When it's more than just "Mommy Anxiety"

 In a research study conducted by the National Institute of Health, “There are over four million live births each year in the United States. Nearly 800,000 — or 20% — of these mothers will experience an episode of major or minor depression within the first three months postpartum” (Werner, Miller,Osborne Kuzava, Monk,2015). Making depression by far the leading complication of childbirth. Gestational diabetes, something that every woman is screened for in pregnancy, only occurs 3-8% of the time but depression occurs 20% of the time, this is something that we need to be talking about. I don’t know about anyone else but I was shocked when I read that statistic.
​
I’m not even going to pretend that I understand how a mom feels because I don’t. I am not a mother, but I am a woman, and I am a therapist who does understand feelings of guilt, loneliness, and fear of failure. I specialize in women’s issues, anxiety, postpartum depression /anxiety, and eating disorders / body image.  All of which can be concerns for mothers.   It seems, Google may have a pretty good idea of what moms are feeling based on the auto populate screen shot I took.
 

​It is no wonder that moms are feeling so overwhelmed. I have yet to find a more vulnerable time in a woman’s life than when she becomes a mother. A woman’s transition into motherhood is uniquely her own.  It’s a sacred time and should be honored with space made for that kind of transition.
​
 When it comes to postpartum depression and anxiety there is no one cause, but more of a perfect storm situation. After childbirth, a woman’s estrogen and progesterone hormone levels drop quickly.  This leads to a chemical change in her brain that may trigger mood swings.  Most new moms also cannot get the rest they fully need to recover from childbirth and are sleep deprived, which leads to exhaustion and physical discomfort.  Our bodies and our brains need sleep and it is the process of sleep that allows our hormones to regulate, assist our bodies in healing, and assists our brains in consolidating memories. If you have struggled with anxiety and depression pre-pregnancy you are at a greater risk of postpartum depression.

In addition to all of these things, we also seem to be living in a culture of pressure. Our culture places a lot of expectations on people, let alone new mothers.  Pressures like being “Pinterest ready,” whether to go to work or stay at home, how to lose the “baby weight”, whether to breast feed or not are just a few of the pressures that new mothers face from society.
​

​In recent years, the conversation regarding the “baby blues” and postpartum depression has been started, which is great, but we need to include postpartum anxiety in the conversation. I like to describe depression and anxiety as besties; where there is one the other is usually close behind. Our current screening tools for postpartum depression such as Edinburgh Postnatal Depression Scale (EPDS) consistently identifies anxiety as well as depressive symptoms.

Now I don’t know about you, but that all seems very overwhelming and I’m not sleep deprived, experiencing hormonal changes, and trying to keep a small person alive. It’s these changes and expectations that bring about feelings of vulnerability not to mention feelings of overwhelming joy or love. If you are familiar with Brene Brown’s work and her book Daring Greatly she discusses that joy is the most vulnerable feeling one can experience.

When filled with love, adoration, and joy, we also feel the most vulnerable and usually put up our armor to protect ourselves. Joy foreboding and perfectionism are examples of armor we can use. Joy foreboding is when we create narratives and images in our mind of something horrendous happening to those we love. It’s waiting for the other shoe to drop because things just can’t be this good. That feeling of love and joy that is replaced by dread when you watch your child sleep or think about how much you love your partner.

Perfectionism is another armor that we can wear to prevent feeling vulnerable. I describe perfectionism as trying to control the environment around us and the setting of unrealistic expectations. Perfectionism works as an armor against vulnerability by constantly working to control everything around us, so that we don’t have to feel anything like vulnerability or failure. It also creates tension with those we are trying to control and doesn’t leave a lot of room for creativity and exploration. Failure isn’t a bad thing, it is uncomfortable, but it isn’t bad. It is an emotion like any other.
For most of the new moms I have worked with, this fear of something bad happening creates a lot of anxiety that can manifest itself in many ways. For some it can look like difficulty sleeping, constant worry, headaches, catastrophic thinking, fear of driving in the car with their children, fear of children being hurt, compulsive checking on children, concern of leaving children with a sitter or at a day care, conflict in relationships, loneliness, or feeling not good enough.

First off, if you are a mom who identified with this post and the feelings I described, or know and love a mom who is struggling, please go talk to a professional therapist, your OBGYN, or encourage your loved one to talk to a professional. I very much look at the work I do as holding space and that space is unique to every individual. At a minimum, it can be helpful to just talk and say whatever it is you need to say and just be heard.

When I’m talking about letting go of anxiety these are tools that I practice and recommend.

1. Sleep: I have sleep as number 1 because that is exactly where it needs to be. Sleep is crucial to mental health and wellness. If that means the baby needs to be bottle fed then the baby needs to be bottle fed. Your mental health is extremely important. If you are experiencing postpartum depression or anxiety, sleep is crucial for your wellbeing and recovery. ​
2. Gratitude: when you experience joy and find yourself moving quickly into worry and joy foreboding come back to gratitude and what you are grateful for. Brene Brown’s research has shown that those who can feel profound joy tap into their gratefulness.
3. Mindfulness: when we are lost in our worries and anxiety we are not in the present moment. Anxiety lives in future thinking which is loosely where I describe anxiety to live and depression lives in our past thinking / rumination. When we practice mindfulness, we are practicing being present and co-existing with our thoughts instead of controlling them.
4. Positive Self-Talk: it is amazing how quickly we can flip into everything we can’t do or everything we aren’t. Building awareness of how we talk to ourselves will give us an opportunity to replace the negative self-talk (I am so dumb, I am a terrible mom, I am ugly) with positive statements about ourselves (I am worth it, I am beautiful, I am a good mother, I love my baby, I am smart and capable, I am enough).
5. Self-Care: Self-care are the things we do because they bring us joy and for no other reason. For a lot of moms that means asking for support and help from partners, family, friends, or even the sitter. I always suggest starting with 15 minutes of self-care time, that may mean an uninterrupted shower, bath, or time to drink a hot cup of coffee. You can build it up from there.
6. Grounding: in those moments of feeling overwhelmed, a grounding exercise can be very helpful to assist in feeling secure and safe.
7. Therapy: Having an opportunity to talk to someone who is a 3rd party only there to support you and your wellbeing can be powerful. Professionals are exactly that, they are professionals who have expertise and experience in mental health and they can help you build upon your strengths and build new tools so you can improve your overall wellbeing.
8. Medication: I know that this maybe not what you thought about when you where pregnant but taking a prescribed antidepressant from your OBGYN or a psychiatrist may be exactly what you need to do. When I discuss medication with clients I describe it like this: if you are down and you need to be up their is usually a big jump to get you from where you are to where you want to be.That can be a big jump to make with talk therapy alone. Medication can act as an enhancer and aid to cognitive therapy. Medication can also help with my number 1 thing on this list, sleep. If your mind is racing so much that you can’t sleep then you trying to get sleep isn’t going to help much.
9. Journaling: I am a huge fan of journaling. Journaling allows you to get down what is in your mind and get it out. It is another way for us to process information and our emotions​
10. Self-Compassion Letter: A exercise that I love to incorporate both in my own life and with my clients is Compassionate Letter Writing.

If this post resonated with you please help to spread the message and remember: You. Are. Worthy. ​​​