Becoming a parent is often not what we expected. Love, fear, worry and joy can all be felt before breakfast, and by nap time we’re wishing we were the ones tucked up in bed. But sometimes the entangled experiences and emotions of parenthood go beyond this regular rollercoaster.
Occasionally new parents can feel an inexplicable sadness, an intense anxiety, or an inability to sleep, even while the baby is sleeping.
If these feel familiar, you are not alone. One in six moms feel like this and, perhaps surprisingly, one in 10 dads. What you may be experiencing is a common illness called postpartum depression (PPD) or postpartum anxiety.
PPD is characterized by a variety of symptoms, has a spectrum of severity, and can occur shortly after the arrival of a new baby or many months later. For some moms, the symptoms may even start during pregnancy (where it is called perinatal depression/anxiety).
One of those moms was Lani Sheldon, creator of Squamish Baby (www.squamishbaby.com). “I was expecting my first baby, working and commuting to the city in a fast-paced career. I had a history of anxiety… that was successfully managed with medication. When we decided to try for our first child, I weaned myself off my medication under very brief instructions from a clinic doctor who had only seen me once before. No support, no follow-up, no suggestion that perhaps switching to a medication that was safe during pregnancy would have been a better alternative.
“Looking back, I thought I was handling it well publicly and managing the stress. But in reality, I was a mess. At 20 weeks pregnant I couldn’t sleep, my whole body was tingling, my mind would go in circles until 3 a.m., at which point I would pass out in exhaustion and tears only to wake up two hours later to commute to work.”
Sheldon’s parents urged her to see a doctor. “I was in shock. I had no idea that PPD, or in my case, postpartum anxiety/perinatal anxiety, often first shows up during pregnancy. It wasn’t even on my radar.”
Within weeks of seeing her new doctor and commencing a medication that was safe for both pregnancy and breastfeeding, Sheldon began sleeping again and, in her own words, “The world didn’t seem so dark.”
Kimberly Daniels, a local mom, doula and creator of Après Baby, a Squamish-based PPD support group, waited six months to seek help.
“I had felt a few ‘red flags’ beforehand… but I was just so in denial that it was happening to me,” she says. “It wasn’t until about six months into motherhood that I hit the wall, and it didn’t make any sense. I had everything I had ever wanted, a healthy baby, a supportive husband, and a new home in a beautiful town... and I hated it all. I wanted to run from all of it, it was too much, too overwhelming to keep it all together.
“After months of being severely sleep deprived combined with my desire to do every part of motherhood ‘perfectly,’ I was out of gas, my tank had run dry and I was barely holding on.
“This baby that I wanted so badly arrived and brought me to my knees. I didn’t cry a lot, instead I felt numb and hostile.”
Despite recognizing the signs of PPD, Daniels spent a great deal of time and energy trying to talk herself out of it – convincing herself and others that she was enjoying motherhood. But when she finally reached out, the relief was astonishing.
“It started with a dear friend. Just being able to say the words to her, ‘I am suffering, I need help,’ felt like such a huge relief.”
Daniels’ friend encouraged her to reach out to the Pacific Postpartum Support Society (www.postpartum.org) and put her in touch with another mom who’d experienced something similar.
“Hearing that woman, whom I had never met, on the other end of the phone saying, ‘You are a good mom for reaching out,’ and, ‘It will get better,’ was like someone had thrown me a lifebuoy that stopped me from slowly drowning.”
Daniels now helps other moms in Squamish through their own postpartum struggles at her support group, Après Baby, and says that despite being a common illness, PPD sadly still carries a stigma, and some mums are reluctant to come forward because of that.
“Women who are struggling with postpartum depression have a hard time reaching out for many reasons,” says Daniels. “There is a lot of fear and shame associated with mental illness. No one wants to be the ‘crazy mom,’ and some think their children will be taken away from them or that they will immediately be put on medication if they admit they are struggling.”
Daniels’ advice to those who think they might be suffering is, “If things just are not getting any better and it becomes hard to get through each day, it’s time to reach out.
“Left untreated, postpartum depression does not get better on its own. The sooner someone gets professional help, the less potential the illness has to affect the new family.”
In addition to a feeling of intense anxiety, other symptoms of PPD can include crying, sadness, sleeplessness, despondency, emotional instability, anger, guilt, tearfulness, worrying, feelings of inadequacy and the inability to cope.
