Talking Postpartum Anxiety with a Perinatal Mental Health Counselor

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This is part two of our “Healthy Moms Take Care of Themselves” series. I interviewed Margeaux Gibson, a Licensed Mental Health Counselor who specializes in Maternal Wellness, to discuss postpartum anxiety after my last post.

>> RELATED READ :: Healthy Moms Take Care of Themselves: My Postpartum Anxiety

A note from the author: 

This is yet another attempt on my behalf to normalize hard and taboo things. Multiple people reached out after reading my last post, wherein I discussed my own struggles with postpartum anxiety, and the overwhelming response was, “Me too!” I felt that calm that you feel after a long exhale, after holding your breath. Thank you, mamas. Thank you for reading. I see you. 

So I’ll say it again:  if one woman reads this series and feels seen, it will have done its job. Because when you hear someone else struggling with what you are struggling with, you feel less alone. So, I hope in the coming weeks, something resonates. 

Is it called oversharing if you’re INTERVIEWING a therapist? 

Asking for a friend. OK, the friend is me. I am said friend. 

I recorded my 45-minute conversation with Margeaux, the above-mentioned therapist, and man; I wish you could hear it all.

I should note that though we have mutual friends, this was actually our first formal meeting and first conversation longer than the standard three-minute “Hey, how are y’all? We’re good.” Within seconds of pressing the ‘record’ button on my iPhone, Margeaux and I got really deep…really fast.

It’s somehow refreshing to meet someone who, like me, doesn’t do well fixating on the pleasantries and the superficial conversations. Instead, as she sat criss-cross applesauce on my living room floor, smiling and playing with my one-year-old, Margeaux shared so intensely her stories and experiences in the maternal wellness space.

I hope that I can do our conversation justice by summing it up in an article.

A cardinal symptom of postpartum anxiety is intrusive thoughts. What are intrusive thoughts?

We began discussing common signs/symptoms of postpartum anxiety, some of which we are trained to identify and others that are much more subtle. In my last article, I did mention that up to 90% of new moms get intrusive thoughts. 

In the postpartum period, we moms are not thinking about ourselves. Moms will sometimes have experiences where all of a sudden, little clues start to pop up and aid us in recognizing that we’re not thriving. The most common symptom is intrusive thoughts (and images). These include: 

  • Seeing flashes of baby being injured, or of mom making a mistake that leads to baby getting hurt
  • Fear of walking up/down the stairs with baby
  • Fear of going near water with baby
  • Being scared to/not wanting to leave the house 
  • Acting out long, drawn-out rituals that have to happen to get out of the house or car with baby
  • All of these intrusive thoughts (and images) are scary and are actually barriers to treatment. Because no one talks about them and Mom feels a sense of shame or guilt, she ends up isolating herself and not seeking help. 

But why do we have these thoughts? 

It’s like the survival instinct of the mom in overdrive. Moms are in a high alert, high cortisol (stress hormone) state, and this leads to a really dysregulated nervous system. So we start feeling afraid of anything. In the tired and overwhelmed newborn state, moms often wonder, “Is this normal?” They start to pinpoint that something is wrong, even if they can’t name exactly what it is. 

>> RELATED READ :: Paralyzed by Postpartum Anxiety

From there, we discussed potential resources for moms. 

Being at home with a baby is so isolating. We talked about this one. Both of us recall the first few times we were social after being at home with a baby for weeks at a time. I think I scared people by how much I talked AT them when I was able to get out of the house. But it’s telling, isn’t it? There is that innate desire for human connection. 

We talked about how there can be a good amount of overwhelm for moms. This can be so detrimental that even if a mom is able to identify the need for help, she’s often so overwhelmed she doesn’t have the energy to seek it out (or know where to start).

Here is a list of (some, not all) resources to start:

Local Perinatal Counselors: 

Margeaux Gibson

Linda Murray

Brie Davis

Pensacola Florida Therapy | Ellie Mental Health

A local directory FULL of Resources through Emerald Coast Perinatal Collective

A directory through Postpartum Support International 

A quick Google search can take you to sites like PsychologyToday.com 

Who to Call in Crisis: 

Dial 911 in case of an emergency (medical attention is needed, someone is actively suicidal, a crime has been committed, violence is occurring, or just if in doubt)

Dial 988 for the Suicide & Crisis Lifeline

Lakeview/Baptist Mobile Response Unit: Dial 866.517.7766 (serves Escambia / Santa Rosa / Okaloosa / Walton Counties)

24/7 Postpartum Support International Hotline: Dial 1-800-944-4773 OR Text “Help” to 800-944-4773

24/7 SAMHSA Hotline: Dial 800-662-HELP (4357) 

Online Resources: 

Postpartum Support International 

Free printable Prenatal Education Booklet and Postpartum Support Guide at Physician Guide to Breastfeeding

Books:

Good Moms Have Scary Thoughts (Karen Kleiman) 

What About Us? (Karen Kleiman) 

The Postpartum Depression Workbook (Abigail Burd) 

The Pregnancy and Postpartum Anxiety Workbook (P. Wiegartz)

Local Support Groups: 

LEAPS 

-Meets last Tuesdays – Royal Sportsplex in Jay, FL – 9-10am

-LEAPS Navarre – Bindu Institute – 10-11:30am. See the Facebook group for dates.

