Tag Archives: new mom

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.

Returning to Work After Parental Leave

By Meri Levy, MFT

Regardless of what you decided about working after the birth of your baby, facing the reality of going back to work or staying at home once the baby is born can be a very stressful time. Many moms, even those who were certain that they wanted to return to work after their maternity leave, have very conflicting feelings about the reality of returning to work. And some moms who always planned on staying home after having children face unexpected emotional challenges in facing the reality of looking toward a future at home full-time with their child.

What is hard to anticipate when considering the decision to work or stay at home before the baby is born is how big a loss either decision represents. For moms returning to work, it is common to feel:

  • An enormous sense of loss associated with leaving your baby in another’s care
  • A concern that her child will be irreparably harmed by the separation from you
  • Anxiety about being away from your baby and having your baby’s care outside of your control
  • An unexpectedly strong desire to quit your job and stay home with your baby
  • Guilt associated with having a desire to return to work or resentment at having to go back to work
  • A feeling that you must rush through your workday to return to your baby as quickly as possible, for fear your baby will forget you, or you will miss important moments.

For moms choosing to stay at home, it is common to feel:

  • An unexpected sense of loss associated with no longer receiving the validation of purpose that is so often gained by outside work and receiving a paycheck
  • A sense of vulnerability associated with being dependent upon their partner’s income
  • Guilt associated with conflicting feelings about leaving the work world
  • Boredom with the tasks of mothering and loneliness, especially in the early months before the baby becomes more interactive and you find activities you enjoy with your baby
  • Loneliness and isolation associated with being at home with a small baby, especially before you connect with other new mothers at home with their babies.

These feelings can be very confusing, and new moms often struggle with the decision regardless of what their prior plans were. As a new mom, your entire world has changed, your priorities have shifted, and your now occupies a huge place in your heart. It can be a struggle to align the new role of motherhood with the values you previously held. Many moms change course and decide to stay home despite having planned to return to work, or choose to go back to work full or part-time despite planning to remain at home. Financial considerations play a big role in this decision, as does the developing relationship with your baby, your own clarification of your needs and wants, and your relationship with your partner.

Many mothers seek therapy during this time. Getting help to clarify your feelings about returning to work, exploring alternative work arrangements or more flexible careers, and getting validation for your choices can make this difficult time of transition go smoother. Whether you ultimately decide to stay at home for now or return to work, making decisions from a place of self-compassion, and understanding that there is no one “right” answer can allow you the freedom to honor who you are and who you are becoming.

For New Moms: When You’re “Just Not Yourself”

By Meri Levy, MFT

canstockphoto14016122Being a new mother should be a joyous time in your life. But what if you’re not feeling like yourself after having a baby? About 10-15% or of new moms experience postpartum depression, which can begin any time during the first year after childbirth. Depression is a treatable illness that causes feelings of sadness, indifference, and/or anxiety.

Postpartum depression (PPD) is different from the “baby blues.” A majority of new mothers experience the “baby blues,” a period of sadness that isn’t debilitating and passes quickly. Symptoms of the “baby blues” include tearfulness, irritability, restlessness, and anxiety. But when symptoms of sadness, irritability or anxiety continue for more than two weeks or make it difficult to care for your baby, there is more going on and it’s time to reach out for help.

Symptoms of PPD include:

  • Fatigue or lethargy
  • Feeling sad, hopeless, helpless, or worthless
  • Trouble sleeping/sleeping too much
  • Loss of appetite/increased appetite
  • Difficulty concentrating/confusion
  • Crying for no apparent reason
  • Lack of interest in the baby
  • Fear of harming the baby or oneself

Symptoms can vary in severity, but persistent depression often causes new moms feel isolated, guilty, or ashamed.

You should tell your doctor if you have several of these symptoms for more than two weeks; if you have thoughts of suicide or thoughts of harming your child; depressed feelings are getting worse; or you are having trouble caring for your baby or yourself.

Depression is an illness. It is not a sign of weakness or of being a bad mother. It can be treated successfully, and getting help is the best thing you can do for your baby.

Risk Factors for PPD

Any new mom can develop PPD. Its causes may include hormonal and other physical changes, sleep disturbance, emotional adjustments and chronic stress. However, women are at increased risk of depression if they have a personal or family history of depression, if they are have experienced particularly stressful life events such as significant losses, a high-risk pregnancy or traumatic birth, or if they don’t have adequate support from family and friends.

Other Postpartum Conditions:

Postpartum Anxiety and Obsessive Compulsive Disorder
Many new moms experience anxiety rather than sadness after giving birth. Anxiety, panic attacks, irrational fears or intrusive thoughts, or images can be associated with Postpartum Anxiety or Obsessive Compulsive Disorder. Symptoms of a panic attack can include a racing heartbeat, unusual physical symptoms, a sense of impending doom, the feeling that you are dying, dizziness or nausea.

Posttraumatic Stress Disorder after Childbirth
New mothers can also develop post-traumatic stress disorder (PTSD) following a traumatic childbirth experience. PTSD involves reexperiencing the trauma through flashbacks or nightmares, having difficulty sleeping, and feeling detached or estranged from friends and loved ones.

Postpartum Psychosis
Postpartum psychosis is extremely rare but also very serious. It affects only two out of every 1,000 new moms. The symptoms are severe and may include insomnia, agitation, hallucinations, and extreme paranoia or suspiciousness. Postpartum psychosis is a serious medical emergency and requires immediate attention.

Treatment for Postpartum Disorders is Effective

If you believe you are suffering from a postpartum disorder, the first step is to talk to your doctor or mental health provider.

You should be evaluated by your doctor to rule out a medical cause that can contribute to depression.

Psychotherapy, medication or a combination of the two may be needed to get you back to feeling like yourself. But you must continue treatment even after you begin to feel better, because discontinuing treatment too soon can cause symptoms to recur.

The support of family and friends is also instrumental to your recovery. In addition, joining a support group for postpartum disorders can help overcome feelings of isolation, increase coping skills and provide social support.

Getting help is the most important step you can take for yourself and your baby. Untreated maternal depression is associated with developmental delays in babies, as well as potentially serious emotional consequences for your growing child.

How Partners Can Help

New moms suffering from Pospartum Depression and Anxiety need the support of their partner, as well as friends and family. Help with baby care and household responsibilities, provide an ear to listen or a shoulder to cry on, and be patient and understanding with her struggles. And make sure she gets help.

Partners also need to take care of themselves. Having a new baby is hard for partners too. And if the mother is depressed, you are dealing with two major stressors. Partners can also suffer from Postpartum Depression, a often undiagnosed problem.

How to help a partner suffering from a postpartum disorder:

  • Encourage her to talk about how she is feeling. Listen without judging her. Instead of trying to fix the problems, just be there for her to lean on.
  • Offer help around the house. Chip in with the housework and childcare responsibilities. Don’t wait for her to ask!
  • Make sure she takes time for herself. Rest and relaxation are important. Encourage her to take breaks, hire a babysitter, or schedule some date nights.
  • Be patient if she’s not ready for sex. Depression affects sex drive, so it may be a while before she’s in the mood. Offer her physical affection, but don’t push if she’s not ready for sex. She will recover in time!
  • Go for walks with her. Getting exercise and sunshine can make a big dent in depression, but it’s hard to get motivated when you’re depressed. Help her by making walks a daily ritual for the two of you.

If you’re not sure if you have PPD, complete the Edinburgh Postnatal Depression Scale. It is a fairly accurate way of determine if your symptoms are normal or may require treatment.

I offer a support group In my Lafayette Office for mothers suffering from perinatal anxiety and depression. You can download a flier for the group here.

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.