The first 12 months of motherhood were the hardest months of my life. I know how hard it can be for a new mum to admit she is struggling. This blog post is a guide to help you to support a mum with postnatal depression. Whether you are a husband, partner, parent, friend or sibling – this post aims to help you to communicate, get help and provide ongoing practical support for the new mama in your life.
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DiscLAIMER: I am not a doctor or a mental health practitioner. Please seek medical advice from your family doctor.
What post natal DEPRESSION felt like for me
In the first 12 months of my new motherhood, I was exhausted, anxious, devastated by my failure and constantly feeling guilty. Most mums experience the low mood that sleep deprivation and hormonal changes can cause in the postpartum period. But when it is a constant black cloud, and feels like there is no light at the end of the tunnel, then it is time to get help.
When we first got home
Life felt completely alien when I first got home from the hospital. Several unusual events had meant that my son’s introduction to the world was not ideal. We spent a week in hospital and when I got home I didn’t know where to be or what to do. I didn’t even know which room to sit in! Unfortunately for me, as time went on, these feelings got worse.
Spiralling catastrophic thoughts
My mind would often get the better of me, and irritation at unwanted visitors would spiral into rage and a desperate need to run away. I felt like I was in a dark place with no one who understood me. Often I felt overwhelmed with the idea that everyone else just wanted to take the baby from me and they didn’t care how I felt. All I wanted was to be left alone, and yet I was so desperately lonely.
Recognise the signs
If your partner is expressing very negative ideas that seem to get darker and darker, then it is likely they need help. Help just means someone to talk to. Talking can put things into perspective again. Through talking, we can also learn self-help tools to stop our thoughts getting the better of us. Help may also mean taking medication for a while until the problematic brain chemistry balances out again.
Fear of being separated or replaced
As a brand new mum with postnatal depression, I also experienced a real fear of being separated from my baby. It felt like people wanted to take him and then get rid of me. I was afraid that I wasn’t a good enough mother and I was going to be replaced.
Mothers and babies are supposed to be together. So a fearful reaction to separation is normal to a certain extent. It’s part of that innate biological programming that we have in our DNA, which protects us and helps babies survive. You can read more about the importance of newborn bonding and the Fourth Trimester here.
But if it becomes apparent that this fear is making even short visits from close family members feel like a real threat, then it is probably a sign that something isn’t right.
These fears became quite prominent toward the end of my maternity leave as I felt overwhelmed by the idea of returning to work. I wanted to run away from everything. Sadly, I experienced suicidal ideation in relation to my need for escape. If you or someone you know has been experiencing thoughts of self harm or suicide, please get help right now. Call your GP or the Samaritans helpline on 116 123 (UK Wide). You can also find more information on the MIND website.
Many women are also affected by trauma. For some it might be historical, for others the trauma might stem from their birth experience and can lead to postnatal depression. There is no way to know whether a birth was traumatic or not without asking the mother how she felt about it. So it is important not to make assumptions about how ‘well’ a birth happened. If a mother is experiencing repetitive, intrusive thoughts about the birth then she may need help to process her emotions.
I spent months going over the details of my birth experience. It wasn’t until I had a birth debriefing session with the surgeon who delivered him, that I was able to really process the experience and move on. Debriefing appointments for women who have given birth are available through the NHS. Contact your midwife, health visitor or maternity unit to enquire about making an appointment.
Life as a new mum with postnatal depression
Generally, my life as a new mother was overwhelmed by negative thoughts and feelings. Exhaustion, resentment, loneliness, isolation, feeling seperate, unwanted or alone even when in a group, and sheer desperation to feel like my old self again.
This is a horrible position to be in. And I know first hand how scary it can be to open up. Many mums feel like they are failing or not good enough. They feel guilty for not enjoying motherhood more. The mum in your life may also be afraid that someone will take her baby away.
At the same time, a mother may be equally worried that her pain and fear won’t be taken seriously. It can be frightening to think that you might bare your darkest secret to someone and be told that you are overreacting. Or worse, a burden.
So how can you help support a mum with postnatal depression?
The most important thing that you can do is be willing to take your partner’s thoughts and feelings seriously and offer to talk about it. That’s why I have put together this guide with communication hints and tips to help you manage that initial conversation. So let’s get started!
