Strategies to support postnatal depression
Postnatal depression (PND) can be an overwhelming and isolating experience for many new parents. I have personally experienced how difficult it can be, suffering with postnatal depression as a new mother. I recollect experiencing overwhelming feelings of anxiety, helplessness and hopelessness. Professionally as a midwife and a health visitor, I have also witnessed many mothers struggling with PND, leading to them experiencing a sense of huge isolation. PND can manifest in a range of emotional, physical, and cognitive symptoms, including:
- Emotional Symptoms: Persistent sadness, feelings of hopelessness, irritability, and anxiety.
- Physical Symptoms: Fatigue, difficulty sleeping, and changes in appetite.
- Cognitive Symptoms: Trouble concentrating, feeling overwhelmed, and a sense of disconnection or guilt.
- Social Symptoms: Withdrawal from friends, family, and social activities.
If this is left untreated, it can affect not only you, but also the baby and family dynamics.
From a positive perspective however, you are not alone and there is hope. There are a variety of treatments and approaches that can really help manage and overcome PND. These include therapeutic interventions, self-care strategies, and practical support systems.
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1. Professional Therapy and Counselling
Research highlights that Compassion-Focused Therapy (CFT) is beneficial for managing PND. It offers a unique and powerful approach to recovery by addressing the emotional, cognitive, and social aspects of PND, through self-compassion and mindfulness. Furthermore, CFT helps you cultivate resilience, reduce shame, and develop a healthier mindset toward yourself and your new role as a parent.
Compassion-Focused Therapy (CFT) is a therapeutic approach that integrates cognitive-behavioural therapy (CBT). In the context of postnatal depression, CFT can be particularly beneficial for the following reasons:
- Addressing Self-Criticism: Many individuals experiencing PND feel overwhelmed by self-criticism, guilt, and inadequacy in their role as a parent. CFT helps individuals recognize these unhelpful thoughts and shift toward a more compassionate and understanding internal dialogue. For example, someone might experience self-blame for not being able to “enjoy” motherhood or feel like they’re not “good enough.” CFT helps replace these thoughts with kinder, more realistic self-talk.
- Building Emotional Resilience: CFT teaches individuals how to regulate difficult emotions, like sadness, anger, and fear, in a way that fosters emotional resilience. By cultivating self-compassion, individuals learn how to be kind to themselves in moments of distress, which can be especially important when navigating the challenges of parenthood.
- Reducing Shame and Isolation: Shame is a common experience for those with postnatal depression, and it can contribute to a sense of isolation. CFT encourages people to develop compassion for their struggles, reducing feelings of shame and encouraging individuals to reach out for support, whether from loved ones or healthcare professionals.
- Encouraging a Compassionate Approach to Parenting: When experiencing PND, the pressure of “doing things right” can be overwhelming. CFT helps individuals reframe their thoughts about their parenting and encourages a compassionate, rather than a perfectionistic, approach. This can help reduce the immense pressure placed on new parents and foster a more balanced, relaxed perspective on their parenting journey.
- Creating a Supportive Inner Environment: One of the core principles of CFT is helping individuals build a “compassionate self,” which serves as an internal supportive voice. For those with PND, learning to access this compassionate self can provide comfort and guidance when feelings of sadness or overwhelm arise.
- Mindfulness and Self-Compassion Practices: CFT incorporates mindfulness techniques that encourage individuals to stay present and non-judgmental about their thoughts and emotions. This can be particularly helpful when facing the emotional and physical exhaustion that often accompanies PND. Simple practices like breathing exercises, self-kindness, and self-soothing techniques can help manage moments of intense emotion.
- Improved Relationships: As individuals become more compassionate toward themselves, they are often able to extend more compassion toward others, including their partner, family, and child. This can lead to improved interpersonal relationships, more effective communication, and greater support in managing the challenges of parenthood.
How CFT Benefits Individuals with Postnatal Depression:
- Empowerment: By cultivating self-compassion, you can feel more in control of your emotions and reactions, rather than being overwhelmed by them.
- Enhanced Mental Health: CFT has been shown to be effective in treating a variety of mood disorders, including depression, anxiety, and trauma, by addressing the underlying issues of shame, self-criticism, and emotional dysregulation.
