You Think Someone You Love Has PPD? Why YOU Need to Speak Up!
If you don’t speak up, the person you love might not get the help they need! Many women suffer in silence. Too many. More than 20 percent of moms are diagnosed with PPD; however, a recent study by BabyCenter shows that 40 percent do not seek medical help they need due to feelings of embarrassment, guilt and the expectation that they can get over it without professional help. There are many risks to mom and baby if postpartum depression or anxiety goes untreated, including:
Last week I got together with a new friend, Shelly, for a walk. When she learned more about the work I do with new and expecting mothers, the worry poured out of her. Shelly’s sister-in-law (SIL) had a baby 8 months ago, and she’s concerned about her. She's tired, irritable, incredibly anxious and doubting herself all the time (Yes, these are also symptoms of PPD--scroll to the bottom of this page for other symptoms you may not know about). Specializing in Maternal Mental Health, it’s par for the course to hear about sisters, friends, daughters and co-workers who are struggling with Postpartum Depression.
One in seven women deal with Perinatal Mood and Anxiety Disorders (PMADs), so really, it’s no surprise to hear about it so often. The thing that routinely does surprise me, however, is the hesitation many people share about approaching those they love with their concerns. This was Shelly to a T. She felt close to her SIL, but was apprehensive about recommending that she seek out some support.
Hesitant to offer support?
The more we talked the more I understood what was getting in Shelly’s way of reaching out. Shelly's the mom of a toddler and seems to have it together-- or together enough. She has a stable partner, family close by, a new business she’s passionate about; she’s confident and happy in her life. Her SIL, on the other hand, lives far from family and is further isolated by her husband’s current deployment with the Navy. She has a history of depression and other risk factors associated with PMADs.
By the end of our walk, I had a pretty clear grasp on Shelly’s hesitation to reach out to her SIL. She didn’t want her to feel judged, or less-than, by addressing concerns about her ability to cope with the adjustment to motherhood: A transition that has come fairly easily for Shelly. Shelly was also concerned about providing the right kind of support. With a history of depression, it was routine for family to jump in to “help” her SIL, and make everyday tasks easier. Her depression would subside for a bit and then the pattern would repeat. While a supportive family can be ideal in helping someone through their recovery, professional treatment may still be needed to address issues that may be contributing to the depression on a deeper level. Shelly wanted to help but she wasn’t sure how to do so effectively.
Why it’s important for YOU to speak up
If you don’t speak up, the person you love might not get the help they need! Many women suffer in silence. Too many. More than 20 percent of moms are diagnosed with PPD. However, a recent study by BabyCenter shows that 40 percent don't seek the medical help they need due to feelings of embarrassment, guilt and the expectation that they can get over it without professional help. There are many risks to mom and baby if postpartum depression or anxiety goes untreated.
RISKS OF NOT GETTING HELP WITH PPD
Risks to mom
- Lower quality of life
- Decreased ability to function at home or at work
- Risk of recurrent depression
- Suicide
Risks to baby
- Insecure attachment to mother
- Interference in cognitive development
Family stress and discord
Decreased care or neglect of other children
Loss of job/income
Also quite common is that women don’t even realize that what they’re experiencing isn’t normal! Just today I saw a third-time mom who started to recognize in my office that she had probably struggled with postpartum depression with her first two children without knowing. Sounds unbelievable but it’s true. The messages that women hear about motherhood reinforce that it’s natural, easy. That yes, you may be tired, but that’s normal. There’s a lot of grey area and it’s not always crystal clear whether what you’re experiencing is a normal adjustment to motherhood or something more serious. So if you notice something doesn’t seem right in someone you care about—Say something!
What to say to someone with Postpartum Depression
Shelly is a great example of someone who really wants to support someone they love, can identify their struggle, and for various reasons isn’t sure how to help. The reality is, it may not be the easiest conversation to have. But I find that women who are struggling are usually relieved to learn that there’s help available and that they don’t need to suffer in silence. Here’s a few suggestions of how to start the conversation:
1. Be direct
It’s important to be empathic, but it’s most important to be direct. Let her know that you’re worried about her; she doesn’t seem like herself. Let her know it’s normal, lots of women (1 in 7!) deal with PPD. It’s not uncommon for many women to go undiagnosed. Don’t let her slip through the cracks!