First of all, it is important to be ready to have that conversation. Do some research on what postnatal depression is and what treatments are available. Here are some useful links:
- NHS Website: What is PND
- MIND.org: PND & Perinatal Mental Health
- PANDAS: PND Awareness & Support
- PSI: Postpartum Support International
How to talk about postnatal depression
Once you have prepared yourself, you can try talk to your partner. It is important that you use active listening skills. This means making a real effort to hear the meaning behind the other person’s words. Focusing on her body language and the message behind her words, as well as the actual words themselves.
So let’s start with YOUR body language.
Show that you are listening by being attentive. Eye contact is important, but not everyone finds it comfortable to maintain eye contact throughout a sensitive discussion. We can use other kinds of body language to show that we are listening too.
Nod or shake your head, acknowledge what has been said with short responses like ‘yes’, ‘no’ or even ‘hmm’ during the discussion. When she has finished, it is important to reflect back what you have heard. This way you can check that you have understood correctly and she can edit your understanding if not.
How to get started
To start your conversation, choose a time when you are both feeling as calm as possible. It is important to be somewhere that feels safe and private. Sometimes people find it easier to talk when they don’t have to look at one another. For example, when out for a walk or a drive, or even eating a meal. It is important not to have too much background noise though, as this can be distracting. So turn off the television, put your phone on silent and give her your full attention.
Validate her feelings
It is important to show this mama that you are genuinely acknowledging and validating how she is feeling. Try to start the conversation with an open and friendly question about how she has been feeling since becoming a mum.
For example, “Having a baby really is a life changing experience. How are you feeling about the way your life has changed?”
Or “You are doing such a wonderful job of looking after our baby. I want to help look after you. Tell me about how you are feeling”.
These questions are phrased in a kind, inviting and open way, to allow her to start the discussion at a level she is comfortable with.
Try not to jump in with explanations or solutions
She isn’t asking you to fix it. And the likelihood is that you can’t. She needs you to simply hear her and recognise what she is feeling, while also giving her space to work through her own thoughts.
OARS is an acronym for a set of communication techniques. These techniques help you to encourage the other person to open up and ensure they feel that they have been listened to. It is also useful for you! To ensure you have understood and know what the person actually wants from you.
OARS stands for:
- Open Questions
It is helpful to ask both open and closed questions. Closed questions are the ones we ask to get straight forward information. For example, did you shower today? The answer will probably be yes or no.
But open questions are really important for getting a person’s story. They invite us to open up in our own way. For example, “how have you been looking after yourself this morning?” Or “What types of things have made you feel better in the past?” By asking open questions, we can find out how life feels for the other person and how they want to move forward.
Start open questions with enquiry words: What, When, Where, How, Tell (me about…)
Affirmations are genuine statements of empathy and encouragement. They demonstrate to the other person that you are listening and that you care about what they are going through. Try to focus on a two-part affirmation statement. Part one is praise and part two is recognition. The positive praise is important but so is affirming the reasons behind it.
For example, “You are a wonderful mother and I know you are working so hard to make a safe and loving home for our child.”
Use affirmations as you move forward in your discussion.
For example, “It’s great that you have opened up to me. I can see how hard this is for you, but I know you are going to find a way forward. I am going to be here to help with whatever you need.”
Use affirmations to provide a sense of love and support. Be positive about the mama’s strengths and abilities. Consider the skills she has used in the past to overcome problems and how they might help now.
For example, “You are such a hardworking person and I know that once we get some help you will be able to learn new skills to overcome this.”
The R in OARS stands for Reflections. This is when we communicate back what we have understood from the conversation. We can reflect on the words used, the person’s emotions and their behaviour. Use phrases that are respectful and curious.
For example, “You seem to be saying that you are feeling trapped at home and that being a mother is making you feel isolated.”
You might also reflect on body language
For example: “I noticed that you tensed up as you were describing the visit from your family. How does having visitors make you feel?
Reflect throughout your discussion especially when it seems like the topic is shifting. That way you can make sure you have understood each important point and you have given the other person a chance to get their message across.
Summaries are the S in OARS. Summarising what has been said is similar to reflecting, except it is usually done at the end of a topic or discussion. Try to summarise the salient points and feed them back to the other person. She can then agree or edit the summary. This gives you both a chance to consider what the overall goals are, as well as her preferences for how to work towards them.
