When Postpartum Depression Doesn't Go Away

“I’ll never forget the day I felt cheated by motherhood. My eyes were met by a dawning sun after a sleepless night of tears, sore breasts, and a general feeling of listlessness and sorrow. Where was the happiness I was promised? Where were the smiles, the baby chortles and giggles, and the endless joy everyone said I would feel? Where was it? And why didn’t I feel this way?”


Does this feel like the opening chapter of a New York Times Best Seller, or perhaps the opening narration of a Lifetime movie? It’s not…. It’s the true story of many mothers all over the world during the first year after childbirth. It’s the feelings of resentfulness and the bitter taste of a darkness that swells and drowns so many mothers, but it is kept silent and locked away in the mourning center of their hearts. Perhaps… it’s your story.



Today, we're going to address a dark side of motherhood that plagues 1 out of every 7 women, and that's Perinatal Depression. The Journal of the American Academy of Pediatrics reports that every year, more than 400,000 infants are born to mothers who are depressed, making perinatal depression the most under diagnosed obstetric complication in America! Can you imagine that?! That's pretty significant.


Let's take this one step further.... Did you know that 1 in 10 new fathers also suffer from postpartum depression? That's 10% of new dads and 15% of new moms that are struggling with Postpartum Depression. And it gets worse!


Studies have revealed that when Perinatal Mood Anxiety Disorders (PMADs) go untreated, there are several risks and complications that can arise, including:

  • Relationship problems

  • Separation/divorce

  • Child neglect/abuse

  • Developmental delays/behavioral problems in the child

  • Tobacco, alcohol, and illicit drug use and abuse

  • Infanticide, homicide, and suicide

That's not a pretty list, and one that you definitely want to avoid! So, the next question naturally becomes, "Can postpartum depression be cured? The answer: YES! PMADs are very treatable and many men and women make a full recovery from their postpartum depression. The key is getting help as soon as you suspect you may have perinatal depression.


To help you on your journey to feeling better and becoming the best mom (or dad) you want to be, I'm going to give you some tips you can begin implementing TODAY to help lessen your symptoms and get you feeling better. I'll also give you some resources at the end of this post to help you find the right support and the help you need to make a full recovery!


Let's look at some strategies you can begin implementing right away to help lessen your symptoms and feel better.


Self-Care Practices to Treat Postpartum Depression


Self-care is one of the most important things we need to work on as moms, and it is a cornerstone to a healthy body, positive mental health, and an overall happy life. There are a lot of different components to self-care, but we’re going to discuss some items that you can start doing today to help yourself feel better! Many of these tips are used in the professional treatment of PMADs. So, if you begin implementing these right now, you'll be on your way to health!


1. Sleep


Sleep deprivation is one of the biggest contributing factors to Perinatal Depression and other PMADs. Sleep deprivation causes your physical body and your mental state to slowly break down over time. Folks who are severely sleep deprived oftentimes will experience auditory and visual hallucinations too! Can you imagine trying to take care of your kids while hearing voices or seeing shadows constantly?


Sleep is pivotal in helping you manage your emotions. If you’re not getting at least 6-8 hours of sleep every night, it’s time to make this a priority. How you do this will depend on your schedule, family dynamics, whether you work or stay home, etc. However you do it, you need to make sure you’re getting some Zzz’s. If you want ideas on how to fit more sleep into your schedule, check out my book, “Trials of the Working Parent,” for ideas on how to manage this.


2. Diet


Sugar, caffeine, and fast food are quick sources of energy, but have little nutritional value. The result is a tired and cranky Mommy. You should be aiming to eat nutritious foods as much as possible. And if you’re breastfeeding/expressing breastmilk, this is even more imperative since your diet is also the diet you are feeding your baby.


Try to eat your fruits/vegetables and proteins every day, as best as possible. Do your best not to skip meals since this messes with your blood sugar and can cause mood swings. Finally, stay away from fad-diets!


If you don’t have time to eat in the morning, consider having a protein shake that you can drink on your way to the market. Or, perhaps grab a hardboiled egg that you can eat quickly when you're in a hurry. You may also want to talk to your doctor about adding vitamins to your diet or getting a referral to see a nutritionist.


3. Basic Hygiene


Please take your showers! There is nothing so basic as getting a bath into your schedule. Every woman wants to feel clean! But how many of us go several days without showering and then rely on deodorant, body spray, and a messy bun to get us through another day? I’m guilty! Trust me, sacrifice the 5 minutes of extra sleep to squeeze in a shower so that you can still feel like a woman when you’re wiping up a poopy butt!


