How Can I Help If I Can’t Tell If My Friend or Loved One Is Struggling with Postpartum Depression?

That’s a really good question, especially if the new mom doesn’t even know she has postpartum depression (PPD) and many new moms (I am guilty of this) want to hide the fact that they are struggling because they think that that would be a sign that they’re not as good of a mom as they’d imagined themselves to be.

You just have to trust your instincts, be proactive in looking for signs that the new mom is not herself/extra exhausted and/or just ask her how the new mom is feeling. It can also be tricky, as just because she doesn’t look depressed doesn’t mean she’s not depressed. I’d blogged about that previously here and here.

It can be particularly tricky now with COVID and people not seeing each other face to face, and people wanting to take extra precautions to protect a new mom and her baby from exposure to the virus.

Megan Markle’s interview with Oprah and Huffpost article dated March 18, 2021 titled “How to Tell if a Friend is Struggling with Depression or Anxiety During Pregnancy motivated me to write this blog post. It reminded me how even I made it difficult for people to gauge that I needed help.  For those like me who don’t like to be the center of attention/make a big deal over something that causes embarrassment/want to inconvenience anyone and who want to appear a capable and strong woman and mother, we tend to try to shrug things off and shoulder on. Then there’s also the fact that PPD symptoms are different for different women, which makes it all the more tough to tell if something is wrong.  Heck, even medical/mental health practitioners find it challenging to diagnose a perinatal (during pregnancy and postpartum) mood disorder in many situations. 

Megan admitted she experienced suicidal ideation (thoughts of suicide).  According to a study published in 2020, there has been an increase in suicidal ideation among pregnant women in the United States in recent years.  Although I didn’t really experience suicidal ideation, I did get to the point that I felt the urge to disappear to escape the God-awful combination of feelings and fears that I found myself experiencing. That may have been one step shy of suicidal ideation, and I shiver to think of what could’ve happened had I not gotten medical help when I did! Because I was feeling at the end of my rope. It really was beyond awful.

New mothers struggling with a perinatal mood disorder should focus more on getting better and getting help than on feeling bad they even need help or are struggling.  It would help if everyone realized that depression and anxiety in expectant/new mothers is very common, and they should not feel any shortcomings if they do experience it.  They (and you) need to know that they need to get help if they experience any/combination of these symptoms, because it can go from bad to worse suddenly if they do not see a doctor and help:

  • Persistent and mostly inexplicable sadness/tearfulness and feeling empty inside
  • Loss of interest/pleasure in most of your usual activities; inability to laugh
  • Overall impaired functioning*
  • Sleep difficulties (either insomnia or sleeping too much)
  • Weight loss (usually fairly quick) associated with a decrease in appetite
  • Weight gain associated with an increase in appetite
  • Excessive worrying (e.g., about the baby’s well-being)
  • Difficulty thinking, concentrating or making decisions
  • Feelings of guilt/inadequacy/of being a bad mom
  • Urge to run away/disappear/vanish into thin air
  • Onset of panic attacks
  • Sense of despair and/or hopelessness leading to thoughts of death/suicide

The Huffpost article lists the National Institute of Mental Health website and of course Postpartum Support International (PSI) as helpful resources that list common and unfortunately under-recognized signs.  PSI can also help an expectant/new mother to local support groups/mental health professionals.

It is extremely common for a pregnant/new mom to feel (and look) fatigued.  After all, there are a lot of hormonal changes going on.  But if she is really struggling, seems not her usual self and/or seems much more anxious than they normally are–to the point of not being able to carry out their daily activities and/or are having trouble sleeping—then you should suggest she see someone who works with perinatal (during pregnancy and postpartum) mood disorders.

Here are some ways you can help:

  1. Being aware of perinatal mood disorders (refer to PSI link above).
  2. Frequently check in with her and ask how she is TRULY feeling.
  3. Realize that pregnancy/postpartum is NOT always smooth and happy, so if she is struggling, tell her it’s okay that she doesn’t feel happy and it is of utmost importance that she is doing okay.
  4. Ask her if she needs help (but I would just offer it—for example, just drop off food).  We all know it’s common for neighbors, friends and family to bring over meals for the first few weeks so the new parents don’t have to struggle to put meals together while they are busy caring for the new baby.  I’ve blogged about postpartum help here.  Less common is offering the expectant mom a prepared meal, but doing that especially if you know your loved one is struggling would be a particularly caring thing to do.  Bringing over food/groceries is another way to show you care and during COVID times, these moments of connection (albeit brief and socially distanced) can help stave off loneliness.
  5. Arrange to go on walks regularly with her.  Walking and getting out are extremely important during pregnancy and postpartum weeks.  I wrote about the importance of getting out here.
  6. Last and not least, just be there for her. Give her company so she feels less alone (especially important during COVID times). It doesn’t have to be a long visit. Nor do you have to have a long conversation or do much (which is hard during COVID times anyway). But dropping by a couple times a week (if you’re able), would mean so much. Check out my previous blog post here.

The Huffpost article does mention that “postpartum care in the United States is anemic” but I won’t go into this because this would take up an entire blog post on its own.  I have already written posts about this in the past, such as this one.

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