National Maternal Depression Month: 9 Tips for Coping with Postpartum Depression

Do you suffer from postpartum depression? Find out what the symptoms are, as well as 9 tips for coping with it from a woman who’s been there in this post on the Bipolar Parent!

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Trigger Warning: This post contains a brief mention of suicidal ideation. If you are suffering from suicidal thoughts, please talk with someone from the Suicide Prevention LifeLine at 1-800-273-8255 or www.suicidepreventionlifeline.org.

Postpartum depression is a special kind of hell. You’ve been told that the time with your newborn is fleeting and magical. That you should be bonding with your baby. That every mother has the blues, so there shouldn’t be anything wrong with you.

But postpartum depression is not fleeting or magical. It interrupts the bond with your baby and leaves you a compromised mess. And it’s not just the typical blues “every” mother gets; if you have postpartum depression, there is definitely something wrong.

May is National Maternal Depression month. The awareness month is intended to acknowledge the seriousness of depression and psychosis during and after pregnancy. Studies show that up to 20% of mothers suffer from some form of depression in the postpartum period.

And you know what they say: “when Mama ain’t happy, ain’t nobody happy.” The damage that can be dealt to families when a mother suffers from depression or psychosis is tremendous.

9 tips for coping with postpartum depression - CassandraStout.com

Symptoms of Postpartum Depression and Psychosis

Postpartum depression symptoms can show up anytime within the first year, though most tend to show up soon after your baby’s birth. If you or your loved ones are feeling three or more of these symptoms, call your doctor right away.

Symptoms of postpartum depression can include:

  • Persistent sadness or anxiety
  • Irritability or anger, especially for no reason
  • Sleeping too much
  • Changes in eating patterns, either too much or too little
  • Mood swings
  • A lack of ability to focus
  • Changes in memory (can’t remember things)
  • Feelings of worthlessness
  • Suicidal thoughts
  • Anhedonia – Lack of pleasure in usually enjoyable activities
  • Isolating yourself
  • Feelings of hopelessness
  • Unexplained aches, pains, or illness
  • Interrupted bond with the baby

Postpartum psychosis, however, usually shows up within 2 weeks of the birth. The most significant risk factors for postpartum psychosis are a family history of bipolar disorder or a previous psychotic episode.

Symptoms of postpartum psychosis can include:

  • Delusions or strange beliefs
  • Auditory or visual hallucinations
  • Enormous irritability
  • Feeling pressured to go, go, go all the time
  • High energy
  • Inability to sleep, or decreased need for sleep
  • Paranoia
  • Extreme mood swings that cycle quickly
  • Inability to communicate at times

Postpartum psychosis is a serious disorder of the mind. Women who experience postpartum psychosis die by suicide 5% of the time and kill their infants 4% of the time. The psychosis causes delusions and hallucinations to feel real and compelling. They are often religious. Postpartum psychosis requires immediate treatment. If you or a loved one are feeling any of these symptoms, head to your nearest emergency room.

My Story

After my son was born, I suffered a postpartum psychotic break and committed myself to a mental hospital, where I was diagnosed with bipolar I disorder. I later wrote a book about the experience. After I recovered from the break, a manic episode with psychotic features, I suffered postpartum depression.

By the two-and-a-half year mark, I was writing daily suicide notes and making plans to die. It wasn’t until I weaned my son and took lithium that the clouds parted. My full recovery took a long time after that, but I was able to recover. I have since had a second child with no ill effects.

But if you have postpartum depression, how do you cope with it? Read on for 9 practical tips from a woman who’s been there.

Tip #1: Get Professional Help

Postpartum depression is a beast that screams for professional help. If you don’t already have a treatment team including a therapist, psychiatrist, and a primary care physician, then make the effort to get one.

(For a post on getting a psychiatric evaluation, click here. For a post on how to start seeing a therapist, click here.)

I know calling and vetting doctors at a time when you can barely hold your head above water sounds about as appealing as sticking your hand into a box of tarantulas. But trust me: the sooner you get help, the better off you’ll be. If you have a friend or a partner willing to support you, delegate the task of finding doctors and making appointments to your helpers.

