Mental Health

How to help someone who is grieving

What has been your experience with grief? Have you gone through the process yourself? Do you feel overwhelmed when others experience loss? Working in the perinatal field, I am surrounded by parents who have survived loss. These experiences vary vastly from the endless cycles of hope and loss during IVF treatment, to processing a miscarriage, or coming to terms with the dissolution of marriages. Grief can be isolating, and I hear repeatedly how much these parents yearn for understanding from their friends and family members. This post is for those who would like to help a grieving friend or loved one. I hope the following strategies will give you an idea of what you can do in these times of need.

8 Things to Consider when Supporting a Grieving Loved one:

1) Know that your job is to listen

Listen to what your friend is sharing and how he or she is feeling. Focus on maintaining a safe and nonjudgmental space for him or her to experience emotions openly. Respect boundaries if this individual is not ready to talk.

Listening to help someone grieving. Validation. Loss and support.

Supporting a grieving individual involves being genuinely present. This involves actively listening, reflecting back, asking questions, showing interest, validation, and providing compassion. There is no need to fix things or make it better because this is not possible. We often worry about being effective support persons, but I encourage you to consider what “effective” truly means in this context. You are not able to bring back the person or experience that has been lost. The best way to support is to be available and present if or when the grieving party is ready to talk or have company.

2) Show that you care

There are lots of ways to show you care from visiting, calling, dropping off food, offering practical help, or giving a hug. If you’re not sure that you’re properly supporting the other person, just ask. We sometimes worry about being a nuisance. Trust that the other person will tell you if they do not want this type of support.

Sometimes our own uncertainties get in the way. We question how often we should stop by, or whether we’re making much of a difference. In these scenarios, listen to your own capacity. Burning yourself out in the process of helping someone’s grief will not work well for anyone at the end of the day. Offer as much as you can comfortably manage.

Again, remember that the goal does not involve the other person necessarily “feeling better”. Sometimes we look for reinforcement that we are doing the right thing because the other person responds back, smiles, offers reassurance, and so forth. Depending on the intensity and recency of the grief, your loved one may not be able to offer this feedback.

3) Stop giving advice

A lot of bereaved individuals are provided support through advice giving. They hear endless phrases like:

  • You should talk about it more
  • It’s important to let it go
  • “Make sure to take some time to do the things you enjoy
  • You can always try again
  • Count your blessings
  • Think of your other children

These phrases are not meant to be malicious and the speaker has good intentions. However, it’s important to recognize that in these remarks are subtle messages informing the bereaved that they are grieving incorrectly. They are being told to feel or act differently from how they are currently experiencing their loss. Recognize that your role in this scenario is not be an advice giver, but to be a friend. Let the person feel how they feel, and trust that this is their way of processing.

4) There is no set time for when a person is done grieving

Some people come to terms with loss within a few months, whereas for others, it will take years. There’s really no set timing when it comes to grief. As far as the support role, the difficulty comes with being patient when the other person’s grief continues despite a lengthy time. I get that you want the other person to feel better, but be cautious of how this comes across. So long as the person is safe and not a danger to themselves (e.g. suicidal intent), step back. As worried as you may be that they are stuck, continue to let them know you are available, and let go of the pressure for them to “move forward” until they are ready.

5) Pay attention to your own discomforts

The pressure we feel to make the other person feel better comes from our own agendas. It comes from our own discomfort in seeing a loved one in pain. Of course, you want the other person to feel better. This is your spouse, your sibling, a dear friend, and you would never wish this type of sadness on them. However, it’s important that, in the grief process, the focus is not about you, but about the other person. We can easily shift into noticing our own systems feeling uncomfortable with intense emotions and wanting to help the other person shut down these feelings. This can be incredibly invalidating, and reinforces a sense of isolation for the grieving individual.

It is helpful to reflect on your own experiences with grief and intense emotions. How have you been supported during times of distress? Were you forced to manage on your own? Did your family members display big emotions? Were feelings welcome, or were you taught to bury your emotions? Did you witness your parents experience big emotions and start to fear them?

Understandably, we can have avoidant parts of our system that shy away from intense emotions based on childhood experiences. We want our caregivers to show us that the world is safe and that they can keep us protected. We need our caregivers to provide a safe environment for us to feel and process our emotions. When parents continue to present in dysregulated manners (e.g. intense grief, shaming us for experiencing distress), children have a hard time coming to terms with these emotions. They may learn to fear strong feelings as unbearable or a problem that must be resolved.

6) Try not to personalize.

If a loved one is grieving, chances are their emotional capacity can feel incredibly restricted. They may not have the space or awareness to consider how their remarks or feedback is landing on others, and you may bear witness to significant mood swings. It is normal to have ups and downs during grief. As a support person, this does not mean you tolerate becoming the emotional punching bag. You are always encouraged to set boundaries if someone is treating you poorly. However, in situations where the other person turns down spending time together, presents as moodier, is not emotionally available, or appears uninterested in your updates, try not to personalize. They are not doing this to be intentionally unkind, but are caught in their own feelings of loss.

7) Don’t be afraid to bring up the loss.

Grief. Supporting grieving individual.

Grief can be a taboo topic, and we are cautious about triggering the other person by avoiding bringing up the circumstances. Simply avoiding the topic does not mean the other person is not thinking about their loss. They are well aware of what’s changed in their life, and need the opportunity to talk about it. Rather than avoid, acknowledge the grief. Comment on milestones, anniversaries, birthdays, and other important dates. As time goes on, your loved one will appreciate that you are not forgetting their loss, and use the opportunity to talk, if it’s needed.

8) Be genuine.

If you truly understand the other person’s pain and have been through a similar experience, let them know. Otherwise, avoid saying phrases like “I understand” or “I know how you feel.” While these types of phrases are meant to offer comfort, they can unfortunately feel really invalidating. Pay attention to whether you use platitudes. While you may find comfort in trying to find the silver lining, the other person may not be ready or wanting to these hear these comments. Again, try not to personalize this, but work with the reality that this is not the way that this person processes grief.

Reach out

reach out. contact for therapy. counselling services for grief. postpartum loss

Whether you feel overwhelmed by witnessing grief, or if you feel your loved one can benefit from additional support, therapy can provide a safe space to process these emotions. It helps to have a neutral party to discuss intense feelings without fear of repercussion, needing to stay strong, or concern about overwhelming others. It takes a lot of courage to seek out for help; reach out when it feels right for you.

Take care,

Kasi

Kasi Shan, MSW, RSW
Kasi Shan, MSW, RSW

Kasi Shan Therapy is located in Kitchener, Ontario. She offers in-person and online appointments supporting individuals with struggling with trauma and perinatal mental health.

Trauma

Should I be concerned about PTSD?

If you have survived a traumatic experience, it’s natural that you are feeling worried about how to proceed. You may have many concerns running through your mind: How long will I feel this way? Am I supposed to seek treatment? Is it normal for me to feel like this? Whether it’s an unsettling birth experience, a difficult pregnancy, a sexual assault, or any other traumatic event, we are left feeling vulnerable and distressed. This post is for anyone concerned about experiencing posttraumatic stress disorder (PTSD). I hope the following information will provide you some clarity and empower you to seek the support that best meets your needs.

What is PTSD?

PTSD is a mental health diagnosis that occurs after an individual has survived or witnessed a traumatic event. What qualifies as a traumatic event differs for every individual. Whatever the circumstance, the individual experiences a significant threat to their physical, emotional or psychological safety, or the safety of a loved one. The situation is so distressing , that the person feels unable to cope.

In working with prenatal and postpartum parents, I see a lot of caregivers who have experienced trauma in the following circumstances:

Is it PTSD? What to do about trauma. Kasi Shan Therapy: counselling in Kitchener, ON
  • Prenatal Loss: e.g. stillbirths, miscarriages, unsuccessful IVF treatment
  • Unplanned pregnancies and abortions
  • Domestic violence, affairs, or marital separation
  • Pregnancy complications: e.g. infections, preeclampsia
  • Early labor or NICU visits
  • Unexpected health complications: e.g. positive screening for trisomy 21 or 18, car accidents

Not every traumatic experience leads to PTSD. There are many components that can influence your healing. Having resiliency factors (e.g. coping strategies, support from loved ones) can greatly improve how you process and move forward from this experience. Having a relatively safe life and limited trauma prior to this event can help us trust that the world is a safe place once again.

Depending on whether the traumatic event was a one time incident (e.g. mugging) versus a repeated event (e.g. ongoing civil war) can impact your healing. When it’s a one time event, our system is better able to see the situation as an anomaly. When there are repeated infractions, we struggle to see the world as a safe and predictable place, and there is increased risk for PTSD.

During a traumatic event:

PTSD versus trauma. what to do after a traumatic event. how to recover from trauma. Kasi Shan therapy: online counselling. Kitchener, Ontario

During a traumatic situation, our survival system kicks in automatically. We are outside of our window of tolerance because this event was unexpected, and our nervous system is experiencing a threat to our well-being. Without conscious effort, our traumatized mind shifts to a state of flight, fight or freeze. We try and escape the situation as quickly as possible, or we try and attack and fight our way forward. If neither option works, we fall into a state of shock or freeze response. When safety is returned, most of us can calm down. However, for traumatized individuals, it’s like their mind is still hooked in that place of danger, and they continue to respond in a flight, fight or freeze manner.

Symptoms of Trauma

A traumatized individual will show symptoms such as:

What should I do about trauma? Being aware of PTSD. Kasi Shan Therapy. Online therapy. Counselling in Kitchener,  Ontario
  • Hypervigilance: a need to assess for constant threat. This involves a high degree of alertness for anything related to the disturbing event.
  • Reliving the traumatic event: e.g. through flashbacks, memories, dreams or intrusive thoughts
  • Avoiding reminders of the disturbing event: this can involve avoiding even the most basic connection. For example, a mother with birth trauma may avoid going to hospitals or visiting medical professionals. She may refuse to talk about her birth experience or listen to others’ birth stories. In the hardest of scenarios, she may avoid any interactions with her newborn.
  • Increase in negative thoughts and feelings: e.g. numbness, guilt, shame, anxiety, irritability, hopelessness. The traumatized person often feels the world is unsafe or unfair. He or she may be cautious about trusting others.
  • Hyperarousal: Feeling on edge, jittery, difficulty relaxing
  • Dissociation or impaired memory recall: In some cases, the individual may forget parts of the trauma, or have blocked out this entire event.

