Taking an Active Role in Your Postpartum Recovery

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These items are the beginning tools for a successful recovery from postpartum mood disorder. I say this confidently, because I believe in recovery being possible. I was once someone who never felt that I’d be normal again nor that I’d ever find my way back to who I used to be. But recovery is made up of small steps that lead us to a successful life of overcoming postpartum mood disorders — these steps toward wellness matter, because being active versus passive about your recovery greatly increases a positive outcome.

For me, a belief in the process, along with an open ear to advice, and full engagement in dialogue with your recovery team of your physician and your therapist, possibly a support group, is essential. I used to go to my appointments and sessions with a notebook filled with questions or thoughts that I had had during the week before the appointment. I wrote everything down of the information they gave me so that I could refer to it later. This helped, since it was difficult for me to concentrate and remember during my time of PPD and PPA. It also shows your recovery team that you see yourself as integral to recovery and that you are there to advocate for your mental health.

Life while in postpartum recovery can feel isolating. For that reason, you need a shared community. You can find a group through your area hospital, health clinic, checking out what’s offered in a local events calendar, or finding one online by searching postpartum progress. To hear others share their current struggles, or by listening to stories of those in recovery or recovered, is a lighthouse during this storm. You can feel encouraged and find ideas on ways to work toward your own eventual recovery.  You don’t have to be “fully recovered” to participate in any group and you don’t have to be fully recovered to start to feel better.

A few nights ago, I was talking with some postpartum warrior moms, some that were currently in postpartum phase, some on the way to recovery, some recovered. I asked them for suggestions on how to be active in PPMD recovery. Here’s what worked for us:

Define your goals. You decide what recovery would mean for you. For me, it was to once again smile, laugh, and enjoy my life.

Accept the importance of your role and the responsibility that you have in your recovery. That means being aware of how and where you spend your time, and who with. Sometimes it means guarding your environment and stimuli at a time when you’re not strong enough to take much negativity.

Know that you have power, and are not weak. You are the one in charge when you see your recovery team. Listen to what they say, but be honest about how you are feeling. If something doesn’t feel right, or you’ve tried and it hasn’t helped, let them know. I have heard cases of women being on the same medication for months with no alleviation or improvement of symptoms. Let your physician know, and work together.

Getting better is not just through pharmaceutical aid. Recovery can take longer than we want it to, and the easy way out is to think that just taking a daily pill will fix us. But other things need to be part of your lifeplan: sleep, diet, exercise, state of mind. Incorporating what spirituality is to you, and a mindful practice, like meditation, creativity, maybe yoga. Only you can discover what centers you, so search new activities out. For me, waking up 15 minutes earlier so I could deep breathe and have a mind free of thought was the cornerstone to my day.

Your social network and friends and family support are what will hold you up. Let people know how they can help you, as well as what is detrimental to your recovery. Relationships and community provide a feeling of belonging and lesson isolation. Isolation can be a huge trigger for PPMD, so reach out and ask for support when you need it.

PPMD recovery is possible with treatment and identification. It comes slowly, and is a growth process because your life has changed. You are no longer someone without a family or children. We have to learn skills and ways to adapt to our new normal. Allow room and space to understand setbacks, transitions, bad days. We learn from what works and what doesn’t work. No one does everything perfectly, and the best way to learn is by paying attention and being aware.

Write in a journal, especially days that feel good. It’s too easy for us to internalize that we are always depressed, or tired, or manic, or incapable. But we are more than that. If and when you have a good day (you will, trust me, they come…) write down what that feels like. See if you can figure out what led to the moment, even if it’s just a flash. In my case, my son was ten weeks old and he suddenly kicked his legs and giggled. I found myself smiling for the first time in a long time, and I believed then, I could get better one day. For you, it might mean a task completed, or standing up for yourself in a situation, maybe having face to face time with a friend. Remember them, write them down, refer to them to help you believe better times are on their way. Find out what promotes a positive feeling in you.

