Kate Kripke

Kate Kripke is a Licensed Clinical Social Worker (LCSW) specializing in the prevention and treatment of perinatal mood and anxiety disorders. She is also a Colorado state coordinator for Postpartum Support International. Kate lives in Boulder with her husband and two daughters and writes an eponymous blog.

To The Postpartum Depression Moms Suffering In Silence

By Kate Kripke March 20, 2012

Too often lately, I have had moms calling my office in desperate need of postpartum depression support ten or 12 months after giving birth to their little ones. This is not at all uncommon, but I have been introduced to an increasing number of these women in the last few weeks, and so I am drawn to tell you about them today.

These are not the moms who felt good for the first seven or eight months only to be hit full force with symptoms of postpartum depression or anxiety upon weaning or when menstruating for the first time. These are the moms who have been struggling on and off for months and who have waited until a breaking point to reach out. What all these moms tell me is this: “I am so ashamed to be needing help like this, but I just can’t take it any more.”

These are the moms who, to the outside world, seem to be doing just fine. They pull themselves out of bed in the morning, have their showers, and pull on a clean set of clothes in order to impress others in their lives while, inside, they feel like complete impostors. They feel good enough to hold conversations, smile at the check-out clerk, and return emails but find themselves in the fetal position when no one is looking. These are the moms who feel terrible for several days and then feel better the next and so they tell themselves that they must be fine until they are hit, again, by several days of near intolerable suffering (once again, behind closed doors). These are the moms who are afraid to let their partners know the depths of their despair for fear of judgment by the people who are supposed to know them the best. Yes. I worry about these moms. A lot. [Read more...]

March 20, 2012 9:30 am Filed Under: Postpartum Depression

Getting Rid of the Guilt After Postpartum Depression

By Kate Kripke March 6, 2012

We have all felt it at one time or another: Guilt. It is a word that you will find everywhere in almost anything that is written to, for, or about motherhood. “Mommy-guilt” they call it. “It is just part of the game,” I have heard people say. Bloggers, journalists, TV writers say all the time that motherhood simply comes with guilt. Moms feel guilty that they can’t give enough, do enough, and be enough to everyone who needs them all of the time.

Okay, so if moms who are functioning to capacity feel guilt, what about the mom who has struggled with a postpartum mood disorder like postpartum depression? Sure, these moms feel guilty about not having the energy to play as they imagined. They feel guilty for being irritable towards their spouse, partner, baby, or children. They feel guilty that they haven’t done the laundry in weeks and the house is a mess. They feel guilty that they have not returned phone calls and emails, or sent thank you notes. They feel guilty that they are serving frozen pizza and mac-n-cheese instead of the home cooked meals that they imagined. They feel guilty for getting an epidural, or not breastfeeding, nor not enjoying teeny tiny diapers at 3am. They feel guilty for wanting to go back to work. Or for wanting to stay at home. They feel guilty for not wanting to have sex. For wanting to take breaks. For taking breaks. And for wanting and needing childcare support. But on top of all of these “shortcomings” moms with postpartum depression feel guilty that they aren’t meeting societal norms about motherhood. In their deepest and darkest places they feel guilt about being so miserable at a time when moms are told that they “should” feel unmatched joy, bonding, and enlightenment in motherhood. And for moms with PPD, guilt is a symptom that is often the last to be remedied.

That’s a lot of guilt. [Read more...]

March 6, 2012 10:04 am Filed Under: Postpartum Depression

How Does Psychotherapy for Postpartum Depression Work, Anyway?

By Kate Kripke February 23, 2012

P.S. They really don't make you lay down on a couch.