Usually, we experience these symptoms right after a traumatic event; however, some individuals have a delayed onset.

When is it “normal” and when is it PTSD?

Posttraumatic stress disorder. What does it mean, and how do you get help? Kasi Shan Therapy. Online support. Kitchener, ON

The majority of us have survived a traumatic situation. In the beginning, we feel jittery, hyperalert, and avoidant. This is normal. There are parts of our system that are scared of a similar event happening again. In order to ensure safety, these parts will assess for danger and remain hypervigilant of repeat offences. During this time, you will likely experience a lot of distress. However, trauma symptoms tend to dissipate on their own within a month without any major influence. Short-term therapies, medication, and support from loved ones are effective tools that can help with this transition.

In order to have a diagnosis of PTSD, you must experience continue to experience trauma symptoms a month after the traumatic event. These symptoms may last for months or years following, and they cause significant impairment in the person’s daily life and relationships. If you are concerned about experiencing, PTSD, you can take the Posttraumatic Stress Disorder Checklist (PCL-5) as a self-assessment. Any scores approaching 40 warrant a conversation with your family doctor or a mental health professional.

What can I do if I still feel traumatized after a month?

I encourage you to seek therapy as soon as you feel ready to process the traumatic event. While counselling is not meant to be triggering, it can be hard to revisit a difficult memory. If you feel too overwhelmed to even think about the traumatic incident, your system may benefit from extra support to manage this anxiety first. This may involve medication, or specific counselling strategies focusing on distress management.

There are many different counselling approaches that can be used to process traumatic events. Some well known options include: include cognitive processing therapy, sensorimotor psychotherapy and narrative therapies. The following three options are services that can be provided via Kasi Shan Therapy.

Eye movement Desensitization and Reprocessing (EMDR)

EMDR. Eye movement desensitization and reprocessing. treating traumatic events. Kasi Shan Therapy. Counselling in Kitchener, ON and online.

EMDR is a powerful approach that divides a traumatic experience into smaller, manageable chunks to slowly process each part of the incident. Typically, the work starts with either the first or worst part of the memory, depending on what feels manageable for you. In EMDR therapy, we use a process called bilateral stimulation to help process traumatic memories (learn more about how EMDR works). IN EMDR, with each passing of bilateral stimulation, the traumatized individual starts to feel some distance from the traumatic event. The event feels less personal, and there is a continued lowering of distress level. An individual quickly moves from negative beliefs and high distress to more positive beliefs about themselves, less fear when thinking of the memory, and calmness in the body.

EMDR does not require you to go into specifics of a traumatic event. Instead, clients can express barebone details aloud while still making sense of a unpredictable and nonsensical event. This can feel helpful for those who are not ready to speak about the traumatic event in detail as of yet. In fact, for those who do get stuck in the narrative of a traumatic event, your therapist will keep checking that you are properly processing a memory versus getting retriggered.

Cognitive therapies and prolonged exposure

When it comes to traumatic events, we form negative beliefs about ourselves and about the world. Cognitive therapies help us challenge these beliefs by assessing their validity. We look at whether our assumptions about the world, others, and ourselves are fair and consistent. The therapist and client works to start formulating more neutral or balanced thoughts.

In addition, many therapists will encourage clients to practice in some form of exposure therapy. With trauma, there is a lot of avoidance of the traumatic event. Prolonged exposure involves slowly approaching the activities or individuals that remind us of the traumatic event. This is done at a gradual pace in order to not overwhelm the system, and to help build confidence in our capacity to manage distress and test out problematic beliefs.

Internal Family Systems Therapy (IFS)

internal family systems therapy. IFS and trauma.

IFS recognizes that our system can become divided following a traumatic event. There are parts of us that carry the wound of a traumatic event. We often bury or push this part away from our awareness. These exiled parts typically carry a lot of shame, guilt, fear or overwhelm. Because they are so overwhelming, we have other protective parts that compensate. We have proactive parts that prevent us from triggering these wounds. We also have reactive parts that respond when we are triggered trying to manage the intensity of these exiled emotions.

For example, following a miscarriage, we may have an exiled part of us that believes we are responsible for the pregnancy not lasting. Because this is such a painful burden to carry, we may have proactive parts that do not let us get pregnant again, cancel IVF appointments, or push fights with our partner to prevent intimacy. If another miscarriage occurs, we may have reactive parts that become extremely angry at ourselves or our partners. This part may lash out through verbal attacks, or may cause physical harm onto our own bodies in order to deal with the pain.

In using IFS to treat trauma, we have to work with all parts of your system. Rather than diving straight into addressing the wound, we work with these protective layers first. We focus on building trust and safety with these protective parts. When they have relaxed, we then start to work with the core traumatic wound.

Reach Out

You may notice signs of healing within the first month, and not require additional support. However, if it’s been longer than a month and you continue to express traumatic symptoms, interventions can be helpful. Trauma and PTSD do not have to be a life sentence, and there are ways to help your recovery. If you or a loved one is struggling after a traumatic experience, reach out.

Take care,

Kasi

Kasi Shan, MSW, RSW
Kasi Shan, MSW, RSW

Kasi Shan Therapy is located in Kitchener, Ontario. She offers in-person and online appointments supporting individuals with struggling with trauma and perinatal mental health.

Pregnancy and Postpartum

What is happening with my mood?! D-MER and Breastfeeding

What is your experience with breastfeeding? Do you feel angry or tearful as soon as you start? Is there a sense of dread when you begin another pumping session? How intense is your anxiety during these moments? When it comes to nursing, there are many parents who enjoy the experience and feel it’s an opportunity to connect with their infants. However, there are also many parents who are frustrated and distraught by the same encounter. Before we assume that the reason we are struggling with nursing is due to postpartum mental health, we want to rule out a physiological illness called D-MER.

Signs of D-MER:

Dysphoric Milk Ejection Reflex (a.k.a. D-MER) is a breastfeeding struggle that occurs during letdown of milk. This includes nursing, pumping, or manual expression to release milk. Normally when lactating, parents experience the warm and loving feelings that come with an increase in oxytocin. However, with D-MER, a caregiver has a sudden drop in mood, and can experience any of the following difficulties:

Breastfeeding and D-MER. Anxiety, sadness or distress during pumping
  • dysphoria, or a state of unhappiness
  • panic
  • restlessness
  • hopelessness
  • anger
  • anxiety
  • sense of dread/doom
  • paranoia
  • thoughts/urges about suicide or self-harm

D-MER most commonly shows up as anxiety, agitation or sadness. The intensity of these experiences can vary from mild to moderate to severe. These symptoms can last anywhere from a few seconds to 2-3 minutes. It typically shows up about 30 seconds prior to milk release. D-MER struggles subside as you continue to nurse, but reoccurs as soon as another let down happens. Typically, parents start to feel better after 3 to 6 months once milk production regulates. Unfortunately, there are no specific tests or assessments to confirm you have D-MER. If you notice an abrupt shift in mood when you are pumping or nursing, it warrants considering whether D-MER is a factor for you.

D-MER versus Postpartum Mental Health

Breastfeeding and D-MER. Anxiety, sadness or distress during pumping

D-MER is a physiological issue. It happens because of hormonal and chemical changes in the brain during breastfeeding. This is not a psychological issue, although it certainly feels like one. Folks who have a history of mental health struggles are not more vulnerable to experiencing D-MER. It is completely by chance. Parents who have experienced D-MER with their first child have a higher likelihood of experiencing it again with future children.

D-MER is not the same as postpartum mental health. While an episode of postpartum anxiety can last for hours or days, D-MER lasts a few minutes and only occurs during the release of milk. Once breastfeeding is completed, parents moods regulate and they are able to re-engage in their daily activities. Unlike any prenatal or postpartum disorder which involves a combination of biological, psychological and social influences, D-MER is caused solely by hormonal shifts.

This does not mean that the two are mutually exclusive. Parents with perinatal mood and anxiety disorders can also struggle with D-MER. If this is the case, then a combination of treatment is useful in order to address both needs.

Why it happens:

D-MER has only recently been identified as a breastfeeding struggle, and research has started in the past 10 years. However, dopamine has been identified as the primary influencer to experiences of D-MER. Dopamine (a hormone connected to feelings of pleasure) must drop in order for prolactin (the hormone which helps produce milk) to increase. What research has found with D-MER is that the drop in dopamine is too significant during milk letdown, which triggers an abrupt drop in moods.

What you can do if you have D-MER:

The first and most important thing to remember about D-MER is that it is not your fault. You are not doing breastfeeding or parenting incorrectly. This is truly a chemical change that is happening outside of your will power. It is not a psychological issue, and there is absolutely nothing “wrong with you.” It’s an automatic reaction, and the emotions and thoughts that come with D-MER are not based on facts, reality, or any truth to your capacity as a parent.

Approximately half of nursing parents stop breastfeeding by 6 months. This can happen for a variety of reasons, and only you are the judge of what is right for your body. If D-MER is one of the reasons to stop breastfeeding, it may be helpful to know that most parents struggling with this issue feel an improvement of symptoms in 3 months once milk production regulates.

Connecting with your health care team:

Lactation struggles. Perinatal mental health. Speaking to physician

Knowing that this ailment is a chemical imbalance, it’s best to speak with your physician or lactation consultant about your experience. In moderate to severe cases of D-MER, treatment options will likely involve medication or herbal supplements to support adequate dopamine production.

Behavioural Strategies

With milder versions of D-MER, there are several behavioural strategies that can be used to support your nursing experience. Firstly, it is helpful to keep track of your symptoms. What varies on days when your D-MER symptoms are worse? Common factors that can improve or exacerbate D-MER include: stress, rest, caffeine intake, hydration, and exercise.

