I have had several people ask me lately about what I did the second time around in order to try and head off another bout of PPOCD or PPD. I know how scary it can be to contemplate having another child. My “another child” is turning 5 this Sunday, so in celebration of her birthday I’m sharing what I did to prepare myself for the next baby. I was very fortunate to experience a disorder-free time!

Here is what I did:

1) I chose to continue on my antidepressant while pregnant. There are risks to this. I’m not suggesting it’s the right answer for every person. It was the right answer for me. Another option would be to go ahead and schedule some therapy appointments during the pregnancy and/or right after. Having someone already set up to counsel you and support you could be very helpful, and if you find as you go along that you don’t need the help because you are doing just fine you can always cancel the rest of them.

2) I had a pretty difficult childbirth experience the first time around, at least as far as I was concerned. So when I got to the hospital to deliver baby number two, I told EVERYONE I could get my hands on about it. I told them I had had PPD (I didn’t say PPOCD because they wouldn’t have know what that was, and it didn’t matter anyway). I told them about my previous negative experience in their hospital, not in a blaming way but to let them know why I was so nervous. I was fortunate that from that point on they treated me with kid gloves. They held my hand. They were very soothing. And my husband was there and had enough experience from the first time around to know what to do if they hadn’t. But they did. Their calm and supportive attitude really helped.

3) I made sure everyone knew I needed and wanted help and that they were expected to pitch in for the health and wellness of my entire family. This would be a team effort, so that we could make sure I either didn’t get sick or had plenty of support if I did. I told them that if I started to withdraw or clam up, it would be a sign that something was going on and they shouldn’t accept an “I’m fine”. I was fortunate that everyone was on the same page as far as that was concerned.

4) When it came to breastfeeding, I decided not to try it again. Breastfeeding caused me untold anxiety the first time around, and I felt it was the right thing for me to do to simply choose to bottle feed from the get go. I then set a boundary that no one was allowed to try and influence me or judge me or guilt me or change my mind. I had a ZERO TOLERANCE policy on that. No discussion. Period.

You need to make whatever choice is right for you and will allow you to be healthy and emotionally available for your baby and family. If that means breastfeeding when others want you not to, dammit you should breastfeed. If that means bottle feeding when others think you shouldn’t, dammit you should bottle feed. If breastfeeding didn’t work out the first time but you really want to try it again, do so and make sure in advance to get help from helpful people.

5) I only accepted the best professional help this time around. I went to specialists for PPD and anxiety, rather than waste months like I did the first time with a psychiatrist who was … well … not so good. Ask around. Talk to other survivors in your area. Find out who they recommend. Meet the person ahead of time if you can and tell them you’d like to work with them in case you become ill.

6) Three words: Sleep management plan.

Please know, some people still become ill again even when they do the things I did. It may be because the circumstances in their life are very difficult. It may be that they don’t have enough support. It may be for other reasons. Those who get it again are not at fault, are not to be judged and are not to be looked at as though they didn’t do enough to prevent it. Just know that if it happens again you know have an army of Warrior Moms behind you.

This is simply a list of the things I did, but there are other things as well. How about other readers out there who were fortunate enough not to have a perinatal mood or anxiety disorder on the next go round? What did you do?

Post update: Please read the comments below because there is a lot of great input from other moms and from healthcare professionals who treat women with PPD. Also, I totally forgot to mention Karen Kleiman’s book, written specifically on this topic, called “What Am I Thinking?: Having A Baby After Postpartum Depression” as a good resource for you.