Category: Pregnancy and Postpartum

postpartum sleep. newborn phase. new parent

It’s not you! It’s your Sleep: Postpartum Mental health and Getting Enough Rest

Published on by kshanmuk
New parent. Sleep and mental health. Learn about poor sleep and its impact on mental health.

It’s unavoidable as a new parent that you are sleep deprived. You’ve got endless disruptions at night from numerous feedings, diaper changes, and the ever-present grunts and squawks coming from your newborn. You may be turning towards different coping strategies (e.g. asking friends and family for help, grabbing naps, consuming endless cups of coffee, or having an iron clad determination to figure out sleep training).

For many new parents, the lack of sleep is one of the most difficult parts of early parenthood. Poor sleep does not cause mental health issues, but it can influence your vulnerability. A lack of sleep can contribute to starting or worsening mental health struggles. But, there are things you can do to ease the exhaustion and reduce the mental health challenges of early parenthood. In this blog post, we’ll share some tips for getting better sleep and managing postpartum mental health.

What does sleep do for you?

Before diving in, let’s take a moment to understand why sleep is so essential. The ideal amount of rest for a person is approximately 7-9 hours. This is a laughable amount of time for new parents to consider, especially when night feeds occur every 1-2 hours. But, irrespective of the amount you’re getting at night, it’s the amount needed for an adult to function.

Cognitive abilities

During sleep, your brain and internal organs are working hard. Your learning capacity is significantly influenced by this nightly practice. It is during sleep that your brain learns to integrate memories and new information. Your brain works through the various thoughts, emotions and information you experienced that day, and learns to sift through these details.

The neurons in your brain need this rest time to recover or else they become overloaded. This is a significant reason why your cognitive capacity feels diminished after a poor night sleep. With enough rest, you’re better able to stay attentive, learn new information, and create long-lasting memories.You can make better decisions, and have a better hold of your emotional capacity.

“Mommy Brain” Is Real

sleep and mental health. Mommy brain influenced by sleep struggles

You may have heard of folks referring to the term “mommy brain” for new parents who present as forgetful or scattered. Often, this term is said with some laughter and derision. But, there’s a biological reason that “mommy brain” exists. Not only is your system going through numerous hormonal changes, but your sleep deprivation exacerbates the situation. Sleep impacts your ability to reason, problem-solve and pay attention to details. If you find that you are making lots of mistakes, forgetting details, or have limited capacity to handle stressors, sleep is a big part of this problem. Both your body and mind are craving the rest they desperately need in order to reset.

Physical abilities

Sleep is also the time when your body recovers. During this rest period, your muscles strengthen and heal from the work it has done during the day. While your resting, your brain is producing the hormones needed to manage your well-being. These hormones regulate your immune system, your metabolism, your blood pressure, your insulin production, and even your hunger cues. When your body is working on limited sleep, recovery takes longer, and you’re more susceptible to colds and ailments.

The confusion with cortisol

Unfortunately, when we are sleep deprived, our body starts to produce more stress hormones. With limited sleep, your cortisol production increases, and this helps you stay alert. You go about your day, irritable and not up to par, but awake. When you take a nap, or get an extra hour of sleep, this production level decreases. Ironically, now that you’re less stressed, you become less alert and you’re more aware of how exhausted your body has become. People often walk away thinking that the naps have not helped, when in fact, it has gotten rid of that false alert experience caused by extra cortisol.

The cyclical effects of sleep and mental health struggles

When you are anxious or depressed, it’s hard to get quality sleep. Your mind is racing, your moods are low, and it’s hard to convince yourself to fall asleep when all of this internal turmoil is taking place. On the other hand, when you cannot get good sleep, you start to feel tired, overwhelmed, and irritable. While sleep is not the sole cause for mental health struggles, these two elements influence one another in this never-ending cyclical mayhem.

Tips to help get better sleep

So what do we do? When we’re so aware that sleep is good and needed, how do we get enough rest with a young baby? The following tips will give you some support in managing those first few months.

Find ways to soothe your newborn

When your baby can be quickly soothed and placed back down to rest, you’re able to get longer chunks of rest. This article explains the 5S technique that helps to settle newborns.

Establish a bedtime routine for your baby

establish bedtime routine. get better sleep as new parent

Identify the ideal bedtime for your child. For newborns, this is typically around 6-7 PM. Create a consistent plan for nighttime routines that will take 10-20 minutes. While your newborn will not pick up on this pattern right away, your future self will thank you for beginning this practice so early on. Your baby will adjust to this routine so long as you’re consistent. Eventually, there will be an association of this routine with the final shift into nighttime. This bedtime routine can include: baths, getting on pyjamas, infant massages, reading stories, signing songs, final bottle/nursing, and placing into the crib.

Use “the pause” to retrain the anxious mind

Our anxieties often want us to intervene as quickly as possible when our newborns are making noise at night. While this makes you a very loving and caring parent, it comes at a cost. Your anxiety starts to build an automatic behavioural pattern with this practice: the baby grunts, and you bolt to check that the baby is okay.

The pause is a technique described in French parenting that involves observing our babies for a few minutes before intervening (this is different from the systematic cry it out method). You’ll learn a lot from these 2-3 minute pauses. You’ll notice your baby can sometimes be asleep and making noise (Newborns have two hour sleep windows where they move, make noise and even cry out despite being asleep). You’ll also become aware of times when your baby can settle and fall back asleep independently. Your anxiety will also learn that a few minutes is manageable and reduce its pattern of “I must fix the crying”-panic.

Pausing for two minutes can feel like a lifetime, especially for parents who are cautious of creating insecure attachments. However, I know that these parents are working all day, everyday to provide their babies a safe and loving home. Giving yourself two minutes to retrain your anxiety will only further support you to show up from a secure place versus an anxious one. If you show up as grounded, calm and loving when you check in on your baby, they will settle faster knowing that you’ve got them and you are not worried about this situation.

Address your sleep hygiene.

It’s not just your newborn that needs a bedtime routine. Your system needs it as well. Establishing good sleep hygiene habits may not get you to sleep on the first night, but it will help your body shift away from activation into rest more quickly. The following post offers some suggestions about improving sleep hygiene.

Exercise

Wait a minute. You’re sleep deprived and you’re supposed to step on the treadmill? I know, it’s the worst advice. But there’s a reason that exercise helps our bodies settle. Getting some cardio into the day helps your body produce more endorphins, which helps you stay awake and alert. When you cool down following a work out, these endorphins leave the system, and helps your body settle back down into a calmer, rested state. This makes it easier when you get to bed shortly after.

Get some help

There may be some very strong, independent and capable parts of you that hate getting help. If this is the case, remember that it’s incredibly hard to raise a human all by yourself. If you have the support, and it’s safe to ask for help, please do so. Create a plan with your friends or family members to sleep chunk so that you can have at least 4 hours of uninterrupted sleep. This gives you the chance to get through at least a few sleep cycles. Ask for helping in managing household chores so that you don’t have to spend your awake time stressing out about these details.