Changing the Pattern:

Using distractions to help during breastfeeding.

Secondly, we want to create a more positive experience when nursing or pumping. When we know we are walking into a stressful event, our system braces in anticipation. With enough occurrences of D-MER, parents are typically anxious about lactation. To break this pattern, we want to pair positive experiences with breastfeeding. While nursing or pumping, add in a pleasurable activity that you can use as a distraction. Options can include: listening to your favourite podcast, reading a novel, playing a game on your phone, watching your favourite TV show, eating a delicious piece of cake. Use this activity only when you are breastfeeding to help your system create positive anticipation.

Mindfulness

Thirdly, mindfulness practices can be used to help during this time. When our system anticipates threat, we are hypervigilant of all signs and symptoms related to the threat. Unfortunately, this can make things worse because we are fixated on every nuance that can go wrong. We can also get caught in a negative spiral after breastfeeding is done because we continue to think about the experience and fret about what did not go well.

Mindfulness involves choosing a neutral anchor to focus our attention. For example, you can focus on the sensation of holding your baby, or keep count of baby’s gulps during a feed. You can pay attention to your own body or breath. You may also focus on external anchors like listen to music or noticing what is outside in your backyard. Your mind may wander, and mindfulness involves re-directing your attention to the safe and neutral anchor whenever this occurs.

Breastfeeding is Tough

There are a lot of factors that can influence our postpartum year, including breastfeeding struggles and D-MER. At the end of the day, no one can or should make the decision to start or end breastfeeding other than you, the lactating parent. If you find your mental health is influenced by your breastfeeding experience, please reach out. You do not have to struggle in isolation.

Take care,

Kasi

Kasi Shan, MSW, RSW
Kasi Shan, MSW, RSW

Kasi Shan Therapy is located in Kitchener, Ontario. She offers in-person and online appointments supporting individuals with struggling with trauma and perinatal mental health.

Pregnancy and Postpartum · Depression · Mental Health · Parenting

Support for the avoidant parent

Sure, you and your partner have talked about having a child. In theory, it seemed fine. But now that your baby has arrived, it feels harder than you ever expected. It is exhausting trying to connect with this unresponsive baby. It feels like everytime you pick up your child, he or she knows to scream at the highest decibel. And while you’re feeling stuck, your partner has somehow become the baby whisperer, whipping out breasts, bottles, and toys and magically making this tiny human succumb into a peaceful and serene state. This post is for parents who are feeling avoidant and helpless. It is for the fathers and mothers who are painfully aware of feeling incompetent, and continue to think “I’m not good at this”. I want you to know, it can get better. I hope the following points leave you comforted and empowered. 

Stop comparing yourself with your partner

I hear a lot of fathers commenting that their partners can do it better. They see their partner staying patient and rocking the baby, doing midnight feeds, and changing multiple diapers. They see how the baby settles shortly after these interactions.  While it’s wonderful to see your partner becoming a successful parent, it can bring up a lot of our own insecurities. It’s really hard not to compare. When your partner picks up the baby, the baby calms down. When you pick up the baby, your adorable little human screams bloody murder. It makes a lot of sense that you feel avoidant.

avoidant parent. new parent. difficulty bonding. perinatal mental health. postpartum depression.

If you have always found security and confidence by doing things well, parenting can bring you outside your safe zone. Rather than work with this struggle, it’s easier to encourage your partner to take the lead since he or she is doing it better. I imagine you already know the consequences to this decision. Sure, the baby is calmer, but your partner is fried. Their arms are aching from constantly holding the baby. They haven’t slept or showered properly in days. And, chances are high, that they are frustrated with you for not taking a more active role. Meanwhile, your own insecurities of being a competent parent continues to worsen. 

Parenting is not always about doing things right. It involves time, patience, and some trial and error to figure out how to best help your little person. Chances are that you have a screaming infant on your hands for the first little while. Please know that this is normal. Your partner has also gone through this trial and error period of being hollered at, and it does get better. If you hand over the baby, your confidence does not improve. It only reinforces to you that your partner is capable and you are not. 

Forget perfection

There is a steep and fast learning curve with parenting. We make mistakes, work through the stress, and try again. We don’t have the option of quitting, and so we keep going back and figuring things out. The stress of doing things perfectly can make us avoidant in getting started. Rather than perfection, please accept that you will screw this up. Accept that you are going to make mistakes, and this will lead to tears (some of it will be yours and some will be from the baby). This is perfectly normal even though it sucks.

avoidant parent. struggles to bond with baby. postpartum depression.

While there are umpteen books and blogs out there about parenting strategies, no one has published a book for your child. Take what you know and try it out. Watch your baby’s cues to see if he or she responds well, or freaks out. It tooks me months of rocking my child to sleep and feeling frustrated before I realized this strategy wasn’t working. We’ve all gone through the nightmare of bathtime and the stress of barely keeping the baby above water. Some of us keep losing the soother- the only thing in the whole world that will make your child stop wailing. It happens. We all make mistakes, and it makes us human.

 We don’t know what will work until we take the time to try it, evaluate its efficacy, and continue or introduce a new habit. This is a normal part of learning new skills. We all start with a keen awareness of our incompetence. We practice and fine tune our skills, and eventually get to a place of being unconsciously competent. Wanting to be a perfect parent right from the start prolongs this very normal learning experience. 

Making mistakes is not the issue. Usually that error in judgment lasts a mere seconds before it’s done. However, our mind can keep us fixated on this mistake, and we get easily sucked into a world of shame, embarrassment or guilt. That small moment plagues us for days. Gently remind your system that you are human and you are learning. Mistakes are inevitable, and you did not do it maliciously or intentionally. You can and will learn from these errors. 

Assess if you have postpartum anxiety or depression

While we often think of postpartum mental health as a mom’s issue, this is just not true. 1 in 10 dads have postpartum depression, although only 3% of dads actually seek treatment. 1 in 7 mothers have postpartum depression. Unfortunately, there is limited research available about sexual minority couples, and the published statistics vary widely. That being said, postpartum mental health does not discriminate based on sex, culture, socioeconomic status, education, or age. It can happen to anyone. 

avoidant parent. struggling to bond with new baby. new dads. postpartum depression and perinatal mental health.

When it comes to depression, symptoms can include lack of energy, disinterest, poor sleep or eating habits, or limited social interaction. Postpartum mental health shows up differently. We want to pay attention to signs like irritability, anger, excessive worries, avoidant behaviours, and poor concentration. Because these are painful struggles, many people try to cope by drinking, avoiding parenting, or getting into arguments. Unfortunately, our friends notice that we are drinking a lot and disengaged with the baby, but they don’t recognize that we are struggling with postpartum depression. 

When it comes to mental health or any diagnosis, we need a treatment plan. This can include: help with emotional processing, behavioural changes, professional interventions, medication, or increased social support. Mental health does not go away with sheer will power. It is legitimate and painful, and requires proper attention. The Edinburgh Postnatal Depression Scale is a helpful assessment that can confirm if you are struggling with postpartum mental health. I would encourage anyone who is questioning their postpartum experience to take this self-assessment.

Exposure therapy can help

If you are struggling with your mental health, you do not have the effort or patience to invest into a new relationship. Depression will make you feel irritable and unmotivated, and anxiety will cause you to worry or panic. Your system just wants to shut down. When we shut down from our relationships and our environment, we address the problem briefly. We find temporary relief because we don’t have to spend time with the newborn. This relief is short-lived because, let’s face it, that baby is not going anywhere. Unfortunately, we fall into this repetitive pattern of feeling overwhelmed by our emotions, and avoiding the stress. This works temporarily until we face yet another scenario where we feel overwhelmed.

 I encourage you to take small steps to help your system see that you can become a strong parent. Exposure therapy involves creating a consistent and gradual plan to do things that you are fearful or avoidant of in order to build your confidence and reduce your fears. We want to first create a list of tasks that provoke anxiety and avoidant behaviours. Then we start with fears that are unpleasant, but manageable, and practice this repeatedly. It is only when the distress goes down and the confidence increases, that we move on to a more challenging task. Everyone’s exposure plan will differ based on his or her comfort zone and anxiety level. The following post explains exposure therapy in more detail, and I encourage you to reach out if you’d like to fine tune or problem solve your specific circumstance. 

Finding the balance between Me and We

Parenting can be a serious buzz kill for our social lives. Chances are that your kid is passing out by 7 PM, which means you’re likely starting a bedtime routine by 6:30 PM. It’s hard to nurture our hobbies, interests, or social lives if you need to be home by that early hour. Parenting can also influence our career path. Signing up for that new project or taking a promotion are incredible opportunities that you’ve worked so hard to accomplish. That being said, these activities mean more hours away from home. 

There is not a simple answer that will help you find balance between your interests and ambitions with your new parenting role. However, I’d recommend first sitting down with your partner and working on a plan. Parenting should not be an all-or-nothing experience. You should not give up all your interests, friendships, or goals. However, being a parent does involve some compromise. You may not be able to take on every project at work. Or, if you do, you will face the wrath and frustration of your kids and partner. It’s hard to win at everything, and we need to let go of the expectation to achieve it all. Instead, pay attention to your priorities. Some activities will feel easy to drop, whereas others may cause a lot of resentment. Fight for the priorities that matter.

While routines and schedules are not sexy, they do ensure you have time for yourself. It’s helpful to speak with your partner to ensure you both have time to do your own things. This might involve you taking on morning chores in order for your partner to go to the gym. As a result, he or she is more flexible about you playing hockey and hang out with your friends during the evenings. The predictability in knowing Mondays nights are yours to do as you please will help settle your anxiety.

There will come a time when your child is old enough to be more self-reliant. He or she will not need you to play such a supervisory role. When this happens, sign up for more things. Until then, work with your spouse in understanding what priorities you would like to invest in during the next few months. Talk about this plan regularly so that there are no surprises and there is room to make changes. 

