The birth of a new child is an enormous life transition. Many expectant parents often feel a mix of joy, anticipation, worry, and the pressure to do the best for their new child. After giving birth, many new parents are told they will experience a deep love and joy that is special to bringing a new life into the world. Up to 80% of women who have given birth experience the "baby blues," which refers to a period of moodiness and tearfulness. This phenomenon resolves within a couple of weeks. However, some women find that these "baby blues" seem to be debilitating and don't go away. About 1 in 7 women who give birth develop Postpartum Depression (PPD). Symptoms include:
● Persistent feelings of sadness, frequent crying spells
● Feeling overwhelmed, questioning the decision to become a parent
● Intense guilt
● Difficulty bonding or forming an attachment with your baby
● Frequently feeling irritable or angry
● Hopelessness, feeling like a failure
● Feeling empty or numb, going through the motions
● Inability to sleep despite being exhausted
● Overeating or lack of appetite
● Difficulty concentrating or making decisions
● Feeling disconnected
● Social isolation, difficulties in your relationships
● Recurrent thoughts of death or suicide
Many women who develop PPD often feel totally overwhelmed with trying to care for themselves and their child, feel deep guilt for not feeling happy about their new baby, and often have their concerns dismissed as the "baby blues." According to the International Childbirth Education Association, some factors that increase the risk of developing PPD include personal and family history of mental health problems, a history of severe PMS, low income, low social support, and poor relationship with their partner. About half of women who experience depression during pregnancy go on to develop PPD.
Many women do not seek help for their PPD, but it is treatable. Partners, spouses, and other loved ones who want to support someone suffering from PPD can use several strategies to help care for them.
One of the most powerful things you can do for someone with PPD is listen to them, fully and without judgment. It works better if you don't jump straight to trying to problem-solve or giving advice. They may be trying to make big decisions about how to take care of their baby and themselves, and giving advice or telling them what to do won't be the most helpful strategy for them. Instead, by listening to them, you can give them space to talk it out themselves so that they can feel more confident and empowered by their choices.
Ask if they would like to talk, and let them lead the conversation. They may have been holding back how they're really feeling due to stigma, and having someone willing to listen to their real thoughts and feelings can be a tremendous relief. Part of listening is being willing to hear painful and uncomfortable things. They may have been experiencing constant sadness and guilt over the way that they have been feeling. Perhaps they've been feeling as if they're not themselves anymore, or like they've been losing their mind. And because new moms are expected to feel happy with their new baby, they've probably been keeping these feelings to themselves. By being willing to listen to someone with PPD, you can help them feel less isolated and alone with their problems.
2. Validate and Reassure
One of the more harmful things that can happen to someone going through PPD is to have their feelings and experiences invalidated. They might hear, "You look like you're doing fine." Or, "Everyone feels the baby blues." Or, "You always wanted a baby, so you should feel happy." Or, "You need to just snap out of it." Or even, "I didn't have these kinds of problems when I had a newborn, so you must be doing something wrong."
Instead, tell them, "That sounds like it's been so difficult for you. I can see why you've been feeling this way." And, "That doesn't sound crazy to me, I'm glad you told me and I want you to know that I'm here for you." And, "It makes sense that it made you feel so angry. I'm always here to listen if you need to vent."
3. Lighten the Load
A person with good intentions might tell a new mother who's struggling, "Let me know if you need anything." Chances are, they won't ask for anything and will feel pressured to do everything themselves. That doesn't mean they don't need help. Women suffering PPD often feel overwhelmed, and taking some chores off of their plate can be a big relief. This is especially true for those whose spouses didn't get very much parental leave and have returned to work, leaving the new mom at home alone.
So instead of vaguely letting them know you can help, be specific and volunteer. When you come over for a visit, take stock of what they might need—are the dishes piling up? Does the lawn need to be mowed? Does the driveway need to be shoveled of snow? Don't drop by unexpectedly. Instead, let them know when you're coming. For example, tell them, "I'll come over at 3PM tomorrow to do a load of dishes and laundry. Is that OK?" Ask them what some of their favorite foods are and bring over meals that can easily be reheated in the microwave or oven. Make sure the food is also healthy, as good nutrition is an important part of recovering from PPD. Volunteer to drive them to pediatrician appointments and help them pack the car with everything they'll need. Tell them you will babysit while they go to their own appointments or have other outings. Offer to take the baby for a walk so that they can have quiet moments to themselves where they don't have to worry about the survival of a tiny human.
Don't let this support disappear once the baby is no longer a newborn. Women can develop PPD in the first 12 months after their baby is born, and PPD does not always resolve itself quickly.
4. Call in Your Supports
The more people genuinely helping someone struggling with PPD, the better. Friends, grandparents, other family, and even professional help can make a big difference. Take the burden of coordinating so the person with PPD doesn't have to worry about it. Set up meal trains, encourage others to call or text them regularly, and set up babysitting times. If they need help taking care of their baby, consider pitching in to hire a postpartum doula. If they are struggling to get sleep and are plagued with sleep deprivation, consider pitching in to hire a night nurse or night nanny. Not getting enough sleep worsens PPD and interferes with recovery. Make sure to check in with them about what help is okay to give, and let it be okay if they say "no."
Many with PPD feel chronic hopelessness that things will get better and may doubt their ability to be a good parent. As a support person, you can help them by encouraging them to do things to address their PPD. It's important to distinguish advice-giving with encouragement, and it's also crucial to do it non-judgmentally. You can't force them to do these things, but you can point out options that will help them feel better. The decision is ultimately theirs to pursue.
For instance, you can encourage them to bring up their symptoms with their doctor, OB/GYN, or other health care professional. You could look up therapists in the area that specialize in treating postpartum mental health issues and give them a list. You could find local, in-person support groups for new parents dealing with postpartum issues. Enable them to be able to take care of themselves by watching the baby while they take a walk, get some light exercise, or take a nap. Give them resources, such as the Postpartum Support International hotline at 1-800-944-4PPD (4773).
6. Take Care of Yourself, Too
Particularly if you are a spouse or partner, supporting a person with PPD can take a toll. Make sure you are taking care of yourself too, by making time for rest, eating meals regularly that are nutritious, socializing, and other self-care activities. If you've ever watched a passenger safety training on an airplane, you know you have to put on your own oxygen mask first before helping the person next to you. You won't be able to support your loved one if you burn out and stop functioning yourself, so make sure to take the time to take care of yourself too.
PPD can have a huge impact on a new mother's life, but it is treatable and temporary with help. If you are concerned that they may be seeing or hearing things that aren't there, seem paranoid or may be experiencing delusions, or you are concerned that they may hurt or kill themselves or their baby, please take them to the emergency room or call 911, as these are signs of a medical emergency.
Dr. Amber Sylvan is a psychologist in Ann Arbor, MI who helps pregnant and postpartum women cope with and heal from Perinatal Mood and Anxiety Disorders and birth trauma.