Rest when you can

Rest is different than sleep. If you’re unable to fall asleep, focus on tasks that are relaxing and comforting to your body and mind. Stretch, read a book, watch a show, listen to music. Give your active, thinking, and organizing brain the opportunity to slow down. Sometimes we get hyper-focused on the baby and the endless amount of chores that need to get done. Ironically, your attention cannot be sustained for the amount of time needed to complete these tasks. Giving yourself the time to rest is like recharging your batteries. The earlier tasks will feel less overwhelming when you consistently take breaks and get the chance to rest.

Use of medication and therapy

Anxiety, depression, and mental health struggles are complicated. It’s not based on will power. If you had the tools and resources to overcome it, know that you would have by now. Seeking help allows you the opportunity to heal from emotional wounds. When the root causes of your mental health struggles have been resolved, your day to day capacity (including your ability to sleep) will get better.

Reach out

Remember that so much of your mental, physical and emotional capacity is influenced by your sleep. It’s not you that’s doing it “wrong”. It’s not your fault that life feels hard and challenging. By prioritizing your sleep, you can support your mental health and better cope with the demands of parenthood.

If you’d like to chat about any of the above pieces, or if you’re looking for support with your mental health during this postpartum phase, reach out.

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.

Contact Kasi

Drinking and Postpartum Depression

Published on by kshanmuk

Your world feels chaotic and there’s no escape. There are endless hours between naps, feedings and the constant fatigue. There is no one around to talk to and you feel overwhelmed and frustrated all the time. Having one more drink feels awful, but it gives you that escape you’ve been craving. Sound familiar?

Whether you want to call it an addiction or not, you’re noticing that you’re drinking more than usual. What was initially meant as a treat at the end of the day is starting to become a coping strategy (and, unfortunately, this one comes with some consequences).

If this sounds like your life right now, I get that you’re really struggling. This post is not about judging you or telling what is right or wrong. Addictions is hard. Postpartum depression is hard. For those who are in these circumstances, I hope the following post provides you some clarity and empowerment.

What is drinking doing for you?

Attempts to Self-Soothe:

Life feels chaotic and things feel too difficult to manage. There needs to be an end. It’s not possible to stay hyper-alert forever. You can’t always be watching the baby sleep. It’s overwhelming to be so stressed out at every feed. Drinking helps to balance your window of tolerance. When you’ve become a ball of stress, your body craves a way to settle down. So, a part of you turns toward drinking to help you calm down and relax.

Alcohol is an effective depressant. It forces your body to slow down giving that reprieve you desperately crave. In this way, drinking is an attempt to self-soothe. It’s a coping mechanism for helping slow down, numb out, or block off whatever it is you don’t want to address. You can’t necessarily leave the baby. You don’t want to call it quits as a parent. Drinking provides that mental escape when physical escape is just not possible.

Gabor Mate quote on addiction. Addiction as a coping mechanism during postpartum months. Addressing trauma to address addiction.

Lack of Internal Trust

If you’ve experienced enough trauma, neglect, shame or hardships in your life, you are likely aware that your internal system feels messy. You’re aware that many days you feel overwhelmed by worries, humiliation, guilt, anger, or self-hate. These parts of you are harsh and relentless. However, in their own unique way, they are trying to protect you. For example, you may have a critical part that shames you in order to encourage change. There may be a perfectionist part that nags incessantly so that you do not make mistakes.

Lack of internal trust. Coping with alcohol instead of being with our feelings. Alcohol and postpartum depression

When our system is full of these protective parts, it’s an indicator that there is limited trust inside. Rather than believing you are capable of handling difficult situations, your protective parts take over. For example, when you feel tired of parenting, there may be a harsh part that steps in. It yells at you to be grateful and reminds you of how hard it was to conceive. Your system doesn’t trust you to sit with the distress of parenting. It would rather help you avoid those thoughts by filling you with shame and guilt instead. This is not necessarily a helpful or effective manner of handling things, but it’s been like this for years.

Working with these protective parts are challenging. No amount of reasoning or negotiating in our minds creates that desperately sought after sense of calm. Our guilt, anxieties, shame and internal critics are forever yelling in our minds. So, a part of us starts to drink. It helps to quiet down all of those loud protective layers inside.

Why is it so hard to give up?

You already know that drinking excessively has consequences. But, why is it so hard to give up? If you’ve ever moved towards sobriety or harm reduction, you know this is no small feat. So, let’s take a look at what gets in the way of recovery.

Physical Dependence

So much of the addiction process is physiological. When we drink, the reward centres of our brain become affected. Suddenly, our brain produces an abundance of dopamine (a chemical that makes us feel good and influences our sense of pleasure). Once we get introduced to this experience of high-level dopamine, we start to crave it. By using, our brain is providing us enough dopamine that things feel so much better, calmer, and happier.

When substances are taken away, we feel depleted and depressed. Our brain is not producing the amount of dopamine that we crave. The normal level of dopamine production no longer feels like enough. For many folks, they can work through the triggers and traumas of their addiction, but their brain struggles to find pleasure in normal activities. It’s hard to read a book, talk to a friend, or go for a walk when you continuously feel so flat and apathetic.

Working through Pain Points:

man drinking and postpartum depression. working through trauma and grief to recover from substance use.

When we use substances to cope with our reality, we have to consider what’s happening in our lives that makes us so desperate to escape? Drinking excessively to cope is not anyone’s first solution to fix a problem. Having a baby should not make us so overwhelmed that we’re needing a bottle of whisky every night. So what’s really going on?

When you are no longer drinking, you are left with pain points. Perhaps it is underlying trauma from childhood that keeps coming up. Being around a baby makes you remember all of your toxic and negative experiences as a child. Your pain points may come from unprocessed grief and anxiety. You feel like you ought to be happy with your newborn, but it’s been years of IVF struggles and multiple miscarriages. There’s no way you can let your guard down because what if one more bad thing happens? The part of you that drinks minimizes all of these pain points. Once the substances go, you suddenly have to face your traumas.

Working through pain points means looking at and processing the original trauma. If you continue to be triggered today by situations from the past, that urge to drink will keep coming up in order to protect you.

Russell Brand quote about addiction. Addiction as form of coping. Processing original trauma helps reduce drinking. Working through over-drinking during postpartum months.

Habits

Habit formation can leads us to automatically reach for a glass of wine once the baby goes down for a nap. At the end of the day, we crave those several beers to help feel calm. We don’t even think or question our urge to grab a cigarette or a joint when we start our day. When it comes to these automatic routines, there are ways to change these habits.

