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How to Talk to Someone Who May Be Suffering from Postpartum Depression

Published in Behavioral Health Services, Birthing Services, Women's Services, OB/GYN Services, Mental Health, For the Health of It Author: Katlin Beckwith, RNC-OB, BSN, Birth Center, St. Cloud

In the United States, up to one in five women suffer from maternal mental health disorders. This illness occurs within the first year after giving birth and varies in length and intensity depending on the person. It is important to recognize if a loved one is experiencing postpartum depression symptoms which may include:

  • Crying more frequently
  • Feeling angry
  • Withdrawing from friends and loved ones
  • Feeling disconnected from baby
  • Worrying about self-harm or harm to baby
  • Feeling guilty
  • Doubting in the ability to care for a child

From my experience as a Birth Center nurse, I find that some moms are not aware of their symptoms, while other moms are aware but may be afraid to speak up because of stigma or the appearance of being needy or inability to cope. For this reason, it’s important to bring up postpartum depression in conversation. When doing so, here are best practices:

Choose the Best Time and Place

Bring up the topic in a setting where the new mom feels safe and comfortable. Take mom outside for a walk or select a time when she is not tending to the baby.

Technology also can be a great tool. If worried you are interrupting something important, send mom a text. She will be able to respond when she has time.

Be prepared to check in frequently as emotions can quickly change — even up to a year or more after delivery. Serious issues tend to last the longest, but family often assumes mom has adjusted after a few months. In the first month, everyone wants to see the baby or offer support but then it fizzles out and parents are left on their own. In our culture, we assume everything will get back to normal quickly and that’s not the case for a lot of people.

Normalize the Conversation

Acknowledge that post-partum depression or maternal mental health issues are common. Don’t tiptoe around the topic because that’s where it gets to be an issue. Remember, it’s OK to talk about the bad parts of having a newborn, too.

Ask the Right Questions

You can start the conversation by asking mom, “How are you feeling today?” “Are you eating and sleeping?” “Are you getting enough help?” “Is there anything you are struggling with?”

Follow up by asking, “Are your expectations of having a baby what you thought they would be? How is it different?” Typically, having a newborn is different than you’d expect. Social media can make motherhood look easy. You’re not often shown the difficult and emotional side of having a new baby.

Open-ended questions can help stimulate the conversation and allow mom to share as much or as little as she chooses. If she doesn’t want to share her personal feelings, you can try introducing the question more frequently. At some point, she may be more willing to open up to you.

If more concerned, directly ask, “I know moms can go through postpartum depression. How are you feeling?” Or say, “People typically start to feel different at this point, are you? Are you feeling any symptoms of depression?” “Are you struggling to connect with your baby? Is Dad struggling to connect with the baby?”

You should be direct with questions if you know that mom has struggled with anxiety or depression in the past. Some women who are taking antianxiety and antidepressants stop when pregnant. When the baby is born, they try to go without it. It’s vital that these moms follow up with their providers to discuss medications taken prior to baby. You should ask, “I know you struggled with this before. How are you handling all these changes now?” “Have you talked to your doctor about how you're feeling?” “Do you need to get back on medication?”

Be an Active Listener

When listening, refrain from judgment. As mom shares her feelings, validate them. Do your homework and research before you have the conversation so you are prepared to offer resources and guidance.

If the issue seems under control, still make a point of checking in frequently, offering your assistance and giving mom a mental break. Let mom know you’re there for her and can help when needed. Keep significant others in the loop. Tell them, “I’ve been noticing that she seems a little bit down. Can you just keep an eye on her? This doesn't seem normal for her.”

If it’s obvious mom wants to hurt her baby or herself, help her make the emergency call. Call or text 988 for help 24 hours a day. Don’t just assume she’ll call for help herself later.

It’s easy to get caught up in the “fun” stuff that goes with a new baby, but as a society we need to make it normal to check on one another and talk about the “hard” stuff. Maybe mom is just waiting for you to ask!