What happens after you have analyzed the symptoms that your daughter or daughter-in-law is experiencing and have decided that postpartum depression (PPD) is a definite possibility?
Doing nothing is not an option. The mother with PPD is suffering, and her baby could be suffering also. If the depression is severe, the baby may not be getting the level of care and attention that he or she needs. Less severe depression can still cause a lack of bonding between parent and child.
In one or two cases per thousand, the mother actually develops postpartum psychosis. For the sake of both mother and child, you must take action.
Starting the Conversation
If you have a good relationship with your daughter or daughter-in-law, you may want to approach her yourself. If you are the grandmother, you can take a woman-to-woman approach.
Simone* reported that her mother was a great help to her even though they live on different sides of the Atlantic. She learned that her own mother went through the same thing after the birth of a child and that, in fact, the grandmother ended up having to take to take care of the children for a year while her mother recovered.
"It helped so much to hear my mom, who did such a good job of raising us, talk about having feelings exactly the same as mine, " she said.
If the grandparent does not feel comfortable broaching the subject, the father can be tapped to encourage the mother to seek help.
This works, of course, only if the marital relationship is relatively sound.
A third approach can be to utilize some outside person. The mother's ob/gyn or midwife is a natural choice. A pastor or other spiritual adviser may be able to help.
"Among the people who helped me the most were my pediatrician and my ob/gyn," said Margo, who suffered after the birth of her first child.
"I had had a C-section, so I was still seeing my ob/gyn. He was a family friend, so I felt closer to him than you might normally feel."
Talking about the situation is important not only because it is the first step in getting help but also because it brings the ailment out of the darkness, so to speak. It can help to know that PPD is something that has plagued many mothers.
Other Steps Grandparents Can Take
Mothers with PPD may need therapy and/or medication. Other strategies, however, may help by relieving some of the more stressful situations in the mother's life. As the grandparent, you are in a good position to enable some of these strategies.
- Offer to help with the baby so the new mother can sleep. Sleep deprivation is huge in many episodes of PPD. Often the mother has difficulty sleeping, so having the opportunity to sleep doesn't always work, but it is a simple solution that is worth a try.
- Offer to babysit so that the baby's parents can go out. It's good to have this happen as soon as possible so that the parents know that they and the baby can survive a few hours of separation.
- Bring up the topic of the mother's feelings. New mothers often feel guilty that they have any feelings other than unmitigated joy. Let the mother know that it is okay to feel tired, resentful, overwhelmed and neglected.
- Get the new mother out of the house. Take the mother and baby out for lunch, or for a stroll. If there is a problem, such as the baby crying, the mother does not have to deal with it alone.
- Reassure the mother. Many mothers with PPD feel inadequate, and as the grandparent, you are uniquely positioned to allay those fears. Don't be gushy, and don't lie. But focus on those things that the mother does well and reassure her that she can do things for her child that no one else can do. If you are the mother-in-law, you have a special power, as most young women want to make a good impression on their in-laws. Approval and validation from you will be especially powerful.
Serious Help for PPD
Sometimes just talking about the situation and taking some common-sense steps will help. If not, PPD must be treated much like any other type of depression, with therapy and/or medication.
Breastfeeding mothers will want to avoid medication if at all possible. If the depression does not abate with therapy, however, it may be best for the mother to take one of the medications that are considered safe for breastfeeding, or even to stop breastfeeding. These are decisions that will need to be made with the help of a professional.
Therapy does not have to be the traditional one-on-one mode. Group therapy can be especially effective since mothers with PPD may feel isolated.
"I joined a support group that met once a week," Simone* said. "The group helped me to realize that no mother is perfect. We all have problems, and we all need support."
Awareness and Self-Help Strategies
In some cases, merely being aware that one's emotional health is a bit precarious can avert an episode.
Laurie, who had experienced episodes of PPD with her first child, was more prepared for it with her second child.
"The baby and I had been home from the hospital for about a week when my husband made some kind of joke that really touched a nerve," she said. "I don't remember exactly what it was, but I remember telling him loudly that this was NOT a good time to say that. He promptly fell all over himself apologizing, because we both knew exactly what was going on. A crisis was averted."
Simone also found that being proactive could avert an episode.
Having play dates, going to the park, getting fresh air and being with other moms really helped Simone. She also found that doing "non-Mom" things like painting her nails and reading a book helped her mood.
"I realized that the only one who could actually get me out of the depression was me," she said.
The Long-Term Outlook
As grandparents, you should be aware that most episodes of PPD will resolve during your grandchild's first year. That's not a reason to ignore the situation. If you handle the situation with kindness and tact, your daughter's or daughter-in-law's bout with postpartum depression can be a learning situation for everyone and a chance for grandparents to show their love and concern.
The end result can be a stronger family.
*Not her real name