Having a baby comes with monumental lifestyle, physical and emotional changes. These changes can be joyous, but they can also be challenging.
For many suffering with PND, it's like any other postnatal symptoms. It's not the result of a poor attitude, nor is it a lack of gratitude. It's not something a woman can ‘snap out of.' PND is a psychological, emotional, physical and spiritual response to the changes, demands, pressures, hopes, dreams, expectations and realities of new motherhood and family life.
The common misconception that women allow themselves to have PND is simply untrue. This only perpetuates the stigma of PND. Sadly, it's the very thing that holds many mothers back from seeking the support they truly need.
Our modern culture also creates challenges for growing families. The lack of ‘village’ support and expectations placed on new mothers makes PND an unfortunately common experience. If you read BellyBelly's article on why parenting is in crisis, it's a sobering explanation as to why PND rates are skyrocketing.
So, as a friend or family member, what can you do?
Here are 8 ways to support a mama with PND:
#1: Encourage Her to Seek Help
If your friend is not already seeking professional support encourage her to reach out. It can be difficult to bring up PND if she has not already acknowledge the possibility, but in the end support is necessary. You can ask her how she is feeling and encourage her to reach out. Remind her that her providers are there to support her and there is no judgment.
If you are unsure how to bring it up, consider mentioning the Edinburgh Postnatal Depression Scale, a self assessment tool for assessing PND risk. As a postnatal doula, I mention this scale to women before they give birth. It's something mothers can do periodically after the baby is born, if they have any concerns.
#2: Practical Support
Depression can mean fatigue, mental exhaustion and everyday tasks feeling impossible. New mothers should be resting, regardless if they have PND — but it is even more necessary if they do have PND. Taking the stress off her typical to-do list might be like lifting a weight off her shoulders.
Tidy the area of her home she rests in most. If it's early in the postnatal period and she is resting in her room, help to keep that space tidy. If she has moved to spending a lot of time in her living or family room, tidy that space. When a new mama doesn't see things that need to be done she is more likely to rest well.
Some women with PND might lose interest in caring about the home. Tidying might not seem necessary for her to rest well but it can still be very beneficial. As she begins treatment and regains interest she will be less likely to feel like she has so much to catch up on. She might also feel less guilt about having let her home go. We know she should not feel guilt, unfortunately many new mamas will.
Suggesting she look into hired help to take the pressure off her to-do list is another idea. It can be hard to accept help sometimes, but hiring a cleaner if finances allow can make a massive difference.
#3: Feed Her and Her Family
Good nutrition is so very important for postnatal healing. Pregnancy takes so much out of a woman's resources, let alone breastfeeding. The baby will get what he or she needs, but nursing mothers need to eat well for their own health.
It's hard to get meals on the table with a newborn. Adding the challenge of PND can make it impossible. Even if a mother is able to get dinner together for her family, she might not eat well herself.
One symptom of PND is appetite changes. Some mothers will simply lose interest in eating. If you know her favorite foods, try to keep her well stocked with them and sit with her for a meal or two. Encourage her to take care of herself. Provide her with nutrient dense snacks that are easy to eat and she can grab without any prep work. Cut fruit, prepared veggies and humus, lactation cookies and nuts are great snacks to keep on hand.
Some studies suggest that increasing omega 3 fatty acid intake can help to prevent and treat PND symptoms. Provide the mother with simple, easy to eat sources of omega 3s. A green salad with salmon is a simple lunch to prepare and is packed with healthy fats. Walnuts, oatmeal with flax seeds, and toast with peanut butter are simple snacks with lots of omega 3s.
#4: Help Her Get Out
When you're experiencing depression, getting outside might feel hard and unappealing. When you have a new baby, getting out the door can be a huge task. So if you have PND, getting out of the house can feel like an impossible feat.
Isolation can make PND worse. But when getting out feels hard, it can be a viscous cycle of isolation and stress. Plan a low stress, baby friendly outing and meet her at her house to help her get ready. Offer to get the baby ready while she dresses herself. Choose an outing without a start time so there is no added stress if baby needs to feed or be changed just as you planned to leave.
Low levels of vitamin D can also make PND symptoms worse, which is likely to a problem for her if she's not been getting out. Going for a walk with mama around her neighborhood or sitting on the back deck with tea can help her get natural vitamin D, good company, exercise and some fresh air. All of those things can help with PND symptoms.
#5: Provide Encouragement and Emotional Support
Being a new mother is challenging. Being a new mother with PND can feel overwhelming. When you are with her, mention how well she is doing. Often, new mothers are not aware that it's impossible to keep everything in order. Unrealistic expectations can add unnecessary stress to an already difficult situation.
Send a text that requires no reply. Mail a card that says you're thinking of her. Remind her that you are there for her and you are an ear whenever she needs it. Do not discount her concerns. If she feels something is hard, then it is hard for her, and she needs that to be acknowledged — not judged.
#6: Be There
Sometimes just having someone nearby can make a world of difference. When you are struggling with negative thoughts and feeling overwhelmed with the tasks of motherhood, just having another adult present can make a world of difference. Offer to come over with no expectation of her acting as a host in any way. Sit with her, eat with her, just be with her.
Offer to drive her or tag along to appointments. A new mother seeking counseling for PND is likely to feel overwhelmed by getting to appointments. Knowing someone is helping her can alleviate some of the stress. It also reinforces that there needs to be no stigma associated with PND treatment.
#7: Watch The Baby So She Can Rest
All new mamas need rest. Unfortunately, PND can bring physical and emotional fatigue to the already sleep deprived new mother. Hold the baby so she can rest, shower or even go read a magazine. A little rest or alone time can help her reset and tackle the rest of her day.
All mothers need to focus on self-care, but mothers with PND need to pay even more attention to it. PND is a real health concern and needs just as much care and attention as any other.
You may like to suggest a postnatal doula, who can help with all of the above things and more. They are truly angels in disguise for new mothers. Government funding for postnatal doulas would make a massive difference to the health and wellbeing of new mothers, as well as save valuable money and resources for our crippled health systems.
#8: Help Her Find Her Village
Though few still live in villages, the saying, “it takes a village to raise a child,” is still very true. Encourage her to reach out for help. If she belongs to a social organisation, a mothers group, church or religious organisation, etc, encourage her to reach out to other members and begin creating that village. If you have a circle of friends that you share, encourage others to reach out and offer a hand.
Offer to go to a new mothers group with her. Host a play date at your home where she feels safe but open to meeting with other mothers. Do not force her, but do present the opportunity to reach out to others.
Even with treatment, healing from PND takes time. As she continues to navigate new motherhood and this added challenge, she is likely to have good days and bad days. Try to be there for both. Remind her that she is not her symptoms, that she is an amazing mother and that in time she will feel better. The support you provide a friend with PND will never be forgotten, even if she is unable to show her appreciation right now.
PND can be mild and short-lasting, or at the other end of the spectrum, it can be acute and potentially life-threatening. If you are supporting a family member or friend who you feel may be at risk of harm, please encourage them to seek professional advice and care.
PND is different from the ‘baby blues’. Read BellyBelly’s article ‘Mood Changes After Birth: The Blues or Depression?’ for more information.