10 Tips For Dealing With Stress For Moms Who’ve Had PPD

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coping with stress, dealing with stress, stress, stress related depression“But I don’t have PPD anymore! I am not supposed to feel depressed or anxious! I should know better than to wake up and feel like I don’t want to face the day! What is wrong with me? Does this mean I am back to where I started?”

Sound familiar?

In the wake of Katherine’s lovely honesty around her period of stress-related depression last week, we decided that a post on this exact phenomenon is important. Because we are all likely to go through stress at some time or another, and for moms who have struggled through a postpartum mood or anxiety disorder like PPD, these periods of distress can feel downright terrifying (and often way too familiar).  Yet they are unavoidable if a mom is in any way human (I know, what a bummer), so understanding what stress related depression is all about and how to take care of you in the midst of it is important.

What do we mean by stress-related depression? Really, all that this describes is an episode of depression (or anxiety) that is triggered by a stressful event or periods of prolonged stress. In clinical terms we call this psychosocial stress, caused by disruptions in someone’s environment. A mom who is typically healthy can go through something that feels stressful — anything from a new job, an exciting move, a vacation, or building and renovating a house, to illness, financial loss, relationship conflict, or loss of a loved one — and suddenly feel as though she has lost all semblance of mental health and clarity. She can feel as though she is suddenly incapable. Behind. Incompetent. Unable.

Here’s the thing though: stress itself is neither bad nor abnormal and is, in fact, an entirely acceptable and normal psychological and physiological response to both positive and negative situations in one’s life. What matters in mental health is not that you avoid stress, but that you know how to deal with it so that it doesn’t linger. Prolonged stress can lead to increased cortisol and decreased serotonin and dopamine (neurotransmitters responsible for emotional wellness) if it isn’t managed well. Without these neurotransmitters and adequate brain functioning we simply become less resilient to the stress that we are facing, and we become symptomatic (tearful, anxious, overwhelmed, fatigued, hopeless, apathetic). This is often what occurs when we aren’t mindful about taking care of ourselves while we are feeling stressed.

While stress-related depression is not necessarily a relapse of postpartum depression, we do know that moms who struggle with PPD are usually those whose brains are genetically more vulnerable to imbalances in brain chemistry. Moms who struggle and recover from PPD may need to be mindful of self care and emotional wellness throughout their lifetimes. This does not mean that they are certain to relapse and develop severe symptoms or depression and anxiety again, but that they need to be mindful of what is required to prevent these symptoms from reoccurring, whether that be with medicine, sleep, exercise, nutrition, or all of the above.  Stress in life is inevitable, and a brain that is predisposed to any form of mental illness (depression, anxiety, OCD) needs to be well nurtured so that it can weather the storms.

Imagine a tree or plant in your yard somewhere. If it is not watered, fed with sunlight, and well cared for it will easily be blown over in a storm. Our brains work the same way.

And the good news?  Stress-related depression and anxiety are usually much shorter-lived than a postpartum mood and anxiety disorder like PPD.  Especially if you have some awareness about what your brain and body need to be well and you can ask for help early.

With that in mind, here are 10 tips on how to both manage stress when it comes in uninvited and how to take care of yourself so that the stress doesn’t take over:

  1. Notice when your life speeds up.  Most of us, when life gets busy, speed right up along with it. We tend to push out our needs when we are in periods of busy-ness and we end up making very little, if any, time for self-care. We forget to eat. We skip the exercise. We stay up later. We give up our rest, our breaks, our downtime, because we feel like we have to in order to get things done. But this never works because more times than not we end up running out of fuel. Crashing. We forget to put on our own oxygen mask first and then we have nothing left to give to anyone. So, instead, notice when your life gets fuller and, instead of rushing to meet it, make a conscious effort to slow yourself down.  Schedule in meals, exercise, sleep, and breaks.  In the long run these moments will save you.
  2. Have a mantra.  “I am okay even when I don’t feel that way”, “This too shall pass”, “I matter”- this can be anything that helps you remember that you are doing your best, that you are not super human, and that times when you don’t feel great do not equate to you not being great.
  3. Take care of the cold.  When you notice early signs of emotional distress (tension, headache, belly upset, tearfulness), nourish yourself like you would at the earliest hints of a cold.  When you wake up with a sore throat or runny nose, do you rush out for an hour-long work out or stay up as late as you can?  Let’s hope not. So, let’s prevent the flu. Eat your veggies and plenty of protein.  Get some rest.  Be kind to yourself as you would if you were noticing early signs of physical distress.
  4. Give yourself permission to feel bad.  With changes in weather, hormonal shifts, increased workloads, childcare demands, and household chores piling up it would be impossible not to feel overwhelmed. Again, remember it is not the feelings of overwhelm that are problematic, but whether or not you take care of yourself when you notice them.
  5. Talk to someone.  Blog. Go see your therapist. Talk to your husband or best friend or random grocery store clerk who asks you how your day is going.  When we hold our tension inside it will inevitably build up until there is no more room to store it.  Give yourself some space in there.
  6. Breathe.  Seriously.  When we are stressed we all tend to become physically tense and take short, shallow, chest breaths. We use only a limited amount of our lung capacity. When we respond physically to an event or situation this way, we tell our brains that it is important to panic. Even if this isn’t really true. Our brains need adequate oxygen to function effectively, and believe it or not, we have a huge amount of control over this. Practicing that deep belly (or diaphragmatic) breath can literally change our physiological response to stress.
  7. Know that it will pass.  Because it will.  Perspective is really important during periods of stress, and it is also the first to go when we become depressed or anxious.  And you can remind yourself if this is your mantra – “This Too Shall Pass.”
  8. Avoid alcohol, drugs, and caffeine.  It is so easy to drink one too many glasses or wine or coffee when you are feeling badly because, in the moment, it feels like it will help.  But the truth is that drugs and alcohol will not help you to feel less depressed (they are depressants) and caffeine will not help you to feel less anxious (it is a stimulant).
  9. Acknowledge cognitive distortions.  This is the basis for Cognitive Behavioral Therapy (CBT) and we know a huge amount about how and why thoughts really do impact the way that we feel.  Catastrophic thinking, should statements, all-or-nothing thinking, discounting the positives, discounting your coping skills, “what if” thinking, fortune telling, and overestimating the threat will, inevitably, make you feel awful.
  10. Be mindful of your emotional limit.  Often, managing your stress alone just isn’t going to cut it.  Don’t be afraid to call and make an appointment with your therapist again as you may need additional support during this time.  Sometimes, just one or two sessions back will be all that you need to resurface again.