Daniels and Sheldon both recognized they needed help and received treatment, but there are many who don’t. Of all those with PPD, only 15 per cent reach out for assistance, leaving many others suffering in silence. But the suffering needn’t continue because there are many options available.
A large part of Daniels’ treatment involved seeking help from both public health nurses in Squamish and the Pacific Postpartum Support Society (PPPSS), who offer toll-free phone support to women and families all over Canada, and in-person group support to those in the Lower Mainland.
Kerry O’Donohue, group facilitator and program coordinator at PPPSS says, “Sometimes people will call us in the first few weeks if they’re struggling, and by six or seven weeks they don’t need our support anymore because they’re doing fine. They were just getting over that initial hump. Other people don’t really realize what’s going on and maybe their sleep deprivation builds up and six to eight, nine months postpartum is when they start feeling it. They might have felt great in the beginning. It’s different for everybody.”
The society also receives calls from moms going back to work or approaching their baby’s first birthday – moms who had hoped they’d feel better by then, but don’t.
As well as regular phone support, the group also teaches cognitive behavioural techniques over the phone. During these calls, mothers learn simple techniques often involving self-care to help reduce stress. “We help moms make a connection between behaviour, thoughts and feelings… and how it’s all connected,” says O’Donohue, who explains that even simple changes in behaviour can have a huge positive impact.
Having suffered from PPD herself, O’Donohue understands the difficulties of coming forward. “Think about it, we’ve all probably imagined how we’re going to be a mom since we were a little girl, so I think we have our inner pressures and ideas of what it looks like to be a good mom, and then we’ve got society pressures of what that looks like,” she says.
There’s a stigma attached to admitting you’re having difficulties, she says. “People will say, ‘I go to the mom and baby groups and everyone looks fantastic and they’re doing so well.’ You can feel like you’re the only one struggling. And you’re not. You can’t tell by looking at somebody from the outside what they’re going through.”
Christina Bergin, a local public health nurse, agrees, “Women do well when they connect with other women. Sharing their experiences, from sleepless nights, frustrations, joys of mothering and exchanging ideas, is helpful.”
Those thinking of starting a family may be wondering how they can prevent PPD or at least minimize the chances that they too will suffer. Though the exact cause of PPD is unknown, physical and lifestyle factors are likely to play a part including not having a close support network after the birth of a newborn, as well as the high expectations mothers often place on themselves.
Daniels adds, “We are also a community of highly driven, highly functioning, athletic, goal-oriented women. Once baby arrives and we are no longer the woman we were before baby, that can be devastating for some.”
There are also many other contributing factors including financial stress, relationship worries, a feeling of isolation, a history of anxiety or depression, complications during birth or pregnancy, a death in the family or even a recent move.
“The important thing to remember,” Daniels says, “is that it’s not one particular thing and that it’s not the fault of the woman.”
If someone you know is suffering from PPD, what can you do to help?
“One of the best things friends or family members can do is to not assume what would be helpful, but to ask the person what would be helpful for them,” O’Donohue suggests. “It’s different for everybody, it really is.”
For example, some might prefer you to take the kids for an hour to give them time alone in the house, while others would rather get outdoors themselves.
“If you know a friend is suffering with PPD, listen to what she needs,” advises Daniels. “Sharing with you that she has PPD is a really big step for her. Reassure her that she is a good mother. If she is all right with handing over practical tasks, give her a hand with housework, fold her laundry or make her a meal. If she is expecting you, be on time, you may be the only break she gets in her day and she is likely really looking forward to seeing you. Some women need someone to go for a walk with to avoid being isolated, while others prefer to have some time to themselves to shower or sleep while someone else cares for the baby. Be mindful to her needs.”
If you need to reach out to someone, you can visit www.postpartum.org or call the PPPSS toll-free on 1-855-255-7999. Lines are open from 10 a.m. to 3 p.m., Monday to Friday. If you call outside these hours please leave a message.
Public health nurses are also a great source of help and can be reached at the health unit at 604-892-2293.
Vancouver Coastal Health also offers parent and infant drop-in groups every Thursday at Squamish Library from 10:30 to 11:30 a.m. There’s a different speaker each week and a public health nurse is available.
Squamish also has an in-person support group called Après Baby (run by Kimberly Daniels) which meets monthly and is open to all new and expecting mothers; you do not need a diagnosis of PPD or a referral to attend.
Dates, times and location can be found on the Après Baby Facebook page and on www.lunamama.ca.