Until recently, postpartum depression was a condition that was largely swept under the rug of medical practice. It was ignored by the public, minimally discussed by doctors, and suffered with unnecessarily in shame and silence by the women who experienced it. This attitude has prevented women from learning about postpartum depression and its highly effective
treatments. Worst of all, it has kept women from getting the help they need.
Fortunately, there’s been a shift in the way the medical community views and treats PPD.
Public education campaigns are or soon will be under way in some states, requiring hospitals to send women home with educational material about the condition so that new parents will be able to recognize the symptoms early and seek treatment.
Practitioners are also becoming better educated about PPD—learning how to look for risk factors during pregnancy, to screen routinely for PPD during postpartum visits, and to treat it quickly, safely, and successfully. There are also several standardized tests (Edinburgh Postnatal Screening Scale and Cheryl Beck’s Post-partum Depression Screening Scale) that have been shown to be effective in screening for PPD.
Postpartum depression is one of the most treatable forms of depression. So if it strikes you, don’t suffer with it any longer than you have to. Speak up and get the help you need now.
For more help contact Postpartum Support International: 927 N. Kellogg Avenue, Santa Barbara, CA 93111 805-967-7636, www.postpartum.net; Postpartum Assistance for Mother:
390 Diablo Road, Suite 115, Danville, CA 94526, (925) 552-5127,
www.postpartumassistance.com; Depression After Delivery: www.depression afterdelivery.com.
First, call your practitioner and ask for a thyroid test. Irregularities in thyroid hormone levels (very common in the postpartum period) can lead to emotional instability. If those levels check out normally, ask for a referral to a therapist who has a clinical background in the treatment of postpartum depression and make an appointment promptly. Antidepressants such as Zoloft or Prozac (which
appear to be safe during lactation), combined with counseling, can help you feel better fast. Bright light therapy may bring relief from PPD and can be used instead of or in addition to medication.
(Recent studies have shown that high-risk women can take antidepressants such as Zoloft or Prozac right after delivery to prevent postpartum depression. Some physicians will even prescribe low doses of antidepressants during the third trimester of pregnancy to women with a history of postpartum
depression.)
Whichever treatment route you and your therapist decide is right for your postpartum depression, keep in mind that swift intervention is critical. Without it, PPD can prevent you from bonding with, caring for, and enjoying your baby. It can also have a devastating effect on your relationship with your spouse and other children, as well as on your own health and well-being.
Some women, instead of (or in addition to) feeling depressed postpartum feel extremely anxious or fearful, sometimes experiencing panic attacks, including rapid heartbeat and breathing, hot or cold flashes, chest pain, dizziness, and shaking. These symptoms also require prompt treatment by a
qualified therapist.
Much more rare and more serious than PPD is postpartum psychosis. Its symptoms include loss of reality, hallucinations, and/or delusions. If you are experiencing suicidal, violent, or aggressive
feelings, or hearing voices or have other signs of psychosis, don’t wait—call your doctor and go to the emergency room immediately. Don’t let anyone reassure you that these kinds of feelings are normal during the postpartum period—they’re not. To be sure you don’t act out any dangerous feelings, try to get a neighbor to stay with you while you contact the doctor.
GETTING EVERYTHING DONE
“Now that I have a baby, I’m falling behind on everything: cleaning, laundry, dishes, literally everything. My once immaculate house is now a mess. I’ve always considered myself a together person—until now.”
Take the responsibility of caring for a newborn baby for the first time. Days and nights that seem to blur together as one endless feeding. Add a few too many visitors, a generous helping of postpartum hormonal upheaval, and, possibly, a fair amount of clutter accumulated during your stay in the
hospital, or in the last days of pregnancy—when you could barely move, never mind clean. Throw in the inevitable mountain of gifts, boxes, wrapping paper, and cards to keep track of. It’s only natural to feel that as your new life with your baby is beginning, your old life—with its order and cleanliness—
is crumbling around you.
Don’t despair. Your inability to keep up with both baby and house during the first weeks at home in no way predicts your future success at the juggling act they call motherhood. Things are bound to get better as you regain your strength, become familiar with the basic baby-care tasks, and learn to be a little more flexible. It will also help to:
Get hold of yourself. Dwelling anxiously on what you have to do makes facing it twice as difficult.
So relax. Take a few deep breaths. Then, instead of trying to do it all at once (which you can’t), focus on what’s really important: getting to know and enjoy your newborn. Banish thoughts of household chores while you’re with her (relaxation techniques learned in childbirth class may help you to do this). When you look around later on, the clutter and chaos will still be there, but you’ll be better able to deal with it.
