Treatment of postpartum mood and anxiety disorders has three possible components. Some women will find one, two, or all three to be important or necessary for successful treatment. Psychotherapy and medication are two methods of treatment that aid in management of symptoms and successful treatment for postpartum mood and anxiety disorders. I discuss each in more detail here and here.
Today I want to discuss with you the importance of self-care in treating postpartum mood and anxiety disorders. For brevity sake I will refer to these as PMAD.
Self-care can feel like a loaded term, casually thrown around as a catch phrase for simply living as healthy as possible. However we often promote self-care without specific examples of what exactly it may look like, and certainly without acknowledging that even things that feel like small steps to promoting wellness may actually be incredibly difficult to initiate, particularly with depressive symptoms. It is this reason that I highly encourage compassion and kindness with oneself when considering self-care and making steps to implement more of it in your life. It can be hard, and certainly made even more difficult as a parent because as parents our primary focus is almost always on taking care of other people.
This makes sense, doesn’t it? We have vulnerable littles who rely on us for every. single. thing. We are biologically programed to respond to these needs, and often have physiological responses to our children’s cries to get their needs met. Of course our attention, focus, and care will be directed at our babies!
The attention, focus, and care for our babies is necessary and part of the infinitely important and protective bonding process. However when all of our attention, focus, and care goes to our babies we can be left feeling exhausted (physically, mentally, and emotionally), overloaded, stressed out, and depleted. The truth is that we mamas also need to have our emotional tanks filled, and regularly. Without at least some self-care and self-focus, we do not provide ourselves with an opportunity to recharge, leaving us burnt out, which in turn affects our ability to parent as our best selves.
It also contributes to PMAD and increases one’s risk for having PMAD.
Areas of self-care that I help clients focus on during treatment include finding external support, stress management, exercise and physical activity, sleep hygiene, and nutrition.
External Support refers to identifying or creating a support system to lean on when you feel stressed, tired, or overwhelmed. It’s also important to include a support system in the more joyous parenting moments–celebrations, birthdays, holidays. This support can be through partners or spouses, friends, neighbors, family, coworkers, or parenting groups. These support groups can offer an emotional support that is necessary and important during the difficult (and often isolating) early years of child rearing. External support also comes in the form of assistance with household tasks, such as grocery shopping, cleaning, or basic errands. Hiring a housekeeper (if financially feasible), a grocery delivery service, or meal service may also help in providing support for the practical day to day stresses that can feel overwhelming when struggling with PMAD or the transition into parenting (or adding more children to your family). Together we will identify support systems and reach out to create new ones that can help you during these difficult transitions and early years of child rearing.
Stress Management focuses on identifying the stressors in your life that may be contributing to symptoms of PMAD. Let’s be honest, parenting is joyous, but also incredibly challenging at times. The stress of it all can feel overwhelming and can exacerbate depressive or anxious feelings. Together I work with clients to identify areas of stress and triggers for stress and then work to find coping skills and management skills that will help to mitigate the effects of the stressors. We will also problem solve ways to minimize as many stressors as we can, sometimes through the other areas of focus in self-care. I also explore the external stressors that may be impacting your emotional health, such as societal pressure or family pressure and expectations. Managing these expectations can be an important step in reducing stress and have long lasting positive effects on PMAD symptoms. Finding ways to relax can feel like a struggle when you are a parent, but they are not impossible and we will work together to find ways to help relieve stress where we can and identify ways to cope when we can’t.
Exercise and physical activity is an important part of treating PMAD. Exercise has been shown to improve mood and depressive symptoms. Thirty minutes of moderate exercise a day is recommended for overall health, but I want to stress that this does not mean that a new mom (or any mom) needs to exercise intensely to get the benefits. Moderate activities (like walking at a decent clip) are just as beneficial. Of course exercise will be individual to each client, is impacted by overall health, and requires doctor approval before taking up new activities (particularly after childbirth). I highly recommend for new mamas to get out of the house for thirty minutes a day and into fresh air. A walk can do wonders for your emotional and physical health. Many babies enjoy being worn or put in a stroller and taken out for fresh air as well. Can’t make thirty minutes work? Break it up during the day. Even simply being outside, or the “fresh air factor” can significantly help. I work with clients to find what feels right, but emphasis that exercise and physical activity is an important part of good self-care.
Sleep hygiene as self-care can feel like a cruel joke to parents of an infant. I often discuss it with clients and can see the bemused look upon their face. Shoot, I had that same look when my own doctor asked me how my sleep was at my six week postpartum checkup. I understand the realities of sleep and babies. They don’t often mix well, and broken sleep is the norm for most of us. However, it is important that we do as much as we can to rest our bodies when we are tired and if at all possible, get the amount of sleep we need for regenerative purposes. We’ve all read the consequences of sleep deprivation by this point–that it’s a torture tactic, that it contributes to depression, that even a few nights of disrupted or chaotic sleep can have dire negative impact to our daily functioning–we know. And we feel it. Boy do we feel it.
I recommend that clients do all they can to get five hours of uninterrupted sleep when possible per night. If your partner or spouse is able to step in and give the baby a bottle in the night–wonderful! For some mothers this simply isn’t possible, and that’s okay. Naps can be restorative as well. This is an age old point of stress for parents postpartum, and one of the toughest. However because sleep is so important to our overall functioning and health, I make it a priority for self-care that we focus on ways to improve your quality of sleep, even if we can’t improve the quantity of it.
Nutrition is an area of self-care that I like to focus on because it’s often one we overlook. After all, many parents find themselves eating left overs of their children’s food or grabbing the quickest snack on hand because we simply don’t have the time or free hands to prepare food on the spot. I can’t count the number of times I’ve eaten the scraps off my toddler’s plate and called it a meal. However, when possible, we need to remember that we will often get back what we put into our bodies. If we fill up with good, nutritious, and healthy food we will simply run better. I’m not a nutritionist or dietician, I don’t spend hours breaking down what you should or shouldn’t be eating. I simply encourage my clients to eat enough throughout the day, eat the good stuff when possible, and be mindful that doing what you can to take care of your body will yield better results for self-care and can contribute to decreasing PMAD symptoms.
With nutrition, it’s also important to consider what your body may be lacking, particularly after the depleting impact of pregnancy and birth. Research linking Omega 3 fatty acids as a protective factor against postpartum depression has been an interesting and new development, as has the relationship between inflammation and depression (see more here). Discussing supplementation with your primary care doctor is a good step in well rounded nutrition if you are not getting enough of the nutrients you need in your diet.
While these areas of self-care are important in treatment, there may be other areas that come up along the way. Each client is an individual person with individual needs and as such we will work together to identify what areas of self-care are helpful to you.
Wishing you wellness!