A therapist can teach you coping skills to better handle your depressive episode. And a psychiatrist can prescribe you medication which can improve your mood and anxiety tremendously. And your primary care physician can give you referrals to a therapist and a psychiatrist.

If you don’t have a primary care physician, go to urgent care or call Postpartum Support International at 1-800-944-4773. Their website, postpartum.net, enables you to find local resources to get treatment, and support groups for new moms like you. You can also ask your ob-gyn if the hospital in which you delivered offers services to treat postpartum depression.

Tip #2: Take Your Medications

If you’ve been prescribed medication, then do take it. There’s no shame in using the tools that you’ve been given specifically to help you.

I know that you may not feel an effect for a couple of weeks, and the first medication may not even work the way you want it to, but I promise, if you stick with them, your meds will help. Stay the course. Work with your psychiatrist (see tip #1) to find the right combination of medication to help you.

Don’t stop taking them abruptly, as they aren’t designed for that, and you will suffer withdrawal symptoms. For a post on what to do if you run out of medication, click here.

You can pull through this. You just need to be patient–and take your meds as prescribed. Give medication a chance, and you’ll be well on your way to recovery.

Tip #3: Practice Self-care

Practice self-care. A lot of people think self-care ideas are limited to bubble baths and painting their nails. But that’s just not true.

Self-care is taking responsibility for your physical and mental well-being. That’s it.

Try to get enough sleep during the week, eat a healthy diet, drink plenty of water, exercise, and spend some time outside and with other people.

Practicing self-care on a daily basis is difficult. It’s the box of tarantulas problem again. But taking care of yourself will help your depression lift.

Tip #4: Lean on Your Friends

If there was ever a time to lean on your friends, this is it.

Tap into your social network and ask for support during a time when you might be feeling vulnerable. Give your friends a call and ask them to listen to your worries, or join an online support group. If you have a church or social organization, see if someone would be willing to set up a meal train for you. Ask your friends or family to come watch the baby so you can get some life-saving sleep.

Sometimes asking for help is the hardest part of being down and out. Pride is a stumbling block. But there’s no shame in asking for help if you really need it. If you’re depressed, you’re really suffering, and you need the aid of others. Lean on your friends.

Tip #5: Journal, Journal, Journal

When faced with overwhelming feelings, you need to express yourself. Don’t stuff your worries, thinking they’ll go away. You’ll only succeed in making them bigger and harder to overcome.

If motherhood is not what you envisioned, write about how unfair this new normal is. Journal your concerns about your baby. Write down your dreams.

Talking to someone also helps. Reach out to your friends (tip #4) and speak with them about your fears.

However, if you have a rare disorder called hypergraphia, the compulsion to write, then try to avoid writing. During my postpartum psychosis, I suffered from hypergraphia, and was compelled to write multiple to-do lists with hundreds of items each. I filled up a journal my husband bought me on the day of my son’s birth within a week.

If you are suffering from hypergraphia, it is even more imperative that you seek treatment (tip #1).

Tip #6: Breastfeed… But Only if You Can and Want To

Studies have shown that mothers who breastfed for two to four months were less likely to suffer postpartum depression. But for mothers who couldn’t or didn’t want to breastfeed and felt pressure to do so, their depressive symptoms were worse.

If you can and want to breastfeed, then do so. You may feel the benefits.

But if you can’t breastfeed or don’t want to, then don’t, and don’t feel shame. You are doing a wonderful job feeding your baby regardless of how you feed them. Ignore judgmental people, and do what’s best for you. What’s best for you is best for your baby.

For a post on which common antidepressants and antipsychotics are safe to take while breastfeeding, click here.

Tip #7: Schedule Me-time

Anyone juggling the demands of a newborn needs me-time. This is doubly true if you’re depressed. Lean on your friends (tip #4) to watch the baby so you can get out for a walk, take a nap, and practice self-care.

