Preventing PPD 7: Staying afloat during really rough waters

This is Part 6 of my Preventing PPD series. Part 1 is here, Part 2 is here, Part 3 is here, Part 4 is here, Part 5 is here, and Part 6 is here.

What if things are really getting bad? What if it feels like the world is falling down around you? It's time to go into Lockdown Mode, and only do things that will directly help you stay afloat.

Figure out who's your true friend. You should start with your partner, if you have one. My hope is that your partner will be your best friend and helper through the postpartum period, and, frankly, for the rest of your life. S/he wants you to be as healthy and happy as possible, and if you tell him or her how much you're struggling, you can pull together as a team to help keep the entire family afloat. You and your partner should look at your support system and find another one or two people you can definitely count on to give you constant, non-judgmental support while you weather this rough time.

But it's not always the case that you can rely on your partner. If your partner is causing or adding to the difficulties you're experiencing now, you need to look at the rest of your friends and family to figure out who will be the two people you can rely on. Sometimes people surprise you with how great they can be in a crisis, so don't automatically write someone off just because you haven't seen them in crisis mode before.

Can't think of who to trust? Maybe one of these people:

• Your mother
• Your father
• Your aunt or grandmother
• A sister or brother or cousin
• Your best friend
• Your best friend from high school or college
• A neighbor
• A coworker or former coworker
• Your mother-in-law or sister-in-law
• One or more of your online friends
• Your midwife or OB
• A therapist
• One of the moms with older babies from your breastfeeding support group

Water, Omega 3s, sunlight, exercise. Keep up with as many of the physical maintenance measures as you can, but if you can only focus on a few, drink plenty of water, keep taking Omega 3s, get a few minutes of sunshine every day, and get a little exercise every day (I'd privilege T-Tapp over other kinds, if you can do the 15-minute routine). Those should help keep you from slipping too far down from chemical or hormonal imbalances so that you can deal with whatever the problem is.

Drop anything you can't manage. Your priorities should be keeping your baby alive and keeping yourself alive and as mentally healthy as possible. If that means you have to let something go, like breastfeeding, or working on a sleep schedule, or cleaning your house, or anything else other people are telling you you "have to" do, then just let them go. Talk to your true friends about it, and they'll help you work out some way to get the essentials done. Let everything else go. You're doing the absolute best you can under the circumstances.

Figure out what the problem is. Talk to your friends (the ones you can really trust) and ask them to help you figure out exactly what the problem is. Are you not getting enough sleep to function at all? Did you have a delivery that's crushing you mentally? Is your baby not healthy? Are there huge problems between you and your partner? Are you feeling overwhelmed by losing your old life and having to be responsible for another person 24/7? Are you in physical danger for some reason?

If you can figure out exactly what the problem is, you can get safe. It is entirely possible that whatever's going on is making it impossible for you to figure it all out on your own. That's why you need to get your true friends in on the process, to help you figure out what's really wrong and what's merely annoying.

Come up with a plan to make things better, or to hold on until things get better. Once you know what's really wrong, you can make a plan to get through it. Is it something you can change? Then ask your true friends to help you figure out a plan to change things. It might be tough, and you might have to give up some of the preconceived notions you had about yourself, or being a mother, or the way your life is going to be for the next few months, but if it will put you in a better place, you have to make the change.

If there's nothing you can do about the situation, at least you know what the problem is and can prepare yourself to hang on until something can change. Knowing there's light at the end of the tunnel can get you through some bad situations. Your true friends can help you figure out how to make it bearable until something can change.

If you're barely holding on and feel like you're crumbling, please tell one of your true friends and ask them to help you get help. They can help you get safe, whether that means being physically safe, or going on antidepressants to regulate your mood (you can still breastfeed on several common antidepressants), or any other way that you're having problems. You aren't alone, and you're doing the best job you can under the circumstances. With a little help, things will get better very soon.

Comments

[hedra]

Wow. Moxie, you have a way of really cutting to the heart of things.

I squidgied into most of that sideways when I was at my worst, and the main point of it was the getting my support people involved. When my DH and my OB knew what was up, that gave me enough structure (it felt like an external support structure, almost a physical sense of scaffolding) to move into making better choices.

I've also seen other women (and some men) succeed by taking those steps. Sometimes the crisis has been relationship-based, other times it has been something un-tended or un-healed in the mom, but the people who take those steps 'get clear'. They also seem much lighter after they do so.

I think this series could be published as a series of pamphlets and put in waiting rooms at pediatrician and MW/OB offices. It is excellent.

