Effective, empathic therapy to support recovery from perinatal or postpartum mood disorders
Postpartum Therapy Approaches
There are several treatment approaches to perinatal and postpartum mood disorders which have been found to be helpful which address symptoms emanating from biopsychosocial stressors; these include Interpersonal Psychotherapy, Cognitive Behavior Therapy, Dialectical Behavior Therapy, Psychodynamic Therapy, Medication, Family Therapy, and Social Support.
In addition, trained practitioners will also focus on nutrition, exercise, coping skills, stress reduction, infant-mother bonding, medical issues and other psychosocial influences. Moderating the effects of social isolation through personal or telephonic attendance at support groups can offer great relief to mothers whose engagement in services is hampered by transportation, child care needs or financial constraints. If you are not responding to one of the talk or group therapies, medication may be appropriate. If your symptoms of anxiety and depression are so severe that you cannot function, if you have not had adequate sleep for several days, the possible moderation of symptoms through medication may be considered to stabilize those symptoms. The kind of medication and duration of treatment depends on many factors unique to you alone. Comparing yourself to others is not helpful as your own response to any treatment cannot be measured by other's results.
Your psychiatrist and therapist will discuss the pros and cons of medication with you. But remember, medication alone without therapy is not prudent. Also important is receiving support, education, insight, developing new skills and awareness, modifying lifestyle and self care that will help prevent these disorders from returning once you have recovered. Talk therapy and medication have consistently been found to be the "gold standard" of treatment for depression and anxiety.
Specifically, the cognitive, interpersonal and family approaches offer support, skills for managing emotions and relationships and important emphasis on wellness through nutrition, diet, exercise, sleep and social support.
If you are feeling suicidal, feel threatened, think that people are watching you or telling you what to do (including harming yourself or your child), or having strange sensory experiences, you may be suffering the effects of postpartum psychosis. This set of symptoms represents a true psychiatric emergency that requires immediate hospitalization and medication. With appropriate treatment, you WILL recover.
After an initial consultation, usually you will meet with your therapist or group weekly. Later, when you are feeling better, you may meet only once or twice a month. The goal of therapy is to help you feel better as soon as possible and to support the healthy development of the maternal/child bond, encourage independence, symptom management, personal expowerment and self-reliance that will build confidence and return you to your pre-therapy level of functioning.
Sometimes homework is given between sessions to practice new skills and begin to apply what you learn in therapy to your home environment. Homework is very important because it helps to integrate new ways of thinking and reacting into your daily life. Through determination of the kinds of activities which soothe, the setting of personal boundaries which protect and application of newly learned skills to manage emotional upset, the goal is to understand your reactions and master your emotional life.
Some mothers bring their infants to sessions because they do not have help or the financial means to hire a sitter. If possible, it's better to reserve this time for yourself.You may want to bring your partner or family members to a session or two so they can become educated about these disorders and learn how to best support your recovery, but initially therapy for you alone can provide a safe haven in which you are able to express your feelings and be understood.
If you decide to pursue therapy, ensure your selected therapist has experience treating ante natal (during pregnancy) and postpartum (after delivery) mood disorders. You should discuss your treatment goals with your therapist and together, outline a plan of how you will reach these collaborative goals. You may want to review the following list of questions your therapist may ask you, so you can think about those that most apply to you. These questions are not diagnostic of an ante partum or postpartum mood disorder. Only a professional consult with a mental health professional can determine a definite diagnosis, but these questions may help you focus on areas which are troubling you.