Postpartum Depression-How To Help

What is PPD?

Postpartum depression (PPD) is a general feeling of sadness, helplessness, or worthlessness occurring at the onset of a birth of a child. It is similar to general depression but is differentiated by the timing that it sets in. PPD occurs in women in the first six weeks of the postnatal period. Men may begin suffering from PPD anywhere from three to six months after the birth of a child.

Signs of PPD and what to expect

The most common signs of PPD are extreme sadness, irritability, mood swings, or general changes in personality. Those close to someone suffering from PPD report an overall change in the person suffering, at times having little in common with their former self. You may not even recognize your loved one while this battle rages in their mind. When PPD hits it hits hard and fast. It comes on like a wave crashing onto the beach.

How you can help

The first step to being able to help is to recognize the symptoms. Once you know what you are dealing with you can being to put these tips into practice.

Be sure to offer love and reassurance to let them know they are not going through this alone. Dealing with a loved one during this difficult time will also require patience and understanding. Try to learn as much as you can about what your loved one is going through. If you can understand what they are going through you will be better suited to help them through it. The best way to do this is by talking to them about what they are feeling. Also, researching as much as possible about PPD will help in understanding what your loved one is going through. When PPD hits it can hit hard and fast. Try not to allow yourself of your loved one to become overwhelmed with emotions. Support of friends and family make this difficult time easier to navigate.

Depression in any form has the ability to nearly incapacitate a person. They may need help just getting out of bed in the morning. While it can be frustrating, staying positive and not allowing yourself to be succumb to the negativity of depression is important in helping your loved one.

Encourage them to exercise, to write down their feelings, even to meditate. Stress and depression often go hand in hand. These three activities will help reduce stress but by no means are the only options available.

Therapy and Medication

These wouldn’t be recommended as a first option but when all other options have been exhausted and relationships are in danger of dissolving, therapy and medication may be the best alternative. Someone suffering from PPD may be reluctant to pursue these options alone. If someone close to them encourages this route that may be enough to convince them to give it a try.

Signs of Perinatal Mood and Anxiety Disorder

Depression has been noted as being the number one complication of pregnancy affecting 15% to 20% of new moms.  Throughout your maternity you are forming life lasting bonds with your baby. Symptoms of Depression and Anxiety can make establishing those bonds very difficult.  Perinatal depression can present itself in many forms.  It can also occur from conception  up to one year after delivery.  Some women may feel an overwhelming feeling of anxiety.  Other may have deep feelings of sadness.  Some women might have fluctuating mood swings.   Women struggling with some sort of perinatal mood or anxiety disorder may experience some of the following symptoms:  
  • Sadness
  • Irritability
  • Crying
  • Feelings of Hopelessness
  • Excessive Worrying
  • Intense Irritability or Anger
  • Loss of Appetite
  • Loss of Interest in Sex
  • Loss of Joy in Life
  • Feelings of Shame, Guilt or Inadequacy
  • Severe Mood Swings
  • Withdrawal from Family and Friends
  • Hallucinations and Delusions
  • Paranoia
  • Confusion or Disorientation
  • Difficulty Bonding with the Baby
  • Thoughts of Harming Yourself or the Baby
  • Attempts to Harm Yourself or the Baby
These symptoms are very serious and are not to be ignored.  With treatment the symptoms will decrease and may even go away completely.   If you are having some of these symptoms it is important that you know that you are not alone, we are here to help.  Take that first step and call now to schedule your first session (786)234-6246.

If you have thoughts of harming yourself or your baby (or if your pregnant/postpartum loved one is exhibiting frightening or bizarre thoughts/behaviors ) call 911 immediately.

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and the psychotherapist walk during their session and incorporate an element of physical activity to the session.  Exercise has been proven to aid in recovery from a host of emotional issues mainly depression and anxiety.  Research has shown  that clients in treatment have higher recovery rates when regular exercise was incorporated into their daily routine.  To Schedule your first session call (786)234-6246.   Start your Nature Immersion Therapy program TODAY!

“Wilderness is not a luxury but a necessity of the human spirit, and is as vital to our lives as water and good bread.”   -Edward Abbey

Anxious All the Time

Moms worry -- it's in our job description. But when normal caution crosses the line it can have serious consequences for our kids.

