Postpartum Mental Health
After Ellie was born I was so vigilant about signs of postpartum depression. I checked in with myself regularly. Feeling hopeless? Nope. Having frequent crying spells? Nope. Struggling to bond with the baby? Nope. Anything else that might be a sign of depression? Nope.
I made it through the first few months of postpartum life without any issues and thought okay, I’m in the clear, nothing to worry about… I can rest easy. It never occurred to me that any other mental health issues could crop up. Or that they might take a bit to fully rise to the surface.
In non-postpartum life, I'd say that my default mode tends to skew towards being anxious (though I appear quite calm on the surface). Add a new baby to my already anxious brain and all the dangers of the world get magnified by 1000%. Of course this is totally normal to a certain extent, our brains want to make sure we're doing all we can to keep the baby safe so it makes sense that anxiety would be heightened when you've got an infant in your life.
However, with Ellie, I was completely caught off guard by just how strong the anxiety came on and by the fact that it didn't really become an issue until I was about 3 months postpartum (which was a lot later than I expected). Intrusive thoughts took over, I got pretty distressed anytime I was away from Ellie and Mike, I wasn't sleeping well, I repeated words/phrases in my head, I rehearsed conversations, I obsessively strategized what I'd do if x, y, or z happened. My mind was going a million miles a minute. Of course starting a new job in a new city that was 3,000 miles away from our support system didn't help either.
With Hannah, I was expecting the intrusive thoughts, the vigilance, the fear of separation, the thoughts that got stuck, etc. Knowing that these things were coming has made this postpartum period go a bit smoother than the first time around. Plus we're not moving and I'm on leave until December so those additional stressors aren't there. Granted, there's a pandemic, I'm still very much in the process of grieving, and we've gone through a number of other family challenges so it's not like there are zero stressors in our lives. Overall, though I do feel a lot better equipped to navigate postpartum mental health challenges than I did the first time.
After Ellie's birth I saw 2 therapists to address the anxiety and OCD like symptoms I was having. The first person I saw wasn't a good fit for me; however, it was helpful to have some support during my first term teaching, which was a big stressor. Because she wasn't a good fit, I ended things shortly before spring term started. I was feeling "good enough" and decided to push pause on therapy for a bit. When the next school year started my symptoms cropped up again, so I sought out another therapist and we worked together for almost the entire school year. When we ended I was about 2 years postpartum and had hit the point where I was finally feeling like myself again (or the new mom version of myself).
After Hannah's birth I knew that finding a therapist was going to be important for my mental health. I thought about reaching out to therapist #2 but she wasn't taking clients. Plus, I wanted someone who specialized in the postpartum period and had some experience with acceptance and commitment therapy (which my previous person did not). After doing a fair amount of digging I found someone who has been an amazing fit, checking all the boxes I was hoping for and more.
I'm 5 months postpartum as I'm writing this so still very much in the thick of postpartum life; however, I've been seeing therapist #3 for a little over a month and have definitely noticed some positive shifts. And compared to my first postpartum experience, I'm already feeling way more like myself and I'm nowhere near the 2 year mark. I'm hopeful that things will continue to improve.
I've been thinking about the things that have been helpful for me in navigating my postpartum mental challenges (particularly related to anxiety). Here's what is standing out in my mind today. Side note (which I know you know), I am not a mental health professional! If you're struggling please seek out professional help (here's a good place to start).
Talk about your symptoms
Let somebody know what's going on, whether it's your partner, a friend, your doctor, a family member... tell someone! Talking about this stuff out loud can be scary but I also find that it gives whatever it is you're facing less power. When I was pregnant with Hannah I did group prenatal classes and we talked about postpartum mental health. Those of us who already had kids shared some of our experiences, particularly with intrusive thoughts, and it was so comforting to hear other people talk about many of the things I experienced. If intrusive thoughts are something you struggle with, I also found this podcast episode on intrusive thoughts and postpartum OCD helpful in normalizing the experience (sent to me by my therapist).
Get professional help
Talking about your mental health with a trusted family member or friend is great. Talking about it with a mental health professional is also important. If you're able, start the process of searching for a therapist prior to baby's arrival so you don't have to sift through people when you're in the thick of newborn life (this is assuming you're not needing a therapist during pregnancy - if that's the case, then find one whenever you need them!).
Figure out what you want in a therapist
I didn't do this the first time around and this definitely contributed to the lack of fit with therapist #1. With Hannah I thought about what specifically I wanted... someone who 1) took my insurance, 2) specialized in postpartum mental health, especially anxiety, 3) had gone through the experience of childbirth, 4) had experience with acceptance and commitment therapy, 5) was comfortable doing grief work, and 6) was doing virtual sessions but had an office not too far away in case in-person sessions became safe.
Take baby steps
I found it helpful to take things really slowly postpartum (to the extent that I could). Driving is something that makes me anxious so I had Mike drive me to my initial postpartum appointments. At the 2 month mark I had a dentist appointment that was less than a 10 minute drive from home, didn't require highway driving, and had easy parking so I drove myself. Despite being quite anxious about it I did just fine which gave me the confidence to take Hannah to the doctor's by myself, and then take Ellie out for an ice cream and library trip. Don't get me wrong, I still get nervous before and during these types of outings but taking baby steps has helped me cope.
Use guided meditations
Before getting pregnant I often meditated on my own. This did not go well postpartum so I stopped meditating all together, which I also don't think was helpful. One day I decided to try out a guided meditation (and also switched up the timing so I was meditating during the day, not at night) and this made all the difference. I'm sure I'll get back to independent meditation at some point but for now I'm sticking with meditations where someone else's voice is telling me what to do so that intrusive thoughts don't overwhelm me.
Write
Because my mind is going a million miles a minute I've found that it's been helpful to get some of my thoughts out with stream-of-consciousness writing (almost) everyday.
Sleep
When I get at least 6 (I'd even settle for 5) hours of consecutive sleep at night I notice such a difference in how my brain functions. Hannah gave us some amazing 6 and 7 hour nights early on but it was short lived. Lately it's been a struggle to get 4 hours at a time which is not great for my (or Mike's) mental health.
Use leave if you're able
I fully realize that having ~6 months of leave is hard to come by in the US and that my experience is far from the norm. Being able to set work to the side while figuring all this out has been so incredibly helpful, and likely part of the reason why I currently feel a lot better than I did 5 years ago (when I was starting my job). Though I’m a few years too early for paid parental leave in Oregon, I've been able to use my sick time (all of it), a sick leave bank that I've donated to, and short term disability to fund my leave, which is better than nothing (which we would not have been able to swing). There are many, many, many reasons why parental leave is imperative for people with kids, especially leave that's paid and longer than 12 weeks. To me, mental health is such a huge factor in why leave is imperative and why we need better leave policies in this country.