Tag Archives: Meri Levy

Postpartum Depression

Risk Factors, Symptoms, and What To Do

Take a Screening Test for PPD

The Baby Blues has become as much an accepted part of being a new mother as engorged breasts and sleep deprivation. But what if the Blues don’t go away? For 10-20% of new mothers, Postpartum Depression (PPD) is an unwanted and difficult part of the first year of motherhood. The causes of PPD are many, and can include hormonal and lifestyle changes, a lack of social support, sleep deprivation, a high-risk pregnancy, a traumatic birth or difficult recovery, or breastfeeding problems. You are also at a higher risk of PPD if you have suffered previously from depression, or have recent losses or trauma in your life. Symptoms of PPD and related disorders can include:

  • Feeling sad, depressed, numb, or crying a lot
  • Restlessness or irritability
  • Unusually strong feelings of anger or resentment
  • Lack of energy
  • Having headaches, chest pains, heart palpitations, numbness, tingling, dizziness or nausea, hyperventilation or other unexplained physical symptoms
  • Difficulty sleeping or excessive tiredness
  • Loss of appetite or conversely, overeating and weight gain
  • Difficulty concentrating, remembering, and making decisions, or confusion
  • Excessive worry about the baby or lack of interest in the baby
  • Feelings of guilt and worthlessness
  • Lack of interest or pleasure in activities
  • Obsessive thoughts or compulsive behaviors
  • Fear of hurting the baby or yourself

Many mothers experience only a few of these symptoms, but if you feel like something is wrong and you’re not quite yourself, that is an important signal. If these symptoms persist for two weeks or more, the mother should promptly get support by talking to her doctor or a mental health professional. PPD is a highly treatable condition, with therapy, medication, or a combination of the two.

If you need medication and you are told that you must give up breastfeeding, make sure you get the advice of a psychiatrist who is knowledgeable about medications for breastfeeding mothers. There are a few antidepressants which are routinely prescribed for breastfeeding mothers with untraceable amounts detectable in the baby’s bloodstream. Moreover, breastfeeding can be beneficial both for the depressed mother, the long-term health of her baby, and bonding, which is even more challenging when a mother is depressed.

Depression not only affects you: it affects your relationships with your partner and your baby. Untreated, depression can lead to bonding difficulties and delayed development or failure to thrive. Getting the help you need to recover quickly is the best thing you can do for your baby and yourself.

Most importantly, tell your support people (your family, friends, partner) how you are feeling. The burden of trying to seem happy and “keeping it all together” can make the depression worse. You need to lean on the people who care about you, get as much help as you need until you’re back to feeling like yourself, and don’t beat yourself up for having PPD. It is NOT YOUR FAULT.

Commitment and Kids

Why the Couple Relationship Is So Important When You Are Parents

baby shoesWhat is it exactly that makes a committed relationship work, after kids come into the picture? It’s maintaining a loving and safe connection that  allows new parents to weather the storms of raising kids with their relationship intact.

If you want to maintain a good marriage, your relationship with your partner has to come first. Most of us have to work to earn a living, and some of us even enjoy our work. And we all have to take good care of our children. But if your partner always comes last, even a good relationship may fail, which will impact both your children and your financial future. A committed partnership takes love, commitment and hard work, and it’s a rare one that can stand many years of neglect.

Most of us want to be the best parents we can. But we don’t always remember that keeping our relationship happy is one of the most important things we can do for our children’s well-being. This means finding a way to spend time together away from the kids, as well as doing things together as a family. It also means keeping your sex life alive and kicking, whatever that takes. And it means working through your relationship difficulties and finding a way to connect and create time for your relationship despite whatever else is going on. It also requires that you accept your partner as a human being and a parent, as imperfect as they may be. Studies show that children fare much better in a family in which the parents’ relationship is solid, even if the parents do an imperfect job.

Communication is crucial. In the short run, it is always easier to bury resentments and avoid conflict. But in the long run, resentments build up and fester – killing intimacy and poisoning your sexual relationship. Learning how to communicate clearly and connect on an emotional level while remaining responsible for your own feelings and reactions can save your relationship.

For example, if your partner spends time caring for the baby and you’re annoyed that you find him sitting in front of the TV watching football, take a minute to think about how you want to respond. Angrily attacking him for not being engaged with the baby will only drive a wedge between you. On the other hand, biting your lip may be even worse, if it will lead to you feeling resentful and unloving toward your mate. If, after letting yourself cool down, you find that you are still resentful about it, one way to start a conversation is by saying something like: “I know you have had a hard day and you enjoy watching football to unwind. And your time with the baby is yours, so I don’t want to tell you how to do it. But I can’t help feeling resentful, after spending the day entertaining and caring for the baby, when I see you watching TV rather than playing with her.”

