PPPSS News & Events

Growing Your Family After Postpartum Depression and Anxiety

By Kelley Allen

My husband and I have started talking about whether or not to have a second child. I have to believe that it’s a hard choice for any parent given the work involved in raising more than one human being at a time. With or without postpartum depression and anxiety, parenting is tough. The biggest fear coming up for both of us is postpartum depression. After being hit so hard in the year after our daughter was born, we are both terrified of experiencing it again. I wonder if I could survive it again. I wonder who would take care of our daughter and also a new baby if I were not well enough to do it. We don’t have any family nearby to help. My husband did the lion’s share of the work during my hardest time last year and the thought of him having to do it again, with two children in addition to a full-time stressful job, is almost too much for me to bear.

 

When we first started talking about it, he said he wasn’t sure if he could see me go through it again and didn’t want to have another child. At first, I was angry with him for this reaction. We had always talked about having two children and I felt he was setting me up for guilt with whatever decision we chose – guilt at only being able to have one child because of my PPD/A, as well as guilt if I do experience it again after having a second child. But I know that wasn’t his intention and we have continued to talk about it since. I now see that he was placing more value on me and my mental health than the possibility of another baby.

 

I know there are things I would do differently regarding prevention and support if we were to have another child. But I have to be realistic about my increased risk of PPD having already had it once, as well as a history of depression. My experience is still so raw. So the questions I ask myself are “Does this fear ever go away? At what point will we know whether or not we should try to have another child?”

 

For some reason seeing mothers with more than one child during my PPD/A was the hardest. The thoughts going through my head included “I don’t have what it takes to be a mother.” “Why would you ever do this again?” “Why am I not enjoying this enough (or why am I not good enough) to WANT to do this again?”

 

I have met a lot of other parents through my experience who have decided that the experience and risk of PPD/A is too high. A decision to care for a mother’s mental health is very rarely discussed. Finding women who have decided that one child is enough, whatever the reason, is rare, but there are stories out there. I recently came across a post here of a mother talking about this decision for her and her family. I fear there is a sense in today’s world that having only one child is bad. My husband and I have certainly heard our fair share of “When are you having your second?” or “Your daughter needs a sibling.” There is no right number of children to have. Every family is different. Every child is different.

 

For us, we recently met with a reproductive psychiatrist who spoke about prevention with regards to medication and therapy. She spoke of the risk of recurrence, about patterns repeating themselves. I feel “recovered” to a certain degree and now have some distance from the worst part of my PPD/A, however hearing this from her spiked my anxiety. I keep trying to remind myself to expect the worst, but hope for the best. She also spoke a lot about how everything is manageable. It may happen again, but it can be managed and we will get through it. My concern with this is how will we get through it with a very aware 3-year-old? How do we continue to parent her while going through it again?

 

We get help. If it happens, we get help.

 

We are to the point of thinking we will try again. And here’s why – what we went through will always be worth it because of what we came out with – our daughter. We can’t remember life without her, and I didn’t understand the concept of unconditional love before I became a mother. I am certain this would be the case with another child, if we have another one. With that being said, I also know that our life is quite full as it is now. We have an amazing daughter and we are all together and healthy. We aren’t going to try again because we feel pressure to have another, or because we think having only one child is bad. It is because we want to and it feels right for our family. I have many days where I worry that I am risking my mental health and the health of our family by trying again. But for us, after a lot of time and a lot of discussion, it is a risk we are going to take.

 

With that being said, I can not emphasize enough how important it is to really look at how you are feeling, what you want long-term, and what kind of prevention and support you have in place. This decision isn’t about what other people think or are telling you to do. It is you and your family’s decision. It has taken me nearly 3 years to get to the point of even considering the possibility of it. So if you’re not there yet, or you decide not to, accept that it is okay. You are important enough and know yourself and what you can handle best. Work to take care of your family, whether it be one child or ten, and work to take care of yourself.

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