The pressure to do it all

As the sole parent attending work, you may feel a huge financial responsibility on your shoulders. You may also come home to a very drained spouse, and your guilt prevents you from taking time for your own self-care. Perhaps the added stress of taking care of another person can feel overwhelming. 

avoidant parent. stressed new parent. building a better bond with your baby. postpartum mental health.

If you are feeling these types of pressure, pay attention to how you respond. Some parents will work more hours in hopes that they can manage this new financial burden. Some will feel resentful towards their baby or family because these changes feel so hard. Others will become avoidant, and spend all of their time outside of the home. All of these reactions are understandable given how much this postpartum year has left you unsettled.

If possible, take a moment to slow it down and reflect. What is it about this responsibility that is worrying you the most? What makes you doubt your capacity to manage these new tasks? Is your system aware that the financial strain will improve once your partner re-enters the work force? Would it be helpful to look at your budget and make changes so that you don’t spend all day working ? Are you feeling guilty because you are struggling to “fix” your partner’s exhaustion? Does your partner want you to take on this role? By understanding the root cause of our pressure, we are able to make wiser choices. We don’t have to react in impulsive or avoidant ways, and can instead focus on problem solving, communicating, or setting realistic expectations. 

Talk about it 

There are many supports and resources for new mothers, and I recognize that the same level of support is not readily available for dads and partners. A highly effective intervention for postpartum mental health is an increase to our support network. There is significant healing that happens when you are supported by others who truly understand and appreciate the hardships of the postpartum year. This can involve leaning on your parents, friends with older children, neighbours with newborns, or a local support group. It’s helpful to speak up, and receive support and compassion from the other end. It helps to talk with others who can share advice or normalize your experiences. 

Reach out

There are many ways you can build a bond with your baby. While you can remain avoidant, this behaviour tends to bring a lot of consequences. If you or your partner is struggling with this new role of parenthood, reach out. You do not have to struggle in isolation. 

Best wishes, 

Kasi 

Pregnancy and Postpartum · Depression · Mental Health · Parenting

Will I have postpartum depression again?

For anyone who has survived postpartum depression, you know how painful and unsettling life felt after your baby arrived. During that first year, you are overwhelmed with feelings of irritability, helplessness, anger, rage, sadness, and anxiety (just to name a few). The fear of ever facing this experience again causes many parents to hesitate about having another child. There is nothing that they want to avoid more than those intrusive thoughts, hours of sobbing, or crippling anxiety. I hope this post will offer you some support and guidance in considering your next steps.

You have the right to say no

Pressures for nuclear families are constantly pushed at parents. I hear many well-intentioned family members asking when moms will be pregnant again, and expressing concerns that their children will be lonely if they do not have siblings. Firstly, let’s all agree that these folks need to chill out. No one should tell you what your family should look like. There are many, many single-child families who have wonderful, happy lives. If you have decided that one is enough, please rest assured that you are making the right decision. After all, it is your body, your lifestyle, your family, your income, and all of your resources. While loved ones may comment, at the end of the day, you have to take care of this little person. You are absolutely entitled to decide that you don’t want this option.

Many factors will influence your mental health

postpartum depression. Mood and anxiety disorders. Kasi Shan Therapy. online counselling. Counselling in Kitchener.

There are a lot of vulnerabilities that influence mental health. When it comes to postpartum depression, the list can include: poor sleep, stress, hormonal changes, physical wellness, relationship struggles, financial worries, history of mental health, multiple children, and complicated pregnancies/deliveries. This is not an all-encompassing list; however, it does address some important influencers during the perinatal period.

History of mental health struggles (including postpartum depression with your first child) is only one contributing factor. Postpartum depression symptoms typically decrease between one postpartum period to the next, showing that we have the capacity for healing. Research has found that there is high variability of whether parents’ symptoms of postpartum depression increase or decrease in future deliveries.

What does this all mean for you? Just because you had postpartum once does not guarantee you will have it again. If you had experienced significant distress in your first experience, err on the side of caution and seek support as soon you are pregnant. Postpartum depression is treatable. Your recovery experience improves when you do not prolong suffering.

You know more today than you did during your first pregnancy

Many first time parents feel nervous and uncertain about taking care of their babies. I mean, why wouldn’t we? If we are not surrounded by babies all the time, or if it’s not within our line of work, it makes sense that we are not experts on this topic. Since there are many unknowns during the first year with our child, we can feel inundated with worries about the baby’s well-being and our own capacity to parent.

Postpartum depression. perinatal mental health. Worries about having a second child.

As cliché as this may sound, practice makes perfect. Consider how vulnerable you felt when you first took your little one home versus how you felt six months or even 2 years in to parenting. You’ve gone from feeling incompetent to suddenly having a knack for diaper changes, effortless feedings, and confidence in bedtime routines. That level of skill and knowledge took you weeks of trials and errors before you could confidently move forward. This is the beauty of having a second child. That level of uncertainty and worry still exists; however, it is significantly more muted than the first time experience. You are much faster at handling all of those questions from your first time simply because you have the experience in your tool belt.

Understand your vulnerabilities

postpartum depression and experiences. journal. mental health.

As painful as it may seem, I encourage you to sit down and reflect on your first-time experiences of pregnancy and postpartum months. What was hardest for you? When did you struggle the most? Did you have support available, and was your support team actually helpful? Were you able to rely on your partner? What kept you down on your hardest days? When did circumstances improve? Did you use medication, or were you able to manage without? What resources did you bring in the last time?

Knowing what was hard the first time can give us a working plan of how to handle the situation differently this time around. Some moms are so clear that they do not want to have another child while COVID-19 is still a concern. Other moms are aware that sleep training is what they needed in order to feel more stable. Many moms know that attending counselling and couples counselling helped them work through anxieties as they surfaced. It sucks to have to learn from our hardships. Knowing what did and did not work can help you decide what to do differently this time around. When you have the awareness, you have a lot more control and influence over the situation.

Find a community

The stats are very clear. About one in seven mothers and one in ten fathers experience postpartum depression. Yet, we live in a world where we suffer silently. Joining a support group, or connecting with other safe parents is one of the best things that you can do for your system. Let go of the pinterest-moms in your world. Don’t try and find validation from your next door neighbour who always looks well-presented and has the most well-tempered baby. These people will (hopefully, unintentionally) make you feel lousy. FInd parents who help you feel less alone. Your worries are similar to the stressors that others have also experienced. Find those who have survived postpartum mental health, and hear about their experiences. Learn what worked for them to not only have this level of encouragement, but to also find strategies that you want to employ.

If you experienced postpartum depression with your first child, it’s highly likely that you felt overwhelmed or frustrated with parenting. The circumstances are much more complicated if you are a single parent, or if your partner works long hours. While this is no one’s fault, feeling isolated in your parenting is an important factor to keep in mind. Gather your support team and come up with a plan that will support your needs. This may involve asking your mother to stay with you for the first week, or asking a friend to check in daily. You might contact resources like a lactation consultant, a postpartum doula, or a sleep-training specialist earlier into your postpartum experience. Your support team can be informal like friends or family, or professionals. Irrespective, these folks are helping you to fill in the gaps. There is a reason for the saying “it takes a village to raise a child.” No one should be expected to do it all alone.

Move your body

When we struggle with depression, our body wants to shut down, isolate, hide, or retreat. This makes a lot of sense when the world feels too much. Of course, you want to escape and disengage. It’s far safer in your home than to socialize, take the baby out, or pretend that everything is normal. When we stay hidden away, we can get caught in this safety net for a long time. Sure the world may feel safer when you’ve stayed away, but it’s also felt bleak and painful everyday that you’ve been hidden. If you are ambivalent to have another child because of this shut down experience, there are strategies that can help. There are many coping strategies that can be employed to use address anxiety and depression. The key is to find the right set of skills that fit for you.

One effective distress tolerance skill is to increase our activity level. I get that exercise is not everyone’s cup of tea, but I want to emphasize how quickly it can help you in getting out of a funk. When it comes to a crisis situation, getting even 2-5 minutes of intense exercise will force your physiology to change. Your shut down system is forced to be more alert with this sudden intensity. After this burst of working out, we have about 15-20 minutes of reprieve. We feel more regulated and think more clearly. This gives you a chance to look at your current setup and schedule. You may find you have more capacity to get out of your room, go for a walk, or call a friend. Things that felt unmanageable, suddenly feel more accessible.

Seek treatment

Postpartum mental health is not based on will power. Crying everyday, or stressing about spending time alone with the baby is not a normal part of parenthood. If this is your experience, I want you to know that it does not have to be like this. Postpartum myths can prevent us from seeking out help, and I can appreciate that these are genuine barriers. Whether it’s due to internal shame, external pressures, cultural expectations of motherhood, or any other factors, it can be hard to shift away from this perspective. However, the best part of working in perinatal mental health is that I know it gets better. I see mothers improving within a year or two of delivery. This may involve regular therapy, a community of support, various coping strategies, use of medication, or a combination of interventions. With support, postpartum mental health can improve.

Postpartum depression does not have to define your experience

If you are feeling scared of having postpartum depression again, please reach out. Just because you struggled with your mental health the first time does not mean it will happen again, or that it has to get as bad. There are numerous preventative and reactive interventions that we can incorporate to help you feel more resilient. Reach out when you feel ready.

Take care,
Kasi

Pregnancy and Postpartum · Parenting

Building a bond with your baby: Strategies to help when you struggle with postpartum mental health

When it comes to postpartum mental health, many parents struggle to building a connection with their little ones. There may be feelings of resentment that our lives have changed. You may feel too tired to want to play or sing nurseries. Your anxiety feels too high for you to be comfortable spending time alone with your infant. Whatever the reasons may be, you’ve been coping these months by maintaining an emotional distance from your child and feel desperate to build a bond with your baby.

I want you to know that attachment can be formed irrespective of postpartum mental health. Our relationships can always grow and develop, even when the onset was rocky. The first five years with your child are pivotal, and there are many things that can be done from hereon in to nurture this new relationship safely and without overwhelming your nerves or emotions.