Get rest. Paradoxically, the best way to start getting things done is to start getting more rest. Give yourself a chance to recuperate fully from childbirth and you will be better able to tackle your new responsibilities.
Get help. If you haven’t already arranged for household help—paid or unpaid—and taken steps to streamline housekeeping and cooking chores, now’s the time to do so. Also be sure that there is a fair division of labor (both baby care and household care) between you and your spouse.
Get your priorities straight. Is it more important to get the vacuuming done while baby’s napping or to put your feet up and relax so you can be refreshed when she awakens? Is it really essential to dust
the bookshelves, or would taking the baby out for a walk in the stroller be a better use of your time?
Keep in mind that doing too much too soon can rob you of the energy to accomplish anything well, and that while your house will someday be clean again, your baby will never be two days, or two weeks, or two months old again.
Get organized. Lists are a new mother’s best friend. First thing every morning, jot down a list of what needs to be done. Divide your priorities into three categories: chores that must be taken care of as soon as possible, those that can wait until later in the day, and those that can be put off until
tomorrow, or next week, or indefinitely. Assign approximate times to each activity, taking into account your personal biological clock (are you useless first thing in the morning, or do you do your best work at the crack of dawn?) as well as your baby’s (as best you can determine it at this point).
Though organizing your day on paper doesn’t always mean that everything will get done on schedule (in fact, for new parents it rarely does), it will give you a sense of control over what may now seem like a completely uncontrollable situation. Plans on paper are always more manageable than plans flying frenetically around your head. You may even find, once you’ve made your list, that you actually have less to do than you thought. Don’t forget to cross off completed tasks for a satisfying feeling of accomplishment. And don’t worry about what’s not crossed off—just move those items to the next day’s list.
Another good organizational trick of the new mother trade: Keep a running list of baby gifts and their givers as they’re received. You think you’ll remember that your cousin Jessica sent that darling blue-and-yellow sweater set, but after the seventeenth sweater set has arrived, that memory may be dimmed. And check off each gift on the list as the thank-you note is sent, so you don’t end up sending two notes to Aunt Karen and Uncle Bob and none to your boss.
Get simplified. Take every shortcut you can find. Make friends with frozen vegetables, your local salad bar, the pizza delivery guy.
Get a jump on tomorrow tonight. Once you’ve bedded baby down each night and before you
collapse onto the sofa for that well-deserved rest, summon up the strength to take care of a few chores so that you’ll have a head start on the next morning. Restock the diaper bag. Measure out the coffee for the coffee pot. Sort the laundry. Lay out clothes for yourself and the baby. In ten minutes or so, you’ll accomplish what would take you at least three times as long with the baby awake. And you’ll be able to sleep better (when she lets you) knowing that you’ll have less to do in the morning.
Get good at doubling up. Become a master of multitasking. Learn to do two things or more at once.
Wash the dishes or chop vegetables for the salad while you’re on the phone. Balance your checkbook or fold the laundry while you catch the news on TV. Check your e-mail or help an older child with homework while breastfeeding. There still won’t be enough hours in the day, but this way you may only crave 36 instead of 48.
Get out. Plan an outing every day—even if it’s just a walk around the mall. The change of pace and space will allow you to return somewhat refreshed.
Get to expect the unexpected. The best-laid plans of mothers often (actually veryoften) go astray.
Baby’s all bundled up for an outing, the diaper bag is ready, your coat is on, and suddenly the distinct gurglings of a bowel movement can be heard from under all baby’s gear. Off comes coat, bunting,
diaper—ten minutes lost from an already tight schedule. To allow for the unexpected, build extra time into everything you do.
Get the joke. If you can laugh, you’re less likely to cry. So keep your sense of humor, even in the face of total disorder and utter clutter; it’ll help you keep your sanity, too.
Get used to it. Living with a baby means living with a certain amount of mayhem most of the time.
And as baby grows, so will the challenge of keeping the mayhem in check. No sooner will you scoop the blocks back into their canister than she will dump them back out again. As fast as you can wipe mashed peas off the wall behind her high chair, she can redecorate with strained peaches. You’ll put safety latches on the kitchen cabinets, and she’ll figure out how to open them, covering the floor with your pots and pans.
And remember, when you finally pack your last child off to college, your house will be
immaculate once again—and so empty and quiet that you’ll be ready to welcome the pandemonium (and dirty laundry) they bring home on school vacations.
NOT BEING IN CONTROL
“For the last ten years I’ve run my business, my household, and every other aspect of my life quite effectively. But ever since I came home with my little boy, I can’t seem to get control of anything.”