4. Movement


Move your body. This might sound silly, but getting some form of regular physical activity into your daily schedule can help decrease stress and anxiety while elevating mood. If you can squeeze in a trip to the gym, then go for it! But it doesn't need to be this either. There's lots of ways to sneak in some movement throughout your day! Consider some of these ideas:

  • Do some aerobics or yoga in your family room with your toddler romping around with you.

  • Play Simon Says with your kids! You play the role of Simon and get your body moving with jumping jacks, crunches, Toe-ups, and different stretches. Your kids will love being played with while you secretly get in some exercise!

  • Take a walk with your baby around the block.

  • Go up and down the stairs in your home or apartment complex a few times.

  • Have a dance party! My family loves this one. I'll play music nice and loud and we all dance around the house. When I had an infant, I would just hold my baby and dance with him. This one is also great because (just like Simon Says) you're fitting in quality time with your kids and getting some movement.

However you decide to do it, just get moving! Shoot for incorporating it into your routine a couple of times a week for a few minutes in the beginning. Then see if you can up it to daily. Exercise releases tons of endorphins into your brain, which helps you feel good and happy, while also burning off the stress hormone (cortisol).


5. Get Support


It’s important for adults to have adult conversations, and part of this is getting some time to vent and let off steam. Most folks will lean on their partner, but sometimes that person is not emotionally available. This is when you need to reach out to a Mom’s Group, Postpartum Group, family members, friends, or a therapist.


The important part to remember is that you want to avoid isolation. You need to break out of the little cocoon your wrapped up in and let yourself come out! You don't have to do this alone. So find some support and actually use it!


How Postpartum Depression is Treated


Now that you have some practical tips you can begin applying today, let's talk a little bit about getting some professional help. We know there is still some stigma about going to therapy, but no one needs to know you're talking to a therapist. And, here's a little secret.... Did you know there are many women (and men!) who go to therapy each week just to talk?!? That's right! Therapists are not only for individuals who have a mental health condition- they make great coaches too!


Many individuals find a therapist just because they want an hour every week dedicated just to them and their own needs! You might call it selfish, but others call this preventative care.


Taking care of your Emotional-Self allows for you to have more patience and empathy when your child is testing your limits. This is an important part of great self-care. It will help you feel better, even if you are sleep deprived and rocking the messy hair-bun. So, let's talk a little about what treatment might look like.


There are multiple treatment options for PMADs. Everything from traditional talk therapy to medications, there are many ways you can tackle this problem. And the great news is, you can try more than one! So, let's break down your treatment options.

Psychopharmacology (aka- Meds!)


Psychopharmacology is just a super fancy way of saying "medications." Whether it is Postpartum Depression, anxiety, OCD-like symptoms, or any other version of PMADs, medications are a fabulous option to help you feel better, faster! The biggest hesitation here is if you are currently pregnant or if you are breastfeeding. If this is where you're currently at, you don't have to turn this option down.


Believe it or not, there is a sub-specialty in psychiatry known as "Reproductive Psychiatry." These are psychiatrist that specialize in helping mothers suffering from PMADs. They know what you can take, how much to give, and all the possible risks you need to know about. They are AMAZING, but are also hard to find. Looking for a Reproductive Psychiatrist (aka- Perinatal Psychiatrist) is like looking for a unicorn... it feels damn near impossible! But they're out there!


If you're interested in getting connected with a Reproductive Psychiatrist, the best place to look is the Postpartum Support International (PSI) directory. It's a great resource to have on hand! And, if you can't find a Reproductive Psychiatrist in your area, you can always connect your OB-GYN, psychiatrist, or family doctor to PSI's National Psychiatric Consultation Line. It provides your doctor access to free consultation with a Perinatal Psychiatrist that can help your doctor determine the best treat options for you.


Peer Support & Psychoeducational Groups


Having a new baby can feel extremely isolating. Mothers often feel trapped in their own home, brewing a sense of loneliness. This, in turn, feeds into depressive symptoms and creates a breeding ground for anxious thoughts. Joining a peer support group can be one of the best things you ever do for yourself.


For women especially, having a sense of community with other moms can help you feel normal, validated, and supported. These groups help you connect with other individuals going through a similar experience, allowing you to see you are not alone. Members often form deep friendships, share resources, and help each other out when things get a little dark. But so many women fail to take advantage of this excellent treatment option that is often FREE!


Here's the thing, women often feel nervous of talking to other women. We're so afraid of being judged by our peers or feeling as though other people will view us as "crazy" or as a "bad mom." But what we forget is that peer support groups comprise of other women fearing the same thing! Furthermore, support groups organized by professional organizations usually have facilitators that are trained to help make sure the group remains helpful, respectful, and positive.


If this sounds like an option you might be interested in, you can check out PSI's website. They have peer support groups for all kinds of moms, including military moms, LBGTQ parents, single moms, etc.