4 Tips to Help with Drinking and Postpartum Depression:

1) Address the pain points.

Drinking is not the problem. It’s a means to make the pain stop. Until your postpartum depression, trauma, grief, and other pain points are addressed, that drinking part will want to self-soothe through substances. Healing from these pain points can involve a variety of interventions, including: individual therapy, support from friends and family, psycho-education, group therapy (for those in Kitchener, Stork Secrets provide wonderful care for postpartum depression), or medication.

2) Explore options for self-soothing

For many, accessing the interventions listed above is not possible. If this is your circumstance, you need to find alternative ways to work through difficult emotions. This is where effective coping skills can help. You need quick and reliable ways to slow things down. My favourite recommendation is the DBT temperature change exercise.

3) Find connection

Our shame drives so much of our need to drink. We worry that others will judge us. We assume they’ll reject us or mock us if they knew how much we are struggling. If there are people like this in your life, I’m sorry. These are not the supports you need right now. Find a safe community to talk to about your struggles, such as neighbours, friends, family, partner, colleagues, or a community-based mental health group. Having others who accept you and love you, just as you are, plays a significant role in healing.

4) Get to know your cues and rewards

One of the best tips for changing our habits is understanding our cues and rewards. Pay attention to what triggers you. Are you most likely to use when the baby refuses to go down for a nap? Are you prone to having a bottle of wine starting at supper time? Pay attention to the time, the place, the people and circumstances. Next, notice the rewards that you get when you drink. Are you able to pass out? Can you suddenly tune out the crying and shrieking? Are you able to manage boredom or frustration? Does your anxiety reduce?

understanding cues and rewards for addiction. Changing our habits to help address addictions and postpartum depression.

When it comes to changing habits, we want to make sure that we intervene with a different habit for these cues AND still receive a similar reward. For example, once the baby has done screeching for an hour and finally falls asleep, you may experience an urge to drink. It’s the only way to release all of that pent up anxiety and tension inside of you. In this situation, the cue is the baby shrieking before nap time. The reward is releasing anxiety. We want to bring in an alternative habit that will lead to the same result. You may find that running on your treadmill for ten minutes releases some anxiety. Perhaps playing loud, angry music on your headphones provides you some relief. You could work with a foam roller and target those parts of your body that are carrying the most tension. Pairing these new activities shortly after the baby has gone down for a nap leads to shifting out of the original habit.

Final Thoughts

Addictions is not simple, and one blog post cannot address the complexities of this mental health struggle. If you are struggling with drinking and postpartum depression, please speak with a safe and trusted person or a therapist. This is not a matter of will power. You are worthy of effective support and help.

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.

Contact Kasi

7 Tips for Parents Going Back to Work

Published on by kshanmuk

How are you feeling about going back to work? The past few months have been all about baby, and now you’re suddenly expected to balance work, childcare, and other needs. There’s no way this can go smoothly.

If you’re among the many, returning back to work after maternity leave (or paternity leave) can be a difficult transition. Here are seven tips that can help you along your emotional journey and set you and kiddo up for success.

#1: Change habits ahead of time

changing routines. Transitioning back to work from parental leave. Kasi Shan Therapy offers therapy for trauma and perinatal mental health. Online and in-person appointments in Kitchener, Ontario

Unfortunately, your schedule will look different. You won’t have the same flexibility with your morning routine. Things you may have fobbed off (e.g. getting ready on time, wearing clothes that are not pyjama/sweats, putting baby in clothes) have to be reintroduced into your routine. Changing your habits can be challenging, and it’s best to give yourself some time with these transitions.

Take a look at your routine and consider what you can do to fine-tune your schedule before going back to work:

  • What is getting in the way for you to have a successful day?
    • Are you staying up late at night scrolling on your phone? Do you drink too much caffeine to fall asleep on time?
    • Once these problem areas are identified, create ways to make them harder to repeat. For example, put the coffee machine away after 11 AM, turn off the wifi after 10 PM. It may sound silly, but any barriers that get in the way will make these problem areas less desirable
    • e.g. If the cookie is right in front of you, you’re going to grab it. If you have to grab the kitchen stool and reach to the top shelf on your cabinet to get the same cookie, you may reconsider if it’s worth it.
  • Consider the habits you’d like to introduce into your schedule: Do you need to wake up earlier? Are you intending to pack your lunch the night before? Do you have a regular night out with your friends? How will you get your child to eat breakfast on time? This step may involve some creative problem solving. You may also have to rely on the support of friends, family, or childcare providers to make it work.
  • Work on introducing one new habit at a time. Rather than manage all of these changes from the get-go, give yourself plenty of time to get used to forming these habits.
  • Have reminders to cue you about your new habits. e.g. Place your gym clothes near the foot of the bed so that you have it ready to go when you wake up in the morning.
  • Use rewards to motivate. Behavioural psychology works! If you pair your new changes with a reward, you’re more likely to follow through. E.g. If your child finishes breakfast on time, you will set aside 10 minutes to play or read before heading out the door.

It takes time to get used to things. Going back to work is huge change from your daily routine of the past few months. If you’d like to learn more about creating changes, check out Atomic Habits or The Power of Habit.

#2 Remember that you will still have a strong attachment with your baby

A big fear of returning back to work is about losing the bond you have with your child. If this is you, remember that attachments and relationships are not so delicate that they will break with having a few hours apart.

If you’re in a secure relationship, you may notice this pattern more easily. In all likelihood, you go to work, hang out with others, pursue your own interests, and you come home to this person knowing that the relationship is still strong. The time apart has not shifted your feelings towards this person. It’s the same with your child. Your infant trusts that you will come back. Your infant will have strong relationships with other peers and adults. You will always be a solid person in his/her/their life.

Going back to work from maternity leave. parental leave. Kasi Shan Therapy offers postpartum and prenatal counselling in Kitchener, ON. Online and in person counselling.

Rather than focusing on the amount of time you have with your kids, focus instead on the quality of the time. Engage in play, conversations, snuggles. Make sure that your kids feel seen and heard by you. This doesn’t mean you have to provide 100% of your attention when you’re at home with them! Instead, try and create some time in the mornings, afternoons and evenings for hanging out. Some examples can include: sitting down together for meals, having chats in the car, splashing around during bath time, or having snuggles while reading a story at bedtime. Going back to work does not have to stop you from having these wonderful moments.

If all of this does not convince, you, there have been studies have shown that babies do not suffer when their caregivers return to work following parental leave. Instead, the results show that children learn they are being left in safe and nurturing spaces AND that their parents always come back to them.

#3 Talk to People

Returning back to work from parental leave. It takes a village. Build a community. talk to people. Kasi Shan Therapy offers online and in-person appointments in Kitchener, Ontario.

Every single new parent I’ve talked to has varying degrees of concern and worries about going back to work! It’s an adjustment and it’s perfectly normal to feel cautious towards change.

