Are you experiencing postpartum anxiety? Are you unsure on how to go about in coping with postpartum anxiety? For tips on coping with postpartum anxiety, I have interviewed psychotherapist Perri Shaw Borish, LCSW, BCD.

Tell me a little bit about yourself:
“I am a Board Certified Licensed Clinical Social Worker with a private practice in Philadelphia, PA. I received my Masters in Clinical Social Work from Bryn Mawr Graduate School of Social Work and Social Research. Perri specializes in Perinatal Mood and Anxiety Disorders and she also volunteers for Postpartum Support International as a State Coordinator.”

What are some tips for coping with postpartum anxiety?
“There are all sorts of factors that might contribute to a woman having postpartum anxiety. The postpartum period can be one of instability and insecurity and women often feel very vulnerable and alone. The best tip I have is to try to reach out to friends or family who can help with both caring for the baby and also with emotional support for mom. During this period new mothers usually aren’t taking very good care of themselves. So it’s very important to get as much sleep as possible, get outside for some fresh air and feel supported by family and friends with whom you can share your anxious thoughts and worries.

If the anxiety is severe and overwhelming it is vital to reach out to a licensed Mental Health professional or to your OB/GYN and ask for help.”

What type of professional help is available for someone that is having a difficult time coping with postpartum anxiety?
“There are therapists who are trained specifically in Postpartum Mood and Anxiety Disorders. Some cities have peer-to-peer support groups . Some hospitals and private therapists and clinics run support groups. There is also a non-profit organization called Postpartum Support International, which has coordinators in every state as well as internationally who are willing to talk with new mothers and help connect them to resources in their communities. This is the website:http://www.postpartum.net/ .

If you are suffering from some kind of postpartum anxiety please remember you do not have to suffer alone, none of this is your fault and with time and help, you will be well.”

Thank you Perri for doing the article on coping with postpartum anxiety. For more information on Perri Shaw Borish or her work you can check out her website on www.perrishawborish.com.

“The only thing that seems eternal and natural in motherhood is ambivalence.” – Jane Lazarre, novelist.

There is a tremendous amount of societal pressure placed on mothers to see the period after the birth of their child as a time of bliss, but for many mothers this is not the case. On the contrary, it is often a time of ambivalence, irritability, anxiety and hopelessness.

“I just want to sleep. I feel terrible and I’m afraid I’m going to drop my baby. Sometimes I imagine my arms may just give out and the baby will fall to the floor. I can’t speak to anyone about this so I pretend that everything is fine but sometimes I wonder if everyone would just be better off if I weren’t here.”

This frame of mind is typical among new mothers I have treated who do not realize that they are suffering from a common and treatable condition. Postpartum depression may appear to be the baby blues at first — but the signs and symptoms are more intense and longer lasting, eventually interfering with your ability to function.

Postpartum Depression, which affects 15-20% of new mothers, ranges in severity from mild anxiety to major depression. There is a wide range of conditions that are considered postpartum depression but here we will focus on the most common form, that of major depression.

Because patients and caregivers often overlook the symptoms of postpartum depression, it is important that we recognize them. Like other types of non-psychotic major depression, postpartum depression is characterized by: depressed mood, irritability, anxiety and loss of interest in general. Also, women who suffer from postpartum depression often express ambivalence toward their newborn child and commonly have doubts about their ability to care for their child.

How should women suffering from Postpartum Depression be cared for?

Ideally, treatment should begin even before the child is born if a woman is at risk for postpartum depression. She should meet with a therapist to create a wellness plan so that she is prepared once her child arrives.

If a new mother shows symptoms that are associated with postpartum depression, a thorough analysis of her medical history and a physical examination should be undertaken so that medical causes of mood disturbance such as thyroid dysfunction or anemia can be ruled out. Treatment should be based on the severity of the symptoms shown as well as the degree of functional impairment experienced by the new mother.

For cases of mild to moderate depression, non-pharmacologic options such as psychotherapy can be helpful. A good diet and plenty of sleep are essential. Friends and family can lend a hand by offering much-needed emotional support and encouragement and by providing hands-on help in taking care of the baby. It’s important to encourage a new mother to eat a balanced diet and to get sufficient rest which play an important role in her well-being. The human brain needs continuous sleep to recharge.

At night, a loved one can help by bottle-feeding the newborn periodically to enable a new mother to sleep. During the day, a loved one or close friend can take the baby for a walk or hold the baby in order to give the new mother much needed time for herself.

Believing the myth that “new mothers love each and every moment with their babies” can push some mothers to ignore their own needs. When we are depressed it can feel as though the walls are closing in around us. A few minutes of exercise, a short walk outside and a breath of fresh air can go a long way in the recovery process.

When a new mom shows signs of more severe postpartum depression or does not respond to non-psychotropic treatments, antidepressant medications taken along with psychotherapy have been proven to be effective. For nursing mothers, antidepressant medications must be chosen with the safety of the baby in mind - first and foremost. When a mother presents with severe postpartum depression, particularly for patients who are at risk for suicide, inpatient hospitalization may be required.

Recognize the Symptoms and Know What to Do

New mothers and those who surround them should be made aware not only of the symptoms of postpartum depression but also that it is a common and highly treatable condition.

There is no reason for a new mother to suffer in silence and shame. It is imperative that those with symptoms of postpartum depression seek the help of a trained professional in order to develop a game-plan that limits depression and anxiety in favor of the enjoyable aspects of becoming a mother.