There’s been a coup in your home—as there is in the homes of all new parents. And the man who would be king in your castle isn’t a man at all, he’s a newborn baby boy. As powerless as he may seem, he is quite capable of disrupting your life and usurping the control you once had over it. He won’t care if you customarily take your shower at 7:15 and your coffee at 8:05, if you favor a leisurely cocktail at 6:30 and dinner promptly at 7:00, if you enjoy dancing into the wee hours on Saturday night and sleeping luxuriously late the morning after. He’ll demand feedings and attention when he wants them, without first checking your schedule to see if it’s convenient. Which means your routine and many of your old, comfortable ways may have to be abandoned for several months, if not several years. The only schedule that will matter, particularly in these early weeks, is his. And that schedule, at first, may have no discernible pattern you can latch onto. Days, and especially nights, may pass as a blur. You may often feel more like an automaton (and if you’re Breastfeeding, a milk cow) than a person, more servant than master, wielding not the slightest measure of power over your life.
What to do? Hand the scepter over graciously—at least for now. With the passage of time, as you grow more competent, confident, and comfortable in your new role, and as your baby becomes more capable and less dependent, you will regain some (though not all) of the control you’ve lost.
In other words, you might as well accept the fact that your life will never be quite the same. But then, would you really want it to be?
NOT FEELING COMPETENT
“I really thought I could handle it. But the moment our little girl was handed to me, all my confidence dissolved. I feel as though I’m a total flop as a parent.”
Though the ultimate rewards of parenthood are greater than those of any other occupation, the stresses and challenges are greater, too—particularly at the beginning. After all, there’s no other job in the world that thrusts you, without previous training or experience and without supervisory guidance, into fully responsible eighteen-to-twenty-hour shifts. What’s more, there’s no other job that offers as little feedback during the first weeks to let you know how you’re doing. The only person who could
possibly give you a job evaluation is a largely unresponsive, unpredictable, and uncooperative newborn who doesn’t smile when she’s satisfied, doesn’t hug you when she’s grateful, sleeps when she should be eating, cries when she should be sleeping, hardly even looks at you for more than a couple of minutes, and doesn’t seem to know you from the next-door neighbor. A sense of satisfaction in a job completed may seem totally absent. Virtually everything you do—changing diapers, making formula, washing baby clothes, feeding baby—is quickly undone and/or needs redoing almost
immediately. It’s not surprising that you feel like a flop at your new profession.
Even for a seasoned pro the post-partum period is no picnic. For a novice, it can seem like a never-ending series of blunders, bumbles, mishaps, and misadventures. Yet there are better times in sight (though you may have trouble envisioning them); competence at parenting is closer than you’d now imagine. In the meantime, keep these points in mind:
You’re unique. And so is your baby. What works for another parent and baby may not work for you, and vice versa. Avoid making comparisons.
You’re not the only one. More first-time parents than ever before have had no previous experience with newborns. Even among those who’ve had some, very few manage to glide through those first weeks as though they’d been doing it all their lives. Remember, parents are not born, they are made on the job. Hormones do not magically transform newly delivered women into able parents; time, trial and error, and experience do. If you have the opportunity of sharing your worries with other new parents, you will be reminded that though you are unique, your concerns as a new parent are not.
You need to be babied. In order to be an effective parent, you’ve got to baby yourself a little. Tell yourself, as your own parent would, that you need to eat right and get enough rest, particularly in the post-partum period, and that moderate exercise to keep your energy level up and a bit of relaxation now and then to elevate your spirits are important, too.
You’re both only human. There’s no such thing as a perfect parent, or a perfect baby—so try to keep your expectations realistic, taking into account that you’re both only human.
Your instincts can be trusted. In many cases, even the greenest parent often knows more about what’s right for her baby than friends and relatives or baby books.
You needn’t go it alone. Realize that you won’t always know what to do—no parent does—and that asking for guidance doesn’t mean that you’re short on instincts, just that you’re short on experience.
There’s a lot of good advice and comforting support out there you can benefit from. Judiciously sift through information acquired from others, test out what seems right for you and your baby, toss what doesn’t.
Your mistakes can help you grow, and they won’t count against you. Nobody’s going to fire you if you make mistakes (though on a particularly bad day you may wish that you could quit). Mistakes are an important part of learning to be a parent. You can expect to continue making them at least until your
children are off to college. And if at first you don’t succeed, just try, try something else (the baby only screams louder when you rock her in your arms side to side, so try holding her over your shoulder and swaying back and forth).
Your love won’t always come easy. It’s sometimes difficult to relate lovingly to a newborn—a basically unresponsive creature who takes but doesn’t offer much in return (except an endless supply of spit-up and dirty diapers). It may be some time before you stop feeling like a fool babbling in baby talk and crooning off-key lullabies and before you can hug and kiss this tiny bundle naturally and unself-consciously. But it will happen.