Managing childcare, work, relationships and your own interests is hard. Rather than sitting with these frustrations alone, please reach out to your community. Let your work know about needing time to pump. Talk to other parents at your workplace to see how they managed. Work with your family members to access emotional and practical support. There’s a reason that the saying “it takes a village to raise a child” exists. Gather your village!

#4 Get to know your childcare provider

Get familiar with your daycare. Ask for a tour. Have a list of questions. I promise you, you are not alone in being anxious. Your daycare provider has answered these questions many, many times.

Talk to daycare providers. Transitioning back to work from parental leave. Nervous about going back. Build a community.

If it’s financially feasible, arrange a few half-days for your child to participate in childcare ahead of time. By having this short time period away, you will both become familiar with the routine of doing drop offs and pick ups. This trial period also provides an opportunity for you to see how your child manages when spending time away. Your childcare provider will be able to provide you some feedback (did they cry for 5 minutes or 15 minutes? Were they able to settle? Did they make friends?). You both get used to this routine ahead of time, which is helpful for when you do officially go back to work.

#5 Create a balance between needs and wants

You may have had all the time, energy and resources to invest in twelve different interests and hobbies prior to having your child. But, it’s hard to keep up at that pace. What can you feel comfortable dropping? What are you willing to be a little less “good” at? Be honest with yourself in what you really want vs. what you really need.

work life balance. going back to work from maternity leave. Support with transitions. Kasi Shan Therapy offers online and in person counselling (Kitchener, Ontario).

Find a balance between work, family life AND you-time. It may feel hard to carve out that space for your own interests, but it’s so important to make time for self-care. Without this time for your own needs and interests, it’s easy to burn out, grow resentful or lose yourself in the process of parenthood.

#6 Acknowledge the feelings

No matter what happens, there are going to be feelings. Some good, and some not so pleasant. Rather than pushing these emotions down, allow yourself some time to reflect on what’s coming up as you go back to work. You may experience rage, guilt, anxiety or overwhelm. If this is the case for you, the solutions may vary. You may ned some time to adjust to the transition. It may be helpful to reach out for support. Or, you may require some specific problem solving to address these emotional needs.

Alternatively, you may experience a sense of calm and peace now that you have some time with other adults. You may feel proud that you and your child are handling the transition as well as can be. If this has been your experience, enjoy it! Everyone adjust to change differently, and this transition may be a smooth experience for you.

#7 Cut yourself some slack

Going back to work after so many weeks or months with your child is a huge transition for you and your baby! Give yourself permission to feel all the feels, make a bunch of mistakes AND learn from your experiences. Trust that you are capable of adjusting, and that it will take time before this becomes second nature. Set up manageable expectations for yourself. You are not always going to crush it every day. Sometimes you will half-heartedly parent. Sometimes you will rely on cartoons to occupy your kiddo while prepping a meal. You are human. You are loving. You are doing your best.

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.

Contact Kasi
postpartum anxiety. dealing with overwhelm. new parent. new baby and struggles.

Postpartum Anxiety and Feelings of Overwhelm

Published on by kshanmuk

It may seem that being overwhelmed is just a given. You’re up to your eyeballs in dirty diapers and wet burp clothes. You can’t remember the last time you had more than a few hours of rest. What even is breakfast? You run on a steady stream of coffee and fistfuls of cheerios. When you put this all together, postpartum anxiety (PPA) and feeling overwhelmed seems to be par for the course.

If being overwhelmed or anxious has been your experience for the past few weeks (or months, or years), it is not fair and it’s not okay. It does not have to be like this. Postpartum is not meant to be a painful or miserable time. If you’re struggling with PPA (or similar symptoms), here are some tips to help.

Know the Signs of Postpartum Anxiety

Postpartum mental health gets overlooked because so many of its symptoms are normalised. Unfortunately, because having a new baby comes with lots of questions, PPA can get mistaken as “normal” adjustments to parenthood. Someone out there has claimed it is acceptable that you are this tired and irritable and anxious.

Yes, it’s normal to have questions and worries. This is part of being human, and certainly a part of being a new parent. However, it’s not normal to have these worries keep you up at night, cause conflict with your partner, or make you avoid time with the baby. Anxiety is only considered “normal” when it’s within your capacity to address it (a.k.a. your window of tolerance).

Postpartum anxiety is a genuine illness that requires attention and help. Here are the symptoms to look for:

  • Inability to stop worrying
  • Racing thoughts
  • Difficulty with sleep or appetite
  • Difficulty with focus and concentration
  • Inability to rest or relax
  • Feeling on edge
  • Panic attacks
  • Irritability or rage
  • Physical cues: tightness, tension, dizziness, nausea, hot flashes

One quick way for you to check about the severity of your postpartum anxiety is through the Edinburgh Postpartum Depression Scale. This is a screening tool that is used to identify postpartum mental health struggles (including PPA). Specifically, any score above 12 on this depression scale indicates a high probability of postpartum mood and anxiety disorders.

Three quick grounding techniques

If you’re struggling with overwhelming anxiety, you likely want these feelings to calm down ASAP. Here are three quick grounding techniques that can help reduce the panic and overwhelm.

1. Butterfly Hug

The Butterfly Hug is a popular technique used in Eye Movement Desensitization and Reprocessing (EMDR) to quickly settle your body and mind.

Why it’s helpful:

  • Does not require much thinking: This approach does not need you to think through things calmly. You don’t have to “logic” your way out.
  • Helps your brain process in a unique way: EMDR uses bilateral stimulation to activate both your left and right hemisphere while addressing extreme anxieties, traumatic memories, or distressing events
  • Activates your parasympathetic nervous system (the parts of your brain needed for relaxing)
  • Reduces your cortisol level (a.k.a. your stress hormones)
  • You can use this strategy anywhere. It does not require any “equipment”.
The following video shows the steps of the Butterfly Hug:

2. Temperature Change

The temperature change exercise is a great strategy that comes from Dialectical Behaviour Therapy. This approach triggers the mammalian dive reflex. This reflex occurs when we are submerged in ice cold water. In order to survive, our body is forced to slow down our heart rate and oxygen is only sent to key organs that are needed. Everything that is considered “non-essential” is overlooked.

Why it’s helpful:

  • Tricks your brain: Your body cannot go into “survival mode” and panic at the same time. Your heart rate is forced to slow down. Your oxygen level drops, thereby making it hard to panic.
  • Provides about 5-20 minutes of calmer thinking. This gives you some time to problem solve or find alternative coping strategies.
  • You don’t have to “think through” it to feel calmer.
The following video shows the steps of the Temperature Change technique

3. Mindful conversation with another person

Using distractions is really helpful to get through a distressing moment. However, if you cannot find a distracting enough activity, your mind tends to wander back to its original anxious thoughts. Participating in mindful conversation with another person face to face is more effective in helping you stay out of the overwhelm. Rather than focusing on the anxious thoughts, you’re turning your attention to the other person, asking and answering questions, and staying present.