If you can’t bear to be separated from your baby, just try for twenty minutes. You can be alone for twenty minutes. That’s enough time to squeeze in a yoga or meditation session, or read a couple chapters of a book.

You need time off to function as an adult. Losing your identity to the vast maw of motherhood is a real concern. Schedule me-time.

Tip #8: Cry

After the postpartum period, your body is flush with hormones. One of the ways to rebalance your hormonal imbalance is to cry. Our bodies secrete hormones through our tears.

Don’t be afraid of tears. Embrace them. Sometimes, if you give yourself over to a good cry, it can be cleansing.

Tip #9: Practice Infant Massage

Infant massage has a whole host of benefits. The baby’s sleep may improve. Rubbing infants down stimulates growth hormone in underweight babies, and helps all babies’ stomachs. And infant massage also helps the pain of teething.

Most importantly, performing regular infant massage can help you bond with your baby. When you’re depressed, bonding with your newborn can be extremely difficult. Connecting with your baby through your hands may help.

Final Thoughts

Postpartum depression doesn’t have to last forever. If you get professional help, take your medications, practice self-care, lean on your friends, journal your feelings, breastfeed (but only if you can and want to), schedule me-time, cry, and practice infant massage, then you’ll be well on your way to recovery.

You don’t have to do all of these tips. Pick and choose the ones that are most appealing. But if you do any of them, do the first: get professional help.

Postpartum depression is a serious condition which requires the aid of doctors. And postpartum psychosis is a medical emergency.

Don’t be afraid to reach out. Trust your instincts. If you feel that something is wrong, then do take the first steps to care for yourself.

I wish you well in your journey.

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9 tips for coping with postpartum depression - CassandraStout.com

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National Maternal Depression Awareness Month: My Experience, and How to Get Support

Trigger warning: This post contains discussions of suicide. If you or someone you know is at risk of suicide, please call the U.S. National Suicide Prevention Lifeline at 800-273-8255, text TALK to 741741 or go to SpeakingOfSuicide.com/resources for additional resources.

postpartum depression
A picture of a black typewriter, above which are typed the words “Postpartum Depression” in capital letters. Credit to flickr.com user Twitter Trends 2019. Used with permission under a Creative Commons license.

May is National Maternal Depression Awareness Month. While up to 80% of mothers experience “baby blues,” up to 20% of mothers suffer from postpartum depression (PPD), a pervasive condition which sucks the life out of them. I’d like to share my experience with PPD in order to help destigmatize the condition and add to the conversation. I will also offer some tips on how to get support for PPD.

Women suffering from PPD endure a deep, pervasive sadness, fatigue, trouble sleeping and eating, thoughts of hurting themselves or the baby, and may isolate themselves. Symptoms may occur a few days after delivery, or up to a year afterwards, and can last for years. Treatments such as antidepressants can help.

My Experience

My experience was a little different. Within a week after the birth of my first child, a son, I suffered postpartum psychosis (PPP), which is the most severe form of PPD and only affects 1-2 mothers out of every 1000 births. Symptoms of PPP include hyperactivity, hallucinations or delusions, bizarre behavior, rapid mood swings, and thoughts of hurting the baby. If you or a loved one are suffering any symptoms of PPP, contact a mental health professional or the American Pregnancy Association immediately.

During my run with PPP, I didn’t sleep for a week. I ate/drank only chocolate milk, and couldn’t stop talking. I had pressured speech, racing thoughts, and other symptoms of mania, like irritability. I often vacillated from euphoric explanations of my “plan” for the baby’s care to intense anger at nothing at all. I also suffered from hypergraphia, writing over a hundred to-do lists with multiple items on them during the first few days. I was obsessed with breastfeeding my son, and attempted suicide when the breastfeeding relationship was threatened.

I committed myself to a local mental hospital, where I was very lucky to find a bed on the day my therapist asked for one, and earned a bipolar diagnosis. The doctors there treated me with Olanzapine, a tranquilizer which knocked me out, and 1500mg of Depakote, which toned down my mania.

