An ounce of prevention

Sitting in a circle, surrounded by other pregnant couples, Samantha and her husband sat quietly.

“Irritability, sadness, guilt, exhaustion,” a childbirth educator at their birthing class described the symptoms of postpartum depression. The list continued, but Samantha was only half listening.

“How could I ever get postpartum depression?” she asked herself. Samantha overcame a rough first trimester, but now in her seventh month, she felt great. “That won’t be me,” she thought confidently.

Unfortunately, many couples experience a kind of magical thinking when it comes to unpleasant possibilities following the birth of a child. They hope that by not thinking about it, postpartum depression won’t happen to them. And yet, one in five postpartum women experiences a mood disorder more serious than the baby blues, such as postpartum. The term “postpartum depression” is an umbrella term that includes depression, anxiety, panic disorder, and obsessive compulsive disorder following the birth of a child. Symptoms can be mild to severe. So, while it’s startling to hear how common these illnesses are, it’s more shocking to know how often they go undiagnosed. More than half of women suffering do not get treated. All too many women suffer in silence, either because of shame and stigma, or ignorance as to the symptoms and treatment available. So looking around her birthing class, Samantha was surely seeing one if not more future sufferers. Maybe it would even be her.

In her memoir of her experience with postpartum depression, “Down Came the Rain,” Brooke Shields wrote, “if I had been better informed, I might not have considered myself candidate [for postpartum depression disorder], but at least I would have been armed with some important information. I recognized early on that something was wrong and that I was able to find help. I hate to think about the women who endure this type of depression for long periods of time without knowing that there is assistance available.”

The good news is that the disorder is extremely treatable, particularly when therapy or medication are started early. Therapists and doctors who specialize in working with new moms are well worth seeking out, as they understand the unique needs of postpartum women. Associations such as Postpartum Support International (www.postpartum.net), and the Postpartum Resource Center of New York (www.postpartumny.org), are excellent sources of information about where to go for help.

And yet, as a therapist who treats pregnant women, as well as new moms with the disorder, I’m sometimes asked if there are ways to prevent it. While I can offer no magic bullet, there are definitely ways to minimize the risk of experiencing it. And the best part about taking these steps? You’ll also be making the transition to parenthood much easier by preparing yourself and your partner for the huge changes ahead.

Here are six things you can do before and after baby arrives:

• Line up as much postpartum support as you need, and then some. I tell my pregnant clients to prepare as if they were having twins. Somehow the idea of having two babies really motivates parents! Get family, friends, neighbors, postpartum doulas — and anyone else you can think of — ready to help you with chores and caring for the baby in the first months. There is no such thing as too much help, and certainly no shame in accepting it.

• Schedule a mental health “check up.” If you have a history of depression or anxiety, schedule a session with a therapist or psychiatrist before the baby arrives to discuss a postpartum plan in case of a relapse. Talk about what worked best to overcome the depression or anxiety the last time you got treatment and look at ways to incorporate these tactics after you give birth. It can be a huge relief to know you have a plan prepared in advance, just in case. Early intervention also results in a faster recovery, should postpartum occur, so don’t wait to get help.

• Don’t isolate yourself. Many new parents are surprised at how lonely and isolating it can be when you have a baby. This is particularly true if you are the first among your friends to have a baby, or if you live far from family. The internet can be a real lifeline for new parents looking to avoid isolation. Sign up for one of the local Yahoo parenting groups in your neighborhood (groups.yahoo.com) to find out news and information about parent gatherings. Look for new parent support groups and “baby and me” classes at the library, religious center, or baby gym, all great places to meet other parents. The sooner you develop a network of other new parents to commiserate with, the more connected you’ll feel.

• Nurture yourself with quality, nutritious foods. New parents are sleep deprived as a rule, and most don’t have time to cook or eat elaborate meals. Oftentimes, they end up relying on caffeine and unhealthy snacks as a crutch. Caffeine can seriously exacerbate anxious feelings and sharp spikes in blood sugar can contribute to moodiness. Make sure you have healthy, quick meals, and snacks on hand and minimize or avoid caffeine altogether.

• Begin gentle exercise once you get medical clearance. Exercise has been shown to be as effective as antidepressants in some studies. Once you get the green light from your healthcare provider, begin gentle exercises, outside if possible. Sunshine and fresh air are great mood boosters as well. Note: if you are prone to panic attacks, avoid strenuous exercise, which can trigger an attack.

• Put off big life changes. Stress is a postpartum risk factor, so try to avoid major life stressors, such as changing jobs or moving, until you get settled as a family, if at all possible.

But even with all the preparation possible, some women will still fall victim to postpartum depression through absolutely no fault of their own. Stress, isolation, and fatigue are all contributing factors, but so is biology or a family history of depression and anxiety, which is completely out of our control. However, armed with the knowledge of where to go and what to do, new parents can get treated and go on to experience the joy they always hoped a child would bring. By seeking help early, new moms can give themselves and their new baby the best gift of all: a happy, healthy parent.

Olivia Bergeron, is a licensed clinical social worker and the founder of Mommy Groove Therapy & Support (MommyGroove.com). She is a psychotherapist who specializes in helping parents — particularly moms — to become less anxious and depressed, and more confident, so that they can best enjoy their children and families. She has an office in Park Slope, Brooklyn, and makes home visits for clients in Manhattan and Brooklyn. She lives in New York City with her husband, daughter, and twin sons. She can be reached at (917) 397–0323 or at Olivia@mommygroove.com.