The following strategies will help you feel more secure to meet your baby’s needs. No, they’re not all about singing songs or giving massages. I recognize that singing and massages are great options, but not everyone is at this starting point. So, let’s start slow so that we can get you to a place of feeling more confident to building a better relationship.

1. Introduce your infant to activities that you enjoy doing.

bonding with your baby, attachment, postpartum depression, postpartum anxiety, strategies to cope

When the bond with your baby is already feeling tested, it’s incredibly hard to push ourselves to do “baby-focused” activities. Your motivation and desire to encourage tummy time or play peek-a-boo is next to nil. When you feel this way, it’s not helpful to ask you to force it. This may work for a day or two, but a stressful event will likely bring you back to square one. Instead, I want to encourage taking small steps that will feel more manageable for your system.

When you focus on your hobbies and interests, you’re often able to relax. There’s less pressure to perform. You have less anxieties about ensuring you’re “doing it right” and, instead, can just enjoy the task at hand. Whether it’s going for a run, cooking a meal, painting, reading a book, playing dungeons and dragons, there are creative ways to bring your baby into your world. Bust out that jogger to take your little one on a run with you. Introduce your baby to different smells, and speak to her about the different spices that are going into your meal. Show her the different colors you’re using while painting. Read outloud from your book so that your baby learns new words. Have her roll large dice for your various rounds in a board game. There are ways to still be you and foster your own interests while including your baby.

2. Build confidence with a support person

When you’re feeling insecure about being a parent, the pressure of parenting independently can feel like too much. Let your partner, friends, or family members know how you feel. Your sense of overwhelm with the baby does not mean you cannot be a good parent. Attachment struggles are a common sign of postpartum anxiety. Rather than avoid your baby all together (many have been here!), or become flooded with frustration or resentment, try and share the load.

postpartum mental health, attachment, bond with baby. family support.

Speak with your family members about spending more time together so that you can grow into this role. It’s easier to play with the baby or learn to handle colicky moments when you have a safe friend or family member supporting you. Your trusted person may give tips (tell them to cool it if it feels too much), or may provide you encouragement as you try. They may be wonderful at providing a distraction, so that you’re less focused on doing things perfectly. This support should also include your friend providing you a time out when you have met your limit and need to take a breather.

adult affection baby child
Photo by Pixabay on Pexels.com

A word of caution that it can feel tempting to step away and allow your family member to take over. But if you are hanging out with your little one and there’s a fellow adult around, the conversation feels easier, and there’s less strain to manage by yourself. When you’ve had enough practice with your infant, speak with your support person about coming over for shorter visits. By slowly reducing the amount of support available, you are practicing gradual exposure. This type of practice helps you work set realistic goals within your window of tolerance, and slowly build confidence as you spend more time independently parenting.

3. Make sure you are getting enough time to sleep.

postpartum mental health. building bond with your baby. sleep.

I know this point sounds strange as far as suggestions to improve the bond with your baby. However, one of the biggest turning points for postpartum mental health is having enough rest. You will never feel at your best if you are working off days or weeks of sleep deprivation. Trust that you will feel calmer, more energetic, more engaged and more like yourself when you’ve had sleep. Once you’ve had a solid week or two of rest, check in on your feelings towards your baby. Are you still feel that intense aversion or fear or has it shifted a bit?

For new parents, I strongly encourage working collaboratively to at least have longer segmented sleep. This might mean that one parent takes an early morning shift so that the other gets to sleep in. Or vice versa, whoever is the night owl takes on the later evening feed so that the other can rest. Understandably, parents will have to consider their comfort levels with pumping or formula feeding. While this is a personal choice, I want to emphasize that your system will feel significantly better after having at least four solid hours of rest.

4. Eye contact and Communication

Eye contact and verbal communication are effective ways to building a bond with your baby. These verbal and non-verbal cues help foster language skills and emotional intelligence in your little one. Your baby starts to recognize faces, understand facial cues, and builds a sense of safety with you. By communicating more, your baby will pick up on various words and gain a stronger understanding of language.

attachment and bond with your baby. Eye contact. postpartum in moms and dads

Maintaining eye contact can be incredibly difficulty, particularly if you struggle with attachment traumas or social anxiety. This strategy may not feel right for everyone, and I encourage you to be kind to yourself and where you are in your healing process. If it feels manageable, try and look directly at your baby while breastfeeding, changing diapers, and when doing any tasks related to your little one. Feel free to look away when the baby loses interest or is over-stimulated. I want to emphasize that doing even a little bit is better than nothing at all. If you are able to maintain eye contact while changing a diaper but feel overwhelmed during breastfeeding, work with that capacity.

Many parents with postpartum depression struggle to spend time with their babies, and it’s a big ask to encourage them to speak to their infants more often. If you are not “feeling it”, you don’t have to coo, speak in baby-talk, or sing nursery rhymes. Keep it simple. Describe what you’re doing in that moment with your baby, even it if it sounds like a tedious play by play. Talk about things that interest you in front of your infant so that they hear the variance in your speech patterns. Have conversations with other adults in front of your babies so they can witness different verbal and non-verbal expressions.

5. When there are no words, use hugs.

Perinatal mental health. Crying, fussy baby. Improving bond. improving attachment

Sometimes the baby cries, and it’s the most aggravating experience. You can’t figure it out. You have tried changing diapers, feeding, rocking, and nothing is working. Rather than stress yourself further, if you have the ability, focus on just holding your baby. There’s no need to walk around or figure out a soothing gait. Spend that effort on giving your baby a gentle hug. Touch is one of the most reassuring options for your infant and it provides them a sense of safety. Having that skin to skin contact, when you don’t know the right words or actions to take, can help both you and the baby feel calmer. Building a bond with your baby can involve a variety of different strategies, but sometimes the simplest action of being held can be enough.

6. When there are no words, walk away.

time outs. improving bonds. frustrated dad.

I know this seems contradictory to the previous point, but this is to give you the option to decide your current capacity. I encourage you to start with hugs when you are capable of this action. When you feel you cannot take it, and you are at your max, it’s essential that you have permission to put the baby in the crib and walk away. Giving ourselves timeouts is a wonderful option to take a break, find ways to regulate, and try again after a few minutes. I encourage using a distress tolerance skill (e.g. dialectical behaviour therapy skills like ACCEPTS or changing temperature) during your timeouts as it is a fast way to calm your system.

7. Plan your day

Boredom can be a significant trigger for many people. When you are bored, your mind starts to wander and, oftentimes, you’re back to that pattern of anxious, racing thoughts. Boredom can lead you to that rabbithole of social media where you fall into the trap of comparing your life to others. Boredom can be a common push factor towards drinking. When we are aware that boredom plays a role in our emotional struggle, we can form a plan. When your mental health improves, your ability to build a bond with your baby also improves.

While parental leave can be wonderful, it can also involve long and tedious days. In many ways, going to work provides us a lot of stability: we have a consistent routine of getting up, tasks to accomplish, opportunities for social interaction and consistent break times. If we know what the day will include, it can ease our anxieties, and we can plan ahead for boredom.

So, what will you do this week? Can you try and wake up and go to bed at the same time each day? Do you have opportunities to socialize each day? Are there playdates that you can schedule, outings that you can plan, activities that you’ve wanted to try out? Are there new play gyms that are available in your city? Will you register for a new online parent and baby class? Are there some new and exciting activities or hobbies that you’ve been wanting to take up (with or without your little one around)?

8. Building a bond with your baby does not require perfect parenting

Parenting has become a dreaded term. It’s a job that involves a lot of effort and patience on your part, and very little on the part of your babies. And as with any job, you may be striving to do it right. While your intentions are commendable, the desire to parent well can sometimes lead to additional stress.

When it comes to providing for your baby, “good enough” is more than enough. We are not able to get it right all the time, and it’s unrealistic to expect this of anyone. There are always going to be factors that pull our attention and that prevent us from being able to attend to our child’s emotional cues. In reality, we only get it right about 30% of the time. Other times, we are completely missing the mark on our babies’ cues or working to repair that misattunement. This is perfectly normal and expected in all parents. Rather than getting our hopes up to parent perfectly, we can focus our attention on repair if we have made a mistake. Repair work may involve: apologizing if you’ve been cross, paying attention if your child is trying to engage you in play, or providing that gentle hug if your baby gets frightened by your exasperated sigh. Our expectations can ease when we know that we will only get it right 30% of the time AND that this 30% attunement is what we can expect even in the most loving and secure of relationships.

Reach out

Everyone’s situation is unique. I don’t want to assume that the points I’ve listed out are going to meet your specific needs. If you are struggling with postpartum mental health and you’re concerned about the bond with your baby, reach out for a free consult. Postpartum mental health is treatable. You can get better, and your relationship with your child can be positive.

Take care,

Kasi

Kasi Shan, MSW, RSW
Kasi Shan, MSW, RSW

Kasi Shan Therapy is located in Kitchener, Ontario. She offers in-person and online appointments supporting individuals with struggling with trauma and perinatal mental health.

Pregnancy and Postpartum · Mental Health · Trauma

“They’d be better off without me”: Suicide and Postpartum Mental Health

“They’d be better off without me.”
“I can’t do this. What am I doing here?”
“How am I supposed to do this everyday for the rest of my life?”

I hear sentences like these frequently in my work with postpartum parents. It is heartbreaking and I know that when someone gets to this place of rock bottom they are feeling helpless and overwhelmed. I’d love for the postpartum months to be an amazing time for parents, but oftentimes it’s not easy. Sure, the baby is cute. But the baby also keeps crying, won’t latch on properly and refuses to take a nap. It’s easy to get caught in a negative spiral of fatigue and insecurities. When this phase goes on long enough, many parents start to have passive or active thoughts of suicide.

Suicidality and postpartum care. Internal family systems therapy. Kasi Shan Therapy, counselling support in Kitchener, ON.