After enduring the harrowing PPP experience, which I’ve covered in my upcoming memoir, Committed, I suffered from two years of standard PPD. I was constantly exhausted despite sleeping well, cried often, and spent my waking hours writing suicide notes. I often thought of plans to hurt myself, and had thoughts of hurting my infant son.

I was still obsessed with breastfeeding him, and refused to take medication that would have endangered the breastfeeding relationship, like lithium. When he turned two and a half, I weaned him, and started taking ,a href=”https://cassandrastout.wordpress.com/2013/01/10/1227/”>lithium, which utterly changed my life. The depression lifted, the sun came out, and I stopped wanting to die by suicide. I was happy again, and started properly loving my baby.

I can now happily say I’ve not suffered a bipolar mood episode, either depression or mania, for the past six years. In order to reach that stability, I tried over a dozen medications until I found a combination that worked. I changed psychiatrists seven times because they kept moving to different practices, and changed therapists twice because of the same reason. I attended weekly counseling sessions for years. I learned how to never miss a dose of my life-saving medication, and how to practice good sleep hygiene. I recently gave birth to a second child, with no ill effects.

Tips on How to Get Support

If you or a loved one are suffering from PPD, or especially PPP, find a mental health professional as soon as possible. If you have a therapist, ask him or her to refer you to a psychiatrist, if you’re interested in pursuing medication. If you don’t have a therapist or a psychiatrist, ask your primary care physician or ob-gyn for a referral to one of those. If you don’t have a primary care physician, go to urgent care or call Postpartum Support International at 1-800-944-4773. Their website, postpartum.net, enables you to find local resources to get treatment, and support groups for new moms like you. You can also ask your ob-gyn if the hospital in which you delivered offers services to treat PPD.

Above all, fight stigma, especially self-stigma, which can creep in without you realizing it. You might feel ashamed or confused that you’re obsessed with your baby’s safety, or that you’ve had thoughts of harming your infant. Don’t be afraid of these feelings. They’re a sign of a mental illness which can be treated.

The difference between you as a mother suffering from PPD or PPP and the mother you can be on the other side of them is like night and day. You are not alone, either. Try to avoid isolating yourself. A therapist will understand, as will people in your support groups. Do everything you can to survive this, not only for yourself, but for your child.

You can do this.

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Antibodies That Cause Encephalitis Linked to Psychosis

antibodies
Credit to flickr user Parthiv Haldipur. Used with permission under a Creative Commons license.

Psychosis, a break from reality, is a common feature of bipolar disorder. People can suffer delusions, hallucinations, depression, anxiety, and incoherent speech. The breaks are especially dangerous for postpartum women, who may harm their infants. The causes of psychosis are varied, ranging from mental illnesses such as schizophrenia or bipolar disorder, to sleep deprivation, substance abuse, or prescription drugs.

But new research has linked psychosis to antibodies that cause encephalitis, a life-threatening disease which inflames the brain. There is hope that removing these antibodies will treat psychosis just as much as doing so treats encephalitis. Some of the antibodies act against a nerve cell protein called NMDAR, or the NMDA receptor.

Belinda R. Lennox, a psychiatry professor at the University of Oxford in the United Kingdom, led a team of researchers who conducted a study on 228 people with first-episode psychosis. The scientists drew blood from the patients within the first six weeks of treatment. They also collected blood from a group of healthy people and used that as the control group for the study.

Seven–three percent–of the patients with first-episode psychosis presented with NMDAR antibodies. None of the controls did. A previous study from 2015 found that children experiencing their first episode of psychosis also had antibodies relating to the NMDAR.

The good news is that, Lennox and her team, using an experimental immunotherapy that targets the antibodies, successfully treated patients with psychosis, and helped them recover function after their episodes.

Three percent may not be much, but it’s three percent more of people who may be able to be treated with immunosuppressant therapies. This is a significant minority, one that shows promise. Lennox and her team plan to conduct a randomized, controlled trial of immune treatment in people with psychosis in 2017.