Here is an example of a Summary:
“So we have been talking about how you feel and you’ve mentioned feeling tired, angry, sad and lost. You said that you would like to see more people, but that too many visitors can be stressful. You also mentioned feeling overwhelmed by the housework and cooking.
support her to problem solve
In response to her difficult situation, you might offer some ideas for moving forward. But it is important to do this in a sensitive way and also provide the space for your partner to make her own preferences clear. Ask more open questions to find out what she thinks might help.
When you both feel there are some clear goals, summarise the discussion so she can check that her needs are being understood and that she is comfortable with the next steps.
Going forward, we considered a plan to speak to the doctor, have just one visitor a day and to ask visitors to bring a meal for the freezer. I’m going to help too – by hoovering, washing the dishes and doing the laundry every day. Have I missed anything do you think? Or is there anything you want to add?”
Remember to double check
You can then double check before finishing the conversation, for example: “Was there anything else you wanted to talk about just now?”
Remember to thank her for opening up to you. She has placed you in a position of trust. So it’s important to show how much you love and trust her too.
Offer space to talk
Remember that even though it has been hard for you to have this conversation, it will have been even harder for your partner. She may feel exhausted and emotionally drained. Offer physical comfort like a hug or a cosy blanket. Perhaps end the conversation by offering to make a cup of tea and put on a funny film if appropriate.
Be prepared for ambivalence
Not everyone wants to get help right away. Some mums may find it hard to ask for help or they may dislike the idea of having to involve someone else. Try asking them what the benefits are of NOT doing anything? Then you can ask what the disadvantages might be.
Help her explore what might change for the better if she DOES get help. And what she feels the disadvantages of asking for help could be. These questions can help guide your partner through her thoughts and feelings, so she can figure out what she wants and what she is scared of.
Another way to support a mother who isn’t sure, is the miracle question. If a miracle happened overnight and the problem was magically fixed, what would you notice first? What would be different first thing in the morning? How would your day look? What would be different at night time? Do you think this is something worth trying to work towards?
These types of questions help to change the ‘What if?’ thoughts. Instead of worrying about ‘what if something negative happens’, we are thinking ‘what if something good happens?’
DISCLAIMER: I AM NOT A DOCTOR OR A MENTAL HEALTH PRACTITIONER. PLEASE SEEK ADVICE FROM YOUR FAMILY DOCTOR.
Get support first and foremost
These communication skills can be very effective when supporting a mum with postnatal depression. But it is important to remember that mental health isssues can have devastating consequences. It is vital you also get some help.
Call for help
If your partner isn’t ready or isn’t able to ask for help, you can. It is okay to make an appointment with the doctor or call a helpline yourself. You are caring for someone who is struggling and your worries are important too. It is absolutely fine to chat through these worries with the doctor or health visitor as they may provide information about what type of support would be available to your partner.
Offer to sit with them while they call
You could also offer to sit with your partner while she phones the doctor, health visitor, midwife or helpline. She may need a friendly hand to hold or someone to give her a reassuring smile. Make sure you have the right number and you have settled the baby before making the call.
Go to your G.P. or family doctor
Remember you can go to your local G.P. surgery. There are some restrictions in place for COVID-19, so you may be required to have a conversation over the phone rather than a face-to-face appointment. The G.P. will be able to refer your partner to other services for postnatal depression. These vary by postcode, but the most common services are counselling, psychologist-led therapies, specialist nurses, and support groups.
The G.P. may also prescribe medication. If your partner is worried, she doesn’t need to agree to treatment straight away. Take a few days to find out:
- what type of medications are being offered
- what their side effects might be
- how long they take to have an effect
- what the consequences of not taking medication might be
It is possible to combine medication with other therapies too. If your partner is breastfeeding she may want to check the medication is breastfeeding compatible. Here is a link to the Breastfeeding Network’s drugs and breastfeeding factsheets.
Find some leaflets / groups
Your partner may not know what is available to her locally. Perhaps she can’t see a way to socialise, get support or even enjoy life now she is at home with a baby. Try to collect some information about mother & baby groups, community projects, breastfeeding support and so on.
There may be specific things she would like help with, so consider whether there are any local services which specialise in postnatal support. For example, a women’s physiotherapist, postnatal fitness classes or even postnatal massage.
Living with PostNatal Depression and how to keep up the support
Once you and your partner have talked, you may wonder where to go from here. Here are some practical ideas for how you can help the mama in your life:
Be at home if you can.
