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  1. Strategies that work
  2. Women's Voices

STRATEGIES THAT WORK

How to Help a Woman Survive Postnatal Depression

  • Assess sleeping problems

  • What are the sleeping arrangements for the family?

  • Who gets up at night with the baby?

  • Does the baby sleep in the same room as the parents?

  • How many hours sleep does the mother get?  (If she is exhausted, other strategies are less likely to be effective.)

  • Suggestions:

  • Take turns getting up with the baby at night (express milk if breast-feeding)

  • Consider having the baby sleep in the same room as the parents.

  • Ear Plugs!

  • One partner to sleep in a separate room occasionally.

  • Stress that sleep deprivation is temporary.

  • Don’t look at the clock – turn it to the wall.

  • If the woman can’t sleep after 15-20 minutes, she should get up, go into another room and do something relaxing or boring.

  • Try to keep as regular a schedule as possible.

  • Avoid tea and coffee and heavy meals before bedtime.

  • Have thyroid and haemoglobin checked. 

  • Assess eating patterns:

  • Does she skip meals?

  • Does she try to prepare meals from scratch?  (Convenience foods, frozen meals, etc save time and energy.)

  • Does she drink adequate fluids?

  • Suggest  keeping healthy snacks on hand.

  • Suggest taking any prenatal vitamins left over, or a good multivitamin tablet.

  • Explain that low blood sugar aggravates depression and fatigue.

 Focus on the basics:

  • Help the woman keep her expectations realistic.  (Women with PND tend to be perfectionists.)

  • Explode the “superwoman” myth – she does not have to do it all.

  • Help her to structure her day – make a simple plan.

  • Advise her to keep her “to do” list short – 2-3 items.

  • Get the woman to ask herself, “Is it important to my whole perspective on life?” e.g. “How important is it to have a fancy christening party?”

Help the mother to develop a support system:

  • Teach the woman to ask her friends or family for help.  (Women with PND have difficulty asking for help.)

  • Tell the woman that she is “borrowing favours” – eventually she will be able to repay them.

  • Imagine a scenario that she has to be admitted to hospital – What would the family do then?

  • Consider asking for help from husband or other family members>  (Women with PND often have partners who work long hours at jobs or studies.)

  • Avoid spending time with people who make her anxious, or make her feel unhappy.

  • Explore babysitting options.

  • Identify local programmes for mothers and babies.

  • Realise that parenting is 3-generational.  The mother may be trying to live up to or rebel against the way she was parented. 

Help her to identify and express her feelings:

  • It is OK to have negative feelings.

  • Explore motherhood as a loss, e.g. loss of self and old way of being

  • loss of independence

  • loss of spontaneity

  • loss of career

  • loss of intimacy

  • loss of joy, energy, sleep

  • Help her to educate herself about PND by reading books.

  • Tell her that it is usual for women suffering from PND to lose interest in sexual intimacy.

Recognise the good job that she is doing:

  • This is the most dramatic adjustment in a woman’s life, and it takes time.

  • Give as much encouragement as possible.  Point out what she is doing right.  (Most women with PND feel guilty if they are not enjoying their babies – most do a more than adequate job of taking care of their babies.) 

Ask the woman to tell you what she needs:

  • Often you will be the first person who asks.

  • The time she invests in herself (e.g., rest relaxation, breaks) will be the best gift she can give to the baby.

  • Self-care is not selfish.

  • Help her to challenge the motherhood myths : that bonding is immediate, that breast-feeding is natural and easy, that mothers are perfect, all-knowing, always loving, always patient and serene.

  • Help her to remember and slowly rediscover the person she was before the baby came.

  • Don’t allow her to compare herself with anyone.

Encourage her to rediscover her sense of humour:

  • Rent a funny video; but avoid TV talk shows and news.  (Women with PND are very vulnerable to problems, and tend to worry excessively.)

  • Read funny books.

  • Take time off to have fun with her partner, or at least rediscover each other.

Suggest postponing major life changes:

  • Don’t move house.

  • Don’t file for divorce.

  • Don’t change jobs.

Reassure her:

  • That recovery from PND takes time and patience, often several months or longer.

  • That she will get better.

  • That it is not her fault.

(Adapted from: Grazyna Mancewicz & Sherry Thompson (St. Joseph’s Women’s Health Centre, Ontario)


Women’s Voices   

These are some of the things my partner can do for me, that I don’t know how to ask for: 

"Just say you understand and mean it."  
v "Give me a hug and tell me you love me and that it is going to be OK."  
v "Take charge of the situation, and take some of the burden off me."  
v "Ask me how I am, regularly, and really want to listen to the answer."  
v "Not express amazement on Wednesday, that I still haven’t pulled out of Tuesday’s feelings of         depression.  Realise that it is not a one-day wonder."  
"Realise that while washing the dishes is great, it doesn’t constitute 'helping with the baby'."
"Realise that it’s the baby I need regular breaks from."  
"Understand that I need to feel looked after and nurtured – even if only from time to time."  
"I’d like you to be able to listen to me complain, without feeling I am complaining about you.  I need you not to clam up.  I’d like you to say something like “That’s okay; but you’re doing really well”.   

"I’d like you not to expect me to be perfect continuously."  

"I would like to be able to discuss my problems and worries, without your  taking it as criticism, or offering solutions."  
"I would like more help with the children."  
"I need to be heard, but not judged."  
"I need to be accepted, and to feel okay about doing it my way."  
Don’t leave me alone.  Don’t expect me to be happy and chatty.  Let me be quiet – but be accepting and understanding about my quiet time."
"Be nice to the children when I can’t be.  Approve of me – tell me what I’m doing right, not what I’m doing wrong."  

I would like you to tell me that you            

  1. think I’m a good mother

  2. love me

  3. think I look great

  4. are happy that you married me.  

 I need you 

v to communicate

v to support me as a woman

v to support me as a mother

v to hold me when I am sad and not to try and sort out my problem

v to really listen to me

v to engage with me

v to actively take decisions with me with regards our child

v to feel your own feelings and express them

v to laugh

v to be present in the home

v to make the fire when you come home

v to love me