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Can Blueberry Extract Help Prevent Postpartum Blues?

blueberries.jpg
Credit to flickr.com user ___steph___. Used with permission under a Creative Commons license.

Postpartum blues, a range of sad emotions that peak five days after giving birth, is often seen as a precursor for postpartum depression. But a recent study in the Proceedings of the National Academy of Sciences (PNAS) shows that dietary supplements, including blueberry extract, may lessen the effect of postpartum blues, and possibly prevent postpartum depression.

Researchers believe that postpartum blues are controlled by hormones, and the changes that occur in them after birth. In the postpartum period, estrogen and progesterone drop severely, which may contribute to depression. Postpartum depression is also coupled with an elevation in the enzyme monoamine oxidase A (MAO-A), which regulates neurotransmitters in the brain.

During the study, scientists gave a group of 20 women a dietary supplement containing L-tyrosine and L-tryptophan–both thought to help balance postpartum MAO-A activity–blueberry juice, and blueberry extract. The levels of tryptophan and tyrosine in breastmilk were not affected by this dietary supplement. The blueberries were added to help the chemicals cross the blood-brain barrier.

A control group of 21 women were not given a supplement, which may mean that the results of the study may be challenged by the placebo effect. But it’s difficult to argue with the results: on the Visual Analog Scale, a commonly-used measure of pain, the group that did not receive the supplement had scores of a thousand times higher than those women that received the supplement. On the Profile of Mood States, the control group showed a significant increase in depressive symptoms, but the women who received the supplement experienced a decrease in the same symptoms. The moods of the women taking the supplement were improved three-fold.

Even though the study did not have a placebo trial, the results speak for themselves. The supplement doesn’t have any negative effects, so researchers plan to have better studies, with bigger sample sizes and placebos. If the chemicals and blueberry juice and extract can  indeed decrease depressive symptoms this greatly, there’s no reason to not give women these supplements. What a great scientific advance!

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What is Postpartum Psychosis?

Postpartum psychosis is a rare condition which includes symptoms of racing thoughts, delusions, hallucinations, the sensation of things “crawling” under the skin, mood swings, paranoia, and confusion. It occurs shortly after giving birth, in the first two weeks postpartum.

psychosis
Credit to flickr.com user Engage Visually. Used with permission under a Creative Commons license.

Psychosis affects approximately 1 to 2 mothers out of every 1,000 births in the U.S. The risks include previous history of psychosis and bipolar disorder, even though roughly half of the women who encounter it have no risk factors. According to Wikipedia, “25 to 50% of women with a history of mental illness experience postpartum psychosis; around 37% of women with bipolar disorder have a severe postpartum episode.” The risk of having a second psychotic episode is roughly 30%. The condition is not recognized in the DSM-5, but is used by doctors worldwide.

Unfortunately, there’s a 5% suicide rate and a 4% infanticide rate lumped together with psychosis. Each woman who undergoes postpartum psychoses breaks from reality. The delusions she endures are quite real to her. However, not all delusions and hallucinations tell the mother to commit harm to herself or an infant. Sufferers require immediate twenty-four hour monitoring and, in most cases, medication, to come out of the fugue.

During my episode, I was lucky enough to have a therapist who helped me commit myself to the University of Washington’s mental ward, which was the only available bed in the city at the time. Because I hadn’t slept in a week, the doctors there prescribed Olanzapine to knock me out for the first twenty-four hours, and then Depakote to help tame the postpartum mania.

I couldn’t sit still; I felt like I was going to burst right out of my skin from all my restless energy. The urge to nurse my newborn, Nolan, was intense. I tried to suffocate myself with wet towels when I found I couldn’t do it. I suffered a single hallucination in the showers: a voice roaring at me to stand up.

If you are suffering from postpartum psychosis or know someone who is, immediate treatment is essential to make a full recovery, which takes roughly six months to a year. The mood swings and delusions can last anywhere from two to twelve weeks. It is not your fault that this happened. You can recover from this.

Have you suffered from PPP or known anyone who has?

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