I have found that the simple act of talking about feelings often helps to alleviate symptoms in my patients. As a therapist often the most important thing I can do for my patients is to listen to them, encourage them and normalize what a difficult and challenging time this is for new parents. With proper treatment and care, the process of becoming a mother can truly be an exciting time, full of new adventures, growth and a tremendous amount of love.

Resources if you are struggling with Postpartum Depression:

American Psychological Association http://www.apa.org

Depression After Delivery http://www.depressionafterdelivery.com

Postpartum Support International http://www.postpartum.net

Center for Postpartum Health http://www.postpartumhealth.com

We read with shock and sadness of the young mother who killed her 8-month-old son, and then attempted to kill herself. It was reported she had been suffering with depression. It’s important to know that one in eight new mothers suffer from postpartum depression. The symptoms include sadness, anxiety, panic, difficulty bonding with the baby, problems eating or sleeping and feeling out of control, or that you’re “going crazy.”

For these women, it’s not about the “baby blues.” It’s a real illness that needs real treatment and immediate attention. The problem is that new mothers often feel very alone and ashamed of their feelings. There are a lot of societal pressures and expectations about motherhood that can contribute to the shame and thus, the burden of silence some women who experience postpartum depression carry.

Postpartum Support International is a worldwide free, nonprofit support network for women and families suffering with PPD. Our website contains educational material, resources, and contact information, so no new mother has to suffer alone. In addition, you can contact any of our coordinators to help you find resources in your own community; such as counseling or support groups. Our website is www.postpartum.net.

ERIN SADDIC, MS

PA Co-Coordinator Postpartum Support International

PERRI SHAW BORISH, MSS, LCSW

PA Co-Coordinator Postpartum Support International

Are you Expecting…a New Mom…a New Dad? How do you know if you are experiencing the “baby blues” or something more serious and long term?

It’s three days after you’ve had your precious baby and you’re finally home, where you spent countless hours as a pregnant woman fantasizing about what it would be like to be with your newborn. Maybe you imagined the lights dimmed as you looked lovingly into your baby’s eyes; or perhaps you imagined your sweet baby lying between you and your partner in your cozy bed. Whatever your fantasy was, reality has set in, and not only is your vision more of a distant memory, but you feel like an emotional wrecking ball. You’re crying and you don’t know why. Your baby is crying and you don’t know why. You can’t seem to make a decision, you’re exhausted and you have even wondered if maybe your baby deserves a better, more suited mother.

As a psychotherapist, I want you to know you are not alone. Many new mothers experience these types of anxious, depressed thoughts in the first few days after giving birth. These feelings are called the “baby blues.” In fact, 50 to 80 percent of women experience the baby blues, which come and go in the first few days after childbirth and are usually gone within three weeks. As the American Academy of Family Physicians states, “’The blues’ are considered a normal part of early motherhood.” Given the large number of women who experience the baby blues, it’s unbelievable that, at some point during the prenatal period, doctors and midwives don’t educate their patients on the possibility of experiencing these symptoms. One reason new mothers are often surprised by their feelings is because along with pregnancy come dreams and expectations of what life will be like with the newest member of the family. It can throw off the equilibrium of the first few weeks at home, and women find themselves having to readjust their expectations. The best way to combat the baby blues is by preparing for it, recognizing and talking about your feelings and asking for help when you need it.

So the question then becomes, how do you know if you have the baby blues or something more serious and long term?

Women who experience the baby blues are at risk for developing Postpartum Depression so it is important for new mothers and their partners to understand the symptoms, what to watch out for and when to consult an expert:

• The baby blues occur during the first three days after birth and can last up to three weeks. If it lasts longer, you may be experiencing Postpartum Depression and should consult your doctor or mental health provider.
• Usually the blues are hormone-related, and women with the baby blues are rarely a threat to themselves or their baby.
• The symptoms of baby blues are crying for no reason, impatience, irritability, restlessness and anxiety. The baby blues are often accompanied with mild depression.

The baby blues can be awful and hard to tolerate, especially given the simultaneous adjustment to motherhood. Fortunately, the baby blues are short-lived. This does not mean, however, that your feelings should be ignored or diminished in any way. As psychotherapists, we treat the blues with TLC. Women experiencing these symptoms need care, attention and support. They need help with the baby and should be encouraged to accept it.

So, to all the partners of these courageous women, I beseech you to pay very close attention to the mother of your baby at this critical time. Do not wait for her to ask you for help. She may be so overwhelmed that she may not be able to name exactly what it is she needs help with.

• Be available to your wife for comfort and reassurance and allow her the space to talk about how she is feeling. If you can’t be there for her, get help from family or friends, or hire a doula or a baby nurse who can assist both with the baby and with the mother during this crucial period.

• At this early stage, do not expect your wife to be able to do all that she did prior to having a baby.
• Act as the gatekeeper and safeguard your wife from well-intentioned visitors so she is not over-taxed by the company.
• Encourage your wife to sleep when she can, as she is no doubt exhausted.
• Make sure she eats well and gets out of the house when possible.

Here’s the Good News: The baby blues are common and are manageable with support and preparation. Whether you are a woman about to embark upon motherhood, or a first time father, or a new grandparent, you can help prepare the family by setting systems in place to give the new mother and her baby extra support during the first few postpartum weeks. You are about to enter what will undoubtedly be the most rewarding and most challenging event of your lives and the more you prepare for it, the more you will be able to enjoy the time with your newborn.

For additional information on the baby blues see the below resources:

• American Academy of Family Physicians

• American Psychological Association

• Depression After Delivery

• Postpartum Support International