La Leche League Support Group

-Meets monthly at Ever’man Education Center (Downtown), follow their Facebook page

Mom-to-Mom Support Group

-Meets monthly on the 3rd Tuesday of the month in the Turtle Classroom at Studer Family Children’s Hospital, 10am (850-416-8088)

Ladder to the Stars Wellness, LLC

-Will soon begin hosting monthly Connection Groups (@LadderToTheStars)

We talked about what to expect in a first meeting with a therapist.

Everything begins with a phone call or an initial meeting, and this needs to happen really quickly for a new mom who is really struggling. The therapist will explain what they practice, what their focus is, and how sessions usually go. For example, Margeaux is a mindfulness, emotion-based therapist. If both parties agree that it’s a good fit, then full steam ahead.

The goal is to help the mom feel unconditionally accepted in her experience. The therapist sees him/herself as the mom’s ally and trusts her implicitly.

Studies have shown there is actually a 20% improvement reported in patients in the time between making the appointment and the appointment itself, so there can be a huge shift just in knowing help is coming, and the mom is not alone.

We talked about holding space for the intensity of being a new mother.

Margeaux explained, “Women often feel like the intensity they are experiencing in the postpartum period is ‘wrong.’ The tears, the irritability, the “bigness” of it all.” And the goal is to hold space for and welcome that intensity because processing that intensity aids in recovery.

Holding space is difficult for everyone – friends, family, even ourselves. Often, people close to us are well-meaning or problem-solvers, so they may want to help, but the ways they choose to do so may not really be helpful. We need to trust mom, love mom, support mom, and always ask how mom is doing (especially in a culture that is so concerned about baby but not necessarily mom). 

We brainstormed a healthy list of activities moms can do at home to aid in the alleviation of some of this anxiety. 

The basics are often the things that aren’t being done, so it’s time to do those and not overwhelm our nervous system more. Getting family involved is very important as they’re needed so mom can step away. Here are some ideas (and yes, we know, they sound too simple, but they work):

  • Open the windows and let fresh air in 
  • Go for a walk, stand barefoot in the grass
  • Take an Epsom salt bath
  • Nap, if even for an hour
  • Sit down to eat, breathing while you chew
  • Stay hydrated
  • Eat nutritious food
  • Try Basic Mindful Abdominal Breathing exercises

We also talked about the need to work together (as a physician and mental health counselor).

Often, it’s your PCP or OBGYN who can help to identify postpartum anxiety. There is so much going on in your body at this crucial time of postpartum, so go see your doctor for your postpartum visit or if you have other concerns.

Maybe labs need to be done. Maybe you’ll be screened not only for anxiety but also for depression. Maybe there are signs of another diagnosis presenting itself, like Obsessive Compulsive Disorder (OCD), which tends to present in the postpartum period. Maybe medication will be recommended. Your doctor would be the one to tease these things out and have a risk vs benefit conversation to foster shared decision-making. 

As a physician, I’ve often seen this play out, and the biggest barrier is always getting in with mental health counselors. It’s a serious issue because there just aren’t enough, so often, I’m managing this person and seeing them back frequently until they can get in with a therapist.

We know that therapy is helpful and medication is helpful (if indicated), but the combination of the two has proven the most beneficial. There is, to me, nothing more uplifting than seeing these patients back frequently and watching the positive change over weeks to months. 

What’s something you would go back and tell your pre-kids self about the postpartum period?

Margeaux: There is nothing that you can’t handle. Also, your thriving REQUIRES you to ask for help. 

Me: Just be kind. Not just to your partner but to yourself. And to other moms. Also, your concern means you care.

At the end of our conversation, Margeaux shared a beautiful story. Her mantra her whole postpartum period with her first baby was: “I can’t do this!” But there’s something about shifting that phrase when we remember there are moms everywhere who are up in the night with you. You’re not alone. This perspective shift looks like: “I CAN do this. Even if it’s really challenging, I’m never going to be alone again. I’m garnering support.”

It’s not about slapping a positive thought on top of a real emotion; it’s about processing the emotion and then working toward more of a positive orientation of yourself in the world during the postpartum period.

Be well, mamas. 

{Please note that though I’m a doctor, I’m not your doctor! The views expressed here are for informational/educational purposes only and do not take the place of consultation from your personal medical specialist. This blog is not meant to diagnose or treat; it is only meant to inform. If you are having any immediate thoughts of hurting yourself or anyone else or are in any way concerned about a medical emergency, please call 911. Reach out to your PCP, OBGYN, or other medical specialist with concerns. And if you do need a doctor when it comes to pregnant or postpartum mental health, reach out to Ladder to the Stars!}

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