are busy and frequently overscheduled. Make sure you schedule in some alone time to rest and recharge. Even if its just having a bath or getting into bed early.
  4. If you’re beyond the bulk of your postpartum issues, remember that the holidays may be a trigger for old symptoms and habits. Watch for signs of anxiety or faltering mood. Be ready to pick up the old self care techniques that worked best for you in the midst of your postpartum journey. Try making a list of your top five self care practices and post it somewhere so you have a plan in place if things start to slide.
  5. Set limits. You don’t have to do it all. Your partner can probably bake some of the cookies. You can probably get away with fewer decorations, fewer gifts, and fewer outings. This year I want to think very carefully about what is essential to the enjoyment of the holidays and be careful not to overdo it.
  6. Don’t be afraid to let some darkness in. My final tip is about the inevitability of darkness during the holidays. As we approach the darkest day of the year and all the associated festivities I like to remember that its normal for some emotional darkness to emerge as well. The holidays are a deeply emotional time and for many people loneliness, grief, loss, and isolation are a reality. It’s okay to mourn over the holidays. It’s okay to be sad, it’s okay to revisit past griefs and invite in the pain that comes with being apart from those we love. The darkness of winter feels like the right time, symbolically, to nurse those griefs. They can be a part of your holiday ritual and just as we light fires in our hearths to chase away the winter chill, its a good time of year to return to the self care practices that will light a fire in your heart to make the darkness bearable. Share with friends you trust, write in your journal, honour whatever darkness comes and let it exist next to the joy.