This is important for lots of reasons – company, reminders for self care, reassurance that someone else is there for the baby, and helping with day to day tasks that might feel overwhelming.
I understand that not everyone can take time off work. But some employers offer things like ‘carers leave’ and ‘compassionate leave’ which might allow you a couple of days at home. Consider using holidays or even being signed off by the doctor if you are experiencing stress yourself. If you can’t be there, chat to your partner and find out if there is anyone else she might like to keep her company, who could help her with the baby for a week or two.
When my son was a month old, his dad had to return to work. I was still recovering from my c-section and struggled to carry him upstairs. My sister is a teacher and was on her summer holiday, so she came round every morning at 8am when my husband left. Then my husband would give her a lift home when he finished work at around 5pm. She made lunch for me, held the baby when I went to the bathroom, we went for walks together and most importantly she made me laugh.
Make sure she has everything she needs
It can be hard work for mums to look after themselves as well as a baby or toddler. Sometimes we make everyone else meals and do the laundry, but forget to eat a proper meal! Why not make your partner a packed lunch in the morning before you leave for work? Stock the fridge with bottles of water or juice.
Let her know you are thinking of her
Leave little notes or reminders around the house to make her smile. Check in if you can. My husband likes to phone us at lunchtime when he’s eating his sandwiches in his work van. If your partner has projects or hobbies, make sure she has everything she needs and leave the bag somewhere easy to get to.
Breastfeeding mums often need an area where they can sit with their feet up while the baby cluster feeds. Help that mama by setting it up each night – with cushions, a blanket, a muslin cloth, remote controls, her phone, book, snacks etc.
Lighten the load and encourage rest
Do what you can to lighten her work load. Wash dishes, put a load of laundry on, empty the bins, tidy up, refill toilet roll holders and soap dishes. All of these little things can add up to make a big difference! Encourage her to rest and not to worry about housework.
Show appreciation for all she does
And remember to thank her for all the things that she does to take care of you, the baby and your home! A card or a bunch of flowers every week will help to put a smile on her face!
Knowledge is power
Understanding psychology and learning about mental health is called ‘psycho-education’. It is one of the most important ways we can manage mental ill-health. Seeing postnatal depression as a mysterious condition can make it feel scarier. Take your time to read up on postnatal depression! You may also consider learning more about women’s hormones and postnatal recovery. These can play a big part in a new mum’s mental health also. Share the resources you find with your partner so she can read them and feel empowered by psycho-education too.
Help her practice self care
Self care is essential for everyone to look after their wellbeing. But it is even more important for new mums who are living with postnatal depression. Mothers are often so busy taking care of everyone else they forget to look after themselves. Encourage your partner to take time for herself. Help her get nourishing meals, rest, drink lots of water and most important – sleep! If you need help coming up with ways to fit self care around the baby, read my post on Savvy Selfcare for Motherhood.
Offer to take baby
One way to help your partner get a break is to offer to help with the baby. This might be taking baby out for a walk or it may just be sitting downstairs with the baby while she is in the bath or taking a nap. Find out what she is comfortable with. Not all mamas are ready to be separated from their babies. And not everyone feels comfortable allowing someone outside the family to change nappies or feed their baby. It is important you respect her decisions and preferences while offering to help.
Learn some skills for comforTing baby when they cry
If you are going to be looking after baby to give mum a break, have a chat with her first and find out how the baby likes to be comforted. A lot of mums worry their baby won’t settle away from them and it is a valid concern. But often we can use other techniques to settle baby for short periods.
Ask mum if it’s okay to use a bouncer chair, rock baby in a pram, try skin to skin or carrying baby in a sling. Some babies also like white noise or being wrapped in a blanket or piece of clothing that smells like their mother.
Help her find her mum tribe
Encourage you partner to be sociable and find other mothers to talk to. Even the happiest couple in the world need friendships too. Having other mothers around who know exactly what she is going through will make all the difference.
Be kind and remind her how well she is doing
Finally, keep boosting that mama’s confidence. Remind her how well she is doing and encourage her with the knowledge that things will get easier. Postnatal depression won’t last forever. This is a season of life and with the right support it will pass. Before she knows it, she will be thriving in motherhood, not just surviving it!
DISCLAIMER: I AM NOT A DOCTOR OR A MENTAL HEALTH PRACTITIONER. PLEASE SEEK advice FROM YOUR FAMILY DOCTOR.
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