The most dangerous element of postpartum depression is silence. The stigma that surrounds maternal mental health disorders is so pervasive and dark that many moms experiencing distress are terrified to open up about it to anyone, let alone their health care providers, for fear of judgement at best, and being deemed unfit at worst.
If a mom you know and love is brave enough to confide in you, I’ve compiled this guide of do’s and don’ts to help you through those early conversations.
If she is willing to talk to you about her difficulties, just start by listening. Encourage her to keep talking and listen with an open mind and heart.
Look, postpartum depression gets a bad rap compared to a lot of other disorders because we have a societal expectation of mothers to be perfect, nurturing, and serene. Hearing of a mother suffering mental health challenges instantly rubs against that perception that it is the happiest time in life. If you aren’t happy, there must be something WRONG with you. DO NOT GO THERE.
Postpartum depression is simply depression after having a baby. It has nothing to do with a woman’s ability to mother or a woman’s level of affection, love and attention to her baby. It is a medical condition caused by a mix of hormones, stressful life events, sleep-deprivation, and lack of supports. It is NOT an inherent failing of a mother. It is not a failing of a mother to need help. It is not a failing of a mother to struggle. EVER.
Do: Ask what would be helpful — gently and openly.
Instead of specific and close-ended questions like “is your baby sleeping through the night?” (spoiler-alert: no), ask questions like “how is postpartum going?” “What is being a mom like for you?” “Can you tell me more about that?” “What can I do that would be helpful for you?”
You can also offer options for helping like, “Can I check in more frequently?” “Can I bring you a meal?” Whatever it is that you have the capacity to offer. Remember, even if you are desperate for help for this loved one, it is not up to you to solve exclusively. Boundaries and community.
Don’t: Make it about you or someone you know.
At least, not at first. PPD is SENSITIVE. It can be extremely hard to admit, let alone share. By hearing about someone else who went through it, who maybe had it worse – while well-intentioned and hoping to help validate your loved one’s feelings, it can come off as minimizing or diminishing. It can feel like the loved one who is going through a very dark period now has to have empathy for that person who had it worse, or respond to a story she really cares nothing about right now. Instead, ask questions and listen, really listen, to the answers.
Do: Let yourself learn. Quiet your desire to give advice or share your experiences, and simply listen and learn what this experience is like for her. This will also show that you are really invested in what she has to say and in her experience in particular. You can say things like, “I don’t have all the answers, but I’m here for you.”
Do: Follow up
If your loved one shares she’s having a hard time, follow up about it a few days later, even if she seems better. I experienced good days and bad days. The friends and family I’m closest to now are the ones who checked in constantly, even when I forgot or failed to call or text back. They asked again and again and again how I was doing. They never treated me differently and they didn’t back off.
Validation is powerful. It is one of the most essential tools in talk-therapy because we so often want to be seen and heard before we want a problem to be fixed. Simply responding to their sharing with statements like the following can make a huge difference in a heart-to-heart:
“Wow, that sounds really hard.”
“I hear how hard this is.”
“It must be really difficult to be in this situation.”
This isn’t exactly fair, and is exactly why I’m doing this awareness campaign to reduce stigma, but I was terrified of being called out for PPD at the time. I didn’t want anyone to say I had it, because I didn’t want it to be true. It was easier to call it “baby blues,” “a hard time”. I was not prepared to deal with the impact of the label at the time.
If your loved one bristles at the suggestion, she may not benefit from a label yet either. Even if you think she has it, the label is only helpful insofar as diagnosing the right course of treatment. Watch her closely and give her time, and try suggesting it again if symptoms seem unchanged or worse.
Do: Show up and Hold The Space
The feelings that are often associated with PPD are anger, despair, emptiness, numbness. During a time when you are expected to be about as overjoyed as a person can be, having these feelings feels like a dirty, shameful betrayal. At least it did for me. This is dark sh-t and I didn’t want to tell ANYONE about it. My husband was the only one who truly saw what was going on and he simply stood beside me and held the space until I was ready for help.
Your person who is opening up to you needs you to be able to hold their hand in the dark. She likely doesn’t know what to do, or where to go, she just sees the darkness all around her. She needs you to stand beside her and hold the space. Let her show you the ugly. Help her hold the ugly. Stand beside her in the dark.
Do: Remember she’s still the same person.
A mental illness does not detract from everything else about the person you love. I was still Eva. I still loved to read, watch tv, write, take photos. I still drank wine and laughed. Through it all, I was still the same person, I was just suffering from a mood disorder. I was just Eva with my head under water. We all fall underwater sometimes.
Don’t: Ignore the signs
PPD is tricky. What was most often confusing, in my experience, was that it wasn’t all-consuming all day, every day, making it harder to pinpoint. I generally took care of basic functions – I showered, I ate, I got outside. I never ONCE failed to take good care of my child. I also simultaneously felt constant anxiety something bad was going to happen to him, an overarching feeling of emptiness, and oscillated between moods so often, it’s amazing I didn’t sustain whiplash. It didn’t look like how PPD is so often portrayed in the media, but there were still signs. If you suspect there is something going on, be brave and ask how she’s doing.
Do: Encourage her to get help.
Start by sending her these posts to let her know she’s not alone. I’ll tell her this for you: There are resources, endless resources (many linked below) for managing postpartum depression and anxiety. It is so much more common than we think, or even know. It isn’t shameful. It isn’t wrong. It is a treatable condition. In retrospect, I didn’t need to suffer so thoroughly for so long. I wish I had just faced what was there and gotten help so much earlier.
Postpartum Support International: Call or Text the hotline, there are online support groups, a smart patients online forum, and so much more:
Call: 1-800-944-4773 or Text: 503-894-9453
Help for Moms: Love their mission statement: “We are glad you are here. We want you to know that you are not alone and you are not to blame. Help is available. You will get better.”
Get The Facts: Learn more about perinatal mood disorders including symptoms, risk factors, & treatments.
*This is Part 3 of a five-part series in honor of Mental Health Awareness month. I will be posting about maternal mental illness and my own experience with postpartum depression and anxiety every day during mental health week (May 14-19, 2018) in an effort to reduce stigma and raise awareness for maternal mental illness. Read Part 2 here.
Photo Credit: Pexels.