Postpartum depression: How to cope and help

Postpartum depression: How to cope and help

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SALT LAKE CITY — The birth of a baby is supposed to be a joyful time of love and caregiving, but for many women and men who experience postpartum depression, it can be a time of darkness.

Nicole Hale, a mother of two, began experiencing feelings of inadequacy and depression with her first baby around four weeks postpartum.

"I just felt like I could do nothing right, the baby didn't need me and that it would be better off with someone else," she said. "It took me awhile to recognize. I've suffered from depression in the past and it was completely different from that. But I realized there was a problem when I wanted to leave my baby at other people's houses. Like, I didn't want to bring him home with me."

National figures vary but generally estimate that between 9 and 16 percent of postpartum women will experience postpartum depression. And, approximately 10 percent of fathers experience paternal postpartum depression, according to the Journal of the American Medical Association.

Partners' mental well-being is tightly linked, with the likelihood of fathers becoming depressed increasing if a mother experiences depression. Repeating episodes of depression are also common, as women who experience postpartum depression once are 41 percent likely to experience it a second time.

Signs and symptoms
Postpartum depression
  • Intense, long lasting sadness
  • Not bonding with baby
  • Excessive crying
  • Withdrawal from loved ones
  • Mood swings
  • Insomnia
  • Overwhelming fatigue
  • Intense irritability, anger, short temperedness
  • Severe anxiety, panic attacks
  • Trouble concentrating
  • Reduced interest in activities you typically enjoy
  • Thoughts of harming yourself or the baby
Info: Info: Dr. Hale
Baby blues
  • Last a few days or a couple weeks
  • Mood swings
  • Anxiety
  • Sadness
  • Irritability
  • Feeling overwhelmed
  • Crying
  • Reduced concentration
  • Appetite problems
  • Trouble sleeping
Info:Utah Department of Health

Symptoms of depression — as opposed to the short-lasting baby blues — include: intense, long-lasting feeling of sadness or depression, interference with bonding or care of baby, excessive crying, withdrawal from loved ones, mood swings, insomnia, overwhelming fatigue, intense irritability and anger, short temperedness, severe anxiety and panic attacks, trouble concentrating, reduced interest in activities you typically enjoy and thoughts of harming yourself or the baby.

But parents don't need to try coping with depression on their own, Dr. Liz Hale, Ph.D, a clinical psychologist in private practice, marriage and family therapy, said.

"We know too much, we have too many resources that can help a woman with postpartum depression, she need not suffer alone," she said. "It is too damaging to everyone, including —maybe even especially— this new baby."

Talk to a doctor

Dr. Liz Hale recommends talking to your family doctor or OB-GYN if you begin experiencing feelings of depression that last longer than a couple of weeks. (Photo: megaflopp/Shutterstock)
Dr. Liz Hale recommends talking to your family doctor or OB-GYN if you begin experiencing feelings of depression that last longer than a couple of weeks. (Photo: megaflopp/Shutterstock)

Lindsay Johnson, a South Ogden mother of one, only realized the dramatic change in her feelings and behavior was depression after talking to a doctor. When her depression lasted through her difficult pregnancy and intensified with the birth of her baby, she sought further help.

"While she (her baby) was doing great, my level of happiness and my mental level of happiness was just crashing considerably," Johnson said. "I was just not happy whatsoever. It was hard to put on a happy, smiley face. Yes, I'm a new mother, I should be happy and saying all the words people wanted me to say, but inside I was just completely empty."

Dr. Hale recommends looping your family doctor or OB-GYN in as soon as possible.

"They're trained to look for that, they're trained to assess it and treat it," Dr. Hale said.

At Johnson's six-week checkup, she talked to her doctor, who recommended her to a therapist in addition to the medication she was already taking. Johnson said therapy brought relief and helped her realize she "wasn't crazy."

"I just had so many bitter, bitter, ornery things inside of me to say and he let me get it out," Johnson said. "And I thought, 'Oh wow, I just needed to really kind of talk it out. That's all I really needed.' I did need medication, but it was pretty great.

Nicole Hale found a lot of help in the schedule and game plan for handling specific situations that her therapist helped set. Getting out and moving for her was also helpful — something that Dr. Hale recommends as well.

Ask for help — build a support system

Build a community of support around you. Enlist family, friends and your doctor to help you cope with postpartum depression. (Photo: Africa Studio/Shutterstock)
Build a community of support around you. Enlist family, friends and your doctor to help you cope with postpartum depression. (Photo: Africa Studio/Shutterstock)

Nicole Hale recognized her risk for postpartum depression due to her history with depression. Her family and doctor were on high alert when she was pregnant with her first baby, and her husband was the person who told her she needed to go see a doctor. With her second baby, she and her doctor had a plan early on, including medication and eventually therapy.

"If you tend to have a history of depression, that's a great thing to talk to your doctor ahead of time about," Dr. Hale said. "Or let's say, after the last birth you gave you had postpartum, let the doctor know that so you can be prepared with a safe antidepressant or something else that may be on the market."

Johnson found a lot of support from family physically and emotionally. Many members of her family had experienced depression, so they related to her feelings. She said the experience helped her understand them, in turn.

"I think there's always that first stigma of, 'I'm better than that, I can beat that, I know I can beat that,' " Johnson said. "Instead of taking (a family member's) advice, or talking to her and asking for help, I didn't. I think there's such a nasty, stupid, dumb stigma whenever we think of someone on antidepressants, we think of them as crazy."

