Wondering When It Gets Easier, Mama? Why it's harder than you imagined to mother an older infant +7 tips to help you through

Your baby is 6 months old. Perhaps 8 or 10 months. You thought you'd "have it together" by now. Or at least feel like a version of your former self. You've managed to piece together some semblance of a routine and take care of the basics- you go food shopping, hit the park after the second nap occasionally. But you feel anything but together. 

You crossed the threshold into motherhood many moons ago, tho some days it feels like it's harder than the first week after you brought your baby home. You knew the media's portrayal of moms was too good to be true, but this?! You had no idea how hard it could be. 

As a mother of 2 and a psychotherapist specializing in maternal mental health, i spend a lot of time reminding my clients (and myself) just what an enormous transition motherhood is. 
 

Reasons why parenting hasn't gotten easier, yet

Becoming a mother is the biggest transition a woman goes through in her adult life. Many women I see in my support group and my private practice struggle immensely with the loss of self, figuratively and literally. There's no way to prepare for the jolt that assaults the mind and body as you pour every ounce of energy into another human, selflessly abandoning your own basic needs like sleeping, showering, using the bathroom and eating to ensure the health and wellness of your baby. Let me unpack that for you. 

Sleep

The average infant isn’t sleeping through the night at 6 months, despite the myth that society continues to perpetuate about sleeping like a baby. It's just that, a story. Babies. Don’t. Sleep. At least most or many don't sleep well at this age. It's not uncommon for older infants to routinely take 30-minute naps. And wake 2-4 times a night. Or more.

As you well know, if baby doesn't sleep, mom doesn't sleep. Lack of sleep is correlated with both depression and anxiety. Sleep deprivation makes life harder, which is why it's is used as a method of torture! 

Many new moms anticipate they'll have time to clean the house, prep dinner and maybe take a shower when their baby naps. Never had they considered the reality of holding, wearing, bouncing or driving their tired or crying child to try and induce sleep and eek out a 30-40 min nap here and there. That downtime you imagined to effortlessly have-- poof! Being a parent is a sacrifice for sure; you knew that cognitively of course. But when you haven't been able to put your child down to nap since they were two weeks old and it's 85 degrees outside and your walking up and down the street so they'll fall asleep-- it's real. 
 

Relationships

Many women I work with share how struggles with their partners seemingly erupt out of nowhere. Relationships that previously had no cracks feel like they're crumbling. As I prod and question I learn more about the communication gap and the resentment that builds when responsibilities fall on the shoulders of one person more than another. When needs go unmet, feelings of not being appreciated, thought of, cared for and loved begin to grow.
 

Identity Loss

It's not unusual that during the very early stage, if mom is breastfeeding or recovering from birth she spends many weeks at home, bonding with her newborn.  But often, I hear that as partners return to work and resume regular social activities, mom feels more isolated from friends, society and her former identity. She's no longer working and no longer engaging in the activities that previously identified her as the person she though of as herself. Instead she's counting poop diapers and bouncing a baby on a ball so she can maybe check her email or do something for herself if she can get the baby into a bed. 
 

Overwhelm

These aren't unusual issues to face as individuals and couples transition into parenthood but they shouldn't be ignored. So many moms I work with talk about the overwhelm kicking in at this stage. They think it should get easier by now. That having a routine should help. But the sicknesses and lack of sleep bookended by full-time jobs and no babysitter leave little time for breathing let alone a date with her partner.

When we have no time to play, to connect and to nurture ourselves, life feels hard. When you've been going and going, devoting all of your energy to learn about this new incredibly important member of your family, to meet their every need, it's intense. 
 

Small steps towards change

When you reach the point of feeling overwhelmed, of questioning how things will get better and why they feel harder every day, it may be time to consider making some small changes. Here are 7 recommendations I often make to families I work with that are struggling during this stage of their transition to parenthood:

1. Open up. Communicate with your partner. Share your feelings, your expectations, desires. Let them know how they can help you feel more supported during this ongoing transitional time. As much as we might like to have married a mind-reader, relationships are built on communication that must be fostered.
2. Get more sleep. Discuss your sleep needs with your partner. Try and develop a plan to get more sleep if you think you aren't getting enough. If you're getting less than 5 hours in a night, that's not enough for most.
3. Eat well. Make sure you're eating well. Three meals plus snacks.  Balanced meals with adequate fats and proteins are important, especially if you're breastfeeding.  
4. Move. Walking is a great place to start.  Physical exercise has been shown to release endorphins, which naturally trigger positive feelings helping to reduce levels of depression and anxiety, and can actually help prevent depressive symptoms. 
5. Get outside! Being in nature is not only restorative but can improve your positive outlook on life and your ability to cope and recover from stress and illness.
6. Schedule breaks. Schedule time for you, even if you have no hobbies, don't play sports and have no interests that come to mind. Schedule a time for you to do whatever you choose. Regularly.
7. Connect with others. Join a support group of other new moms. Find a way to connect with people and activities that you enjoy and bring joy to your life. 