Whether you’re considering or getting therapy for postpartum depression or any other mental health issue, you’re going to love this clear explanation of how psychotherapy works and why it helps from Kate Kripke:

Lately in my office I have been having a very scientific and detailed conversation with folks about how psychotherapy works for women with antenatal or postpartum depression and anxiety. I mean how it REALLY works, inside the brain. As many of you can relate, a large percentage of the new moms who come to my therapy practice have never been in therapy before. Although these women may have had symptoms of anxiety or depression in the past, they have been able to manage their symptoms through exercise, managing expectations, ensuring (apparent) control, and other coping behaviors. And now, with a baby in hand, these strategies no longer work and they find themselves in the last place they expected themselves to be after giving birth: my office.

Because this setting is so unexpected and never before experienced, many of these women enter our work together doubting the process. Does therapy really work? What is the point of talking about how I am feeling? Is it really going to get me somewhere? [Read more...]

February 23, 2012 9:20 am Filed Under: Postpartum Depression, Psychotherapy

When Relationships Worsen After Mothers Recover From Postpartum Depression

By Kate Kripke February 8, 2012

The women who I see in my office constantly amaze me. These women work hard. They ask themselves difficult questions and do their best to uncover the answers that resonate most for them. They face their fears head-on. They exemplify a braveness that comes from a desire to get well. And they do. So often, the women who leave my office for the last time after months of suffering, hard work, and recovery do so with a new sense of self that feels stronger, more clear, and more deserving than before postpartum depression or anxiety walked, uninvited, through their doors. Many of these women will continue to work with a therapist throughout their lifetime. Yet, even for these women, there comes a time when their suffering decreases or no longer exists and when the crisis phase of their work is over.

This new self feels hopeful, and optimistic, and at ease. For many of them.

For these women, now it is time to celebrate, time to realize that being a mom feels more “right” than “wrong”. Time to celebrate a sky that looks more blue. Time to get to know a sense of self that feels more forgiving and human. And a time to (dare we say it?) be happy.

And yet, lately, I have seen a number of these moms back again only weeks after leaving my office for that final session. Understand, these moms are not back because their postpartum depression symptoms have returned so soon after realizing that they feel better, although this is something that almost every mom fears. These women are back because something unexpected has resulted from their new, emerging self: their relationships with their partners have seemed to unravel. [Read more...]

February 8, 2012 12:18 pm Filed Under: Postpartum Depression

9 Ways To Beat Back The Winter Blues For Moms With Postpartum Depression

By Kate Kripke January 30, 2012

If you recognized yourself in my story about winter blues, seasonal affective disorder and postpartum depression this weekend, then my goal is to be able to offer you some hope. Here are nine things that can help you fight against seasonal depression in winter:

1. If you do see sunlight, try to get outside, even if for only a few moments. We do know that vitamin D and sunlight can lift the winter blues and so if you see it, I encourage you to pocket some of it if you can. Or, if it is too cold to be outside, stand or sit by a window and soak up whatever rays are available to you.

2. Consider a way to get movement and exercise while at home. Yoga or exercise DVDs can be a great way to bring your movement home to you. Or dance! A mom who I have been seeing in my office uses the long winter months to turn up the music that she loves and boogie with her baby. If they are little enough they might just love the movement, too. And watching you may just be the entertainment that your little one needs! Plus exercise can help with your postpartum depression, too. [Read more...]

January 30, 2012 2:19 pm Filed Under: Postpartum Depression

Winter Blues: What You Need To Know About Seasonal Affective Disorder And PPD

By Kate Kripke January 27, 2012

On seasonal affective disorder, what the symptoms of SAD are, and how it may impact moms with postpartum depression …

It has taken me a while to get this post to all of you. Each time that I have tried to sit down and put thought and experience onto paper, I have felt stumped by lacking creativity. Perhaps it is the transition back from the holidays, I have wondered. Or the demands of a developing tw0-and-a-half-year-old. Or a busy practice and paperwork on my desk. Or the driving desire to get out of my office and release some steam outside only to be reminded that it is wet and gray and too cold out there for my running preference.

Or, as Katherine reminded me, it might just be that it is the middle of winter.