- Practical Tools: CFT provides concrete strategies to help you cope with the unique challenges of new parenthood, such as managing stress, improving self-care, and balancing caregiving with personal well-being.
- Holistic Approach: CFT not only addresses the symptoms of PND but also considers you as a whole, helping you to build a healthier, more compassionate relationship with yourself, others, and the world around you.
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2. Medication
In some cases, antidepressant medication may be necessary to manage the symptoms of PND. It’s important to discuss the risks and benefits with a healthcare provider.
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3. Social Support and Practical Help
Social support is one of the most powerful tools for recovery from PND. A lack of support, or feeling isolated, can worsen symptoms. These strategies can help:
- Building a Support Network: Surrounding yourself with family, friends, or other new parents who can provide emotional support, offer practical help with childcare, and just to listen can be invaluable. Connecting with support groups, both in-person or online, can help you realise that you are not alone in your struggles.
- Help with Household Tasks: New parents often struggle to keep up with household chores, and the pressure to do everything can exacerbate feelings of guilt and inadequacy. Accepting help with cleaning, cooking, or running errands can reduce stress and allow time for self-care.
- Partner Support: It’s essential for your partners to be involved and supportive. Open communication, shared responsibilities, and emotional validation can help you enormously: to feel understood and less overwhelmed.
- Baby Care Help: If possible, alternating with a partner or family member for night time baby care can help you to get some much needed rest. Sleep deprivation worsens the symptoms of PND, so rest is essential for recovery.
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4. Physical Health and Self-Care
Looking after your physical health is an important aspect of managing PND. Physical well-being and emotional health are closely intertwined, so paying attention to these areas can help reduce your symptoms:
- Exercise: Regular physical activity can boost mood by increasing the release of endorphins and serotonin. Activities like walking, yoga, or postnatal fitness classes can also be a gentle way to reconnect with the body after birth.
- Sleep: Sleep deprivation is a major trigger for PND, so getting enough rest is crucial. This might involve accepting help with night time baby care or taking naps during the day. Improving sleep hygiene, such as creating a calming bedtime routine and ensuring a comfortable sleeping environment, can also help.
- Nutrition: A balanced diet rich in nutrients supports both your physical and mental health. Omega-3 fatty acids (found in fatty fish, walnuts, and flaxseeds), whole grains, vegetables, and lean proteins will help to regulate your mood and energy levels. Avoiding excessive caffeine or sugar can help stabilize mood and reduce anxiety.
- Relaxation and Mindfulness: Practicing mindfulness, deep breathing, or meditation can help reduce stress and increase your emotional well-being. Mindfulness will help you to stay grounded in the present moment rather than getting lost in negative thoughts or anxieties.
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5. Restoring a Sense of Control and Purpose
PND often makes individuals feel powerless, isolated, or disconnected from their pre-pregnancy self. Rebuilding a sense of control and purpose can help improve self-esteem and emotional health.
- Setting Small Goals: Setting manageable daily goals—such as getting dressed, taking a walk, or eating a healthy meal—can help boost confidence and combat your feelings of being overwhelmed.
- Self-Compassion: Many individuals with PND are hard on themselves, feeling guilt or shame for not “enjoying” motherhood. Learning to practice self-compassion and accepting that it’s okay to struggle can help reduce feelings of inadequacy. Talking to yourself kindly and seeking support is crucial.
- Rediscovering Enjoyable Activities: Gradually returning to hobbies or interests that once brought you joy, whether it’s reading, cooking, or engaging in creative activities, can help you re-establish a sense of personal identity outside of parenthood.
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6. Psychosocial Factors and Trauma-Informed Care
For some individuals, postnatal depression may be linked to past trauma (e.g., childhood abuse, previous mental health struggles, or a difficult childbirth experience). In these cases, it’s important to address your trauma through receiving the most appropriate psychological support.
Postnatal depression is a serious and complex condition, but with the right interventions and support, recovery is possible. It’s important to understand that healing from PND takes time and that seeking professional help is a critical step in the journey. Combining therapy, medication, self-care, social support, and physical health strategies can significantly improve your mental well-being. Remember, experiencing PND does not reflect your worth as a parent or individual; it is an illness that can be managed and treated. Reaching out for help and accepting support is an essential first step towards your recovery.