When Tammy Revia's daughter, Celie, was 9 months old, she had yet to get a cold or a fever, but Revia made a point of keeping her off public playgrounds anyway. She also avoided exposing her baby to children with even the slightest sign of illness and used antibacterial wipes or hand sanitizers before and after touching everything from her cell phone to a supermarket cart to door handles. "Whenever I heard Celie sniffle or sneeze, it took my breath away," says Revia, a nurse from League City, Texas.
Celie isn't immunocompromised or sick. But Revia's first child, Devin, had been born prematurely, and after struggling in the NICU for more than nine months and then finally coming home, he died just before his first birthday. Now she sees danger everywhere: A disinfectant commercial discussing hidden germs makes her heart race, mosquitoes seem like germ-carrying mini missiles, and a bump on Celie's head makes her think subdural hematoma. "When you've been through so much, you're just waiting for the next bad thing to happen," she says.
Many mothers like Revia are struggling with severe anxiety, often triggered by a real health scare that is long gone but has left an imprint on their psyche. For some, it can lead to symptoms of post-traumatic stress disorder (PTSD), traditionally associated with surviving war. But even when it's not that severe, this anxiety can add layers of stress to daily family life and put your child at risk for behavioral problems later.

Deep-Seated Stress

Maternal anxiety isn't necessarily on the rise, but it is getting more attention. "There's a growing recognition that anxiety levels and depression are both high among mothers of young children," says Diane Langkamp, M.D., a developmental and behavioral pediatrician at Akron Children's Hospital, in Ohio. Experts point to rising rates of premature babies who survive the NICU and medical advances that allow children to fully recover from a variety of traumatic illnesses. Parents of preemies, who have lived through the trauma of seeing their tiny infant hooked up to machines and surrounded by extremely sick babies, may have a particularly difficult time shaking their experience. This can lead to nightmares, depression, feeling agitated, and being hypervigilant about their child's health long after he leaves the NICU.
Jamie Klavans went into labor during her 35th week of pregnancy and gave birth to her son, Matthew, who needed emergency surgery on his colon. Over the next 15 months, he had four more surgeries. Though Matthew, now 5, is completely healthy, Klavans fears that he'll end up back in the hospital. "When he was sick as a baby, we were always on the go, and I didn't have time to process anything," says Klavans, of Brookfield, Connecticut. But a late-night trip to the E.R. for croup when Matthew was 22 months old brought back terrible memories and caused Klavans to have bouts of diarrhea. For about six months, she'd wake up in the middle of the night hyperventilating, and she felt anxious when she was alone with her two children. After these scary symptoms, her pediatrician suggested that she might have PTSD; she's been getting help for it ever since.
Sometimes a woman's experience even before having children -- such as a miscarriage, failed IVF treatments, a difficult pregnancy, or the unexpected death of a family member -- can set off anxiety. Moms who have been anxious or depressed in the past or suffered from postpartum depression have a greater risk of being anxious about their children's health, explains Faye Kokotos, M.D., assistant professor of clinical pediatrics at the Children's Hospital at Montefiore Medical Center, in New York City.

