All women who have recently had a baby go through hormonal changes. (Moms, you remember the random times you’d just break into tears out of nowhere, right?) Then there are moms who have a rougher time with the baby blues or struggling with postpartum depression (PPD). As a friend, how can you support a mom going through PPD?
FOUR STEPS FOR SUPPORTING A FRIEND
Lauren Taff with Taylor Counseling Group says:
1. Recognize the signs of a deeper problem, then see if you can put yourself in your friend’s shoes.
“Depression comes in many forms, and it’s not just sadness and crying spells,” she says. “Your friend may be experiencing intense anxiety, obsessive thoughts, apathy toward their baby, irritability, indifference toward their own self-care [and so on]. In addition, shame and guilt often accompany the already heavy burden of depression. Many women will wonder why they’re feeling so sad, and then beat themselves up for feeling that way. They feel broken, like something is wrong with them. They feel isolated, like no one could possibly help them or understand what they are going through. Ask yourself, how would you want to be treated if you were feeling that way?”
2. Let your friend express their feelings however they need to. That could be just sitting with them while they cry, or simply watching a movie together in silence. Being there for them and reminding them that you’ll make time for them can be enough.
And if you make a promise to your friend with PPD, follow through. “The broken promise of saying you will help and then not helping is worse than not helping at all,” Taff shares.
3. Consider reminding your friend that PPD is a medical condition that she has developed by no fault of her own. “She doesn’t need to blame herself for ‘thinking bad thoughts’ or for ‘being sad all the time.’” It wouldn’t be a bad idea to also revisit Maslow’s Hierarchy of Needs—meeting your friend’s needs in a specific order: psychological, safety, love and belonging, esteem and, finally, self-actualization.
4. To take it a step further, Taff says she often talks about cognitive distortions with her clients.
“Cognitive distortions are negative ways of thinking that cause people significant distress,” she explains. “Cognitive distortions can change a person’s positive self-talk into negative self-talk in a matter of seconds. One of the most common cognitive distortions that people experience is the distortion of ‘should or must.’ People often place a lot of pressure on themselves when their self-talk consists of ‘You should’ve done that’ or ‘I must do this. If I don’t do this, then I’m not good enough.’
The distortion of ‘should or must’ can cause a person who is not clinically depressed to begin to feel ashamed, sad or depressed. When a person is clinically depressed, whether that is a result of major depressive disorder or postpartum depression, the cognitive distortion of ‘should or must’ can be amped 100%.”
Sure, all moms feel some guilt: the normal, everyday “shoulds” moms place on themselves. But imagine now that the intensity of that guilt is 10 times worse. Taff says that amped-up guilt is what a mom who is suffering from PPD feels like. “The hard part is, realistically, she has nothing to feel guilty about because PPD is nobody’s fault,” Taff notes.
STARTING A CONVERSATION ABOUT POSTPARTUM DEPRESSION
Worried about starting this conversation with your friend? Taff says it’s always better to offer to have a conversation than to not say anything at all.
“However, offer to have the conversation and then respect your friend’s decision,” she adds. “Some people really crave the ability to share all they are feeling, while others will just want to avoid the topic altogether. If they don’t want to talk, then don’t talk. Even if you have the best intentions, pressuring someone to talk will not make them feel supported.”
And how should you start that conversation? Try starting with telling that person how much you care for them. “The use of ‘I’ statements come in handy here,” Taff says.
Some examples of conversation starters could be:
- “I really care about you and I think you are such a great mom. I’ve noticed you mentioned that things are really hard right now. I’d love to talk with you about whatever is going on.”
- “I’ve noticed that you seem to be tearing up when we talk. Is everything ok with you?”
- “How are you doing now that you are a (first time, second time, third time, etc.) mom? I’ve noticed that some of my other friends really started struggling at this point in time postpartum. I wanted to check-in and see how you are doing.”
Before entering into any conversation, Taff adds that it’s good to check the nature of your relationship with this person as well. For example, if you’re really close and have talked about deep subjects before, then you can definitely give your friend an outlet to talk about their symptoms.
But, if you’re more of an acquaintance, just ask if they would like to talk about their experiences with this pregnancy. “Your friend will open up if they want to, and if they don’t, then just let it be,” she says.
Other than talking, distractions—such as outings—are a good idea. “Just know that when someone is depressed, they may turn you down several times before they say yes,” Taff notes. “It isn’t you. The depressed state of mind legitimately prevents people from doing the things that used to be normal for them. You may just have to gently remind your friend that you love them, you are there for them, and you are open to whatever would be easiest and best for them during this time.”
MEET MASLOW-BASED NEEDS
If you need some ideas for outings or other ways to provide support to your mom friend dealing with postpartum depression, Taff provides a breakdown of actions based on Maslow’s Hierarchy of Needs:
- “Babysit their baby for an hour so that the mom can sleep. Sleep is crucial for the body and the brain. Lack of sleep can make depression worse.”
- “Bring her a pre-made meal so she doesn’t have to cook. Create a meal train for her. Give her an Uber Eats gift card so she can choose what she wants.”
- “Remind your friend that whatever thoughts or feelings she’s having, she can tell you. You can handle it, and if you can’t handle the thoughts or need help, then you will find the help your friend needs together.”
- “Validate her feelings.”
- “Sometimes women feel unsafe with their baby or have intrusive thoughts of wanting to hurt their baby. Give your friend your number so that she can call you if she starts having those thoughts. Put her in touch with a therapist or help her make a doctor’s appointment if she starts having those thoughts.”
Belonging and Love Needs:
- “Let your friend know that you love her no matter what. Validate her feelings and let her know that you wish you could understand.”
- “Put her in touch with a support group or help her research support groups. It could even be as simple as a Facebook group. If it is an in-person group, offer to go with her.”
- “Praise her when she does something you think is amazing. For people with depression, even the smallest things can be a big deal.”
- “Remind her that she had a baby, and what an accomplishment that is. Even if your friend doesn’t feel like she is doing well right now, the fact that she carried and gave birth to a child is amazing.”
- “Help your friend decide how she want to treat her depression—through therapy, medication, massage therapy, yoga, etc.”
Looking for more recommendations? Taff suggests checking out smartpatients.com. “It’s a wonderful online forum for support groups,” she says. “They have chat lines for postpartum depression, postpartum anxiety, postpartum psychosis and postpartum OCD.”
Of course, the group Taff works with Taylor Counseling Group, is another resource. She says it can be helpful for you as a friend to schedule one or two sessions to consult with a mental health provider to determine how to best help them.
Editor’s Note: Taff reminds readers that her recommendations and suggestions are all with the assumption that this mom had a healthy pregnancy and delivery, and is still experiencing PPD. She says the complexity of the PPD symptoms are going to be much more involved if there is a tragic component in the delivery and birth, and the mom perceives the experience as traumatic. She says examples of this include: a baby born with special needs, a miscarriage or a still-born. The same principles and ideas for support mentioned above still apply, but it is important to note that if one of these examples has happened, the mom will also be experiencing grief. In that case, professional help is highly recommended.
This article was originally published in December 2020.