Prepare a list of go-to activities that make you feel better. When your mind is muddled, it’s hard to find a way out of dark thoughts. I kept a list taped to the inside of my kitchen cabinet, on it were things like a trip to the bookstore or a walk. I also had “watch SNL” because laughter was and still is, important to me. Be sure to exercise, sleep adequately, eat right, drink water, take your medication, talk to someone at least once a day. You could list creativity, cooking, photography, writing, nature walk, yoga. Whatever is part of things that need to happen every day for you to recover. I still refer to a daily list for my mental health, it includes sleep, exercise, good food, and water.

If you have a bad day, tell yourself that it’s not permanent. The feelings are not here forever, and tomorrow is a fresh start. Have a plan for a bad day, whatever that may be. For me, I have a close friend whom I trust. She always knows what to do, she just listens.

Recovery from PPMD is possible. After a long time of being depressed, we have trained ourselves to think that’s who we are and it’s easy to fall into old habits, with thoughts of discouragement and hopelessness. I don’t make light of the challenge it will be to be active in your recovery, but the result is one of hope and empowerment.

There will be better days, but they won’t happen by magic.

Medication and therapy are an important part, but reframing how we talk to ourselves and being open to change and implementing suggestions for lifestyle changes by our recovery team, are just as integral. I know it’s not easy, especially at a time when you have never felt more lost or overwhelmed. Recovery is an arduous process that feels endless on some days — there were times when I thought I would never get better,  but I assure you, the day will come when PPMD will be behind you. The way to increase your chances on the path to recovery is to take an active role in your personal journey. It’s a lot of work, but there are many people here to help you, and it’s a thousand times worth it.

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When You Compare Yourself To Mothers Without Postpartum Mood Disorder

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alec the babyFrom my viewpoint, everyone around me had it together.

I saw the dark-haired mom seated on the other sofa in the gathering room. Her hair was smooth and fell neatly to her shoulders. Her three-month-old daughter looked up at her from her knee, dressed in a spotless blue one-piece. Next to her sat another mom. Short hair, obviously clean, as were her clothes. In her lap, a cooing infant, he was fresh and shining, I was sure he had been bathed just that morning.

Everywhere I looked, I saw put-together and neat as a pin mothers. In unstained clothing with faces dewy and bright from their morning shower. I couldn’t bear to look up and meet their sparkling eyes. Neither could I bear to look down, into my stained three-day-old T-shirt. My baby, my life, really, nursed blissfully in my arms. Alec was always clean, so beautifully well taken care of by me. But that’s all I could manage to do during these first days of new motherhood, just tend to this precious child of mine.

I was in the throes of newly diagnosed postpartum depression and anxiety. Alec was four months old, and my therapist had recommended that I get out of my house at least once a day. And that’s how I came to be at this morning’s Diaper Bag Club at a local hospital. From my end of the sofa, I saw no one like me there. Stringy hair, with the same clothes as yesterday and without a shower since the Sunday before when my husband had been home to hold the baby.

Alec, my precious baby boy, screamed anytime that he left my arms. I had grown so used to his cries, that even when he napped, I still heard them. I adored this child, but he was all-encompassing, and with the days without sleep piling one on top of another, even thinking felt difficult and impossible.

The gathering room on this Wednesday morning was filled with women who could do what I couldn’t do. That’s what I believed, and what I told myself. They were who I compared myself to. Women who looked together with babies who barely sniffled. I sat in the middle of this group of nine women, and my eyes began to fill with tears.

I couldn’t even mother.

What I was doing, was one of the worst, and yet, most common things that we do as postpartum mood disorder moms: we compare. We compare ourselves to mothers who are living in a different world than we are. But I didn’t know that, and I didn’t understand it enough to help myself. It was my therapist who helped me see my way out of this dangerous unproductive mindset.

“What you are doing, thinking that you should be right where others are now, and comparing yourself to them, is apples and oranges,” she explained to me at a therapy session later that week. “You haven’t even started the recovery phase and yet you want to live in another land without crossing the bridge to get there.” She talked to me firmly, but not brusquely. She explained how I was still on this side of the world, with my goal being to get across the ocean to get to that side of the world, and that our sessions, my medication, along with support of family and friends, would be part of the bridge over those waters that would get me there.