Suicide is a taboo topic, and it’s hard to talk about having these thoughts openly. Unfortunately, keeping our feelings buried tends to backlash for the majority of us. Postpartum depression does not necessarily mean you will have suicidal thoughts. However, when we are vulnerable, it’s not uncommon for our thoughts to shift into this space. Whether we are struggling with our baby, handling new stressors as a result of the baby (e.g. financial burdens, isolation), or addressing our already existing mental health diagnoses in combination with a baby, we want an escape. Suicide provides us one of the fastest option for escape. My hope today is to help you recognize that there are safe ways to support you. We can talk openly about suicide and get you to a place of feeling more at peace so that you no longer feel the desperate need to escape.

Step One: Name it

Mental health sucks. In our culture of independent, pinterest-loving super moms, it’s so hard to say that we’re struggling. The statistics for postpartum depression is 1 in 7 moms and 1 in 10 dads; these parents are not all seeking out help.

I appreciate the strong desire to be independent and feel competent. I have parts of me that also feel adamant to manage on my own. We can play this game for a long time and test our limit of how much we can handle. However, there comes a point when we recognize that even our best efforts are not actually effective. Despite going for a walk, eating well, or calling a friend, at the end of the day, you still feel bleak and beyond help.

Postpartum support for suicidal thoughts. Online and in person counselling in Kitchener, ON.

The first step in getting better involves accepting that you’re struggling with postpartum mental health. This is not your fault. When it comes to postpartum moods, there are so many lifestyle changes and hormonal changes that are beyond your control. This is not just a matter of will power. If you truly could manage to get through these months with determination and grit, I promise, you would have done it. However, if you realize that something is still feeling off, name this. Acknowledge that there is a part of you that is really having a hard time and is feeling helpless. This part deserves the space to talk, process, and recover.

Step Two: Reduce isolation

Suicide and postpartum care. Internal family systems therapy to help work through suicidal ideation. Kasi Shan Therapy, counselling support in Kitchener, ON.

There is a reason that we have the saying, “it takes a village to raise a child.” Childrearing should be done with support, and in our culture, we don’t often have the network nearby. In line with our independent values, we are not always comfortable reaching out to these village members.

In encouraging a stronger support network, I ask that you reach out to any means of support that you feel is genuinely helpful and compassionate. This may include contacting family members, friends, neighbours, support groups, mental health counsellors, health care professionals, really, anyone who you feel safe around. If our loved ones are unaware of how much we are struggling, they may not recognize the need to offer help.

Suicide and postpartum care. Internal family systems therapy to help work through suicidal ideation. Kasi Shan Therapy, counselling support in Kitchener, ON.

I know that some of us do not have the best support team. Sometimes our family members cause more harm than good. Their offering of help may come with judgments, criticism, or other consequences that make you feel worse than when you started off. Sometimes our family members become overwhelmed when we share our mental health struggles. Ironically, you may end up spending more time consoling them that your own needs are not addressed. In these situations, I encourage you to reach out to a local therapist (if financially feasible), or to find a non-profit counselling agency. Connecting with postpartum programs (e.g. Pregnancy and Postpartum Mood Disorders Program, Stork Secrets, Postpartum Support International) can help you find safe others that truly understand and are capable of helping with thoughts of suicide.

Your internal system

In Internal Family Systems Therapy, we recognize that our internal system is divided into parts. There are parts of us that are carrying wounds from the past (e.g. abandonment, betrayal, shame). These parts of our personality are often pushed away because they are too painful to acknowledge. In pushing away, we form protective layers. There are managerial parts of our system that work to prevent these wounds from getting triggered. These manager parts can appear as perfectionists, hard-working, critical, or conflict-avoidant. Their roles in our system is to run our day-to-day functioning without having our deepest burdens and wounds show up.

As I said before, when we push our feelings away, they tend to backlash. At some point, we get triggered. At these moments, we have reactive parts of our system that take over. They work to get rid of these vulnerable feelings as quickly as possible (e.g. drinking, anger, suicide). Ironically, whether our parts are playing a reactive or preventative role, there is a protective intent to help you from being overwhelmed by your wounds.

Step 3: Meet the key players of your internal system

Suicide and postpartum care. Internal family systems therapy to help work through suicidal ideation. Kasi Shan Therapy, counselling support in Kitchener, ON.

In therapy, I work with clients to get to know all of the parts involved in pushing you towards or protecting you from suicide. We work on skills to separate from these intense emotions so we can observe them, hear them out, understand their fears and concerns, and have a better relationship with them. Can you imagine how you would feel if, when sadness took over, you could actually have the capacity to listen to it calmly without becoming overwhelmed? That is the beauty of IFS. When we can step back and listen to our system, we can begin to hear the fears, concerns and protective intent of even our harshest emotions. We are able to access those underlying wounds and support their recovery so that the rest of your system does not have to work so hard at preventing or reacting to triggers.

I understand this may sound unbelievable to many people. After all, you may have experienced suicidal thoughts for months and come to terms that you are “just an anxious mess” or “a pathetic parent.” Therapy can help shift this outlook. You are more than your anxieties, depression or other extreme parts.

Step Four: Address your coping mechanisms

In therapy, we take a close look at the patterns that your parts take on when they are active. We pay attention to what triggers your extreme emotions. We look at all of the coping mechanisms that are used to manage these extreme emotions.

Suicide and postpartum care. Internal family systems therapy to help work through suicidal ideation. Kasi Shan Therapy, counselling support in Kitchener, ON.

For many postpartum parents, their biggest fear is feeling incapable of taking care of their baby. When this fear gets triggered, these parents respond in anyway or form to self-soothe. Some of parents turn to drinking to help these thoughts calm down. Others look to their partners, parents or loved ones to take over, and avoid any time alone with their infant. Some parents get caught in a spiral of self-hatred, focusing on criticising themselves for being incapable. In therapy, we look at all of these coping mechanisms without judgement. These are the strategies that have kept you going all of these months, and we want to work with each piece respectfully, and discuss opportunities for change.

Change comes in many different ways. Each parent is unique and I don’t want to give generic advice when your needs may be significantly different from the next person. What’s important in understanding our system is that we learn to slow down to get to know these key parts better. We want to build trust that these coping mechanisms no longer have to be employed to keep us safe. We want to have permission to address those underlying wounds so that you have permanent healing.

Suicide is a quick fix for a problem with many alternative solutions

When it comes to postpartum care, I get that suicide is a fast response. We are struggling and we want the struggle to be over. Ending our life would be the fastest option out. While this may be true, this is a decision you can never take back. Before any part of you makes that ultimate choice, it’s important to ensure all of your alternative options are tested. The struggle in this request is that we may need some time to try out these other options. Your suicidal part is taking a risk in working with me. Rather than having a quick fix, I’m asking that we make some permanent shifts so that life does not feel so miserable.

If you would like to talk further, please feel free to reach out.

Take care,

Kasi

Pregnancy and Postpartum · Mental Health · Parenting

A Note for all “Mothers”

On Mother’s Day, we are bombarded with social media posts doting on all the maternal figures in our lives. While there is no denying that there are some fantastic mothers out there, not all of us feel lucky to have this type of positive influence. Many mothers do not feel confident enough to call themselves fantastic parents. Working in the perinatal field, I am surrounded by mothers who struggle with this internal assessment of whether they are good enough parents to their children. On this Mother’s Day, I wanted to gather a few quotes that I hope will offer some comfort and guidance as you move through your own journey of understanding or experiencing motherhood.

What does it mean to be a mother? Mother's day. Maternity. motherhood. kasi shan therapy offers counselling for mothers experiencing trauma and perinatal mental health.

I love this quote for recognizing that, as parents, we are working with a blank slate. Our interactions, guidance, compassion, and boundaries are all critical in teaching our children how to navigate in the world. In many ways, we will do an excellent job in offering the secure attachment to let them explore and gain independence. However, some of our own anxieties can come forward to affect the ways in which we influence our children. This does not have to be a deal breaker. Relationships grow. They can strengthen and weaken. Making a mistake or being imperfect is not a life sentence for your children or your relationship with them.

What does it mean to be a mother? Mother's day. Maternity. motherhood. kasi shan therapy offers counselling for mothers experiencing trauma and perinatal mental health.

We all carry wounded parts within our system. These wounds stem from trauma, heartbreak, grief, or other hardships we have endured in our lifetime. Sometimes, however, our wounds are not our burdens but those of our parents and the generations before them.

Your mother will pass many adaptive and effective qualities on to you. Other times, she will pass on teachings from her own hardships. Experiences like war, poverty, and racial injustice have taught the generations before us how to survive. Your mother’s emotional system had to change in order to adapt to these events. Accordingly, she may be anxious around police officers, she may push for frugality over spending, and she may express bitterness or anger towards a certain group of people. These behaviours are learned survival tactics. She needed them to manage in her world. It’s easy to pass on these tactics to you. These adaptive needs suddenly become part of your story, and you learn to navigate in the world using these behaviours, even though they may, or may not, be as relevant today.

What does it mean to be a mother? Mother's day. Maternity. motherhood. kasi shan therapy offers counselling for mothers experiencing trauma and perinatal mental health.

I loathe when social media bombards us with pictures of idealistic parenting. I’m referring to those images of a parent serenely staring at her child (who is dressed to the nines and displaying perfect manners). Let’s face it: that is not reality. My child has meltdowns, just like yours. There are times when I have to coach myself before going to a grocery store or completing errands because I know my patience will tested. Being a mother can be very fulfilling. It’s full of love, laughter, elation, warmth and so many other beautiful feelings. Just as equally, motherhood knows exactly how to push your buttons. Your child is incredibly brilliant in knowing what will make you explode. And it is absolutely normal for you to want to some compassion and understanding (as well as a break!) during these moments.

What does it mean to be a mother? Mother's day. Maternity. motherhood. kasi shan therapy offers counselling for mothers experiencing trauma and perinatal mental health.

Following a birth trauma, we can get stuck in the narrative of how we conceived, carried, or delivered our child. This unsettling onset of motherhood can hold us in a state of frustration, guilt or even anger. Our traumas keep us caught in the past, and prevent us from fully enjoying the present moment with our newborn. Moreover, our trauma can keep us stuck in grief when we did not have the chance to welcome our baby into our lives.