Why it’s helpful?

  • When your postpartum anxiety is highly activated, your sympathetic and parasympathetic nervous system work overtime. Your body turns to survival strategies like fight, flight, freeze/shut down in order to cope. Social engagement, on the other hand, activates our ventral vagal pathway. This pathway tells our brain that we are in a safe and socially connected space.
  • Focusing on topics outside of your postpartum anxiety helps your system recognize that there are still safe options in your world.
  • Gives you the option to engage with someone else outside of your baby.

Working with your anxiety

So now that you’ve coped more effectively in reducing the anxiety, you may be wondering about your next steps. After all, these earlier coping strategies only resolve things for a short time. They’re not actually fixing the issue, and instead, providing brief respite. This is where the hard work of listening to our anxiety comes into effect. In order for you to gain more clarity, you will need to work with your postpartum anxiety.

Internal Family Systems Therapy (IFS) explains that there is always a positive intention to our worries (even though it rarely feels “positive”). It’s challenging to slow our body and mind down enough to hear what your postpartum anxiety has to say. But, we can break down the steps to better support our mental health.

Step One: Find where your anxiety is in your body.

Daniel Siegel coined the term “name it to tame it”. Basically, when you are able to find the feeling in your body and label it, you can get a bit of space from that feeling. Rather than “being” the emotion, you can observe it. So, call out what and where you are feeling things: “I am feeling scared… There is a ball of anxiety in my chest… my shoulders are feeling tense and stressed.”

Step Two: Stay curious

In this step, you will use a bit of mindfulness to approach your emotions. Now that you’ve noticed the emotion, keep your awareness on this feeling. Be aware of the thoughts, sensations, memories, and whatever else comes to mind as you focus on this feeling.

This step involves staying curious about your anxiety is telling you without judging it, trying to get rid of it, or needing it to change. Your anxiety will start to share more as you stay open to it.

As a word of caution, your anxiety may not share the nicest feedback. It may share beliefs such as: “Get me away from this baby! I can’t do this! What was I thinking? I need this to stop!” Stay aware of these thoughts so long as you are within your window of tolerance.

Step Three: Understand what your anxiety is trying to protect

IFS recognizes that our anxious parts are trying to help out in some way or form. Because they tend to communicate in harsh and overwhelming ways, it’s often difficult to understand what our anxieties are trying to achieve.

As you complete step one and two, you will start to identify what your anxiety is telling you. Then, ask yourself, what would happen if these anxious thoughts stopped? What is your anxiety trying to prevent? For example, if your anxiety is often saying, “Get me away from this baby”, what would happen if this warning was no longer present? You might presume that you’d be calmer. While that’s true, what else would happen? Would you suddenly be considered calm enough that others encourage you to parent independently? Would you spend more time with your newborn and make a mistake? What if your baby keeps screaming and you’re reminded that you’re not cut out for this whole parenting thing?

Sometimes your anxiety gets triggered, and it forces you to escape the circumstances. Your brain says, “This is too much, I can’t cope,” and you turn towards avoidance, drinking, zoning out in front of your phone or some other strategy. I’m not saying that these are effective ways to manage things. In all likelihood, this form of “self-soothing” will create new problems. But, as far as your anxiety is concerned, it is satisfied that it has reduced your distress and gotten you away from the “danger” (e.g. time alone with baby).

Step Four: Befriending

Have you seen “Beauty and the Beast”? The Beast is known for being a lousy character. He’s rude, ill-tempered, and scary. But, we see that meeting the Beast with compassion (mixed with assertive boundaries) helps him shift out into a kinder character. (For those who are cringing reading this example, humour me. It’s an analogy. I’m not trying to condone Stockholm syndrome).

In many ways, your anxiety is like the Beast. It’s loud, frightening and has awful manners. However, what happens when you approach your anxiety with compassion or confidence? Have you ever shown any desire to get to know this part of you? What happens when you acknowledge what your anxiety is actually trying to do? Imagine what it would be like to approach your anxiety by saying: “I get it… I get that you’re really scared of me making a mistake… I know this feels like the only way you can help me.” How would it respond to you?

Becoming kinder to yourself

IFS brings in a different level of self-compassion. We are not only meeting our inner system with kindness, but we’re also identifying what our anxious parts are attempting to achieve. When we treat ourselves in this manner, our anxieties will soften. These steps don’t cure postpartum anxiety. We have to address the actual issue, whether it’s the fear of making mistakes, feeling insecure about parenting, or addressing our own childhood traumas. But, meeting our anxiety in this way will reduce the overwhelm.

Curious to learn more?

Postpartum anxiety is treatable. If you found the above examples helpful in reducing your overwhelm, please let me know. If you have any questions about the above steps, or want to work with your own unique circumstances, reach out.

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.

Schedule a free consult
gray scale photo of a pregnant woman

Struggling with body image during pregnancy

Published on by kshanmuk
struggling with body image. weight scale. prenatal appointments and weighing in

The worst part of prenatal visits? Going to your healthcare provider’s office and stepping on that scale at Every. Single. Appointment. As if you need any reminder that your weight is increasing at an alarming rate. You know this. You feel huge. No other pregnant mom looks as big as you do. You shouldn’t have eaten that extra serving. Why won’t these pants fit anymore? … Do any of these thoughts sound familiar? Struggling with body image is a huge frustration during and after pregnancy.

Being pregnant can be incredibly challenging if you’re struggling with body image or disordered eating. Yes, rationally you’re aware that this peanut growing inside of you is taking up a lot of real estate. You’ve read all of the instagram posts about body positivity, and know you “shouldn’t” be feeling this way. But, all of that aside, you still feel lousy when you see your reflection or step on the scale. So what can you do? If you’re struggling with body image, here are some thoughts to consider:

Re-assess “normal weight gain” in pregnancy

When you’re pregnant, your body is truly being taken over. Your metabolism shifts, your energy wanes, stretch marks suddenly appear. It’s natural, and it’s hard. When you’ve spent a long time meticulously taking care of your weight and appearance, these drastic changes to your body feel jarring. Check in with yourself about how you are seeing these changes. Is there shame and personalization involved? Are you feeling at fault for gaining “too much”?

body mass index (BMI) and impact on body image. Addressing BMI during pregnancy. healthy weight gain guidlines

Unfortunately, we have been given guidelines that it’s “normal and healthy” to gain 15-30 pounds during pregnancy. But this number is based on BMI, which research continues to point out is a flawed system for assessing health. Your recommended weight gain varies on so many factors. This number shifts based on whether your BMI was over or under prior to pregnancy. Your weight gain will vary if you are having twins. The number on the scale will look different if you’re struggling with hyperemesis gravidarum or if you’re managing your nausea by eating differently. In reality, only a third of pregnancies stay with the recommended weight gain, while about 50% gain beyond this number.