She took a pencil and drew on a piece of paper. There was me, an “x” over here, and then a dotted bridge, with my destination, me, another “x” over on the other side. I folded this paper and carried it with me. I thought about the “x” of me thinking I could do what the other women on the other side were doing when I didn’t even have one foot on the bridge yet.

Comparison to others will always engulf us. When you have postpartum depression, postpartum anxiety, or any other mood disorder at this time, you’re not at the same starting point as those without. Some of the women I sat with that morning entered into motherhood with their feet set and ready to go. They had no postpartum repercussions. Add to that, many had “easy” babies. Some had husbands who worked out of the home and were there with them during the day to combat the loneliness and some even had mothers or mothers-in-law, friends or siblings who came at least once,maybe more, during the week.

It was a vastly different world from mine, and yet… I held myself up to the same standards and results that they had. I thought I should be marching along in their identical unencumbered rhythm.

What my therapist did for me was help me feel pride in all that I was doing, and overcoming. When I said to her with tears in my eyes, “But these women are better mothers than me!” She laughed softly and asked back, “Really? Let’s see what happens when I try and hand Alec off to one of them.”

When I said that these women looked so good and that I looked so disheveled, she countered with, “Problem solved. Put on a fresh shirt before you leave home.” That sounded so easy, and yet? I never thought of doing it. I know it’s hard to understand, but with postpartum depression and anxiety, along with fatigue and a colicky baby, you can’t see your way out of the simple things.

No matter what I volleyed at her, my therapist smiled at me warmly and helped me to see that I was the best mother at this time with what I was surviving. Her comforting reassurance of how Alec seemed to be in love with who his mother was brought me to grateful, gushing tears.

My baby loved me, I could see that. And all I had to do was tell myself that I could get to the world I hoped for me and my baby. With small things to help me along the way, like a change into a fresh shirt before I left home and with big things to help me, like our  continuing therapy. My therapist had me check my reality. And more important than anything, she gave me a map, one I could look at and envision the me on this side, on the way to the me on the other side, and to be patient with the bridge that would get me there.

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Warrior Moms and Social Media: Benefits and Pitfalls

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My lifeline throughout my recovery from postpartum depression and postpartum anxiety was social media.  I credit Google for leading me here to Postpartum Progress.  From this website I found the blogs of fellow Warrior Moms.  I found my tribe, a community of fellow Warrior Moms who helped encourage, commiserate and inspire me with messages of struggle, solidarity and hope.  I felt more comfortable with expressing myself on Twitter and in private Facebook groups.  Those women had been through it, and they understood exactly where I was at.  The key for me was taking my emotional temperature.  I felt loved, supported, validated and heard when I expressed my fears and frustrations.  Just a simple “me too” warmed my heart as much as a hug.

The opposite side of this coin is knowing when to take a break from social media.  Mental health bloggers and Warrior Moms are fantastic at letting readers know if a post contains potentially triggering content.  If you are feeling fragile, limit your consumption of social media.  Notice how you are physically feeling.  Does a certain social media application make you feel less than? I love to look at Pinterest, but I personally get overwhelmed by all the beautiful crafts and recipes.  Does watching or reading the news on Facebook exacerbate your anxiety?  Hide those feeds from your timeline.  Stick to private Facebook groups instead of the general news feed on Facebook.  Use your lists on Twitter to curate the social media that you allow.  Boundary setting on social media was key to my recovery.

As someone who is in recovery, it is crucial to give yourself grace.  Our Facebook, Twitter, Instagram and Pinterest feeds can at times compound a struggling mom’s belief that she is not a good enough mom.  The limits are different for each mom.  The most important skill that I cultivated during recovery was critical reading.  I chose when to consume certain types of media.  I hid some friends on Facebook because I fell into the comparison trap.  I unsubscribed from blogs that did not actively assist me in my recovery efforts.  I do not regret those decisions at all.  I made the choice to surround myself with social media that inspired me and supported me.  That also meant that I did not engage in any type of political debate of any kind.  Since recovering from postpartum depression, I have begun to share my political views more.  I still keep my mental health and well-being a priority.  The support I received from the Warrior Mom community helped me to find my voice as a mental health blogger and advocate.

