Moms who suffer with postpartum depression and anxiety feel alone.  Almost always.  They feel misunderstood, unseen, isolated and lost.  Moms who suffer with a perinatal mood or anxiety disorder feel, when they sit in my office, like they are in battle all by themselves.

But here is the thing, and perhaps one of the biggest differences between treating postpartum depression and treating generalized depression and anxiety: the moms who sit in my office are not my only clients.  When I treat a mom for symptoms of depression and anxiety, I am also treating the whole family. She is there in the context of all of her relationships: the one with her baby, her other children, her husband/partner, her own parents, her friends and her extended community.   I cannot treat that mom for her symptoms without understanding the deep complexity between her symptoms and the rest of her world.  Postpartum depression is one big tangle of symptoms and relationships and to work with that mom in a bubble simply misses the most complex piece of these illnesses: she is ill at a time when relationships matter most.

There is the mom who feels detached from her baby and worries that she will never love him as she should.  There is the mom who loves her baby so much that she is afraid to ever let her cry or be cared for by others.  There is the mom whose pregnancy was unwanted or unplanned and who feels resentment for the growing belly or the baby who she wants desperately to love but feels anger towards.  There is the mom who feels unable to manage her toddler once the new baby comes or who feels unrelenting guilt about not being able to give enough of herself to anyone.  There is the mom who feels let down by her partner and who wants nothing more than to be understood by the one person she knows best.  There is the mother who feels a new wave of anger toward her own parents for not providing her with what she feels she needed during her own childhood or who are not there to support her now, as she suffers.  There is the mom who feels threatened by her in-laws and whose uncertainty around these relationships is interfering with her marriage.  There is the mom who feels let down by her community of friends during a time when she needs them so much.  For each of these moms, recovery comes not just in the reduction of symptoms, but also in the repair of the relationships that feel so damaged to her.

So how do I do this?  There is attention paid to her definition of a “good enough mother,” her development of confidence with her baby, and work around attachment and bonding.  We invite dads and partners in to discuss missed communication, each others’ needs and expectations, and ways to work together as a team to get mom (and her family) well.  There is talk of new boundaries and shifting relationships with parents and in-laws so that mothers feel comfortable in the changes that occur in these relationships when a baby is born.  There is work done around asking for and receiving support from community so that she feels more connected and less alone.  There are often conversations with those who are important to her (partners, parents, friends, siblings, in-laws) about what postpartum depression and related illnesses are so that the judgment decreases and the understanding and support becomes more tangible.

You have heard it before: Happy mom, happy family.  At times, this statement may feel like an undue amount of pressure that is put on a mother to be well for others.  The way I see it, mom and family are so interrelated during postpartum depression that the many players deserve support and attention in the effort to get mom well.  She cannot do it all alone, nor should she be expected to.

So, moms, if you are suffering and feel alone, know that you are not.  There are others who need you as much as you need others even if there are relationships that may need readjusting and repair.  When you sit in my office, or the office of any other expert in postpartum depression, know that you are being seen both as an individual and also as a part of something much larger than you, even if you may not feel connected to much of anything at the moment.

~ Kate Kripke, LCSW