[hedra]

Hmm, thought I'd said that by getting my support people into it, they helped me get most of the rest of that done, too. But that wasn't clear, huh? Doing all the parts is needed, but the first step for me was just tossing the info out there to my supports. I kind of learned who to trust by which supports took the weight... fortunately, none of them snapped back and dinged me, some just kind of vanished.

[jessica]

I think something important to mention (and please forgive me if you've already done so somewhere else) is to be gentle with yourself. I'm talking about the way we speak to ourselves mentally. While it's of course important to keep in touch with our external support, it's also vital to be friends with ourselves and learn how to positively coach ourselves through the hardest moments.

[Menita]

Moxie, this is excellent, as always. Something I'd like you to tackle, though, is male post-partum depression. With #2 I was fairly well prepared for everything except that, and in hindsight it's glaringly obvious that this was a big part of our problems. Your thoughts?

[hedra]

Hey, you're reading my mind! I was just mentioning this to someone last night - her husband has a LOT of couvade symptoms (blood sugar issues, mood swings, panic attacks, cravings) and has all pregnancy. I wondered aloud if he'd be more at risk of paternal depression/male PPD.

One of my twin-mom friends realized only when her husband was crashing REALLY hard that he had classic PPD, and a severe case of it at that.

People don't realize that men have hormone changes during pregnancy and after a child arrives in their house, too (estradiol levels skyrocket, testosterone declines). Even adoptive fathers have this change. Don't know if they know how it works, but it sure could explain some of the shifts. Add in the sometimes extreme panic when one realized that financial responsibility (or a large portion thereof) is YOURS. I sure felt the fear when I was the sole wage earner!

Neither hormones nor rational panic are reason enough to ignore the symptoms. Yes, they're hormonal, or they're situational. But if they're problematic, then get some support/help - dads do get this, too.

[Molly]

I love these 'stay afloat' posts. They bring tears to my eyes, for some reason.

What helps me get through the tough times is the one promise of life: it will change. Everything will change sooner or later. Life will not always be like this. Children grow up, hurts heal, new problems emerge, what was once excruciating is replaced by another burning issue.... and sometime things get better, too.

So you always have to hang in, because things will change.

[Emily]

No kidding about the hormone shift for men: the week after our daughter was born, my husband broke out like a teenager.

I've wrestled with clinical depression on and off for years, and am starting to wonder whether I'm just peering in the window of PPD right now or have already been sucked in the door. Moxie: many thanks for this series; it's invaluable.

[Shelley]

Moxie, can you give us a little more info on the T-Tapp stuff? I went to the site and took a look -- I've been trying to find some sort of DVD exercise that isn't "dancy" as I'd feel like an idiot bouncing around in my living room -- and this could be it. But the description on the site sounds a bit informercial-y and I'd truly appreciate an honest review of it... from you and/or any commenters familiar with it. Thanks.

S

[Moxie]

Shelley, the site looks a little infomercial-y, for sure, but the DVDs aren't at all like that. It's *totally* not dancy. I have no grace or coordination, and I can do it really well.

I think the best way to describe it is as being kind of like a standing version of Pilates, only with elements of tai chi. It's really about teaching your body proper alignment and building up the muscles from the inside. Within about 2 weeks of starting (the 15-minute routine) I could feel a girdle of muscle in my torso. The other real benefit is that it pumps your lymphatic system, so you have more energy and focus. I noticed the energy, focus, and better sleep within a few days of starting.

I don't have anything negative to say about it, except that it doesn't do itself. If there was a way I could stay on the couch and let the DVD play by itself, *then* it would be the perfect workout. :-)

[Shelley]

Moxie-- thanks so much for the add'l info. A last question -- which of the DVD packages would you recommend? I'm looking at the "15 minute Basic Plus Workout" for $39.95... before I plunk it down want to make sure it's the right one, as I very much like the idea of a "girdle of muscle." Did it make a corresponding difference in how your clothes fit?

[Christi]

I second the idea that it'd be great to have these tips published in some form for OB/GYN and midwife offices.

Moxie, this is really a tremendous service. I wish I'd had this advice when going through my own ppd - but I'm thankful that other women are reading and will have it. Thank you.