Winter. It can be a tough time for all of us. The days get shorter and colder, the weather often chaotic, the roads sometimes dangerous, the gas bills go up. Fresh fruits and vegetables can be harder to find and usually become more expensive in these long months. Runny noses abound and the flu seems to be around every corner. The air gets drier, our skin cracks, and we often are not drinking enough water. Children tend to go stir crazy when the playtime outdoors is limited. And, if we do attempt to get those little ones outside, the efforts at managing struggling kiddos into appropriate layers can feel for naught when red-cheeked toddlers decide that they are cold and wet after only a few minutes of play.

Winter tends to be a time when our neighbors are rarely seen, when communities are harder to access, and when we find ourselves spending more time at home. We tend to loose our patience more. We tend to have a harder time concentrating. We often have less energy. We feel less creative. We might, even, suffer from a bit of Seasonal Affective Disorder. [Read more...]

January 27, 2012 5:18 pm Filed Under: Postpartum Depression

An Explanation of Suicidal Thinking In Plain Mama English

By Kate Kripke December 19, 2011

Last week, Katherine received the following question from a Warrior Mom:

What is considered a “suicidal” thought, ideation or gesture? I remember being asked by my physician if I was having suicidal thoughts and I honestly didn’t know if I should say yes or no. I wasn’t making plans in my head on killing myself when I was in the deepest of depression, but I was having fleeting weird thoughts about things like “what would it be like to throw myself down the stairs?” and “my family would be so much better off without me here because I cause them so much stress”, etc. There were many days that I know I just kept holding on because my baby needed me and loved me and I couldn’t bear the thought of leaving him. But was this considered being suicidal? I honestly still don’t know. When you look up “suicidal thoughts” on medical websites, there’s no plain mama English description on what this could be, it is focused on the emergent and description of planning and/or acting on these plans to try to kill yourself. I figure other moms out there may be just as clueless as I am and it could be useful to have a plain mama description of this so we know if we should say yes or no to that scary question from our doc.

It is a terrifying place to be when the thought of suicide or harming yourself comes into your head. Moms who suffer from postpartum depression do not always go to this place even though they may be suffering greatly. But those who do are usually dealt an additional level of uncertainty and fear: Does this mean that I am really crazy? Will I be locked up for these thoughts that I am having? Will my baby be taken away? Will anyone even notice if I am no longer here? Usually, for these moms, the thought of harm and/or suicide comes from one of two places: either the belief that her family will be better off without her or the feeling that she is in so much pain that she can’t go on.

And, there is of course a spectrum with respect to the nature of these thoughts. There are the moms who are in such distress that they have fleeting thoughts of wanting to escape it all. There are the moms who have fleeting thoughts about putting themselves in harm’s way. There are the moms who know that, despite their thoughts, they would never choose to follow through with these actions. There are the moms who wonder if they might follow through if things get bad enough. There are the moms who have a plan about what they would do to hurt themselves. And there are the moms who have already made a commitment to do so.

So, as for the question above: What, in “plain mama English” is suicidal thinking?

Technically speaking, a mom is having “suicidal thoughts” if and when she begins to think about hurting herself and/or ending her life. These thoughts are, indeed, red flags and a very necessary reason to seek out help. It is true that not every mom with postpartum depression having these thoughts will act them out, but any time that the thoughts occur, those of us in the field of postpartum depression treatment and mental health will pay attention and note that a mom is really, really suffering. In my practice, any time a mom talks about having had thoughts like this I put my “medication talk” in a whole new category – medications are a very important part of treatment for moderate to severe cases of postpartum depression and are usually a relatively quick way to reduce symptoms. My lead towards medication in these instances are NOT because I think these moms are “crazy” or “insane” or “unfit” to be moms, but rather because I know from their thoughts that they are suffering greatly, and I simply don’t want them to have to struggle like that.