It may be that this discussion will involve some conflict, and your partner may express anger. But he also might acknowledge that he is at a loss for how to interact with the baby, or that he feels inadequate or inexperienced with parenting a baby. And you might express your concerns about exposing the baby to TV, and your desire for both of you to be good parents, while acknowledging that a football game probably won’t ruin your child for life.

After such a discussion, you might find that you don’t feel angry anymore. You may understand where your partner is coming from and recognize that the baby will survive some football-watching with Dad. Or, the discussing may spark the idea of giving Dad more time with the baby to improve his confidence. But either way, your feelings of resentment will be less if you work through the issues and understand each others’ feelings.

This is not to say that there are never times when it pays to let something go rather than discussing it with your partner. But the important question to ask yourself is: “will I truly be able to let this go?” If the answer is no, then you have to talk about it, preferably when you are both feeling calm, so you can move past the feelings of resentment and reconnect with your partner.

Remember that there is no intimate relationship that can remain loving without dealing with some conflict. Expressing feelings in a sensitive way is how you grow closer and resolve difficult situations. If you find that these discussions are unproductive, get the help of a qualified couples’ counselor sooner rather than later, so there is enough good will between the two of you to work on making the relationship better.

Often, the issues that keep coming up between you two mask fears and anxieties about the safety and security of your relationship. Reestablishing that bond can make all the difference in resolving the little conflicts that arise and maintaining a strong, healthy bond with your mate.

Co-Parenting With a Partner

The First Year Can Be Rough, by Meri Levy, MFT

family twinsIf you’re like me, I really thought that, despite my decision to breastfeed, my husband was so gung ho about being a Dad that we would share the parenting responsibilities pretty equally once our first child was born. I was in for a rude awakening. Breastfeeding meant that much of the time I was literally attached to my new baby, and when I was not, I had an easier time calming him than my husband did. And even when I didn’t, I couldn’t stand to have my husband trying to comfort our fussy baby without stepping in and trying to help. Whether due to biology or psychology, I was so attached to my new baby that I couldn’t tear myself away long enough to really get a break. As a result, I became more comfortable in the baby care role, and he became less.

There are many reasons why fathers often take a backseat in the early days with a new baby. Whether because of a hormonally-afflicted “helicopter” Mom, an inexperienced Dad, a baby who is more easily calmed by the mother, or gender-related attitudes about who does what, newborn care often falls disproportionately to the mother. And since Mom is generally recovering from childbirth, likely adjusting to breastfeeding, undoubtedly sleep deprived, and in the throes of huge hormonal changes, this disproportionate share can become a BIG PROBLEM. You know that saying that “if Mom isn’t happy, nobody is happy?” I think the truth of that statement is widely underestimated.

So, we’ve got a Mom who can’t let go to allow her partner to care for the baby, a Dad who is either mildly incompetent or feels he is (or is being treated like he is), a baby who’s getting used to being cared for by Mom, and a Mom who is at the end of her rope and feels like she just can’t get a break (and is not sure she would take one if she could). Not a recipe for a happy family.

Negotiating who does what, recognizing the barriers to fairly allocating parenting and household responsibility and actually making and carrying out a plan to address those barriers and create a cooperative, supportive and fair allocation of workload is one of the major tasks of the first year of parenthood. Working out a plan for who does what, figuring out how to set goals for change if change is needed, and implementing those changes, can make a world of difference.

I once read a study (and I don’t have a citation, but I like to believe that it is true) that claimed that of all the factors that might predict the well-being of children as they grow up (e.g. praise, affection, discipline, structure, etc.), the one variable that is most predictive of a child’s future well-being is the degree to which his or her parents have a cooperative relationship around parenting. So, if that is true, it matters less who does what (or if it is done correctly), and it matters more that parents are supportive of each other as parents and partners.

Becoming a Parent to Your Newborn

By Meri Levy, MFT

Regardless of your expectations, the arrival of a first baby is, first and foremost, a radical role adjustment for the new mother and father. As you grow from being a child to an adult and into a partner in an adult relationship, most of us experience shifts in our relationships as daughters or sons, sisters or brothers, and friends or lovers.

But the birth of a baby changes everything! Now perhaps your most significant role in life is as a parent. This is an altogether new role, and babysitting experience aside, there is no real preparation for it. But it is truly amazing to see how our babies foster and nourish our growth as parents, almost from the beginning.

While you adapt and grow to fill your new role, it can be difficult at times to hold onto formerly cherished roles, as a professional, a friend or lover, and an independent person in your own right. You may find that you are redefining yourself in ways that make these roles change (e.g. leaving behind a career, changing roles in your marriage, etc.)

Ultimately, however, we are ourselves. While we adapt to our role as parents, we also must adapt our view of parenting to include who we are as individuals — to allow ourselves to fit into our vision of a good parent.