[Moxie]

Shelley, go read Summer's explanation of how to start T-Tapp here:
http://summertime.blog-city.com/how_to_get_started.htm

She recommends just going straight for the $80 Total Workout (which contains the short workout and the long workout, plus a walking workout), and I do, too. I started with the $40 short version, and was ready to have the long version to do a few times a week after a month. I wish I had just bought it all at the same time

[Dani]

Any advice for someone whose infant is very sensitive to both fish oil and flax? I took them religiously through my second pregnancy, and they did wonders to keep my mood even. But within days of H's birth, it became apparent that both of those things really irritated her digestive system. When I stay away from them, and dairy, she is a champion sleeper and rarely cries. Now I'm struggling with PPD, and I know the omega 3s would really help. But the last thing I need is to make the baby cry and sleep poorly.

By the way, I want to thank you for bringing T-Tapp to my attention. I've been doing it for two months now and it's the best workout system I've ever used.

[Moxie]

Dani, you could try Omega 3 fortified orange juice and eggs, walnuts, and dark green vegetables. Grass-fed beef also has some mega 3s (corn-fed doesn't).

[Shandra]

I've been thinking about this post this weekend and I wanted to add - it may help to give your true friend (or another friend who is perhaps not exactly true, but pushy) a key to your house, metaphorically and literally, and ask them in advance to take the initiative to come over/call often. It may be too hard to reach out sometimes.

[Hanna]

Moxie,

I'm so glad you picked this series up again - if I would have had this information 2 & 4 years ago when each of my 2 kids were born it really would have saved my bacon with the PPD I dealt with. I agree on every point you've made, and applaud you for taking this on.

For Omega 3's, I've had great results even now quite post-partum with Omega Brite - http://www.omegabrite.com/ - 3 capsules/day. I almost never have any fish burps, unless I forget to not drink my coffee right after taking the capsules.

I first heard about Omega Brite from a nurse/therapist I saw who specialized in nutritional options for managing depression. On her recommendation, I take 3 omega brites plus a multi-vitamin with selenium and an extra multi-B vitamin daily, and I find it makes a huge positive difference in my mood & irritability.

The Omega Brite is more pricey than what you buy off the shelves, but it's a higher concentration the "good stuff" you want from fish oil, and they give you a 10% discount if you place a standing order.

[swimmermom]

"If that means you have to let something go, like breastfeeding…" I so agree that women who are dealing with PPD (or incipient PPD) should simplify things and drop non-essentials. However for several reasons I hope that breastfeeding isn't one of them. Breastfeeding mothers are less likely to have PPD in the first place, and when they do have it, breastfeeding helps. I'm not just talking about the logistics of not having to buy formula & supplies, mix it up, and clean up vs. simply lifting your shirt. I'm talking emotionally. Breastfeeding is the normal state for a postpartum mother. It provides prolactin and oxytocin, hormones that make us feel good and loving.

There is also evidence that breastfeeding protects babies against some of the negative effects of maternal depression. Their patterns of brain activity don't show the abnormalities that often occur in babies of depressed mothers. If the mother is not making an effort toward interacting and bonding with her baby, the breastfeeding does it for her.

I have known women who stopped breastfeeding, thinking it would make things easier, and found that it was actually a lot harder to carry on without it. If a mother is really struggling with breastfeeding, for example pumping around the clock to bring up a low milk supply, or dealing with a baby who isn't latching well or who is failing to thrive, it could make sense for her to stop, But for most mothers I would suggest that breastfeeding is a lifeline to normalcy for both her and her baby, and not to let it go.

(Moxie, I know you are a strong supporter of breastfeeding, as in part 2 of this great PPD series for example, and would not lightly recommend stopping. I just wanted to add some more information around this point!)

[Rach]

I looked your blog up as a last resort. I am so, so sad and I don't know what's wrong with me. My baby is almost 3 months old and I have a little girl who just turned 2. I keep rehashing the fact that I had a repeat c-section at 37 weeks and now I'm doomed and can't have any more kids because I had 2 c-sections. I guess I'm also angry with my doctor because I don't feel like I was really educated about the whole VBAC experience. I am so worried about my kids all the time and so sleep-deprived. Anyway, thank you for this blog! Wow, was that a brain-dump or what?

[Preved]

Your post seem a little cynical, how come ? http://11111111djgl.com gabwls 222222 [url=http://33333333333ztrl.com]333333[/url] Hopefully I’ll be back soon!

[emmi]

I want to thank you for your blog. Your post about depression during pregnancy (in response to Jodi) made me cry because it perfectly put into words what I'm feeling and it gives me some hope that it won't always be like this. Just thought you'd like to know that 5 years after you wrote it, it's still reaching and helping people.