Speaking for my own body, with my first son I gained 45 pounds during my pregnancy, whereas I gained 20 with my second. I didn’t do anything differently. Bodies changes and babies are different. It isn’t personal. You’re not doing it wrong. That number on the scale doesn’t say anything about you or how well you are doing this pregnancy.

It will not be forever

This is not your forever shape or size. I do not have a crystal ball to confirm you will go back to your pre-baby weight, and I won’t deny that perhaps you’ve gained weight. However, the size you are while pregnant does not stay on forever. Whether it’s 6 weeks postpartum or 6 months postpartum, your body will change after delivery. Remind yourself as many times as needed that it took you 9 months to help your baby develop. Give your body at least 9 months to settle back to what it considers is the “new normal”.

Find safe others

Talking to safe person about body image. Struggling with body image during pregnancy.

It’s easy to feel isolated with our crummy feelings. Body positivity is an amazing trend that our culture is trying to lean into; however, it doesn’t leave much space to acknowledge when we are struggling. When we feel ashamed or alone in our thoughts, it can be debilitating. We become worried that others will judge us, shame us or minimize our feelings. If you have judgmental folks like this in your life, they are not the ones to turn to right now.

Find those who truly appreciate how hard this is for you. They know that you want to be healthy AND they respect that body image is something you’re struggling with today. This person doesn’t need to know how to fix the situation. Instead, they just need to let you know that you’re heard, you’re loved, and you will always be safe with them irrespective of how your body looks.

Use movement

using movement to help address prenatal weight anxiety. walking to help with pregnancy and body image

During pregnancy, find ways to move whenever possible. Let go of the standards that you used to meet whether it was a certain distance, speed, repetitions, or weight level. Focus instead on what movements means to you. For me, movement provides me opportunities to let go of stress, it helps my body feel strong, and it helps me feel energized. Once I stopped trying to meet my old standards, it felt easier to accept that this is what exercise could do for me today.

Our Society and Thin Privilege

I won’t deny that being thin and beautiful doesn’t have privileges (read more about thin privilege). Thin privilege allows for your weight to not define you and how you move through your environment and world. There is an awful amount of discrimination with fat phobia. People living in a larger body have been overlooked, groaned at, or mocked because of their weight. In these situations, being thin means they will finally receive respect and courtesy from other people. Being thin means the ability to walk into a store and actually be able to buy clothes. If you’ve been subjected to others’ fat phobia, you may have coped by maintaining a certain weight. Pregnancy has thrown this weight plan out the window.

If being pregnant or weight gain puts you into a space of losing your self-respect or self-worth, that’s not okay. It’s not okay for society to put you in this position or for you to suffer simply because of the way your body naturally flows. So how do we learn to externalize this? How do we shift from assuming there is something wrong with us to there is something biased and unfair about the culture we live in?

Tips for boosting body image:

tips for improving body image. shifting the way we think about our bodies. diet culture. comparing.
  • Diversify what you see: Follow influencers of all shapes and sizes. Follow those who look like you and don’t look like you.
  • Stop the comparison game: Envy is a tough emotion to contend with, and it leaves us feeling lacking. Start by checking the facts: do you know for sure that this person truly has more than you? Do these factors make them better or happier than you?
  • Highlight your own positive attributes: Notice what is awesome about you, and spend time acknowledging these positive traits. e.g. expressing pride in your career or grades, appreciating the health of your relationships
  • Become critical of toxic diet culture: We all know it’s out there. Start by challenging these constantly shifting body ideals. Unfollow or speak up about the companies and individuals that make you feel bad about your body.
  • Focus on what your body is doing for you: What are your thighs, arms, and belly meant to do? What are their functions? Focusing on their role as a function vs.

What are you avoiding by focusing on body image and food?

Sometimes body image acts as a (horrible, awful, exasperating) scapegoat for our actual struggles. By focusing on that number on the scale, you may find that you can avoid addressing other things. You spend hours staring at the fridge, planning meals, going to the gym, organizing your closet with “comfy” clothes, that you don’t have time to deal with the real stuff.

We all cope in different ways. Previously, you may have turned to a glass of wine, a cigarette, or going out dancing to get rid of all your stress. Now that you’re pregnant, these coping mechanisms aren’t as available. Food, on the other hand, is always there and doesn’t take as much effort. It soothes our stressors and pains. But, using food as a coping mechanism offers a temporary solution. It doesn’t allow us to address the actual cause of stress and turmoil in your life.

So ask yourself, if you didn’t spend all this time on body image and food, what would you be left with? Would you suddenly have to address your loneliness? Are you more aware of your anxieties about work, the state of your finances, or your struggling relationships? If we looked at negative body image as a coping mechanism (again, not vouching that it’s a nice or effective one), we realize it’s trying to prevent you from dealing with a deeper vulnerability.

Addressing the original trauma: When did this struggle with body image start?

body image and teenager. Struggling with body image in pregnancy. trauma from childhood

Body image rarely shows up in pregnancy without some form of history. Consider when else in your life have you struggled with this issue. Have you been painfully aware of your appearance since adolescence? Have you managed to shove aside any struggles with your appearance by exercising and maintaining a “healthy” diet? When did you make the connection between your appearance and your self-worth? How was this message taught to you?

When it comes to body image struggles, pregnancy makes things worse. However, it’s not the culprit. After your little one is born, things may feel manageable with dieting and exercise, but it’s a fragile set up. Anytime that weight starts to increase, that same panic may come back.

If this has been your experience, then it’s important to recognize that there is some earlier trauma to be addressed. Your body image struggles could have slowly formed while participating in gym class, listening to your mom comment about her (or your) weight, looking at skinny actresses and models, or a myriad of events. These moments stayed with you. That vulnerable part of you still worries about your appearance, fitting in, or whether you will be considered “worthy.” This is where therapy can be helpful in processing these earlier emotional burdens.

Reach out

If you or a loved one is struggling with body image during pregnancy, reach out. Therapy is a safe space to voice your concerns and work through these difficulties. Schedule a free consult call to see if we would be a good fit.

Take care,

Kasi

Schedule a free consult call
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.

Contact Kasi

Shame and the postpartum experience

Published on by kshanmuk
shame and postpartum. perinatal mental health. shame and pregnancy.

One of the biggest aversions to attending postpartum therapy is shame. You feel ashamed that your emotions are messy. This isn’t like you. Normally, you’re calm and cool. But, suddenly your hormones are all over the place, your hair is a mess and you can’t remember the last time you showered. There hasn’t been a single day where you haven’t burst into tears or rage.