Some mothers plan to stay at home full-time, but must still figure out if staying at home with their new baby is what makes them a happy mom. Or conversely, working mothers may find that they cannot leave their baby in another’s care. For fathers, you may have expected yourself to be the provider, but you still must figure out if spending the weekend satisfying that picky client at home is how you want to be a father — or if your partner is even the better choice as the bread-winner! And parents must weigh all sorts of other priorities, to friends, yourself, and the world, in figuring out how you will incorporate being a parent into your life.

No one can do this for you, because you are as unique a person as your new baby, and uniquely qualified to create the best family for your child.

If the process of evolving into the parent you want to be is more challenging that you thought, working with a therapist who specializes in this transition is a good way to work through your competing goals and figure out the path that is right for you.

Nurturing the Nurturer

By Meri Levy, MFT

Taking Care of Yourself as a New Parent

As parents, our job is never-ending. For the next 18-21 years, you are either “on duty” or “on call” 24/7. Strangely, while this never-ending job doesn’t necessarily get easier with time, it often seems less like “work” as our children (and we) mature, and more like “life.”

But it is easy, as we grow into our role as caretakers of our children, to forget another important person who relies upon our care – ourself. We all make this mistake sometimes. If you don’t make sure that your own nutritional, health, emotional, and spiritual needs are met, who do you think will? It has been my experience that the answer is “no one.” As much as our partners may want to attend to our needs, they cannot do it for us. No one but you really knows what it is you need, and many of the things that fulfill us as human beings cannot be done for us.

No one but you can make sure that you eat a balanced diet, get regular exercise, indulge in treasured hobbies or activities, get needed downtime, or connect with beloved friends and family.

How important is it to make sure that your own needs are met? Only you can say. One mom might be able to tandem-nurse twins and a toddler while home-schooling her older two children and never see a movie or have dinner out for five years. And be perfectly content. Another might feel burdened and overwhelmed if she doesn’t have lunch with a friend or enjoy a leisurely uninterrupted bath weekly. Or maybe you need an hour every day to drink a cup of tea and read the paper or a good book. You are the only person who can say when your engine’s running low on gas, and what it takes to fill it up.

And it doesn’t help to feel guilty about what you need to do to take care of yourself. If your child needed a nap long after his peers had given it up, would you tell him to “tough it out” and be grumpy for half the day? No, you would do whatever you could to arrange things so that he could get his nap. You deserve the same recognition for your unique temperament and needs.

And you don’t do anyone any favors if you let yourself run on empty for too long. No one wins if you allow yourself to run out of gas on the side of the road. And everyone is affected when you are running low, not just you. You don’t make it to the finish line any faster if you never slow down and take it easy.

This is your life. And raising children is a path, not a destination. You cannot travel the path with joy and stamina without giving yourself the same care you give your children. So take some time this week and plan a couple of activities you can do that will help “fill up your tank.”

Bonding With Your Baby

The Importance of Attachment to Your Newborn, by Meri Levy, MFT.

Most new mothers face a number of fears as they look forward to welcoming their first child. Will they be “ready” when the baby comes? Will they have everything they need? Will the birth go smoothly, without too much pain? Will the baby be healthy? Will they know how to care for their new child?

But the process of bonding with a new baby is rarely considered. Of course you will love your new baby. Of course you will feel attached, and be able to relate to your own flesh and blood.

What is bonding?

Bonding is the process of attachment which, when everything goes smoothly, creates a symbiotic relationship between mother and baby. The mother feels a loving bond with her baby and feels capable of meeting her baby’s needs. The mother’s hormones (aided by breastfeeding in the best case), combined with the babies reflexive response to soothing by the mother, help the two form a positive attachment. Add in a good dose of mother/infant physical and eye contact and the bond between mother and baby are virtually guaranteed, in the absence of other barriers.

What can cause bonding difficulties?

Sometimes the process of bonding doesn’t go as smoothly as expected. There are many factors that can contribute to a new mom having difficulty bonding with her baby. Among others, these include:

  • A traumatic birth experience and/or a difficult recovery
  • A colicky or fussy baby who is difficult to care for or soothe
  • Feeding difficulties
  • Separation from the baby associated with medical interventions
  • A lack of support for the new mother, causing feelings of being overwhelmed or unable to cope.
  • Perinatal depression or anxiety, which can also be correlated with the other factors

Sometimes, a combination of these or other variables can cause a new mom to feel disconnected from her baby. She may feel unable to calm her baby, like the baby isn’t really “hers,” or that she is a bad mother.

Early intervention in the case of bonding difficulties can have a dramatic effect on the well-being of both the baby and the mother. Prolonged failure to bond can be associated with attachment-related mental health problems in the developing child, as well as a sense of failure by the mother. Getting help early on to recover physically and mentally from birth, addressing feeding and calming difficulties, maintaining close physical contact between the baby and mother, and addressing other barriers to bonding can have a huge impact on the lifelong relationship between mother and child.