Amber Koter-Puline: On Navigating Your Way Through PPD

postpartum depression, mother's day rally, maternal mental healthDear new mama, 

Wow.  What a long, and maybe even strange, trip it’s been.  Whether you’ve just given birth or your adoption process has come to a fruitful end, I’ll bet you’ve experienced a lot of anticipation and waiting on your journey.  Perhaps things worked out pretty much as you expected, or maybe like my first birth experience, you’ve had a rough go of it.  Unfortunately, there is no way to guarantee a perfect entry into motherhood.

There’s so much I want you to know.  I’d love to be sitting on a comfy couch, both of us with a warm cup of tea, and my hand on top of yours reassuring and encouraging you.  I hope that since I can’t be “there” for you, that you’ll find someone who can be.  A support system is so important.  And sometimes your support can come from unexpected places.  It might not be your partner, you best friend, your sister, or your mother.  It might be a fellow sleep-deprived soul you’ve met at the park.  It might be an older woman at church who had a tough transition into motherhood.  It might be because you’ve intentionally sought out a group of women who understand by looking for local peer support for PPD.  No matter where it comes from, I hope you’ll keep your eyes open for someone who fits the bill and will ask for help.  It’s a sign of strength to know and admit that things are overwhelming.  It’s also normal.  And there a no awards for going it alone.

If you’re feeling badly right now, and you are more than two weeks past birth*, there are some things you can and should do quickly.  First, see a doctor.  If you feel confident in your OB or Midwife, start there.  If you don’t have a great relationship with that provider than either reach out to your PCP or find a provider who specifically serves in the area of maternal health.  The best place to start is probably a psychiatrist who specializes in women’s mental health, preferably perinatal mental health.  Ask to be screened for postpartum issues like PPD.  They should do blood-work to check your thyroid, hormone, and mineral levels. They should also use a tool to screen you for symptoms of postpartum depression and anxiety.  *Even if you aren’t two weeks postpartum, but you are really anxious, depressed, “off”, or experiencing symptoms of postpartum psychosis, get professional help immediately.

There are some things you can’t control, at least not immediately.  However, there are also things you can do that will improve your health, regardless of your diagnosis.  Self-care should be your number one priority right now.  It is absolutely true that you cannot take care of anyone else properly if you are not caring for yourself.  So, get sleep.  Seriously.  Every single time your baby sleeps, try to sleep or at least rest.  The only exception to this is women who are experiencing severe insomnia.  If trying to sleep and not being able to do so is causing you more anxiety, then just read, watch a show, or do something calm that you enjoy while your baby rests.  The dishes, vacuuming, laundry, and thank you notes can wait.  In fact, caring for yourself and your baby should be your only goals these first few months.  Let others do all the other household tasks, if possible.  Get fresh air, sunlight, and take your vitamins.  If possible, try yoga, massage, and other proven methods of reducing anxiety and improving mood.

Say YES.  When someone offers to bring a meal, clean your house, do your shopping, or provide childcare help for you, don’t be a martyr.  They are offering because they want to help.  And there is no shame in accepting it.  In fact, often people offer their support because it makes them feel good to do something for others.  So think of it as doing them a favor, too!

Put the kibosh on advice and parenting “methods”, unless you’ve asked for specific help.  Every situation is unique and each parent and baby combo will find what works for them, even without the aide of baby books, websites, and relatives who think they know it all.  Trust your gut, and if you feel like you can’t, then ask someone you trust and respect to help you make decisions while you get professional help so that you can recover your instincts with your health.  There will come a time when you will feel confident that you, and no one else, know what is best for your family; it just may take some time and treatment.

Be open to a variety of treatment options if you are diagnosed with a perinatal mood or anxiety disorder like PPD.  It was very, very hard for me, but I had to accept that the severity of my illness required prescription medication.  I am so glad that I was able to move past my dogmatic point of view and allow the combination of mediation, therapy, and “complementary options” to work together so that I could get well as fast as possible.  Unfortunately, I know a lot of women who pushed back on the treatment prescribed for them because of strong beliefs or financial concerns and then later, and after suffering for far too long, regretted that they hadn’t made a different choice so they could have recovered more fully and quickly.  Please don’t let that be you.

Make yourself aware of resources for challenges like breast-feeding struggles (lactation consultant, common issues like tongue-tie, etc.) and common health issues with baby (lactose intolerance or milk/food sensitivities, skin problems, etc.).  If you feel well armed with info and go-to people, when faced with a problem you’ll be more confident and less anxious.

And lastly, please, please remember that it takes time to develop a relationship.  Most moms don’t “fall in love” instantly with their baby, and sometimes an initial blissful feeling is replaced with a bit of confusion over how to bond with this brand-new being that you’ve just met.  Parenting is not a string of mountaintop experiences.  It is real life, which means there will be ups and downs.

Be your own best friend.  Guilt, negativity, depression, and anxiety are all thieves of peace and joy.  Be gracious with yourself.

~ Amber

Amber Koter-Puline is a survivor of traumatic birth & postpartum depression and anxiety (2007).  She went on to have a positive childbirth and postpartum experience with her second son in 2011.  Connect with Amber atAtlanta MomBeyond Postpartum, or the Atlanta Postpartum Support Group. Follow her on Twitter @BeyondPostpartum.

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Postpartum Progress, the world’s most widely-read blog on all things related to emotional health around pregnancy & childbirth, is a service of Postpartum Progress Inc., a 501c3 nonprofit devoted to raising awareness of postpartum depression and similar illnesses. Please consider making a donation today, Mother’s Day, so we can continue and expand our work supporting maternal mental health. Thank you!

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About Katherine Stone

is the creator of this blog, and the founder and executive director of Postpartum Progress. She has been named a WebMD Health Hero, one of the fiercest women in America by More magazine, and one of the 15 most influential patient advocates to follow. She is a survivor of postpartum OCD.

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  1. Cristi @ Motherhood Unadorned says:

    Such good advice Amber. I especially love saying YES to help. So important!

    • Thanks, Cristi. That was one of the hardest things for me to learn to do.
      Interestingly, at the beginning of L2’s bday party on Saturday, my friend walked in the door as I was unloading the dishwasher at the last minute. She asked, “Can I help?” and normally I would have said, “No! Go get a drink and sit down, I’m sorry for doing this with company here.” But instead, I said, “Yes, thanks. I’ve learned to say yes when offer help and I’m proud of that.” She, having walked this journey with me, agreed and happily helped me put away the few remaining dishes. I love how much I’ve learned because of motherhood.

  2. Amber,
    I like the clear and practical advice you provide. I also really like what you said about sitting on the “comfy couch” and being supportive to the women hurting right now. I didn’t want to “go it alone” when I was struggling, but I still felt quite alone. As happy as I am to see all the great support out there online now, I had no idea it was there when I was struggling. (That’s why I’m currently telling everyone I know all about postpartum progress and PSI). Thanks for your support!

    • Thanks, Ana. I agree…I didn’t know/nor was there much, even online, back in 2007 when I suffered. I try to offer direct and practical advice because it is what I was really needing when I was not myself in the throes of PPD. The only thing I can think to do to raise awareness of online resources is to share in places where people who might not even know they need the info can find it. You were/are not alone, and no one else has to be either…so many of us are right here, waiting. šŸ™‚