talking about postpartum depression

If you think a new mom may have PPD, what should you say, if anything?

Scenario #1: You are at the playground with your toddler, and you overhear a pregnant mom talking about how sad and anxious she has been feeling.  In her conversation to another woman, she mentions that she doesn’t know what to do about her increasing sadness.

Scenario #2: Your neighbor, who you do not know extremely well, has just returned from the hospital with her newborn.  Like so many brand new mamas, she looks tired and worn.  You ask her how her birth was, and she gets tearful as she talks about her traumatic and unexpected emergency C-Section experience that left her baby in the NICU for seven days.

Scenario #3: Your childhood friend has a pregnant friend who is in the middle of a divorce and custody battle over her two older children.  Your childhood friend, not yet a mother herself, mentions how worried she is about this pregnant mom.

Scenario #4: You are at the grocery store, and overhear two moms talking.  One of them is anxiously noting all of the things that worry her about being a mom- the risk of limitless danger that can potential come to her little one.  She mentions choking hazards, air quality, radiation from technology and pesticides.  You overhear her talk about how badly she needs a break but how she trusts no one to help her with her baby.  By the end of this short conversation, this mom is sobbing, and no amount of reassurance from her friend seems to help.

Scenario #5: A colleague from work has recently told you that she is pregnant.  She is overjoyed.  She also mentions that she has taken herself off of her medication for a bipolar disorder that she has managed since her late teenage years.

If confronted with any of these situations, should you step in and share what you know about PPD? Do you share your own experience, even if uninvited?

Whether or not to start a conversation about postpartum mood and anxiety disorders like PPD is such a great dilemma as it speaks to a number of issues that I know recovering and recovered Warrior Moms contemplate: Is it okay for me to talk to other moms about postpartum depression and anxiety?  How do I talk to others about these issues without assuming that their experience will be exactly like mine?  How do I stay away from contributing to fear?  What kind of words do I use and when are the appropriate times to reach out?  What if that mom gets angry with me for speaking up about the potential for PPD?  What can I do now, as a Warrior Mom, that will give back to the larger community of women who struggle?

There is, of course, no textbook answer to these questions; no shoulds and shouldn’ts about whether or not to initiate a conversation with other moms about what you now know about PPD.  But in light of bringing some clarity to the confusion about this, I offer the following suggestions and things to consider

1. How well do you know the mom who is struggling?  If you don’t know her at all, do you know someone who she knows who you can educate and inform?  Sometimes this information is simply best heard from someone who a mom trusts, and so seeking out these people can be helpful.
2. What is the setting?  A busy playground with many other moms may not be the most appropriate place to approach someone about the risks of PPD.  But if you are alone in a park and see someone struggling, it may be that a supportive ear is just what that mama needs in the moment. 
3. Being careful about assumption is hugely important.  Talking about your experience specifically may be helpful, but is also useful to speak about women in general and the larger picture of PPD.  Using words like “many women” and “moms with newborns” will probably cause less defensiveness than using “you.”
4. How far away from your own experience are you?  If you are still struggling through your own PPD and are easily triggered, it is best to wait.  Sometimes hearing another mom’s story about anxiety, scary thoughts, or deep distress can aggravate yours, and protecting your own health is first and foremost.
5. It is important to remember that when someone gets angry at your efforts, it does not necessarily mean that she doesn’t need, or appreciate, your support and information.  In fact, we are often most defensive when we are also most insecure.  If you are worried about another mom’s safety or the wellbeing of her children, it is always okay to attempt to support her and/or reach out to others who may be able to do so.  Using respectful and appropriate words is important as is staying away from assumption.  But it is better to reach out and be wrong in a moment of crisis than to step away for fear of making someone angry.
6. Have you done your homework?  If you are going to approach someone about PPD, it is important that you know your facts.  Giving correct information about the risk factors, warning signs, treatment options and more is imperative if you are going to attempt to pass along this information at all. 
7. Do you have any resources to pass along?  While validation and support is super helpful at a time of distress, so is information about where to go for support.  Knowing ahead of time about a direction to point a mom in is important, whether that is toward on-line support like Postpartum Progress or local support in your area.
8. When and if you do decide to talk to a mom about PPD, it is important that you let her know that struggling with postpartum depression is not her fault and that with support she will feel better.  Providing hope is imperative. 
9. When you make yourself available to moms for this discussion, you may find that you need support for yourself afterwards.  It can be hard, and often draining, to spend time talking with a mom who is in distress, and so making sure that you are able to fill yourself back up afterwards is hugely important.  Having a friend, partner, or therapist to support you around whatever comes up for you in that conversation is something to think about.
10. Reaching out to moms who are struggling with PPD is sometimes best done by reaching out to the larger community. If you are a Warrior Mom who wants to give back and be a support to others, there are limitless ways to do that.  Can you write an article for your local paper?  Contribute a blog post?  Give a talk at a local moms group or community center about PPD?  Reducing stigma and increasing awareness about postpartum mood and anxiety disorders is a team effort, and we need you.

~ Kate Kripke, LCSW

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