Tuesday, April 11, 2017

Will It Ever Get Better? Depression and Anxiety in Mothers


by Alicia Schuster-Couch, guest blogger

Over five years ago when my first baby was born, I expected to be a happy mother with a happy baby. And, why shouldn’t it all be happy and great? Seemingly, parents’ posts on social media portray pure happiness and joy surrounding their children. Movies and stories are filled with tales of mothers being completely fulfilled and satisfied with motherhood. And  well-intentioned friends and family endlessly reminded me to enjoy every sweet moment of babyhood. Unfortunately, I was struggling as a new mother. More accurately, I felt like I was drowning. My baby was perfect but I was not. The guilt of not being perfect, of not enjoying every moment, of not being satisfied only served to exacerbate my depression. I never felt like hurting my child, but I frequently wondered if she’d be better off without me and sometimes thought about how much better everyone’s life would be if I ended mine.

How could this happen to me? I have a masters’ degree in counseling and years of experience in mental health. How could I be suffering so badly? When I went to my six week follow up OB appointment I had planned to bring up my feelings. Unfortunately, I was met by my overbooked and rushed OB who quickly wanted to make sure that my stitches were healing, wanted to talk about birth control, and needed to rush out the door. I also wanted to tell my husband, my friends, my family, my old coworkers that were still in the mental health field, but I couldn’t. I didn’t have the courage to tell anyone. I felt embarrassed. So, I retreated into isolation with my baby and wondered if I would ever get better.

Of course I got better, but it was a painful journey. Now with three babies and one pregnancy loss under my belt, I feel strong and have a sense of contentment. I did get depressed again after my second child, but not as severely as with my first. Then, when I was devastated by the loss of my third pregnancy, I reached out for help (finally!) and was quickly able to get back on track after some counseling. Thankfully, after my third baby I didn’t have any clinical depressive symptoms. I still don’t know what I’m doing half of the time as a parent and feel like I’m winging the roller coaster ride of motherhood. But, thankfully, I’m out of my depression. Now after my journey through depression and anxiety as a parent of young children, I feel compelled to use my formal education and professional experience to try and reach out to other mothers who may being sharing my past struggles.
 I frequently wondered if she’d be better off without me and sometimes thought about how much better everyone’s life would be if I ended mine.
I was surprised to find out that post-partum depression is the number one complication of pregnancy. There are higher incidences of post-partum depression than preeclampsia and gestational diabetes. How many times did your health care provider check your blood pressure? Check for swelling in your feet? Screen your urine? And, remember that tasty beverage you had to choke down to screen for gestational diabetes? Now, how many times did you get a mental health screening? How many conversations did your healthcare provider have with you about mental health or about treating mental health complications? Although all of the above mentioned screenings are important to your health and your baby’s health, I find it odd that we are screening mothers for preeclampsia and gestational diabetes, but not for depression, or anxiety, or other mental health diagnoses. Moreover, if you are one of the few that were screened by your healthcare provider for depression or anxiety, did they provide adequate referrals and follow up? After three births and one miscarriage, I never once had a conversation about my mental health with an OB, nor did they ever offer any referrals to mental health treatment. I am not bashing OB’s. They have a challenging job and have an enormous amount of responsibility when it comes to the physical health of not only mother, but baby as well. However, I think there is a dangerous void in screening for mental health. I’m not sure why there is a huge gap in offering mental health services specifically to pregnant women and to mothers. Nevertheless, this very vulnerable population deserves better.

I could write pages and pages of all the variables that contribute to mental health disorders in pregnant women and mothers. There are organic factors and family history; there are interpersonal and social factors, and many, many more. Regardless of the cause, it’s painful. It creates difficulty in accomplishing day to day tasks. It creates difficulty in parenting children. It can facilitate isolation, guilt, intrusive thoughts, and a litany of other symptoms that make life a struggle. Just like words can’t adequately describe love or joy or grief, I don’t think that words can actually capture the pain of living with a mental health disorder while concurrently trying to care for a baby or child(ren).

So, what are some important things for pregnant women and mothers to know about mental health? Let me quickly break it down into symptoms, treatment, and prevention. For the purpose of this article, I’ll stick with depression and anxiety, although I realize that some mothers experience other mental health symptoms.

