Supporting Someone With Post-Partum Depression

When someone (usually a mother) takes their life due to post-partum depression (PPD) their community is in shock and reactions are often less than ideal. Social media posts demand that people should “ask for help” and seek to assuage our survivor guilt by claiming we would have “done anything” for the depressed person “if only they had told us” how bad it was. Behind the scenes gossip is often even worse, even as we claim to feel “so bad” for the deceased and “how they must have been suffering.” The problem is, these reactions display a fundamental lack of understanding of depression and they exemplify exactly why people don’t reach out to us for help when they are struggling. Here’s what we each need to know, and some things we can do to better support each other.

Depression Facts:

  • 1 in 5 women will have PPD, which includes depression and anxiety during pregnancy and following childbirth (or loss)
  • Fathers/non-birthing parents can also suffer from depression and anxiety at these times, approximately 1 in 10 men experience PPD
  • Depression symptoms include sadness, irritability, a sense of being overwhelmed that doesn’t go away, hopelessness, feeling disconnected, problems thinking and making decisions, loss of interest, difficulty sleeping, fears that you will not be able to care for your baby, feelings of guilt or shame around your ability to parent
  • PPD can strike anytime within the first two years after childbirth, and it can be a short-term issue or turn into a longer-term depression disorder so it should be addressed
  • PPD can be a complete surprise to parents who have never experienced depression before
  • Parents with a history of depression or anxiety are far more likely to also experience PPD and it may be more severe, but often loved ones don’t recognize there is a problem

What Depression Really Feels Like:

Telling someone with depression to “just reach out” makes no sense when you know what depression really feels like. It can be impossible for many to ask for help because depression not only saps all energy but also includes feelings of worthlessness. When I am depressed, even if I can somehow muster up the ability to say I need help, I am unable to believe there is anything anyone can do that will significantly change my situation for the better. In fact, this is statistically true because the most common reaction to expressing a need for help is to be told to “get up and do something” or “make a change” — both of which are unhelpful, blame us for feeling bad, and minimize the struggle we are going through. Added to this is the sense that asking for help makes us a burden on others or that people will declare us unfit parents when they know our secret fears and thoughts.

Suicidal thoughts are common with depression and PPD because it is impossible to see things getting better. Often the parent feels trapped and like it is a personal failure they will never be able to fix, so they believe their child and family is better off without them. One mother I know shared:

“You’re trapped in a box with your life’s greatest failures projected on the walls around you on an endless, repeating loop, and you’re slowly running out of air. Death is the freedom, the great escape, from the crushing, living dead existence you’re suffering through.”

When my son was born I was a single parent who felt like a loser because his father had gone to prison while I was pregnant. It felt like my son never slept, cried constantly, and I wasn’t able to breastfeed because of a rare condition I had. I felt like a failure as a wife, as a mother, and as a person. I had no idea how I was going to provide for him on a waitress paycheck and all the reading I had done while pregnant had not prepared me for reality. I had struggled with depression my whole life, and now I had a baby I was also responsible for and couldn’t help but feel anything would be better for him than having me for a mother. Suicide crossed my mind daily, and it’s a miracle that I never gave in to the urge.

Depression, for me, often feels like a complete inability to move. I am paralyzed by a combination of fear of making things worse, inability to think through solutions, and despair that nothing I do matters at all.

Supporting Parents Through PPD:

When we understand that depression debilitates a person, we can better see why it is up to us, the community, to provide necessary supports proactively rather than waiting for someone to come to us for help. The unintended message projected by comments to “reach out,” “get out,” and “do something” is it really is our own fault if we feel terrible and we really are to blame for anything bad that happens. When I read posts saying that I should “do anything but suicide” I feel like that person is not, in fact, a person I could open up to at all.

Here are five practical ways we can support new parents, and most of these things are useful for any friend dealing with depression:

  1. Provide post-partum doula services — Post-partum doulas are professionals that come into the home to provide lactation support, housecleaning, cooking, babysitting for parents to rest/catch up on sleep, and other education/support to new parents. Once upon a time these services were provided by the extended family, but as our culture has changed many parents do not have access to their family during this time and may feel isolated. The best option is a professional, which community could chip in to pay for. Alternatively, pitching in time and effort to informally provide housecleaning, cooking, grocery shopping/delivery and babysitting can make a huge difference to a family.
  2. Encourage parents to talk openly about their feelings — Be willing to share your own struggles and let parents know they are not alone in feeling overwhelmed, anxious, or unprepared for parenting, while also sharing how you got through it and how things do work out. These are very normal feelings to have, but most people think they are “bad” feelings. Recognize and acknowledge the signs if your friend seems to be experiencing depression and suggest additional help and support. Let your friends know there are others that share these feelings and that there is nothing wrong with needing to vent, cry, or talk through their fears. Provide them a safe shoulder to cry on or ear to vent to. Be really clear that you are not judging them and that if they need a more impartial resource to talk to you are happy to help them find one. There are many services, such as peer counselors, home-visiting nurses, doulas, and support groups that they can engage with where they will find themselves in good company. This goes for fathers and other parents/caregivers who did not give birth as well.
  3. Show you care — Little treats go a long way to making a parent feel thought of and cared for. Whether it is a notecard or chocolates, a box of their favorite tea or some fancy bath salts, the tiniest gifts or words can help support them on their roughest days and remind them they are loved. Send a text message when they cross your mind, just to say hi. Invite them over for coffee and make it clear they should come just as they are. Celebrate little victories with the parents.
  4. Be empathetic — When you see or hear of tragic stories, don’t be quick to judge, express outrage, or respond with platitudes and motivational-poster speak. If you want friends and loved ones to feel safe to tell you when they are struggling, we need to see that you are someone we can talk to. Most people experiencing depression don’t need a motivational coach, but instead need to know there are concrete ways out of the pit we feel we are stuck in.
  5. Respect boundaries — Don’t overdo it with your advice. Don’t tell someone you “know” they are depressed and they need to do x, y, or z. Don’t be pushy. Do be kind. Do offer support but don’t demand action. Understand that you cannot save everyone and that there may be many factors you are not aware of or circumstances they did not share with you. Don’t make things about you and your discomfort.

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