You feel ashamed about your relationships. It feels like a huge risk to acknowledge how you truly act around your family. What would the other person say if you admit you don’t really like your baby? What if you told them you sometimes screamed at your children? Are they going to judge you if you tell them you’ve stopped breastfeeding? Would you get mocked for admitting you haven’t had sex in months? What if you revealed that you suddenly can’t stand your spouse? How will the other person react?

It’s incredibly vulnerable to open up to a stranger, especially if you worry how he or she will respond. So rather than talk, you stay silent. Shame feels awful, but it protects you. It keeps you safe from being judged. But it also means you are stuck with all these difficult thoughts and feelings bubbling inside.

The shame of mental health

Despite all of the social media posts, campaigns, and recognition about mental health today, there is still a stigma in admitting we are struggling with mental illness. You may worry about what it means to be attending therapy or starting medication. Does it make you incompetent? Are you still able to say you are a good parent if you also admit you are mentally unwell? How do you cope with your family members telling you to “suck it up” or “get it together?” All of these shameful questions and thoughts prevent you from admitting that you need help.

shame and postpartum. perinatal mental health. shame and pregnancy.

Perinatal mood and anxiety disorders are genuine illnesses. During pregnancy and postpartum months, an individual could live with anxiety, depression, OCD, bipolar disorder, or PTSD. The chance of experiencing any one of these illnesses is not uncommon (e.g. approximately 1 in 4 Canadian mothers reported experiencing symptoms of postpartum depression or anxiety).

As with any illness, you deserve appropriate treatment and care. It is not a matter of will power. We cannot wish it away. My favourite recommendation is to consider how you’d talk to a friend in a similar position. Chances are you would be more compassionate and open-hearted. For example, following a surgery, you would encourage said friend to attend medical appointments, take prescribed medications, and follow their health team’s recommendations. In the same way, would you be able to give yourself the permission to seek the treatment and attention that your mental health needs?

What if the therapist judges me?

Every therapist claims they are nice and nonjudgmental. That doesn’t mean you truly believe it. For those cautious and skeptical parts of you, I want you to know, that’s okay. It’s absolutely okay to have your guard up. Starting therapy feels awkward. As with every relationship, it takes time to build trust.

Take the time to share slowly, if that is what your system needs. Watch how your therapist responds to your words and concerns. You will notice that you either feel more settled and at peace, or if your shame increases. Trust this internal feedback. If you are comfortable, let your therapists know you feel this way, and see how they respond to your words.

Will I get in trouble?

shame and postpartum. perinatal mental health. shame and pregnancy.

One of the biggest fears that pushes clients away from voicing their experiences is the fear of how others will react. In prenatal and postpartum therapy, I see many clients hesitate to talk about how they truly are with their children and relationships. Not only are they managing their internal shame, but they are weary of judgement and negative consequences. Clients are often fearful because they fear the truth will lead to the therapist ending the relationship, calling the Children’s Aid Society or disliking the person. So let’s address these fears:

1) If I am truthful, my therapist will end the relationship:

In most cases, therapists will only end the relationship if they are outside of their clinical scope or the treatment goals have been met. If you have met your treatment goals, that’s wonderful! Celebrate all of your hard work. You don’t necessarily have to end your relationship with your therapist, but you can talk about tapering off sessions or increasing the time in between appointments. If it’s loneliness that drives you to stay, your therapist will support you in exploring how to improve outside relationships. It is not okay that the therapy room is the only space where you are heard, validated and supported.

If your counselling goals are beyond your therapist’s knowledge and skills, they will admit this to you. It isn’t personal. Consider your experiences with other specialists. You may really love your hairdresser, but this is not the person who can necessarily answer your medical concerns. You connect with the clinician who is best able to meet each of your needs. If you keep asking your hairdresser for advice on all things medical, neither of you will leave satisfied or confident that your goals can be achieved.

2) What if they call the Children’s Aid Society (CAS)?

shame and postpartum. perinatal mental health. shame and pregnancy.

This is a common myth that prevents parents from reaching out for postpartum therapy. Postpartum depression often shows up as rage, anger, outbursts and distress. I see many parents who are frustrated with themselves and with others, but are too scared to ask for help in fear of being reported. Postpartum depression deserves respect, compassion and appropriate support. The only reason to reach out to CAS is if there is a genuine concern about a child’s physical or emotional safety. If there is a worry about abuse or neglect, your therapist will ask you directly. However, yelling at your child does not mean an automatic phone call for outside authorities. Having negative or intrusive thoughts does not mean we are automatically contacting outside authorities.

3) What if my therapist dislikes me?

shame and postpartum. perinatal mental health. shame and pregnancy.

I can’t speak for other therapists, but I can speak for myself about this worry. The beauty of Internal Family Systems (IFS) therapy is that IFS therapists are always looking for positive intentions. This means, irrespective of the behaviour, words, or emotion (anger, infidelity, jealousy, disgust, etc), your IFS therapist is always trying to understand how there are parts of you trying to get you through a difficult moment. It’s not about assessing whether the outcome is successful or whether the efforts are worth it. It’s about understanding the actual intention.

IFS therapists go to their own therapy. It’s how we do the work we do. If I feel triggered in a session, that’s an indicator that there is some part inside of me needing support and attention. It has nothing to do with you; it has to do with my own history and experiences. That part, similar to yours, will need support and processing. I take it to my own session or my supervisor. IFS therapists’ intentions are always to keep our parts out of the session, because in therapy, it really is about the client. It’s not about my agenda or my needs; it’s about yours.

The shame of not meeting our own expectations:

You had lots of hopes and dreams of how your pregnancy or postpartum months would turn out. Chances are you did not wish for mental illness.

Many of us struggle when our expectations are not met. We feel a sense of shame and inadequacy in falling short. You may have hoped to be a Pinterest-parent, and realized you have zero interest in arts and crafts. Perhaps you thought you’d enjoy spending days with the baby, and found you were bored out of your mind by week 4. Maybe you thought you’d ace the whole sleep training thing, only to be struggling 15 months later with a toddler who refuses to go to bed. Somehow these results create a sense of failure that we equate into our self worth.

For any parent who struggles with this sense of “inadequacy”, please know that you are not alone. We all have moments where we worry about being good enough parents. Remember that you have so many years ahead of you to figure this out. We often label ourselves as success or failures, but we fail to pay attention to all the efforts and practice we need to improve our skills. We will screw up many times, and we will learn constantly. In this way, there is always space for us to grow.

goals, high expectations. shame and parenting

It isn’t fair to assume we’ll be great at parenting from day one. Think about how it was like when you first learned to drive. In the start, you were in the “conscious incompetent” stage where are very aware that you have no idea what you are doing. However, with time, you get to a place where you can automatically drive your car. Unfortunately, when we are at this place of “unconscious competence” (a.k.a. “I don’t have to think about it, I can do it in my sleep”), we forget how much we initially struggled. We forget the intensity and shame of not doing well.

