how to tell when you need help for a maternal mental health disorder

…and how to get the support you deserve

BY DR. WHITNEY CASARES

Before I became a mother, I was a pediatrician. I trained at Stanford University, I worked hard and logged countless sleepless nights. Naively, I thought I was ready. Then I entered the world of new moms. To be honest, I entered it with a bit of cockiness. I thought all my training, all my experience, and all my education would make me the perfect mom. At my baby showers, people teased me, “Well, we won’t give you any advice. You already know it all.” I was beyond confident.
Well, you know what they say…pride goeth before a fall.

When my first daughter arrived, she was not easy. I loved her from the moment I met her, but I second-guessed my decision to change my life so drastically within about 1 week of having her. She cried nonstop, spit up constantly, and would not sleep. I can remember rocking her and holding her in the dark for hours, often crying right alongside her. Countless nights, after nursing and shushing and swaddling every 45 minutes to get her calmed, my husband would put her in the car and drive around town in a giant freeway loop. It was the only way to get her settled for any extended period of time.

It was the first time in my life feeling so completely out of control and, eventually, I started to fall pretty deeply into postpartum depression (PPD) and postpartum anxiety. I would go on a walk to the grocery store, see a five-year-old child with her parent and think, “Wow, it is really amazing that you survived to grow so old.”
That’s when I realized I needed help.




I was one of the millions of women who suffer from Maternal Mental Health (MMH) disorders. MMH disorders comprise a range of disorders and symptoms, including but not limited to depression, anxiety and psychosis. These disorders and symptoms can occur during pregnancy and/or the postpartum period (together often referred to as the perinatal period).




I reached out to my fellow pediatrician and other new moms for advice. After a few weeks, I started taking regular chunks of time for myself away from my baby—just small trips to a coffee shop or to the park at first—so I could come back more refreshed. I did a lot of baby-wearing and talked to my own obstetrician about support and resources for PPD and Anxiety. When possible, I made my husband the soother-in-chief. If I wasn’t breastfeeding, he was in charge. Slowly, I changed and my daughter did, too. As she got older, she got a little easier and I got a little healthier. We emerged from a place of dark hopelessness to—not a perfect rainbow- and pony-filled haven—but to a new manageable normalcy.


I wish, looking back, that I paid attention sooner to the clues that I wasn’t quite myself to Postpartum Depression signs like:

• Crying more often than usual
• Feelings of anger
• Feeling guilty about not being a good mom
• Doubting my ability to care for my baby
• Worrying I would hurt my baby
  
  
  
  
  

I also wish that my partner and my village understood more about what I was going through. They could have more effectively helped me if they had known more about what I needed. I also wish I had the real information I needed to be successful with my infant—information about realistic expectations, about how to take care of myself, and about how to recognize and troubleshoot the tricky, awkward parts of the newborn experience.

Now that I’ve lived through PPD, I know better how to help the moms who come to me in my office suffering from the same disorders. If you are a new mom, you know that this journey called motherhood isn’t very elegant. It’s amazing and, sometimes, it is better than you ever thought it could be. It is also really hard.

Here are my top tips to maintain your mental health as a new mom:

know the signs of a mental health issue




If you find yourself feeling significantly stressed, sad, or anxious, talk to someone about it! Even if you’re unsure if you meet the clinical definitions of a MMH disorder, it’s worth it to reach out to a professional for an assessment. Your medical provider or your child’s pediatrician are great places to start. If you don’t feel comfortable talking to someone you see routinely, Postpartum Support International offers a free, confidential hotline and a local resource finder you can access via text.

invest in self-care



Early motherhood is not a sprint, it’s a marathon—or maybe an ultra-marathon. Taking care of yourself along the way with rest, time away from your baby (even five minutes in the shower counts!), and nutritious food is paramount to your wellbeing. Minimizing your social media use and engaging in positive self-talk also helps. When you feel happy and calm, it allows your baby to develop in a happy, calm environment. However, emotions like stress and anxiety can increase particular hormones in your body, which can affect your baby's developing body and brain.

cut down on chores and errands



Delegate your daily to-dos (I’m talking diaper changes and grocery store runs) to others in your village if possible. Pick companies you know you can rely on for fast service and convenience for all your new mama and baby needs. Less running to and fro, and more time enjoying your little one, means a happier mama, and that means a happier baby, too.
Remember, if you are struggling with an MMH disorder, you are not alone. Ask for assistance, seek out support. Rely on the others around you. Find resources to make your new parent journey as simple and streamlined as possible. Finally, be kind to yourself. You are an amazing mom—the perfect mom for your perfect baby.

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About Dr. Whitney Casares

Whitney Casares, MD, MPH, FAAP, is a board-certified pediatrician, author, speaker, and full-time working mom. Dr. Whitney is a Stanford University-trained private practice pediatrician whose expertise spans the public health, direct patient care, and media worlds and is a boots on the ground advocate for the success of women in the workplace and at home. She holds a Master of Public Health in Maternal and Child Health from The University of California, Berkeley, and a Journalism degree from California Polytechnic State University, San Luis Obispo.

Dr. Whitney currently practices pediatrics in Portland, Oregon, where she and her husband Scott raise their two young daughters. Check out modernmommydoc.com and follow her at @modernmommydoc.