And lastly, ask for help! If you're not sure if what you're experiencing is part of the normal transition to motherhood or something more, like postpartum depression or anxiety, I encourage you to reach out for help from a therapist trained in maternal mental health. Many people are surprised to learn that they can develop a perinatal mood or anxiety disorder at 6, 8 or even 12 months postpartum. Here are some of the symptoms of perinatal mood or anxiety disorders (aka postpartum depression or anxiety). 

It's not realistic nor do I anticipate that someone would adopt all of these changes at once. I'm a strong believe that small acts change lives. See if you can find just one thing from the list above that you can do this week to help improve the way you are feeling. What will it be? Make a commitment! I'd love to hear your plans for change in the comments. 

If you're reading this article and thinking about a friend or loved one, you can help them get the support they need. If you'd like some tips on how to do that you might find this article useful. If you're in San Diego, please feel free to reach out. I maintain a private practice in the Banker's Hill neighborhood where I women struggling with infertility, loss, and pregnancy and postpartum mood and anxiety disorders.. I offer a free 30 minute in-person consultation to find out if I'm the right therapist for you. Postpartum Support International (PSI) is a national organization that maintains a warmline and a 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.

Reducing the Stigma of Maternal Mental Health Disorders

May is Maternal Mental Health Awareness Month. It’s a month to raise awareness for postpartum depression and anxiety and just how prevalent it is—One in seven! It’s a month to educate people about postpartum PTSD and that you CAN in fact be traumatized by your birth. It’s also an opportunity to let our community know that some women are at a higher risk for developing postpartum psychosis (a personal or family history of bipolar disorder increases her risk). Many are surprised to know that up to 80% of new moms experience the baby blues, it’s that common! Perinatal Mood and Anxiety Disorders (PMADs) are the number one complication of pregnancy. 

Advocates are hopeful that by normalizing the prevalence of maternal mental health disorders, more women will understand the differences between the baby blues and postpartum depression. Greater awareness will help people detect when “something’s not right”— with me, my wife, my sister, my daughter, and hopefully lead to more screenings for prenatal and postpartum depression and anxiety. It's estimated that less than 50% of women struggling with a PMAD seek treatment, despite the fact that they're extremely treatable with professional help. Some reports estimate as few as 15% of women who struggle seek treatment, though it's difficult to know for sure since shame and stigma prevent many from reaching out. 

There are many ways to support the mental health of women and their families during the childbearing years. Below are 5 ways that you can help reduce the stigma of maternal mental health disorders and advocate for greater awareness in our community.

5 Ways to Advocate for Maternal Mental Health 

1. Join your local chapter of Postpartum Support International. In San Diego, our chapter is called the Postpartum Health Alliance. I’m proud to volunteer my time as the Outreach Co-Chair and serve as a warmline volunteer. There are loads of ways to help build awareness and educate your community through your local organization.
    
2. Display a Blue Dot—the new national symbol for Maternal Mental Health. You can purchase your magnet or sticker here. Not only are you supporting this important cause with your financial contribution, but you’re letting those around you know that you’re an aware and concerned citizen; It’s a conversation starter that will let more people know about PMADS and the risks to moms and babies who go untreated. 
    
3. Write letters to congress in support of the Bringing Postpartum Depression Out of the Shadows Act of 2015! That will provide grants for screening and treatment for perinatal mood and anxiety disorders. 
    
4. Participate in your local Climb Out of the Darkness hike in June to raise awareness of maternal mental health disorders. These events are coordinated by local volunteers through Postpartum Progress. To join San Diego’s hike, contact Julie Thorpe
    
5. Don’t forget to ask the mothers you love and care for about their mental health: How are you sleeping? How are you eating? How are you feeling? If you're not sure how to address someone you think is struggling, this article provides some helpful strategies. 

If you suspect that you or someone you love has a perinatal mood or anxiety disorder, reach out for help today. Rachel Rabinor, LCSW is a psychotherapist in private practice; she helps women struggling with their transition to and through motherhood in her San Diego office. She also offers in-home counseling and Walk and Talk Therapy. For resources outside of San Diego, contact your local chapter of Postpartum Support International.