Postpartum Depression Action Plan

By Alison Heyerdahl

Postpartum hormonal changes and depression can make it extremely difficult to care for yourself or your baby.  Affecting around 1 in 7 women after childbirth, postpartum depression is usually much more intense and persistent than the baby blues.  Excessive crying episodes, severe anxiety and depression, and thoughts of harming yourself or your baby are common symptoms of postpartum depression.  It is important to visit your healthcare provider to discuss treatment options for the condition because it can last for many months if it is not managed.  Common treatments for postpartum depression include the use of antidepressants such as Selective Serotonin Reuptake Inhibitors (SSRIs) and psychological or behavioral therapies. 

Even if you have to take prescription drugs, you may also be considering alternative methods along with counseling to help you feel better.  This article will outline effective alternative treatments such as self-care activities that you can perform daily.

The following lifestyle changes and self-care activities can help to relieve your symptoms:

1. Social support

Lack of social support is an enormous contributor to the emotional turmoil experienced by women after childbirth.  Furthermore, it can also cause adverse effects in your baby, for example, it can cause poor mother-infant bonding and can set the stage for longer-term difficulties in your child's life.

Share your feelings with at least one other trusted friend.  It is always a huge relief to reflect on what you are experiencing with someone else.  It helps to know you are not facing the situation alone and other people can help put things in perspective.  Furthermore, spending time with people you love increases your “feel good” brain chemicals.  If you do not have many close friends that you can draw on for support, find a support group in your area and attend regular meetings. 

This week I will spend time with __________________________ (person’s name/support group).  I will try and share my experiences with them and let them know how I need to be supported. 

2. Prioritize sleep

Although having a newborn and sleep deprivation are almost synonymous, research has found that women with significant sleep disturbance are more likely to report symptoms of postpartum depression.  Getting enough sleep should be a high priority in your weekly schedule.  The following strategies may help improve your sleep:

• Sleep when your baby sleeps.  When your baby goes down for a nap, put everything else aside and take a guilt-free nap.  Do not use this time to phone friends or catch up on your TV series, sleep is much more important.

• Accept help from willing parties.  If other people in your support network offer to take your baby for a few hours so that you can sleep, take them up on it.  Sleep is not a luxury, it is a medical requirement.

• Don’t worry that you won’t hear your baby crying.  As mothers, we are highly attuned to the sound of our baby’s cries, and they will always wake us up.  If your baby's bedroom is far away from yours, buy a baby monitor so that you are sure to respond if they do wake up.  It is also OK if they happen to cry for a short period before you hear them. 

• Do not take on any extra responsibility when you have a newborn.  Although it is tempting to volunteer for your older child’s school excursion, you are already stretched thin and need to focus on yourself and your newborn.  You also don't have to be a superwoman.  It doesn't matter if the washing has not been done in a few days, or you haven't polished your floors.  At this stage, your priority needs to be caring for your newborn and looking after yourself. 

• Talk to people in your support network about your lack of sleep.  Making your partner or spouse aware of how sleep deprivation is affecting you will garner their support and understanding.

For ______days this week, I will take a nap when my baby sleeps.  I will also not take on any unnecessary responsibility, I will talk to my partner or spouse about how sleep deprivation is affecting me and I will accept help from people in my support network.

3. Stay Active

According to a study performed, physical activity is “essential for preventing depressive disorders in the postnatal period” (Kolomanska_Bogucka, Mazur-Bialy, 2019).  Exercise has a significant positive impact on the physical and mental states of women after childbirth.  The American College of Obstetricians and Gynecologists recommends around 150 minutes of moderate activity per week.  Exercise improves blood circulation, strengthens abdominal and spinal muscles, improves lactation, and stimulates the production of "happy hormones".

Make time for activity every day.  This can include walking for 20 – 30 minutes a day with your baby in a stroller, dancing, cycling, or strengthening exercises (provided you do not hurt yourself).  You may want to have an examination by your physician to check if there are any limitations on your activity.

This week I will spend at least ________ minutes a day doing ___________________________

4. Meditate

Childbirth, while being the most miraculous period of your life, is also fraught with enormous psychological, physical, and emotional difficulties.  Meditation and mindfulness practices have become increasingly popular over the last few decades and have proven very effective for managing postpartum depression.  Meditation helps you develop “moment-by-moment awareness”, which results in a “more objective view of the process of experience” (Shaydaei et al., 2017).  Mindfulness and meditation practices can help you overcome the challenges of depression by making you deeply aware of your own thoughts, mental processes, and internal feelings. Mothers who went through meditation and mindfulness training were better able to control the negative feelings of guilt and worthlessness related to postpartum depression.  Remember that even 5 minutes of meditation a day can make a difference. 

Every day I will dedicate ________ minutes to a meditation or mindfulness practice.

5. Set realistic and simple goals.

Having a baby is the most life-altering experience of your life.  It is important not to put too much pressure on yourself or expect too much too soon.  Do not make big life decisions when you are feeling overwhelmed or extremely anxious.  Keep in mind that having the baby blues or postpartum depression can make it difficult to get moving.  Consequently, you should set goals that are realistic and in line with your current circumstances. 

For example, if you would like to clean up the house, don’t try to do it all in one day.  Your first goal may be to dust one shelf or vacuum one room. 

In order to set goals, the following guidelines may be useful:

• Set specific goals:  Have a very clear and defined idea of your goal so that you will know when you have achieved it. 

• Set realistic goals:  Don’t set goals based on what you think you should be able to accomplish.  Remember that depression makes it difficult and slows you down.  Set small and easily achievable goals so that you don’t feel disappointed and discouraged.

• Schedule your goals:  Have a clear idea of when you will carry out your goal.  For example, "I will go for a walk at 10 am on Thursday", rather than "I will try and exercise on Thursday".

Always give yourself credit for the small goals you achieve.

This week I would like to achieve the following goals:

1.       ___________________________________________________________________________.

2.       ___________________________________________________________________________.

3.       ___________________________________________________________________________.

4.       ___________________________________________________________________________.