Symptoms of PPD

What does depression look like? It’s not as simple as being sad. Sometimes people who are clinically depressed show symptoms of appetite changes, sleep changes, fatigue, low self-esteem, difficulty making decisions, feelings of hopelessness, feelings of irritability, thoughts of harming themselves, and decrease in pleasurable activities. Now, some of these are a natural part of having a brand new tiny human move into your house, but these symptoms cause problems when they are pervasive and do not seem to get better. Anxiety can look like perfectionism, excessive worry, intrusive thoughts, panic attacks, and obsession. Neither of these symptoms lists is provided with the intent for you to diagnose yourself with depression or anxiety. They are simply some of the common symptoms associated with depression or anxiety. If you feel like you’re experiencing some of these symptoms, I hope that you seek a professional diagnosis so that you can receive proper treatment.

Treatment of PPD

Treatment for depression and anxiety begins with a diagnosis. To receive a diagnosis, you’ll need to visit with your health care provider or with a mental health provider. Mainstream treatments include therapy and medication. I believe that treatment should also include education because after all, knowledge is power. Other important factors during treatment include nutrition, exercise, social support, and self care. These treatment factors are ones that should also be considered for prevention. Although it’s impossible to prevent a mental health disorder if you are predisposed to it, there are things that you can do to insulate yourself from the blow of having a mental health disorder. I am not a nutritionist or a personal trainer, but I do know that a healthy diet and regular physical activity make a world of difference. In our era of processed and dyed foods there are a lot of things in our food that negatively impact our bodies and have an effect on our biochemistry. Therefore, it’s important to eat a healthy and varied diet. Exercise is also important. I’m not recommending that you get an expensive gym membership or start training for a triathlon, but it is important to be active. This can mean going for a walk or jog in your neighborhood. This could also mean gardening, or riding a bike, or playing with your kids outdoors. We know the importance of Vitamin D (sunshine) on our physical wellbeing and the importance of hormones that are released through exercise. We all know how important nutrition and physical activity are, but it can be difficult to be motivated to partake in those healthy behaviors if you’re overwhelmed with depression or anxiety.
From RockYourormomes.com

Another important treatment factor is self care. What is self care? It is whatever it means to you to maintain your wellbeing. For some women it can be reading or writing. It could be yoga or meditation. It could be a glass of wine and your favorite television show. Self care is completely subjective and individualized. The important point is that self care is crucial. Your kids and significant other and life are demanding of you; nevertheless, you also need time to decompress so that you are able handle day to day stressors.

Easy enough, right? Nutrition, exercise, self care, social support, and therapy will set you up for a healthy and happy life. I realize that this is easily stated advice. I know how hard it is to just get one of those things on the list done. I also know that when you’re wading through the mud of depression and anxiety, all of those things seem totally impossible. It seems like you have no options, no time, no motivation, and no money to make any of those things happen. All of those feelings of doubt are normal and even expected. However, if you find yourself struggling, I hope and I pray that you can find the courage to reach out for help. Whether you reach out to your significant other, your sibling, friend, or professional, please reach out. Once you reach out you can begin to release the burden that you’ve been carrying around. You can begin to make a plan to address your symptoms and make your life enjoyable. I once wondered if things would ever get better for me. They got better, much better and I’m confident that things can get better for you, too.

I just want to acknowledge that this article does not capture the depth of mental health issues in pregnant women and mothers. The article needs to be ten times as long to adequately address all of the issues. For instance, I didn’t even address issues relating to the role that trauma plays. I didn’t address thoughts of harming others or thoughts of harming your baby or many of the other symptoms that mothers experience. This was meant to be an introductory overview of the issues. If you feel like you want to learn more about mental health in pregnant women and in mothers, please contact me. I’m a local counselor who is passionate about helping mothers and their families. I think mothers deserve better and more comprehensive treatment.

My name is Alicia Schuster-Couch and I am the owner of New Leaf Counseling Services of the TN Valley, LLC. I can be reached by phone at (256) 755-4599 and by email at alicia.newleaf@gmail.com . I am passionate about working with women to help them achieve their goals. I am currently an Associate Licensed Counselor (ALC) under the supervision of Liz Howell, LPC-S. I hold a Master’s degree in Professional Counseling from Texas State University and two Bachelor’s degrees in Social Work and Women’s Studies from New Mexico State University.

Please feel free to contact me or another professional if you feel like you need help. I wish you peace and grace.

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