For any parent who has experienced a birth trauma, I want to emphasize that healing is possible. Working through traumatic events can take time and support. Every mother goes through processing and acceptance at a different pace. However, PTSD does not nullify the fact that your life has changed. No matter how your birth experience turned out, your world has suddenly shifted. You may have brought home a new addition to your family. Your family may have lost the possibility of including a new member. No matter what has happened, your world looks different today than it did yesterday.

What does it mean to be a mother? Mother's day. Maternity. motherhood. kasi shan therapy offers counselling for mothers experiencing trauma and perinatal mental health.
What does it mean to be a mother? Mother's day. Maternity. motherhood. kasi shan therapy offers counselling for mothers experiencing trauma and perinatal mental health.

I love comparing these two quotes. Our kids can ground us and guide our lives. It’s easy to get sucked into their world doing after school activities, focusing on their development, and helping nurture their interests. However, as parents, our ultimate goal in child rearing is that our kids become independent people who no longer rely on us in this same way. In preparation for this eventual transition, I like to remind all mothers to not lose themselves completely in the process of parenting.

When we’ve done parenting right, our kids will leave us to live their own lives. It’s a big shift to suddenly focus on ourselves instead of them. To prepare for this change, nurture parts of yourself throughout their entire development. This may involve taking an hour to yourself at the end of the day, or going on mini-vacations on your own. It may mean developing your career alongside your childrearing. You were your own person before becoming a parent, and it’s important to not forget this pivotal detail.

What does it mean to be a mother? Mother's day. Maternity. motherhood. kasi shan therapy offers counselling for mothers experiencing trauma and perinatal mental health.
What does it mean to be a mother? Mother's day. Maternity. motherhood. kasi shan therapy offers counselling for mothers experiencing trauma and perinatal mental health.

These are messages that I love to remind my perfectionist side. While my education has taught me how to provide therapy and support the emotional side of life, I am not an expert in all things related to motherhood. I recall panicking the first time my child had a fever. I remember feeling overwhelmed when I had to help my little one learn to sleep independently. There are countless memories of us trying to rush out the door on time for work, and of me losing patience.

While we want to be experts at everything, it’s next to impossible to achieve this goal. Your child did not come with a manual, and they will constantly throw new issues at you to figure out. Give yourself the time and patience to screw up and learn from these mistakes. You will not always be calm, you will not always know the right answer, and you will not always look like you have it together. That’s okay. We learn from all these experiences. Surround yourself with others who are also learning and can resonate with this need for patience and forgiveness. This is your support system that will get you through those hard moments. Mothers come in all different shape, sizes, capacities, histories, strengths and weaknesses. There is no formula that will be make us perfect parents, but we can do well in this job.

What does it mean to be a mother? Mother's day. Maternity. motherhood. kasi shan therapy offers counselling for mothers experiencing trauma and perinatal mental health.

I had to include this quote only because Matilda was one of my favourite books as a kid. But in many ways, Roald Dahl is right. Our kids can be ridiculous. They can be the obnoxious and make terrible fart jokes. They can be surly and give us the sassiest comments that make us want to scream. However, by the end of the day, we (usually) have our rosy-colored glasses back on and finding them to be magnificent, charming creatures.

To my fellow mothers, mothers-to-be, women who wish to be mothers, and maternal figures, I hope you all recognize your strength and patience in this process. Mother’s Day doesn’t have to be a special day if you don’t wish to celebrate it. Mother’s Day should not be only one day of the year that you are appreciated. I hope these quotes and messages offer you comfort and get you through this day. If you need support, please reach out.

Warmly,

Kasi


Kasi Shan, MSW, RSW
Kasi Shan, MSW, RSW

Kasi Shan Therapy is located in Kitchener, Ontario. She offers in-person and online appointments supporting individuals with struggling with trauma and perinatal mental health.

Pregnancy and Postpartum · Mental Health

Postpartum Rage: I am going to lose it!

I feel like society normalizes feeling overwhelmed, insecure, and stressed as a new parent. While our society is more compassionate towards these vulnerabilities, there is much less acceptance when it comes to our anger. Postpartum rage is a common occurrence during the first year with a baby. It can show up as a symptom of postpartum depression, but it can also show up on its own. Unfortunately, since there is so much stigma about anger (especially anger towards an infant), parents hesitate to reach out for help. For this post, I’d like to open the conversation about postpartum rage. I’d like to normalize this anger, explain the ways it can show up, and strategies we can use to feel better.

What is postpartum rage?

Postpartum rage are short or lengthy bursts of overwhelming anger. Parents feels completely out of control, and struggles to get their temper under wraps. Everyone expresses anger differently; however, common signs of postpartum rage include:

  • screaming/swearing
  • physical expressions of anger (e.g. throwing items)
  • violent thoughts
  • inability to stop thinking about the upsetting situation
  • difficulty getting their emotions back to state of calm/neutrality

There is no one issue that triggers postpartum rage. Sometimes it’s the baby waking up at the middle of the night for the third time, other times it’s your partner forgetting to do the dishes. This can make it really hard for parents to predict when they will become upset. Or worse, they feel a lot of shame that a simple event, like forgetting to do the dishes, caused them so much distress.

When postpartum rage comes out, it’s extremely difficult to manage. For many parents struggling with this issue, they face a backlash of overwhelming emotions once the rage has subsided. This often includes guilt, self-hatred, shame, helplessness, or hopelessness. These reactionary thoughts and emotions can keep us spiraling in a low place well after the anger has passed.

Emotions last in our body for 90 seconds. After that, the physical sensation dissipates, UNLESS our cognitive brain kicks in and starts connecting our anger with past events.

Jill Bolte Taylor
(Neuroanatomist, author, and public speaker)

Anger as a secondary emotions

Working from an Internal Family Systems‘ perspective, I know that anger comes from a protective intent. It is often an impulsive act or last-case resort in responding to another issue. For many parents, postpartum rage is a result of feeling overwhelmed, resentful, isolated, uncertain or guilty. Unfortunately, these are all very common emotions during the postpartum year.

It’s easy to feel resentful of our single friends who can go out at night or sleep in on weekends. Many of us feel resentful towards our partners who have the option to get away from the baby for several hours a day to attend work.

A sense of isolation during maternity leave can feel debilitating. We are stuck at home with our insecurities, and only the company of a (demanding) baby for entertainment and companionship. The impact of isolation has become exponentially harder during the pandemic when activities like baby/mom groups, gyms, libraries, and other resources are no longer available.

photo of mother dressing an infant
Photo by William Fortunato on Pexels.com

The first year with a baby is full of so many overwhelming anxieties. From the baby’s first cold, to poor latches, and low weight, there are ample opportunities for a new parent to feel distressed. When we have had time to breathe, or if we have older children, we are more confident in our approach to parenting. We can forgive ourselves more easily after making a mistake. However, when we are vulnerable (e.g. being a first-time parent), the guilt and overwhelm can take over whenever we make mistakes.

Anger allows a safe option to cover up these underlying and more vulnerable emotions. It is an instinctive coping mechanism. Anger gives us a quick and fast way to release all of our pent up feelings. Once those feelings are released, we have more space to manage life, or we can push aside our resentment for one more day. In order to have anger soften, we have to work with these underlying issues. This can take time and trust with a therapist. After all, who actually likes acknowledging that they feel resentful or incompetent? Once these underlying factors feel more at peace, our anger will slowly start to shift. It no longer needs to take over in order to protect you.

What you can do on your own

Not everyone wants, is ready to attend, or can afford consistent therapy. Exploring your own underlying emotions is a unique journey. It will lead us to understanding your vulnerabilities, where they stem from, and what these parts of you may need from you in order to heal. However, if this is not an option for you today, there are things you can do independently.

  • Pay attention to triggers. Write down when your bouts of anger happen, and start paying attention for commonalities. Is it a specific person that gets you going? Is it a certain time of day? By noticing when you are most likely to get angry, you can have more options to problem solve or work around this trigger.
  • Recognize your body cues. Your anger will often show up in the same way somatically. Take a moment to think about the last thing that really pissed you off. How does your system respond? Does your body start to tense up? Does your mind start to race? Do you notice if there is a certain location in your system that carries the most activation? Once we are aware of our somatic cues, we can start to respond to them faster. Similarly to knowing our triggers, it’s helpful to know our bodies. For example, if your heart starts to race and your hands get clammy, that can be a wake up call to have your partner take over while you take a break.
  • Evaluate your expectations. A lot of our guilt comes from high expectations of how we ought to be as parents. Consider if these standards you’re setting are fair. The best way to consider if you’re setting yourself up is to ask if you’d push these same expectations on a friend or loved one.
  • Address loneliness. It can be incredibly challenging to ask for help or voice to others that we are feeling isolated. Yet, if there’s one thing this pandemic has taught us, we need to stay connected. As human beings, it is in our nature to be social. This does not mean you have to plans everyday; however, scheduling a weekly check in with a friend, or going on a regular walk with your neighbour may be enough to shift out of the loneliness.
  • Prioritize sleep. I have written earlier posts about sleep hygiene, and I encourage you to try out these strategies. Your little one may be waking up several times at night, in which case, I recommend coordinating with your family members to have at least 4-hours of consolidated sleep. This allows you to have the opportunity to complete one full sleep cycle. It’s okay that this deep rest comes at 6 PM. As long as you are having these four hours daily, your mental health has a chance to be less distressed.
  • Make time for your own interests. You can be an incredible parent AND be your own person. It’s easy to lose ourselves in becoming parents. All of your interests, hobbies, and passions get dropped to the wayside to focus on your little one. While this is normal at the start, we want to ensure you create some balance. This little person will always be in your life, and it’s important you don’t lose your good habits (e.g. self-care, exercise, extracurricular activities, time with friends) while parenting. When you carve out some consistent time for your own interests right from the beginning, it can be an easier habit to maintain long-term.
  • Reduce your to-do list. Sometimes, in the sake of being productive and managing all of our expectations, we create a lengthy lists of tasks to accomplish. Postpartum rage is often a result of feeling overwhelmed, and one of the simplest ways to manage is to look at what can be dropped from your list. I get that we’d love to have a pristine household, be incredibly fit, have time for work, and manage a full social calendar. However, it’s not possible to achieve all of these needs at once. So consider what needs to be prioritized and what you’re willing to be flexible on.