Psychotherapy


Psychotherapy is the formal name for "talk therapy." Whenever people think about seeing a psychologist or therapist, this is what they're thinking of. Traditional talk therapy is arguably the king of treatment for PMADs. It's well researched and empirically supported to be effective and safe for both mom, dad, and the baby.


Now, for a long time, PMADs were on the "hush hush." Nobody really talked about it. If you wanted to find a therapist, any therapist was an option. Over time, however, people began to realize that Perinatal Depression was its own specialty. There were special considerations that therapists needed to think about when treating pregnant and/or postpartum moms. As such, a movement began, a long with a lot of research, and from there a specialty within the field of psychology arose.


Today, therapists that want to work with moms suffering from PMADs take post-graduate trainings to help them better understand the unique circumstances surrounding these conditions. Professional organizations have collaborated to make sure that providers are getting the extra training they need to effectively help families struggling with perinatal depression.


So, if you are interested in therapy, here's what you should be looking for:

  • Start off by looking for a therapist that has taken post-graduate training in PMADs. When you call the therapist, ask them if they have taken any specialized training in perinatal depression. It's ok to "interview" your potential therapist! You need to feel confident that the therapist you're working with has the skills to help you.

  • Look for a therapist who has been trained or certified in Cognitive Behavioral Therapy (CBT) or Interpersonal Psychotherapy (IPT). There are A LOT of therapeutic modalities and treatment orientations, but when it comes to PMADs, these are the 2 modalities that have been proven over and over again to be the most effective.

  • If you think your relationship with your partner might be part of the problem, then consider Couples Counseling. Even though you might be suffering from a PMAD, easing the tension and conflict in your romantic relationship can greatly improve your symptoms and help you to feel better. In this case, you want a therapist that provides couples counseling. Although all therapists have the capacity to do couples therapy, not all of us actually provide this service.

  • Finally, you can look for a therapist that utilizes Attachment and Parent-Infant Therapies. These treatment modalities include: Watch, Wait, and Wonder, Child Parent Psychotherapy, and Circle of Security. These modalities focus on building the bond between you and your baby, which can be helpful in the treatment of PMADs.

Postpartum Depression: Where to Get Help


There are so many places you can look to get the help you need. In this section, I'm going to provide you with some places you can look for help, as well as resources to help you on your journey to wellness.


Let's start by talking about insurance. Insurance companies have a variety of therapists that are "in network" with them, which means that your cost out-of-pocket might fit into your budget a little better. Here's the problem with insurance companies, however... they don't classify therapist by specialty. That means that the list of therapists that you get from your insurance company may or may not specialize in maternal mental health. So, you'll have some investigating to do.


Another place to check is with your OB-GYN. They might have some therapists that they recommend who specialize in maternal mental health. The only thing to remember is that these individuals may or may not take your insurance. That doesn't mean you'll have to bare the full cost yourself, however. Most insurances have Out-of-Network benefits (aka- OON) that you can take advantage of. If a therapist states they can give you a "Super Bill," that's what they're talking about. More on that later!


Online directories are a great place to look for a therapist, especially if you are looking at the right ones! PSI has a fabulous directory, and in order to be listed in their directory, you have to have specialized training in PMADs. That means that ANYONE you find on the PSI directory is going to have the training you need! It just makes it that much easier.


Now, there are some other directories, but they aren't specific to Perinatal Mental Health. It doesn't mean that you can't find a specialist though. Some of the popular directories are:

  • Psychology Today

  • Good Therapy

  • Therapy Den

Now, once you find someone you really like to work with, we come back to affording your care. IF they take your insurance, then you're in good shape. If they don't take your insurance, (which is the case most of the time) then you'll need to consider private pay (basically paying cash out of pocket) or trying to utilize your OON benefits.


OON benefits are a well kept secret that can really open the door to you getting the treatment from the therapist you want. You can ask your therapist of choice if they can provide you with a Super Bill so you can get reimbursed by your insurance company for your treatment. Your out-of-pocket costs might still be higher than if you were to go with a therapist "in network," but utilizing your OON benefits will make it much more affordable for you.


I hope you found today's post helpful on your road to health, happiness, and wellness. Check out the additional resources I've added to this post, and if you think you're ready to work with a therapist to treat your Perinatal Depression, you can utilize the resources to help get you linked to a provider. Of course, if you live in California, you are welcome to reach out to me. Not only have I completed those specialized trainings in PMADs, I've also been trained in CBT and IPT. Remember, even if I'm not in network with your insurance, we can use your OON benefits to make treatment with me more doable for you!


With that said, Happy Parenting!


Additional Perinatal Mental Health Resources


· Inland Empire Perinatal Mental Health Collaborative

· Postpartum Support International (PSI)

· Maternal Mental Health NOW

· 2020 Mom

· Maternal Mental Health Alliance