Make it safe

We can all play a role in reducing the shame of mental illness and perinatal mental health. Talk about your experiences openly with safe others. Offer validation and compassion to those who are in this phase of life. Reach out to a therapist that you can trust. We can work to shift away from judgment, and instead, appreciate that we are all doing our very best.

Warmly,

Kasi

Book a free consult
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.

newborn baby breastfeeding

The pressures of breastfeeding

Published on by kshanmuk2 Comments

That first year with a baby is all about feeding, feeding and more feeding. For every parent, there is a time when he or she decides whether to breastfeed, exclusively pump, stick to formula, or use a combination approach. There are a variety of factors that push a parent towards one choice over the other. There is no “right” choice outside of what works best for a caregiver and baby.

pressures of breastfeeding. support for parents who are struggling to breastfeed

Unfortunately, there is a push in our society to breastfeed. We see signs of it right from the day we deliver. There are subtle cues from healthcare staff as they share latching tips before inquiring whether formula is preferred. We are provided pamphlets of breastfeeding support in our care packages before bringing our newborns home. There are posters for breastfeeding help at our midwives’ office.

This blog post is not to push formula feeds. I have no right to claim whether formula is better than breastfeeding, or vice versa. Ultimately, I am true believer that fed is best. As long as your baby is getting the nutrients he or she needs to develop, I consider it a win. Instead, this post is for the parents who are struggling to breastfeed. Whether by choice or by capacity, they are stuck in that internal battle of guilt, frustration and helplessness as they face yet another feed.

The pressures of breastfeeding:

We live in a culture where breastfeeding is encouraged and subtly (or sometimes, not so subtly) pushed as the best option for our baby. New mothers face an onslaught of judgemental messages about breastfeeding, and these comments are made in permanent and absolute terms: “breastfed babies have higher IQs”, “breastfeeding will prevent illness, infections and chronic conditions,” “breast is best,” “you won’t have a good bond if you formula feed,” etc, etc.

struggling with breastfeeding. postpartum support. new mother.

I agree that there are a lot of values to breastfeeding. However, I also work with parents who are driven to the point of exhaustion and anxiety in trying to produce enough supply for their baby. These parents are so angry at their bodies for failing them and not doing enough to support their baby’s growth. If the option of working with a lactation consultant or consuming fenugreek daily is working, then please keep it up! In fact, I encourage you to start here if you truly want to breastfeed. However, if your baby is losing weight, you are feeling stressed out, or are experiencing any number of production difficulties, I want you to take a moment and consider why you are trying to keep up with this expectation.

The “Mommy Wars”

New parents would love to have the ideal postpartum experience. We see images of celebrities looking beach-wear ready a few days after delivery. We see influencers posting feeds of their babes sleeping through the night. There are endless tweets and posts about the “right ways to parent”.

pressures of parenting. super mom. mommy wars.

With all of these messages of ideal parenthood, it makes sense that we are self-conscious about our own parenting. The Times wrote a beautiful article in reference to the Goddess Myth: “Like millions of other American moms, [mothers have] been bombarded by a powerful message: that she is built to build a human, that she will feel all the more empowered for doing so as nature supposedly intended and that the baby’s future depends on it. ” With this constant push for doing things “naturally”, moms carry the stress of parenting a certain way. There is a need to delivery vaginally, breastfeed on command, only feed your body the “right” foods, and of course, look stunning throughout the process. Of course, mothers then bear the burden of immense guilt when they are unable to meet these pressures.

This push to parent in a specific way also comes from mom-shaming experiences. These experiences can include rude comments and glances from others as a new mother orders a second cup of coffee, buys a drink, and of course, pulls out some formula. It’s as if there is a moral obligation that has been violated by not following the rules others deem best for our children. It’s no wonder that new parents are surrounded by a sense of failure and dread as they step into parenting.

Know that you’re not alone

The American Pediatric Society encourages breastfeeding for the first six months of your baby’s life. While 80% of mothers start off with this intention, the Center for Disease Control and Prevention state that only about 58% make it to the six months.

Why is this? Breastfeeding is described as natural and easy; however, any parent who struggles with breastfeeding can vouch that this is not the case. From poor latches, supply issues, mastitis, and other complications, many women start to experience a sense of dread when it comes closer to feeding times. These parents may undergo a period of grief as they cope with the disappointment of needing to put aside their hopes for breastfeeding.

Other parents prefer to not breastfeed. This decision could be based on a variety of reasons: struggles with hormonal shifts while breastfeeding, managing the demands of other children, returning to work, wanting support with nighttime feeds, sexual abuse histories, or simply not wanting to feed in this way. These are not selfish or bad parents. They care deeply for their children while also respecting their own boundaries. At the end of the day, a happy parent is better able to support their baby. If formula feeds provide a calmer structure for the parent, then this is the right decision for this family.

Worries about attachment

Sometimes we push ourselves because we think it’s what’s best for the baby. Sure there are physical benefits to breastmilk, but there are significant benefits to having a grounded and calm parent. If you are overwhelmed everytime you start nursing, that bond is going to feel so much more difficult. You have years to build and nurture the relationship with your child. It does not have to be perfect from day one. Listening to your mental, emotional and physical limits will set you up for success.

For those who feel that nursing creates a better attachment, I encourage you to consider your attachment with your own parents. Are you truly better connected with your mother because she chose to breastfeed versus formula feed? Is your IQ significantly higher than a peer who was formula-fed? Who even asks these questions today of other adults?

You are doing your best for your child

cheerful young multiethnic parents admiring sleeping baby on bed
Photo by William Fortunato on Pexels.com

A hungry baby is a cantankerous baby. A guilty mother is an unhappy mother. Pressures that come from strangers, the internet, and sometimes our own friends and family are perhaps meant with good intentions. However, you are this child’s parent. And if you are feeling stressed and guilty about breastfeeding, you are allowed to stop. You will always be this child’s caregiver, and your bond can be secure irrespective of how you feed this little one. Your baby will grow up and eventually eat food, and this pressure to breastfeed will no longer be the central focus of conversations. So for now, go and enjoy your child. Focus on getting those baby snuggles. Spend time playing, singing, talking, and teaching him or her. And when your little one gets hungry, feed them in whatever way is feasible for you.

All the best,

Kasi

Schedule a free consult
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.

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

Published on by kshanmuk

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

Schedule a free consult
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.

Support for the avoidant parent

Published on by kshanmuk

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 

Schedule a free consult

postpartum depression. Kasi Shan. Counselling in Kitchener, ON. online therapy. new mom.

Will I have postpartum depression again?

Published on by kshanmuk

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

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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

Schedule a free consult