Perinatal mood and anxiety disorders (PMAD), which include postpartum depression, can show up during pregnancy or days or even months following. These disorders are incredibly common; according to the Centers for Disease Control and Prevention (CDC), about one in nine U.S. women experiences symptoms of postpartum depression.
If you have a friend or loved one who you think could be struggling with postpartum depression, here are the most important things you can help do to support her, according to Stillman and other experts:
1. Ask them how they’re feeling
Stillman says that it took one of her close friends asking her directly about her mental health to make her realize there was an issue. “It really wasn’t until a friend of mine was like, ‘Are you okay?’ and I was like, ‘Yeah, I’m totally fine,’ and my friend was like, ‘No, really, I don’t actually think you’re okay,’” Stillman recalls. “I just broke down on the phone. I was like, ‘No, you’re right. I’m not okay.’ It just took that for me to realize that I needed to get help.’”
Stillman says that her friend had experienced postpartum depression and anxiety herself, so she recognized that Stillman wasn’t acting like herself and thought to ask what was going on. Even if you haven’t experienced postpartum depression yourself, it’s absolutely possible to look for certain warning signs in your friend, such as extreme mood swings, difficulty bonding with the baby, loss of interest in favorite things and activities, and severe anxiety or panic attacks.
Reaching out to a friend who you think is struggling is important, says Ann Smith, president of Postpartum Support International (PSI). When you do, be mindful of your language—you want them to be comfortable and honest with you about how they’re doing. Instead of leading with, “You’re feeling okay, right?” she instead suggests asking, “I know some moms have a really hard time in the postpartum period. How’s it going?”
2. Listen with compassion
Stillman says that just telling people she trusted about what was going on was helpful for her. “The more that we can share, the more that we can communicate what’s going on, the less power it has over us,” she says.
If your friend wants to talk about what they’re experiencing, one of the most important things you can do—even if you don’t have any experience with postpartum depression—is listen. “My friends who had not been through postpartum depression before, they couldn’t necessarily relate but they could listen and they could understand,” Stillman says. “And then for my friends that had experienced it, they could share with me what worked for them, just give me the tools, and they just came alongside to support me every single step of the way.”
3. Normalize their experience
“A lot of mothers really feel very ashamed of [postpartum depression], like somehow they’re doing it wrong,” says Kathleen Kendall-Tackett, Ph.D., clinical associate professor of pediatrics at Texas Tech University School of Medicine and author of Depression in New Mothers, 3rd Edition. Remind your friend that while this completely sucks, it’s something that’s normal and happens to many new mothers—and it’s not her fault.
PSI has a mantra: “You are not alone, you are not to blame, and with help you will be well.” Smith suggests telling your friend your own version of this. “I had [postpartum depression] twice,” she says. “When I got it again with my third [child], I guess it didn’t shock me that it happened. It was just as painful, the symptoms were just as horrible, I felt just as bad. But it wasn’t scary because I knew it would go away. So the key message in all of this is the last one of the three: ‘With proper help you will be well.’ That is the most important message that anybody can give.”
4. Help her get help
Finding help when you’re experiencing mental health issues is hard enough; doing it when you also have a newborn is that much harder. Make the overwhelming process of finding a therapist or a trusted expert a bit easier by sharing resources and knowledge with your friend. PSI’s website lists local support and offers a helpline for calling (1-800-944-4773) and another for texting (503-894-9453). “Someone will get back to you within 24 hours with information, support, and referral to providers in your area who have been trained to treat this,” Smith says.
That’s the best place to start, says Dr. Kendall-Tackett. She says you could also reach out to your local psychological association and get their recs for postpartum depression experts. Screen them (look at their credentials, read reviews, vet if they’re LGBTQ-affirming, etc), and then recommend a few to your friend.
5. Lend a helping hand
Besides encouraging her to get help and take good care of herself, Stillman says her friends supported her recovery in lots of little ways, from showing up on her porch with a Diet Coke to coming over and watching her son so she could take a nap.
“I think child care, unless somebody has a sitter or something like that, is one of the nicest things that you could possibly do to give [your friend] a break,” adds Smith. She recommends reaching out to your friend and asking, “How about if I watch the baby for two hours and you take a shower, read your emails, have some personal time?”
Also, take your friend out! Schedule Saturday night plans or, if they want to bring the baby along, grab a coffee. “One of the things that a lot of new moms feel like is they’re losing their friends, their friends don’t care anymore,” says Smith. Make sure yours knows that’s not remotely the case. It could mean a world of difference for her.
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