~ Kate Kripke, LCSW

Photo credit: © Stuart Miles – Fotolia.com

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About Kate Kripke

Kate Kripke is a Licensed Clinical Social Worker (LCSW) specializing in the prevention and treatment of perinatal mood and anxiety disorders. She is also a Colorado state coordinator for Postpartum Support International. Kate lives in Boulder with her husband and two daughters and writes an eponymous blog.

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Comments

  1. Thank you Kate! Great tips. I’m sharing. :)

  2. Superb article, thank you very much. The idea that it’s okay to feel bad sometimes (#4) is crucial–sometimes our world gives us the message that we’re supposed to be happy and perfectly in-control at all times, but we’re humans, and a range of emotions is healthy and normal! Permission to have a bad day is a very good thing.

    • I completely agree, Kim.. thanks for highlighting that one. When we feel badly about feeling badly we are simply adding another layer to already existing distress… and none of us are super-human (even if we’d like to be ;-)

  3. Thank yo so much for the article. Unfortunately, my baby is already one year old and I’m still dealing with anxiety, panic attack and follow the anxiety the horrible sensation that I want to cry but I can’t. I’m so tired to feeling like that. Anyone ladies with same symptoms?. Thank ypu so much in advance for any comment.

    • Yes, Lett, that happens to me too. My baby is 14 mos old. There is no time limit for this. Though super frustrating, I still have PPD and PTSD symptoms too and am in active treatment. I am working with my therapist on the extreme shame I feel for having this disease and part of that involves my feeling that I should be better by now. There’s no timeline though….and as I said below, I went back to work and it didn’t go well at all so now I’m half time. That decision to take better care of myself and make time for myself has helped the anxiety and stress go down. I encourage you to talk to a therapist with PPD, PPA experience….the relief just by being listened to is huge. Take good care. You are a wonderful and brave mom. I am tired of feeling this way too but I know lots of other people here have this happen and somehow that helps…..you are not alone.

  4. Wow, this is so timely for me. I am recovering from PPD and PTSD, diagnosed when my baby was 8 weeks old, which was one year ago. I just went back to work in September and my stress level went sky-high and some of my PPD symptoms seemed to return. I am now working only half time, and am taking that extra time to exercise, do things around the house, do work for my job etc…. The difference since I dropped to half-time, in my stress level, is measurably better already. I am frustrated by this situation as I was worried I was sliding back into that awful dark pit of PPD and I never want to go back. My therapist said that I am still getting better but that I just don’t have the psychological reserves yet to handle stress and the inevitable balancing act that is working motherhood. This article is so helpful with real tips that make sense and with a reminder to be aware to seek help and to take care of ourselves. Thank you so much for making me feel “normal” again.

  5. jenniferspeaks says:

    Thanks so much. I am entering another round of PPD (after feeling really good) with weaning my 19 month old and it is freaking me out. I need to keep #9 in mind. I have been doing some negative fortune telling!

  6. Love this!

  7. Hi there.
    Thank you for such a great posting. It is spot on. I had pdd and have a little relapse of anxiety as my daughter had her first fever/illness. I fell apart for a bit but made it through. This tips are great. Pdd is so under shared but so common. Thanks again for the encouragement and help.
    Shannon

  8. I too am recovering from PPA for the last 4 months. Mine started when I weaned my daughter at 1 year and had a few stressful occasions at the same time. I tried a therapist, but that didn’t help me much, my husband, family and friends have been a great support system and know me better than a therapist would, so I turn to them. I’ve been taking holistic meds and supplements to help keep me level. I also found out the drop in hormones after nursing took a toll on me and caused a lot of the anxiety, so I’m on the pill to help with that. Even though I have been on the road to recovery, I’m getting nervous with the holidays coming, not to mention my sons 5th bday party and 5 other bdays between now and the end of the year. After a really bad day yesterday, here I am back on the internet trying to find ways to keep my stress low to get through this without going back to where I was. I’m very fearful of returning to that awful place. Has anyone been there, weeks of pretty good days, then a really bad one setting you back? How to get through this without losing it?

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