Post-partum depression (PPD) takes the joy away from what should be one of the most joyful life experiences… the arrival of a new baby. If you suffer from PPD there are steps you can take to hasten your recovery.
1. See your doctor
If you suspect you may be suffering with postpartum depression (PPD), the first step on your road to recovery is to have a chat with your doctor. He/she will take a thorough medical history and provide a physical examination, which may include some blood tests. If appropriate, he/she may also recommend the use of antidepressant medications and/or offer referral to counseling or support services in your local area.
Seeing your doctor is very important because there are several medical conditions which may result in a depressed mood or symptoms of anxiety and these include...
- Endocrine disorders (e.g. hyper/hypothyroidism)
- Autoimmune disorders (e.g. lupus, rheumatoid arthritis)
- Infections (e.g. hepatitis, mononucleosis, HIV Disease, AIDS)
- Certain cancers
- Anemia (e.g. iron deficiency anemia, pernicious anemia)
There are also several psychological disorders that can either first appear or become worse in the postpartum period. These include...
- Post traumatic anxiety disorders and panic attacks
- Obsessive/compulsive disorders
It would be a real pity to struggle through each day mistakenly believing your symptoms are due to depression when in reality they were due to a medical condition that could be treated.
2. Watch what you eat and drink
Poor nutrition is extremely common in people who are depressed. Inappropriate food choices may deplete your energy reserves, adding to feelings of fatigue, agitation, impatience, poor concentration and poor impulse control. Eating poorly can also further lower your self esteem, in doing what you know you shouldn't.
Your need for adequate nutrition is great during the postpartum period, especially if you are breastfeeding. Not only is nutritious food needed for our physical health, scientists have proven that what we eat can affect chemicals in our brain, called neurotransmitters, which in turn affect our mood.
A large percentage of the population is unaware that their mood and feelings of well being could be the result of common nutritional deficiencies. These can be corrected or avoided by making changes to your diet.
- Iron deficiency - Iron is found in red meat, liver, raisins, spinach, broccoli, egg yolks and iron fortified breakfast cereals.
- Folic acid deficiency - Folic acid is found in beans, peanut butter, oatmeal, mushrooms, broccoli, spinach, asparagus, red meat and liver.
- Vitamin B12 deficiency - Vitamin B12 is found in fish, milk and milk products, eggs, red meat, poultry and fortified breakfast cereals.
- Selenium deficiency - Selenium is found in tuna, swordfish, sunflower seeds, whole-grain cereals, and Brazil nuts.
Eat protein rich foods
Protein foods are broken down into amino acids during digestion. One amino acid called tyrosine increases the production of different neurotransmitters, such as norepinephine, epinephrine and dopamine. These neurotransmitters are known to increase levels of alertness and energy. (See antidepressant medications for more on the importance of neurotransmitters.)
Protein rich foods include: fish, chicken, meat, eggs, legumes, cheese, milk, yogurt and tofu.
Limit sugary foods
Limit your intake of foods such as sweets, cookies, cakes, donuts, ice-cream and sugary beverages such as sodas (soft drinks) and fruit juices. These can cause rapid swings in your blood sugar levels which can mimic or trigger panic attacks. If you absolutely must have that sugary treat, have it at the end of a meal rather than a snack by itself, as this will help protect you against rapid fluctuations in blood sugar levels.
Eat complex carbohydrates
Complex carbohydrates (as opposed to sugary foods) maintain blood sugar levels on a more even keel, providing a more enduring source of energy. Foods high in complex carbohydrates include; whole grain breads and cereals, pasta, rice, fruit and vegetables.
Eating smaller more frequent meals can help to maintain your blood sugar levels and energy source. Every 2 - 3 hours stop for a meal or a snack.
Drink plenty of water
Water plays a vital role in maintaining body functions. Fluid makes up an astonishing 66% of our body weight. Even relatively small fluid loss can cause physical symptoms such as headaches, dizziness, tiredness and confusion. The average person requires a minimum of eight to ten 8-ounce (250ml) glasses of water per day. Drinking plenty of water is good but don't go overboard; it is possible to drink too much water. Drinking excessive amounts of water can upset your electrolyte balance, depleting your body of essential salts.
Caffeine is a stimulant. Foods containing caffeine include; coffee, tea, colas, caffeinated sports/energy drinks and chocolate.
Where depression is mild, caffeine in low amounts can be an effective antidepressant. There is evidence which supports the safety of drinking 1 - 2 cups of coffee a day. More than that, however, can have unfavorable effects in some people. High levels of caffeine (over 4 cups per day) may trigger anxiety attacks and contribute to insomnia (difficulty sleeping), making symptoms of depression worse.
Alcohol is a brain depressant which may further add to feelings of depression. It also causes sleep disturbances. Contrary to popular belief alcohol does not aid breastfeeding. Babies don't like the taste of alcohol in breast milk and tend to nurse less often and gain less weight.