2. Be genuine
Speak from your heart. Let your love and care shine through. If she’s struggling to care for herself or her baby, this is serious. Remember, she’s not choosing to be neglectful, she’s struggling. You know she wants the best for her baby, for her family. Help her get the professional support she needs.
3. Be available
Make time for her. Once you connect her with people and resources she needs to improve her mental well-being, she will still need lots of support from people in her life who love her. She is vulnerable. Bring her food, go for a walk, watch her baby so she can take a shower. Keep her company.
If you or someone you know is struggling with a Perinatal Mood or Anxiety Disorder, please reach out for support. PMADs are very treatable. Postpartum Support International (PSI) is a national organization that maintains a warmline and also list of trained providers specializing in Maternal Mental Health. If you’re in San Diego, CA, The Postpartum Health Alliance is our local chapter of PSI and a wonderful resource.
Pregnancy loss: How to help your daughter/sister/BFF cope
Someone you love has lost a pregnancy, her baby. You don’t know what to do. Or say. Or how to act. You’re wondering how to show your love for your daughter. Your sister, or your friend you adore so much she’s like your sister. You never had a miscarriage, or lost a baby and have no idea what’s the “right” thing to do or say.
Someone you love has lost a pregnancy, her baby. You don’t know what to do. Or say. Or how to act. You’re wondering how to show your love for your daughter. Your sister, or your friend you adore so much she’s like your sister. You never had a miscarriage or lost a baby and have no idea what’s the “right” thing to do or say.
As a psychotherapist and Licensed Clinical Social Worker specializing in Reproductive Mental Health, I see clients struggling with miscarriage, pregnancy loss, and infant loss in my private practice in San Diego, CA. My professional and personal experience has taught me that there is no one “right” way to console a grieving loved one. That being said, I do have some suggestions to share that seem to be universally appropriate. There are always exceptions of course.
How to help
1- Be Present
Even if you can’t be present physically, don’t shy away. Make your care and love known in some way. If you are local or want to jump on a plane to be with her—do it! When you get there, to her house, to her couch where she sits with tears in her eyes, her heart torn wide open. Just sit. Just be there right next to her. Hold her hand. Hug her. Let her cry. Or let her be mad and curse the world. You don’t have to say much. Being emotionally present will let her know just how much you care.
2- Show acts of love
Bring food, send flowers. It doesn’t really matter what it is. The act of giving shows her that you’re thinking about her. If you don’t have money to spend, come and cook the food in her fridge, clean her home, send a card. The point is to let her know you feel her pain and you are there for her.
3- Honor important dates
Mother’s Day, the baby’s birthday or due date, the day she found out the pregnancy wouldn’t last or the baby died. These are important dates for grieving mothers. Even months after, when the calls have ceased, and the flowers have wilted, these dates will come and bring a torrent of emotions with them. Acknowledge these significant moments; she is thinking about them more than you will likely know.
4- Verbally acknowledge the loss
Many many women have shared with me that the worst thing someone can do is say nothing. Ignore the loss. You might feel this is unthinkable, that someone could move on with life without a single word of love, empathy or care, but it happens. And it’s devastating. If you’re not sure what to say, check out my guide below.
5- Listen
Listening seems so obvious, but I can't stress how important it is to truly truly hear her out. It's normal to think about your own losses when you sense her pain, but avoid sharing the details of your own experience during this sensitive time. Let her know you're there for her. Listen to her and nod your head, acknowledge her pain.
6- Remember: tone trumps content
A few words on tone before jumping into the what to/not to say guide below. HOW we speak often has more impact on the way our message is received. If you stumble and say something you "shouldn't" have, it will blow over if you've said it with empathy and love. If you're callous and try to be funny and say the wrong thing-- it might not go as well. This is a time for honesty, for being vulnerable and being real.
I’m hoping you noticed that the answer to each of the above scenarios comes back to expressing your empathy and care for her. Why? Because that’s the bottom line. You’re sorry someone you love is dealing with this. You can combine any of the recommended "what to say instead" statements. Make it feel natural. Find your own way to express your empathy. But that's the key— empathy. It’s important to squash your own burning desire to know what her next steps are, or to inquire about what went “wrong”. Let her guide you. Pay attention to her, check in with her and she will let you know when she’s ready to share more.
These tips and guide are intended to support and strengthen relationships. What has been helpful for you? Please share your experience in the comments below. And please, let me know what I’ve missed!