POSTPARTUM COUNSELING

Postpartum Professional Counseling Services for Healing

Managing Postpartum Feelings

depressionYou are not alone. You are not to blame. With help, you will get better.

Professional counseling for those who are experiencing postpartum depression, postpartum anxiety, postpartum OCD, and just plain old adjustment blues. In addition, support regarding issues of transition to parenting is provided. Research-based support about infant sleep is available.

There are several perinatal mood disorders. The main types are classified as: the baby blues, postpartum depression, postpartum anxiety, postpartum OCD and postpartum psychosis. Remember these diagnoses often overlap and co-occur, and there will be different opinions from different clinicians, so diagnosis is not that simple and prescribing medications is not that simple either.

You are not alone. You are not to blame. With help, you will get better.

Use the services for which your health insurance pays.

Baby Blues

It can be difficult to recognize postpartum depression as it is sort of an imposter. Its more intense feelings are on the continuum of feelings that women normally experience after giving birth, the “baby blues.” Having a baby is naturally a time of emotional highs and lows.

Research shows that about 85% of women who give birth experience feelings of sadness, fatigue, flowersoverwhelm, weepiness, anxiety, irritability and possibly some fleeting scary thoughts during the first two to three weeks postpartum. There is so much evidence to support this type of emotionality two or three weeks postpartum that it has a name, the “baby blues.” The baby blues is considered a normal part of the human emotional experience, and will fade as the mother’s body, mind and spirit adjust to parenting.

When these feelings continue beyond two, three, four weeks after your baby’s birth, it might be a sign that you are experiencing postpartum depression. The symptoms of postpartum depression can include sadness, weepiness, anxiety, irritability, fatigue, compulsive behaviors and obsessional thinking about the baby’s safety and possibly some scary thoughts about harm to self and others. Your relationship with your partner may suffer, as existing problems become exacerbated. But these intense feelings are symptoms, they are “normal” for someone who is experiencing postpartum depression, just as feelings of fatigue, irritability, extreme hunger and thirst are symptomatic and “normal” for someone experiencing untreated diabetes.

Postpartum Depression

What is deceptive about the feelings of postpartum depression is that they can appear much the same as the baby blues, but are actually more long-lasting and severe.

The woman experiencing postpartum depression deserves treatment, which can help her feel better. A treatment plan consists of being evaluated for medication, talk therapy, discussing non-pharmacological treatments for postpartum depression, getting practical help on a short-term, setting up long-term goals, and, if in a committed relationship, paying attention to improving communication.

Sometimes a woman is opposed to taking medication because of concerns about the side effects for herself and her baby. There is more and more research regarding the side-effects of specific medications and its benefits. This decision in the private individualized decision made by the woman health care team. An informed decision is possible, weighing the cost-benefits of a particular medication in an individualized case. The Organization of Teratology Specialists has free information and phone support regarding pregnancy, breastfeeding and medications.

women_talkingTalk therapy with the postpartum woman usually includes discussion about short-term adjustments to parenting but also introducing a focus on the longer-term strengthening and development of her maternal identity.

Developing communication skills with her partner might also involve discussion about short-term adjustments to the household schedule and chores and also longer-term dialogs about conflict management, perpetual issues and acceptance of each other’s differences and individual strengths and challenges.

The risk factors for postpartum depression is biopsychosocial, which are a combination of biology, psychology & social events. A list of such risk factors follows:

  • A personal history of a mental illness in your lifetime, such as depression, anxiety, PTSD, OCD, bi-polar disorder.
  • This could be undiagnosed or untreated through a personal decision not to take medication or seek treatment.
  • A history of depression or anxiety disorders in your family. These could have gone undiagnosed.
  • A personal history of premenstrual syndrome, perhaps indicating a heightened sensitivity to hormonal changes, indicating you may have:
    • A sensitivity to hormonal fluctuations of childbirth
    • Lack of social support
    • Trouble in the marriage relationship
    • Mental illness, such as addiction, in your spouse
    • Poverty is a an indicator for postpartum depression
    • Financial difficulties, such as the recession has brought to many households
    • Being in a abusive relationship, even “just” verbally or emotionally abusive
    • A past history of sexual abuse or sexual assault
    • Experiencing a past traumatic birth, such as a protracted labor involving multiple medical  interventions, even if they were medically indicated. Many factors feed into a woman feeling traumatized during her childbirth experience.
    • Having a infant born with a disability
    • Having a stillborn infant
    • Being the mother of a premature infant
    • Having had extensive infertility treatments
    • Feelings around a personal choice to terminate a past pregnancy
    • Unresolved issues from childhood regarding parenting and being parented
    • A previous episode of postpartum depression. A mother who has had a previous episode of PPD has a 50 to 80 percent risk of developing it again with her second baby (compared to a 10 to 20 percent chance without a prior episode).