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Six Things You Should Know About Antidepressants and Pregnancy

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antidepressants pregnancyIn light of the recent uproar over the article on antidepressants and pregnancy that was published this week on the New York Times‘ Well Blog, I thought I would pause today on the unknowns that likely burden every single mom who suffers with a perinatal mood or anxiety disorder like PPD.  There is so much mixed-up and contradicting information out there: co-sleep/don’t co-sleep, breast-is-best/healthy mom-is-best, have a birth plan/let go of the birth plan; cloth diaper/disposable diaper; medicine for depression and anxiety is safe/medicine is not safe.  As if being a mama wasn’t confusing already, all of this conflicting info is enough to make a mama’s head take a double-spin.  And its exhausting!

Those of us who specialize in perinatal mental health wish more than anything that there were more “knowns” for you- that there was one right answer for everyone so that we could take the burden away from you for having to figure it all out.  And we know that when you are tired and anxious and overwhelmed and unsure there is nothing more difficult than having to make a decision when the information is complicated and so much unknown exists in the midst of it all.  Truthfully, it’s not okay that we don’t know more and we need to keep on doing the research necessary to continue to build toward more clarity.

So, what I want to say to you is this: If you are frustrated, we get it.  If you are confused, it makes sense.  If you are angry, you get to be angry.  And if you have questions, ask them.  When you reach out for help from a trained professional you have a right to know their expertise, their commitment to best practice and professional development, and their loyalty toward helping YOU decide what the best course of action is for your particular situation.  Not every mom with postpartum or antenatal depression or anxiety will end up including medicine in her treatment plan, but many will.  And those of us out there rooting for you and your babies understand the trust that you put in us to help you decide what is the safest and most appropriate way to help your family thrive.

So, to summarize what I consider to be some of the most important parts of the beautifully written response to the New York Times story on antidepressants and pregnancy from PSI, here are six important facts:

  1. It is not possible or appropriate to make one blanket statement regarding the use of SSRI medication during pregnancy (or breastfeeding).  These decisions need to be made on a case-by-case basis and must take into account each mom’s unique symptoms and family picture.
  2. While there has been some research that suggests that SSRIs may not be safe to take during pregnancy, there is more research to suggest that they are.  And, when we look closely at this research, the statements made to suggest that SSRIs are dangerous to a fetus are selective and do not account for the whole picture.  Another way of saying this is that many of these studies you sometimes see covered by the media are not “clinically sound.”
  3. Untreated and under-treated perinatal mood and anxiety disorders can have significant negative effects on a developing baby’s social, emotional, and cognitive development.  This, by the way, is rarely if ever debated.
  4. Sometimes lifestyle changes like increased sleep and nutrition or non-pharmaceutical treatments like acupuncture and light therapy help a mom recover from her symptoms, but sometimes they do not and a more involved treatment like psychotherapy or the use of an SSRI is required for a mom to be well.
  5. Taking an SSRI medication during pregnancy under the guidance of an appropriately trained clinician is not irresponsible.
  6. There is most definitely some “gray area” when it comes to the use of SSRI medicine during pregnancy and breast-feeding.  And many of us are uncomfortable with the “grays” and want instead for there to be more a more black-and-white, clear answer to these things.  While this gray area can be confusing, however, it does not need to be as scary as the New York Times suggests.  Instead, we can try and think of the gray as a place for options….

So, moms:  On behalf of all of the appropriately trained perinatal mental health specialists out there, we know that these decisions are hard for you and that the choice of whether or not to take medicine while you are pregnant or lactating is rarely simple.  We believe that you want what is best for your baby (and so do we!) and we are confident that the choices that you make that lead you to wellness will undoubtedly benefit your kiddos in the long run.  We will continue to research and understand the role of pharmaceutical medicine in the treatment of perinatal mood and anxiety disorders and will advise you on best practice and sound clinical knowledge.  We will not mislead you.  We will let you know what we don’t know, but we will also let you in on what we do and we will do this with educated knowledge and research-based understanding.  And, we know that this does not feel easy, although we wish that it were.  But you have our promise to continue to learn and push and stand by your side as you do what is required to be your best self.  For you and for your baby.

~ Kate Kripke, LCSW

 Photo credit: © Valua Vitaly – Fotolia.com

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