3. Exercise regularly
Exercise is not only good for your body it is also good for your mind. Regular physical activity has countless benefits including improved mood, increased self-esteem, reduction in anxiety levels, increased ability to handle stress, and improved sleep patterns, not to mention the many other benefits of improving your physical health.
Studies have shown that in many situations regular exercise is as effective as counseling and psychotherapy and antidepressant medications in treating mild to moderate depression. Exercising regularly may enhance the effectiveness of these therapies in the treatment of moderate to severe depression.
You don't need to run a marathon, even 10 minutes of brisk walking with your baby each day can be beneficial. If it's been a while since your have exercised, start out small, you will be surprised at how quickly your stamina builds. Aim to build up to at least 30 minutes or more of moderate physical activity most days of the week. Many gymnasiums offer child minding facilities.
4. Rest when you can
The majority of women with PPD suffer from chronic sleep deprivation. Difficulty sleeping and staying asleep even when your baby is sleeping is a classic sign of PPD. Unfortunately sleep deprivation also increases the risk of PPD developing, so it can become a vicious cycle. Common symptoms of sleep deprivation include exhaustion, fatigue and lack of physical energy.
Your brain relies on sleep to function effectively. Sleep gives your body time to rebuild damaged tissues and replenish neurotransmitters like dopamine, which affects your mood and level of alertness. Insufficient sleep interferes with your ability to control speech, access memory and solve problems.
Rest when your baby sleeps
Even if you find you can't sleep, rest when your baby sleeps. It can be difficult for some women who are perfectionists to not feel guilty "wasting time" sleeping when they could be doing something. You will provide a greater service to your baby by taking care of yourself than by maintaining a spotless home.
Establish your own bed time routine
Although there is much to do in caring for a new baby, you cannot expect to settle quickly into a good night's sleep if you are rushing around directly before going to bed. Just as a bed time routine can assist your baby transcend into sleep so it can for you. Plan your day so that you have a wind-down period close to bed time. This may include a deep relaxing bath, warm milk, a few pages of a good book or listening to relaxing music.
Encourage your baby to settle to sleep independently
You cannot continue to provide a high level of care for your baby if your own needs for sleep continue to go unmet. If your baby is waking during the night more often than would be considered 'normal' for his age, then encouraging independent sleep habits may assist him to sleep longer periods, without waking you as frequently through the night. This does not mean you need to leave him to 'cry-it-out' to do so.
5. Involve family and friends
Involve your partner
Partners are often great in helping with practical tasks but are not always as good at providing emotional support. It's mostly not for lack of wanting, more from lack of knowing exactly how to support you emotionally.
Your partner is not a mind reader and you may need to tell him exactly where and how he can help. Take care not to be overly critical about how your partner does things. He may not do things exactly as you would do them. Just as you do not need to do everything perfectly neither does your partner.
In much the same way as you may need to be specific about practical tasks you may also need to be specific on how your partner can support you emotionally. If you need your partner's reassurance that you are doing a good job taking care of your baby, you need to tell him exactly what you want. Vague suggestions of "I need more support" may not be sufficient.
Spend time with your partner
PPD can test a marriage/relationship like nothing else you have ever encountered. Once your baby comes along often the first thing to be sacrificed is time with your partner. Set some time aside for 'couple-time'. Do something you both enjoy. Talk about something other than the children.
Maintaining your relationship with your partner is one of the greatest gifts you will give to your children. It will provide them with an immense sense of security and a wonderful model on which to base their own future relationships.
Family and friends
Women are so used to helping others it can be very difficult for some women to ask for help. Family and friends are a wonderful source of practical hands-on support and emotional support that should not be overlooked. Start out by asking for help with practical tasks.
Don't be afraid to tell your family and friends how you are feeling. Although they may not be able to resolve any problems you are experiencing, often the act of expressing your feelings and concerns can be very therapeutic. You may be surprised to find some of family or friends have had similar experiences in the past.
Maintain social contacts
Withdrawal from social contacts is common when people are depressed and yet a strong social network can provide enormous benefits. People do better when they feel connected to others. Try to maintain social contracts with family and friends.
6. Treat yourself like your best friend
Use positive self talk
Self talk is what we say to ourselves. (This doesn't mean you say these things out loud, most of the time we just think them.) Much of our self talk revolves around making minor day to day decisions, but self talk also reinforces what we think and feel about ourselves.
When a person has low self esteem, which is a common problem experienced by women with PPD, negative self talk is often used, e.g. "I'm hopeless", "It's all my fault". Negative self talk reinforces negative beliefs and feelings.
You would not talk to your best friend in such a derogatory fashion, so try talking to yourself like you would your best friend, with compassion and understanding. Try changing your negative self talk into positive self talk, e.g. "It's okay that I'm not perfect, no one is", "I am a good mother".
