Are you still there? Holding your own hand and looking your suffering in the eye, as we talked about in yesterday’s post on wishing away postpartum depression?

If so, then you are probably ready to add some of the “doing” parts into your recovery process. Yes, the “being” and “doing” is a tricky balance that needs to be considered all along the way. Sometimes you may need to allow yourself to slow down the pace and to acknowledge, once again, where you are and how you are feeling.

We know that perinatal mood and anxiety disorders like postpartum depression are a biopsychosocial challenge for women, meaning that they are most likely caused by disruptions or challenges in a woman’s biology (physiological system), psychology (emotional and psychological system), and social network (including friends, family, and community). Usually, finding wellness requires a look into all of these areas to see where there are strengths and where there are challenges. And these systems are usually somewhat overlapping, like the Olympic Games logo’s circles. There are places where strength in one area might allow for strength in the other, and vice versa. But wellness almost always involves feelings of wholeness in each of these three areas.

So, in my practice I often walk women through each one of these areas in an effort to take inventory, so to speak. We look at where she is grounded and full and also where she is feeling untethered and lacking.

This process looks something like this:

PHYSICAL SELF

What are you doing right now to help your physical body to feel strong? What does your nutrition intake look like? How is your sleep? Are you currently taking medicine for your postpartum depression or anxiety symptoms and, if not, is it important to have a medication evaluation? Are you pushing yourself too hard? Are you engaging in some exercise each day whether it be stretching or walking or other more moderate forms? Are you breathing deeply? Are you drinking plenty of water? Are you getting outside to breathe fresh air and feel the sun on your face?

PSYCHOLOGICAL SELF

Are you meeting yourself where you are or do you need to set more realistic expectations? Are your priorities clear? Are you consumed by the “shoulds” placed on us by society, books, family, and friends, or are you allowing yourself to follow a path that feels right to you? Are you using words of kindness and compassion with yourself or are you using a tone with yourself that is harsh and unsupportive? Are you engaging in thought patterns that are useful and realistic or are you engaging in perfectionist thinking? Do you find yourself thinking in black and white extremes or are you allowing yourself to be open to all that is in between? Are there old family patterns or unresolved family conflict that is interfering with your ability to be present with your baby right now? Do you have a trauma history that is resurfacing and deserves attention? Do you have a number of stress reduction and grounding strategies that are useful in times of chaos or are you feeling ill equipped in this area? Are you currently working with a trained therapist who can help support you and work with you to find new ways of thinking and managing your stress or is it time for you to find one?

SOCIAL SELF

How supported are you? Are you able to ask for help when you need it? Do you have a community of friends, family, neighbors and/or health providers to support you along this journey through postpartum depression? Are you and your partner able to work together during this time of high vulnerability or can you use some support around relationships?

Sometimes it is helpful to see all of this on paper, to create a sort of a table along the way. If this resonates and if you choose to go this route, you might consider a table in which the vertical columns contain the 3 areas of wellness (physical, psychological, and social) and the horizontal columns contain space for strengths and challenges.

I want to reiterate that this is a process that is correlated and, often, requires the help of a trained professional who can work with you to sort through the many layers of your being. Sometimes, sometimes, simply going through this process with intention can help you to feel more empowered and in control of your wellness. Often, this is not the case and unbalanced biochemistry or sleep deprivation is just making it too darn difficult to do what you know that you need to feel better. It is likely that once you find some sense of wholeness and wellness in your physical body (including adequate sleep, nutrition, and balanced biochemistry), the other three areas will be easier to work with. And, usually, when you feel a bit more full in all three areas of holistic health, you will feel happy to great yourself right where you are. And you will find joy in simply “being.”

Kate Kripke, LCSW