If the depression occurs four – six months after the birth, research shows that there is generally an additional stressor present in the woman’s life, such as substance abuse by her marriage partner, an accident, or the death of a close friend or relative.

Postpartum Anxiety/OCD

Postpartum anxiety /OCD, like postpartum depression, also has biopsychosocial causative factors. Anxiety is a normal response that protects and motivates us to avoid and correct threatening situations.

However, when a mother suffers from postpartum anxiety, the anxiety response has become unbearable. There can be a barrage of scary thoughts regarding the safety of the mom and the baby and enacting of rituals that will supposedly protect the baby and herself.

If a person already has a predisposition to rigidity in her thinking, is generally intolerant of uncertainty, has feelings that you can prevent things from happening by worrying, then the intense life change of having a baby can trigger postpartum anxiety.

There is evidence to suggest that a new mother has a biological propensity for a heightened protective response when her infant is born. So the behavioral actions of protecting and checking the infant is biologically based. Research suggests that this response may also be heightened by a sensitivity in some women to oxytocin, the bonding hormone, which over-stimulates feelings of over-protectiveness in new mothers.

What you can do if a perinatal mood disorder is suspected

Protect the mental health of the mother.

Treatment:
Take her to see her primary care physician immediately, especially is there is a history of mental illness in her life or in her family. There are natural methods to treat symptoms of depression, but a diagnosis of a depressive episode, postpartum onset, needs to be treated with medication and therapy.

At home:
Increase self-care for the mother, help the mother get some practical help in the way of sleeping and eating properly. It is worth it to spend the money to hire a postpartum doula to help with the night shift for a month or so.

sleep-with-a-roseProtect the sleep.

Help her look at her mothering practices and beliefs. There are many methods of raising a securely attached and emotionally health infant. If she is invested in attachment parenting, there may be a way to compromise so she can get sleep.

Eat well.

In many towns, a local deli or restaurant might have a special menu for people who are experiencing an illness, and you can order from this menu, or maybe organize a meal preparation chain.

Provide practical help.

Go over the house and hold the baby, let her take a shower, organize friends & family to come over once a day every other day for a few weeks, to get past the time when the medications can start working.

Postpartum psychosis

Postpartum psychosis is a psychiatric emergency. Approximately 1 in 1000 suffer from this illness. According to the surgeon general, women are most susceptible to psychosis after birth according, usually for the first thirty days after birth.

Women with previous cyclical mood disorders are vulnerable to postpartum psychosis, or if there is schizophrenia or bipolar illness in the family. This can be diagnosed or undiagnosed illness.

A psychotic state is un-nerving to observe, especially if you are seeing it for the first time, or if you are seeing it in someone you know.

Signs of a psychotic state are:

  • the woman is not sleeping for a few nights in a row
  • she has strange delusions
  • she speaks about nonsensical beings
  • has thoughts about evil beings
  • talks about death, blood
  • she is mumbling
  • her movements are robotic and stiff
  • she acts as if hears words coming from somewhere else
  • she is staring
  • she has a flat look on her face
  • has a flatness to her feeling states
  • her speech is deadened and flat
  • gives one word answers,
  • she is fearful and paranoid.

Remember:

  • to remain calm yourself
  • the person is not faking it,
  • the person is ill, needs help, not ridicule or increase of fear.
  • You cannot talk a person out of their delusions.
  • Best to nod your head, listen,
  • GET HELP IMMEDIATELY.
  • Do not leave her alone.

Contact her husband, partner, mother, whomever is closest, these people must call 911 or escort her to the emergency room for a psychiatric evaluation.

If you cannot reach her next of kin, you will have to call 911 yourself.

You are not alone. There is help available. Seek the help you deserve. You can go to your local doctor or therapist for assistance. If you are feeling you need immediate help, please contact Befrienders Worldwide . Befrienders Worldwide is a worldwide resource dedicated to reducing emotional suffering and suicide prevention.

Postpartum Support International has information and support available as well.
The Organization of Teratology Specialists has free information and phone support regarding pregnancy, breastfeeding and medications.

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Perinatal Mood Disorders