The Mom Before The Storm

Alexandra Sacks MD on how to survive Postpartum Depression —  and Take Good Care of Yourself in Motherhood

 

We’ve all seen the Instagram image of the postpartum supermom: a wise, efficient, gorgeous-but-modest multitasker who glows in her delivery room photo and seems unfazed by the challenges of intrusive mother-in-laws, grumpy sex-starved partners, and sleep training. She always has a blowout, she doublefists coffee and chardonnay, she wears skinny jeans six days after giving birth; her house is chic and clean. Sound familiar?


If you feel like you can’t measure up to this woman, then congratulations, you’re normal. All new moms struggle with moments of chaos, moodiness, frustration and self- doubt. And for some women, anxiety can become so debilitating that you may meet criteria for Postpartum Depression (PPD).


It’s kind of confusing, but Postpartum Anxiety and PPD are actually the same disease. In fact, the term “Postpartum Depression” is a bit misleading. The condition could more accurately be described as “Postpartum Mood and Anxiety Disorders.”


Excessive worry can be the most debilitating component for most women with PPD. You may feel guilty about almost everything. You might make statements like, “It’s my fault whenever the baby cries. I’m worried I’m just not cut out for this. She deserves better.” You might feel trapped, lonely, and overwhelmed. There is probably a voice in your head declaring that you are a bad mother.


Trust me on the following:  No one is judging you as harshly as you’re judging yourself— the people who love you will want to help once they understand what you’re going through.  And those picture perfect A+++ moms who make you feel like crap? Most likely, they’re feeling pretty fragile too.


Below, 10 tips for kicking Postpartum Depression’s ass.


1. Eat Superfoods

Science now shows that the food you eat may be as impactful for your mood as other treatments for depression.  Superfoods may stimulate the production of “happy” neurotransmitters in the brain like serotonin and dopamine. Magnesium from black beans, protein and iron from grassfed red meat, Omega 3 fats from salmon, and even flavonoids from dark chocolate can be healing and preventative.

  

2. Exercise (Even Just A Little!)

Endorphins are real. They provide a serotonin boost and act as a natural medicine to fight and prevent depression. No matter where your body is in the postpartum period, find a way to get moving, even if for just a walk around the block or some stretching in at home.


3. Try Body Work

Mindfulness, meditation, deep breathing, yoga, acupuncture and massage are all effective ways to calm the nervous system and get your GABA flowing. GABA is the same anti-anxiety neurochemical released by alcohol or pills, but you can conjure it naturally to relax when you’re feeling wound up.  


4.  Take Time For Yourself

Caring for yourself is just as important as caring for your newborn. Really. Sometimes spending a day or night solo works like magic to help your mood. It’s hard to believe, but some mothers who think they should run away from home as a way of escaping the burdens of motherhood feel relief after a night of uninterrupted sleep. So if you’re being pushed to the edge, ask someone to take care of your babe —  and book a room at a hotel (or stay at a friend’s house) for a day or two.


5. Communicate With Your Friends

In the throes of depression, it may be hard to remember what you normally find fun. Ask the people who know you best to remind you about the little things that made you happy. It can be as simple as getting a coffee and croissant in the morning, going to a yoga class (even lying on the mat can help), getting your first haircut in 6 months, watching mindless TV or having an uninterrupted dinner out with a friend. You might have trouble motivating yourself at first —inertia is another depression symptom — so sometimes you have to “fake it ’til you make it.” The joy will follow in time.


6. If Breastfeeding Sucks, Stop

We’ve all heard about the benefits of breastfeeding, but these messages can leave you feeling like it’s the only valid choice. Among the many challenges of breastfeeding, the pressures to be “perfect” in timing, pumping, and production of milk can become a trigger for worry and exhaustion.  If breastfeeding is presenting real complications, then it may actually be a healthier choice for you and your baby to switch to (or supplement with) formula.


7. Take Sleep Seriously

Studies have shown that in order to treat depression, you need to get enough high-quality rest. The brain benefits from at least four hours of uninterrupted sleep in order to function well. This might mean you need to set up a sleep schedule with your partner or ask a friend/family member to cover some night feedings so you can sleep. If money allows, hiring a night nurse is extremely helpful.  


8. Talk It Out

Sometimes there’s nothing more healing than talking with a confidential, unbiased, and empathic therapist. You may like a more open-ended therapy approach, or if you’re more action oriented, make a list of your worries before your first session. Simply naming the new stresses in your life can be as soothing as fixing them. Talking to a professional about these changes and your reactions to them may help you feel calmer, more in control, and less alone. Postpartum Support International is a good place to start if you’re looking for a therapist.


9. Don’t Be Afraid Of Antidepressants

For years, most doctors were reluctant to give pregnant and breastfeeding women medications for fear of harming the baby. But it’s a misconception that all psychiatric medications are harmful during pregnancy and breastfeeding. Scientific data now shows that ignoring psychiatric illness during pregnancy and postpartum is not only bad for the mom, it’s bad for her baby too. A mother’s health is always interconnected with her baby’s. Experts can walk you through a risk/benefit analysis that compares the effects of the medication with the effects of the untreated illness. Mother to Baby and The Massachusetts General Hospital Center for Women’s Mental Health are two great resources for learning more about medication safety during pregnancy and breastfeeding.


10. Share Your Story.

Narrative therapy is a real thing! Once you start speaking up, you’ll hear that the MAJORITY of mothers around you are feeling some version of what you’re going through. Roughly 1/10 mothers you know will have PPD, and the remaining 9/10 will likely have a story to share about feeling sad, afraid, ambivalent, disappointed, guilty, competitive, and even angry during pregnancy and the postpartum.  The more we can encourage moms to show real images of the hard days of motherhood, the more we can get women talking to each other and supporting each other. Our #motherhoodunfiltered campaign on our @mothermind  Insta  is all about this.



Alexandra Sacks MD is a Reproductive Psychiatrist in New York City who specializes in the emotional experience of pregnancy and the postpartum. To learn more about her forthcoming book coauthored with Catherine Birndorf MD, click here and sign up for her monthly newsletter with more information and advice.