Clinically, a “suicide assessment” has to be done any time that a mom discloses that she is having thoughts of hurting herself or ending her life. When moms, like the one above, disclose these thoughts and then assure me that they have no intention of following through, I will make a verbal commitment with them that they will let me know if they do begin to think seriously about acting upon these thoughts or if these “thoughts” become “urges” (meaning that they are being drawn by an impulse to act upon their thoughts). And, if they are not already, I will let them know that I think medication treatment is imperative. For moms who have a plan or who fear that they really may put themselves in harms way, hospitalization is a necessary part of her treatment simply in order to get her immediate relief and to protect her.

The Mayo Clinic lists the following as “warning signs” for suicidal thinking:

Talking about suicide, including making such statements as “I’m going to kill myself,” “I wish I was dead” or “I wish I hadn’t been born”
Getting the means to commit suicide, such as getting a gun or stockpiling pills
Withdrawing from social contact and wanting to be left alone
Having mood swings, such as being emotionally high one day and deeply discouraged the next
Being preoccupied with death, dying or violence
Feeling trapped or hopeless about a situation
Increased use of alcohol or drugs
Changing normal routine, including eating or sleeping patterns
Doing risky or self-destructive things, such as using drugs or driving recklessly
Giving away belongings or getting affairs in order
Saying goodbye to people as if they won’t be seen again
Developing personality changes, such as becoming very outgoing after being shy

Any time a mom with postpartum depression is struggling with the above symptoms, it is absolutely important for her to reach out for appropriate support, even if it is hard to do so. In fact, acknowledging suicidal thoughts, answering, “yes” to the question “are you having suicidal thoughts” and being honest with yourself and others is usually the hardest part. But please, please know that you do not need to suffer in this way. Even if you have gotten very used to doing so. You owe it to yourself to live your life without these (even fleeting) thoughts or fears. And your babies and families do need you.

~ Kate Kripke, LCSW

December 19, 2011 9:04 am Filed Under: Postpartum Depression

Having A Baby After Infant Loss: The Complicated Mix of Grief & Joy

By Kate Kripke December 15, 2011

The loss of a baby — whether it be through miscarriage, childbirth, neonatally, SIDS, the heart-wrenching decision to end a pregnancy due to issues discovered through early screening, or any other reason — is without doubt one of the most painful and traumatic experiences to endure. The process of attempting to make sense of this catastrophe is complicated and layered and it leaves most women with uncertain and raw emotion that is not easily understood. I work with many women through their grief and eventual healing once a baby has passed, and while these women would give anything to have their babies with them in the ways that they had dreamed, they are usually aware and accepting of their own need for support during this impossibly difficult time.

But what about those women who go on to have healthy babies after losing a child? Are they finally happy and content and able to “move on” now that they have brought their babies home? Many people think this should be so … but in reality, a large number of these women are hit hard with a depression or anxiety that is unwanted, unwelcome, and unexpected when the new baby arrives. And because these emotions are occurring at a time when these women want so desperately to be happy and connected to their babies, feelings of guilt, shame and insecurity abound. [Read more...]

December 15, 2011 9:30 am Filed Under: Postpartum Depression

Love In The Time of Postpartum Depression

By Kate Kripke November 30, 2011

Is it possible to love your baby and simply NOT love the logistics that go into having a newborn? Yes. Yes. And Yes.

This is, perhaps, the myth that is most voiced and de-bunked early on in my work with new moms. Moms who are struggling with postpartum depression feel so much guilt for not being well. They judge themselves up and down and around the block for dreading the night time feedings, for questioning whether or not they “should have done this,” for feeling claustrophobic when holding their babies all day, for not enjoying breast feeding, and for wanting – more than anything – a full night’s sleep. Each mom who comes to see me for support postpartum is afraid, at least initially, that I will think she is not cut out for motherhood and that she is a “bad mom” for not loving the early weeks and months to pieces.

[Read more...]

November 30, 2011 1:25 pm Filed Under: Postpartum Depression