In addition to honesty with her husband leading her to get help, Nicole Hale said her family stepped in to help after her diagnosis. Her mother would take her on walks and help her with small tasks around the house like doing the dishes.

"It's hard for me to admit I have a problem and that I need help. It was hard in that aspect," she said. "But I started realizing it was more about the baby more than it was about me and I had to put my feelings aside at this point."

Helping partners cope with PPD

Partners can help one another cope with postpartum depression by doing simple things like giving one spouse time alone to recover, go to doctor appointments or care for themselves. (Photo: sergiu.birca/Shutterstock)
Partners can help one another cope with postpartum depression by doing simple things like giving one spouse time alone to recover, go to doctor appointments or care for themselves. (Photo: sergiu.birca/Shutterstock)

Dr. Hale encourages couples to tune into each other and ask after their spouse regularly.

"Just know already that there's less of you to go around," she said. "Continue to reach out for and touch and smile and support and love each other, but most importantly, tune in so you can see the changes."

She said couples should watch for signs of depression in each other and promise ahead of time to be honest.

"(Ask): 'Remember how we made that commitment to be honest with each other? I'm worried. I think that we probably need to get some help. I noticed that you're not showering every day like you used to, I noticed that you're losing your cool a little easier, you sleep a lot. This concerns me. I think we need to get some help like we agreed to,'" she said.

Partners should also work together ahead of the baby's arrival to address any existing marital, financial or external stressors when possible, Dr. Hale said. She reminded couples to draw close together at this time — share the highs and the lows, the beautiful moments and the frustrating.

If a partner is diagnosed with depression, work together to get through it. She recommends the supporting partner make arrangements for childcare during doctor and therapy appointments or driving them to the appointment, if they need it. Even things as simple as starting the car can help. Whatever couples do, Dr. Hale said, they should practice unconditional love during this time.

"I think the best thing to have your spouse realize is that you need some sort of assurance or backup or help in the sense of, 'Hey, I'm feeling overwhelmed, can you please watch the baby while I go read a book or take a nap?'" Johnson said.

Helping family and friends

Related:

Often, someone coping with depression needs outside help. Checking in on the well-being of new parents — if they are eating and sleeping — is instrumental, Dr. Hale said. They can also pay attention to how mom and dad are bonding with baby.

From there, loved ones can offer their help. She recommends simple things like offering to hold the baby while its parent showers, eats or does something else to care for themselves. Family and friends can also offer to watch the baby for an afternoon or run errands. Sometimes though, just a visit can help break the isolation new parents may feel.

"You need support. Whether it's through your spouse or mother or mother-in-law or a best friend, you need that support," Johnson said. "Because if you feel completely and utterly overwhelmed, that's when the darkness hits you and you have no idea what to do. You feel like you can't breathe and you find yourself in an absolute panic attack."

And, she reminded, don't forget about dads. While mothers most commonly experience PPD, fathers often get forgotten when their world has been turned upside down, too.

Talking to other children in the home about it

Parents can talk to their older children about their feelings in age-appropriate ways. They can also arrange special playdates for them so they don't feel left out or forgotten. (Photo: Denys Kurbatov/Shutterstock)
Parents can talk to their older children about their feelings in age-appropriate ways. They can also arrange special playdates for them so they don't feel left out or forgotten. (Photo: Denys Kurbatov/Shutterstock)

Children will likely notice a change in a parent's behavior, and Dr. Hale said it is important to help them understand in age-appropriate ways that it is not their or the new baby's fault. She recommends addressing the behavior and acknowledging your feelings.

"Always reassure them. 'I'll take care of it, I won't always feel like this, honey, but right now I just feel like a slug — no energy,'" she said. "So call a spade a spade with your younger children. Normally, I want them to know that things happen to us that are outside of our control, and depression is one of them. So use that language, 'I used to love to sit on the floor and play ball with you and I can't believe I can't even do that. I just feel too sad to even play ball.' They'll be relieved to know there's a reason. This baby didn't just suddenly zap all of you away from them."

She also recommended parents draw on their support network to get their children out of the house and give them some special attention. A trusted adult could take an older child out for ice cream or to the park for some one-on-one time.

Opening up

Both Nicole Hale and Lindsay Johnson have found common ground with others who have experienced depression. They both said that as their depression lessened, they were able to help others.

"The more open you become about it, the more people are willing to tell you about their experiences. And everybody's experience is a little bit different I feel like," Nicole Hale said. "...It's helpful to know that there's strength in numbers, that I'm not alone going through it."

Johnson said she believes it happened to her for a reason — so she could advocate and have empathy for others.

"Any time I've ran into someone who is going through depression and doesn't know what to do about it, I'm able to help in some sort of way," she said. "Not be pushy, but just be like, 'I get it. I'm there, I've been there. You know what works? This person is really great.' "

Whatever path of treatment people choose, Dr. Hale just reminds people to get it taken care of early.

"The sooner you get help, the more fully equipped you will be to enjoy your baby and that's going to be key," she said. "'How do I get back to enjoying this baby?' That's the whole goal. I don't want to miss a beat and I'm missing it if I'm depressed and that baby is missing out on me."

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UtahFamily
Celeste Tholen Rosenlof

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