Positive self talk is a powerful tool. By changing what you say to yourself will challenge and eventually change the way you think about yourself. (It will take time and practice for this to occur, but the benefits of changing old habits can last a lifetime.)
Take time out for yourself
You cannot continue to give and give without taking care of yourself. This involves not only taking time to care for your physical needs but also taking time out to remember who you are. You are much more than a mother, a wife, a daughter, a friend or an employee; you are also an individual, with your own unique interests, dreams and passions. Try to take time each day or at least each week to do something you enjoy. Even an hour each week can help.
Many mothers feel selfish in taking time just for them, but the rejuvenating effects for you and subsequent benefits to your family can be great. Taking time out may also provide a wonderful role model for your children to see that Mom has outside interests.
7. Take steps towards managing your stress
Maintain realistic expectations
You're not super woman, so you don't have to be super mom. Young babies demand a lot of time. It's not possible for you to achieve all the things you were achieving before your baby arrived. Rather than further exhaust yourself trying, it may be necessary to take stock of the situation and assess what is important.
You may need to 'let go' of a few things for now. Delegate or postpone anything that's not essential to be achieved at this time. Your baby will quickly grow and become more independent (sooner than you expect!) Your depression will pass and you will find you have more time and more energy in the future.
Learn to say "No"
As women we are socialized from birth to put others needs first. Most of us genuinely enjoy caring for others. However, there may come a time when you need to set limits on what others are expecting from you and focus your efforts on your baby, yourself or your family. Learn to set limits and say "No".
Use relaxation techniques
One of the most stressful times a parent faces is adjusting to life with a new baby. When you feel out of control or under intense pressure, you may experience many different physical, emotional, or mental symptoms brought on by negative stress.
Practicing relaxation techniques will assist you to manage stress, improve your health, release unwanted emotions, clarify your thoughts, increase your energy, feel more peacefulness, sleep better and more.
Three of the most popular relaxation techniques are...
- Deep breathing techniques
- Progressive muscle relaxation
There are many books and CD's available on the market, which teaches these relaxation techniques and others. Some community centers also run classes to teach effective ways to manage stress.
Aromatherapy is the science of using oils extracted from aromatic plants to enhance health. There are 2 ways in which essential oils may be absorbed into the body for therapeutic effect...
- Receiving a massage and absorbing oil through the skin.
- Inhaling the odor of the essential oil.
Essential oils used in the treatment of depression include...
- lemon balm
WARNING: Aromatherapy is not for everyone. Infants and young children, pregnant women and people with skin allergies may want to avoid them altogether.
8. Consider the use of antidepressant medications
Studies have shown that depressed people have reduced amounts of brain chemicals called neurotransmitters compared to non-depressed people. Neurotransmitters, such as serotonin, dopamine and norephinephrine, dictate how we experience emotion and how we feel. Insufficient quantities of these chemicals can lead to depression, irritability, anxiety, sleeplessness and food cravings. Antidepressant medications work by restoring the brain's chemical balance of neurotransmitters.
There are so many myths surrounding the use of antidepressant medications that many women are afraid to use them, and yet they have been proven effective in relieving the symptoms of depression in 80% of people who use them.
Antidepressants are prescription only drugs. There are numerous different types that work in slightly different ways. Your doctor will be the best person to discuss whether antidepressant medications are suitable for you.
9. Seek professional counseling/psychotherapy
There may be times when you want someone to listen to you (outside of your immediate family and friends) or there may be times when you could use a little professional help to assist you to change lifelong patterns that are presently impacting on your life.
Counseling and psychotherapy have long been recognized as providing effective treatment for depression. There are many benefits that can be gained from professional counseling or psychotherapy. It can help you to have a life which you can enjoy and appreciate more fully and also help you to become the sort of person you want to be.
There are many different types of therapy. The cost of therapy can also vary significantly. In many countries counseling and/or psychotherapy can be obtained for free or a nominal fee. Your local doctor will be the best person to discuss the most suitable type of counseling or psychotherapy for your situation, as well as refer you to services in your local area.
10. Join a support group
New mothers' groups
Women often feel isolated when their lifestyle changes when they have a baby. Many local community centers run parenting groups for new mothers. These groups not only provide much needed social support, but are a wonderful opportunity for you to talk about parenting issues. Some groups also provide organized play activities for babies.
Postpartum support groups
These are self help groups which are usually led by women who have experienced some form of PPD. Sharing experiences with each other mothers who are or who have experienced similar thoughts and feelings, can provide an enormous amount of support and hope for women who feel isolated by PPD. Support through self help groups is given by telephone, email or letters, meetings or planned group outings.
Postpartum therapy groups
Unlike self help groups these groups are run by professional therapists , often in addition to individual treatment with the same therapist. These groups may meet weekly for a set number of sessions or may be ongoing. These groups offer many of the same benefits as the self help groups.
Written by Rowena Bennett