Parents' fears and perception of their child inevitably affect the way they treat him. They may coddle him, go overboard to try to shield him from possible pain (both physical and emotional), or avoid disciplining him. This can, in turn, cause a child to develop behavioral issues including separation anxiety that lasts beyond age 5, oppositional behavior, frequent tantrums, hyperactivity, as well as hypochondria, says Dr. Kokotos. This reaction is known as vulnerable child syndrome (VCS). The term was coined in 1964, when researchers discovered that a number of children with behavioral and learning problems also had something else in common -- they'd experienced a serious illness or a life-threatening accident early in life. Even though the children had fully recovered, their parents continued to treat them with kid gloves. That makes the diagnosis somewhat confusing, as it's used to describe a child even though it's caused by a parent's actions -- but experts say VCS is becoming increasingly common.
One way to predict whether a child may develop VCS is if her mother or father overuses the health-care system, says Dr. Kokotos. "The parent frequently brings her child to the doctor or emergency department for minor symptoms or exams that turn out to be normal." It's all part of her perception that her child is vulnerable to physical or behavioral problems.
This was the experience for Melissa, a mom in Larchmont, New York, who asked that her name and that of her daughter be changed to protect their privacy. Her 6-year-old, Maya, had a liver transplant when she was 3 months old and was hospitalized four times during her first year. The immunosuppressant medication that Maya still takes to prevent her body from rejecting the organ makes her highly susceptible to infections. Melissa is justifiably protective, but she also overindulges Maya and cuts her more slack than she does her other daughter. The consequence: "Maya runs the show," admits Melissa. She can be dominant, demanding that the TV be changed to her channel or screaming that she wants to hold the leash when they walk the dog. "My older daughter says I always give in to her," Melissa adds. "But the poor kid has had an endoscopy and a liver biopsy. How can I not let her have what she wants?"
Because these parents assume that any stress on their child could harm her, they tend to discipline ineffectively. They may give in too quickly when she cries or throws a fit. Some moms blame themselves for their child's premature birth or other health problems and try to make up for it in some way, such as indulging her or rarely enforcing rules.
But all children -- whether or not they have health problems -- thrive when they have limits and consistency. "If you're always giving in to your child or not being clear about your expectations for her behavior, then she'll develop more disruptive behaviors," says Dr. Langkamp. Kids learn that they can get what they want and get away with bad behavior, and they'll instinctively take advantage of that, she says.
Tiptoeing around a "delicate" child ultimately works against him, says Rahil Briggs, Psy.D., assistant professor of pediatrics at Albert Einstein College of Medicine, in New York City. "When a child faces fears and challenges, like meeting new people, starting school, or getting a vaccination, she'll begin to develop a sense of mastery and coping skills." But if she isn't given the opportunity to deal with normal, growth-promoting stress, she'll be less able to tolerate frustration or not be as confident in new situations.
A kid may also adopt her parents' fears of germs and illness and start to see herself as somehow frail or vulnerable. A worried mom can unintentionally send the message that every experience is a potential disaster. "If Mom seems nervous every time her child falls down, the child is likely to become nervous when she falls," says Jeffrey L. Brown, M.D., clinical professor of pediatrics at New York Medical College, in Valhalla.

Turning Things Around

If you think you're worrying unnecessarily about the health and safety of your child, talk to your pediatrician. "Consider whether you might be misinterpreting information or overreacting to physical symptoms that aren't especially significant," says Richard J. Shaw, M.D., associate professor of child psychiatry at Stanford University. Your doctor should be able to help you distinguish justifiable concerns from inflated worries. For example, many preemies have a higher risk of illness in their first year of life, but after that it's generally no greater than that of full-term babies. "When talking to anxious parents, I try to point out what's normal about their child, what his strengths are, and how well he's growing and eating," says Dr. Langkamp. If your doctor discusses any type of abnormality in your child, make sure you understand exactly what it means and whether you need to restrict his activity in any way so you don't put unnecessary limits on him.
Try getting perspective on your fears by writing them down, suggests psychologist Tamar Chansky, Ph.D., author of Freeing Yourself From Anxiety. List your worries on the left side of a piece of paper and the facts on the right. For example, if you're concerned that your child will not survive an asthma attack at school, write down the steps you've taken to prevent this (talking to the nurse, having an inhaler in his backpack, for example). For 24/7 worriers, Dr. Chansky suggests devoting five minutes each day to your scariest scenarios and considering the reasons why they're unlikely. During the rest of the day, do your best to push those thoughts away, reminding yourself it's worry-free time.
It also helps to talk to other parents or join a support group. "I don't find much comfort in speaking to friends who haven't been through this," says Tammy Revia. "I want somebody who knows what it's like to have a sick child or who has lost a child." In some cases, partners are the best people to talk to. But couples aren't always on the same page. One of you might be more fearful or overprotective while the other may want to avoid indulging your child. Keep talking to each other about your anxieties and fears and try to come to agreements on your approach to parenting, suggests Dr. Shaw, director of the Pediatric Psychiatry Consultations Service at Lucile Packard Children's Hospital, in Palo Alto, California. If that's not working, you might get help from a professional.
Revia has found comfort in an unexpected place: the very NICU where her son was treated. After more than a decade as a cardiovascular nurse in that same hospital, and on what would have been Devin's fifth birthday, she switched to the neonatal intensive care unit. "I'd stayed in touch with many of his caregivers," she says. "They were like extended family." She's grateful to work with people who understand what she's been through, and she's discovered that it's healing to give other parents the kind of care that she and her son received. Sometimes the monitors' alarms trigger awful memories, but Revia is working through that: "I mentally process the alarms and within seconds I go from overwhelmed to feeling a sense of accomplishment."
Originally published in the June 2013 issue of Parents magazine.
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