Postpartum rage can get better

Postpartum rage is awful and it’s incredibly common. Unfortunately, for many of us, we carry so much shame in getting triggered. Postpartum rage is one of the many postpartum mood and anxiety disorders that can take place in the first year. As Postpartum Support International wisely tells all parents in this phase, “You are not alone. You are not to blame. With help, you will be well.”

Warmly,

Kasi

Kasi Shan, MSW, RSW
Kasi Shan, MSW, RSW

Kasi Shan Therapy is located in Kitchener, Ontario. She offers in-person and online appointments supporting individuals with struggling with trauma and perinatal mental health.

Pregnancy and Postpartum

Working through the Baby Blues

Many postpartum parents can attest that the first two weeks after delivery can feel like a nightmare. With the numerous changes that a parent experiences (e.g. hormones, sleep patterns, feeding schedule, diaper changes, etc), those initial days are about surviving the storm. Unfortunately, for many of us, adapting to these new changes can feel like an emotional roller coaster, and we begin to experience baby blues.

Baby blues can show up in a variety of ways. Within the first few days postpartum, caregivers can experience one of the following symptoms:

  • Easily irritable and snappy
  • Feeling overwhelmed
  • Sadness or tearful (sometimes with limited reason or triggers)
  • Higher levels of anxiety and worry
  • Impatience
  • Restlessness
  • Fatigue
  • Difficulty sleeping (even when the baby is asleep)
  • Mood changes
  • Poor concentration

Unfortunately, baby blues is a normal part of the postpartum phase. It is experienced by approximately 80% of caregivers, and improves within two weeks without any intervention. While baby blues is no longer considered a mental health issue, many parents struggle during these early days. For anyone who has experienced this distress, you can relate to the desperation of needing to get off this emotional roller coaster. I hope the following tips will offer comfort to you and your family during these times.

1. Remember that it takes time to adjust

Beyond the hormonal fluctuation, a new parent is thrown into various physical and lifestyle changes. Your body has just gone through the painful experience of child birth, and is trying to recover. You are figuring out how to breastfeed, or coming to terms that you will use formula with your little one. You may have limited access to rest as you wake up every two hours to feed your baby. Perhaps you are struggling with regrets (e.g. you were hoping for a different delivery experience, or grieving that you have a baby boy instead of your preferred baby girl). Many mothers struggle to accept their post-delivery body, and resent that they still look pregnant. There is a huge learning curve with your partner in managing household chores and parenting. These are just a handful of changes that a parent can experience during these early days.

These changes are significant, and can take time to sort through. When it comes to adjustment, every one has a different capacity of how well they transition. For most people it can take anywhere from 4-6 months before accepting a new reality (e.g. adjusting to new job, new career, new city). This time frame will vary if there are additional stressors placed on our system (e.g. lack of sleep, financial constraints, loneliness, grief).

While we know that change can take time, we often have a hard time accepting that we need the time to adapt. Ideally, we’d love to shine and present as well-adjusted human beings irrespective of whatever stressors are thrown our way. While I hope you are one of the lucky few who are adaptive, chances are you are among the norm for needing some time to readjust. My favourite reminder during my own postpartum phase was that it took me 9 months to grow this baby, it’s okay for me to take the 9 months to learn and adjust. This time frame helped me ease my own expectations of getting things right or expecting fast results. What time frame have you set for yourself?

Watch out for shame

Baby blues is not your fault! I hope you repeat this line to yourself as many times as you need to in order for that message to sink in. The majority of your emotional distress is influenced by hormonal changes. During the course of pregnancy, there are thousands of hormones taking over a mother’s system. These hormones quickly leave your body within the first two weeks following your child’s birth. Unfortunately, this quick shift in hormonal fluctuation can create a huge emotional roller coaster inside. For example, a reduction in estrogen can affect our ability to concentrate, and a drop in progesterone increases our fatigue. Both estrogen and progesterone plummet once our body recognizes we are no longer pregnant.

Many new parents struggles with attaching to their newborn. While this is perfectly normal, it’s not often openly discussed. Instead, we are bombarded with images online of parents who are overjoyed and attached to their new baby as soon as delivery happens. There can be a lot of shame for parents to voice that they do not feel attached to their baby. I want you to know this is perfectly normal. In all other relationships you are given the time to build rapport and get to know another person. This doesn’t mean we stop taking care of the baby, or attending to its needs. However, like with any relationship, it’s okay to take the time to get to know one another. For many folks attachment can take a few months. We often see improvements when the baby becomes more interactive and starts to respond to smiles and other social cues.

As often as possible, I encourage you to practice self-compassion and forgiveness during these two weeks. You will, understandably, have less patience when you are sleep deprived and tired. It would make sense that you are having a hard time concentrating on what others are saying because you feel like a walking zombie. It’s normal to feel overwhelmed during a major life transition. As much as this is a beautiful moment in your life, it can also be a moment of suffering. This moment will pass, and you will keep surviving. As long as you are not jumping on that guilt/shame-train, you can get through this moment.

Find opportunities to rest

I found that the most frustrating tip that others gave to me during my postpartum period was to nap when the baby was napping. Unfortunately for me, I am not a napper. I realized I became more frustrated and upset whenever I tried to nap during the day.

So let go of the pressure to fall asleep. Instead of focusing on getting some shut eye, try to take some time for your body to relax. This may involve watching TV, reading a book, or taking some quiet time outside in your backyard. If you happen to take a snooze during one of these activities, great! But ease off on the pressure to make this rest happen.

If it’s feasible, make a sleep chunking plan with a partner or family member. Find a way to ensure you have four hours of uninterrupted sleep so that you have the opportunity to complete a full sleep cycle. For example, speak with your partner and assess which one of you prefers to stay up late versus wake up early. This might involve going to bed at 7 PM so that your partner can do the 11 PM feed. You may also have to problem solve with your partner about feeds. This may involve pumping or formula feeding in order to have this time for sleep.

Do you want help or do you need space?

Everyone’s need for space and help changes and fluctuates. Knowing what your system needs, and being able to request this openly with our loved ones can make a huge difference to our moods.

There may be times where you are really craving alone time with the baby, and this is perfectly healthy and allowed. Pushing yourself to see friends and family who are eager to meet the baby may actually be causing more stress than good. The majority of us are conflict-averse, and oftentimes, we say yes for the sake of avoiding potential drama. However, what does that short-term aversion create for your system? If you find you are irritable or tired for hours afterwards, you get to decide if this option is actually working for you. The hard part with boundaries is that they are OUR limits, not those of others. Others will keep voicing their own needs; however, our mental health struggles if we become a ‘yes person’ for too long.

What to do with baby blues. Kasi Shan Therapy offers perinatal mental health in Kitchener, ON & online.

There may be times when you need support. If so, try and be specific of what would be helpful. Do you want someone to watch the baby while you rest? Would you like your parents to bring over some home cooked meals? Do you need a friend to help you organise the nursery? Your loved ones may say no to these requests, which is allowed. However, they will not always know that this is the type of support you need unless it’s stated. We would all love for others to mind read and “know” just what we need and crave. However, until this ability becomes feasible, we just have to ask.

What can my family members do?

Whether you have your loved ones read this section, or you have to explain it to them, make sure they are well-versed in these points. Family members, please try the following suggestions:

  • Check your expectations. Delivery is similar to surgery; your body needs 6 weeks to fully recover. Pushing a mom to do chores, make meals, manage what she used to, have sex, or any other responsibilities may not be feasible right now. Asking for these requests will not work in your favour and will only cause this new parent to feel guilty, ashamed or enraged. For everyone’s sake, wait it out.
  • Show lots of compassion. This is not a parent’s fault. Baby blues is not based on will power. This is truly a biological upheaval that is happening before your eyes. Your loved one will get better, and you will see a semblance of that person in a few days.
  • Ask what would be helpful. A lot of us love to cuddle babies. But if your only offer of support is to hold the baby while mom rests, this may not actually be as helpful as you intend. The easiest way to avoid this issue is to simply ask or offer suggestions.
  • Find other support systems. This new mother may be your favourite person to talk to and confide in. While this relationship works beautifully most days, she may not have the capacity to attend to these needs right now. Ask her what’s preferred. Pay attention to cues of stress. If it’s too much, it’s okay to reach out to other friends and loved ones.
  • Learn about postpartum mental health. Your loved one may not see the signs of postpartum mental health struggles until it is too late. It can be challenging to acknowledge we are struggling, and most of us experience a time of denial or avoidance. By knowing the signs for postpartum mental health disorders, you can be aware when you see your loved one shows symptoms. Let them know that postpartum mental health is treatable, and they can absolutely get better with the right help.

When should you be concerned?

The Edinburgh Postnatal Depression Scale (EPDS) is a self-assessment that can be taken during pregnancy and postpartum to assess moods. Complete the EPDS during your first two weeks postpartum, and take it again when you are closer to 4-6 weeks postpartum. If this current struggle is truly baby blues, your score numbers will be down significantly (either 8 or lower) by 6 weeks postpartum. If your anxiety and sadness continue to be a struggle, you may be experiencing other perinatal mental health struggles like postpartum depression. The wonderful caveat about postpartum mental health is that it can improve! With support and the right interventions, you can start to feel like your old self.

If you have any questions about the above information, reach out.

Warmly,

Kasi

Kasi Shan, MSW, RSW
Kasi Shan, MSW, RSW

Kasi Shan Therapy is located in Kitchener, Ontario. She offers in-person and online appointments supporting individuals with struggling with trauma and perinatal mental health.