Depression is not all-encompassing of the range of mental illnesses that 1 in 5 women experience either during pregnancy or after delivery. The better term to classify these changes in mood is less commonly known, but on the rise– Perinatal Mood and Anxiety Disorders, or PMADs. Postpartum depression and postpartum anxiety are the most common symptoms, but they should not overshadow other possible diagnoses of OCD, PTSD, bipolar disorder, and psychosis in the perinatal period.
The anxieties and pressures to be that perfect mom that society paints an image of are actually far too common and often minimized and downplayed as “normal.” New moms feel that things are hard with a newborn, but they think they have to just swallow their feelings because it “should” pass eventually. All the other moms did it somehow, so this is just a hazing ritual to grit your teeth through, right?
Newsflash!–wrong.
Many of you already know that I suffered from a severe postpartum depression, and there were definitely also significant components of anxiety and insomnia that likely exacerbated my PPD. I probably sound like a broken record, always talking about the lowest points of my life, but for everyone who’s heard it a hundred times, there’s a new mom who has just heard it for the first time and is realizing that she is not alone.
So excuse my squeaky record, but I’m going to keep reaching out to that mom who needs to hear it. Because I never felt like my feelings were truly acknowledged, and I wish someone would have validated my feelings, while telling me that it does get easier.
Read this part carefully. This isn’t a hazing ritual, and you shouldn’t have to feel like your baby would be so much better off without you because you think you are failing them. Those are intrusive thoughts that are not normal, and you can find help. With help, you will be better.
A few people have reached out to me recently asking me about what resources I recommend for moms going through PPD or how they can find help, whether professional or self-help. I was happy to point people in the right direction, but I figured it would be great to write it down somewhere for more people to be able to utilize if they didn’t feel like personally contacting me or couldn’t remember where to look. I know when I was going through my PPD that I did not feel like talking to anyone–even my own family sometimes.
So this blog post is a list of my resources for any new moms who might feel like they are going through postpartum depression, anxiety, or insomnia. I would also be super appreciative and welcoming of any resources that anyone who has been through a PMAD found helpful. Please by all means share it with me, and I will try to addend this article as this list is by no means comprehensive and just my humble little corner of the Internet.
And you can always feel free to private message me for more details if you wish, even after reading through these. I’ll add some quick links below to skip ahead in the article if one particular resource jumps out at you more. There will be a link to jump back to this menu when you finish a section too. Please help me pin the article on Pinterest if you want to come back to it later!
Quick Links
- Postpartum Support International (PSI)
- Provider Lists for Perinatal Professional Help
- Postpartum Stress Center
- Meditation and Mindfulness Apps (and how to get some for free!)
- EFT Tapping
- EMDR International Association
- Motherhood Understood
Postpartum Support International (PSI)
One of my favorite organizations for perinatal (pregnancy and postpartum period) support is PSI, or Postpartum Support International. They are a leading non-profit organization dedicated to promoting awareness, prevention, and treatment of perinatal mental health worldwide. The funny thing is, my sister actually sent me a link to their main page when I was going through my PPD, but I think she didn’t want to feel too pushy about it and she hadn’t actually researched all the tools and resources.
After I got better from my PPD, I really wanted to give back and volunteer with a postpartum group and I came across PSI on the Internet. It looked so familiar and that’s when I recalled my sister sending it to me. At the time she sent it to me, I was in no place to navigate the website, which truly has an abundance of great resources. The sad thing about PPD (and other depressions) is that you lack the energy or focus to do anything about your pain; you may want to get better or find help, but you just don’t have the mental willpower or concentration to sift through “resources.”
Believe me, no one gets that more than me. I barely had energy to get out of bed to move myself to the couch. But if you DO have the energy, I highly recommend looking through the PSI website. If not, keep reading because I’ve picked out a few of what I think are some of the coolest support features that PSI offers, now that I volunteer with them and have been oriented to a lot of the resources they offer!
PSI Support Groups
When I took the leap to see my first therapist out of desperation, she suggested that I join some “mom groups.” This suggestion made me roll my eyes because I thought it just highlighted exactly what I knew before coming into this appointment, that there was nothing they could offer me that would solve my problems. I barely made it to this appointment and nearly got into a car accident on the way; how did she expect me to put myself together enough to attend a mom’s group??
But what I didn’t understand was how powerful it could be to hear others’ experiences with new motherhood and how sometimes just hearing someone else say, “Oh my god, my baby does that too!” could be heavenly music to my ears. And what I didn’t know was that most moms are way less judgmental than you might imagine because we’re all struggling. I think I was still trying too hard to put up a front.
In hindsight, joining a support group probably would have been helpful, but not the magic bullet panacea for all my problems. You must understand that TIME is the best medicine to heal but the most painful and bitter to swallow. So in the meanwhile, if you are at a place where you can understand that part about time, joining a support group could be really helpful. PSI offers FREE weekly online support groups so you don’t even need to leave your house. (Not like many of us are doing that these days.)
There are more target specific support groups too, like NICU moms, military moms, South Asian Moms, and Black Mamas Matter. The other groups they offer are Perinatal Mood Support, Pregnancy & Infant Loss, Dad Support (yes, dads get depression too!). You do need to sign up for a free account, and when you register, you will have to put an emergency contact down. It looks like most sessions are 90 minutes and they do fill up. But there are waitlists for last minute meetings, and it seems like there’s usually a few meetings a week that are open.
PSI Peer Mentor Program
The Peer Mentor Program is a new program that started last year (2020) to pair a mama currently going through a PMAD during the perinatal period (pregnancy up to 1 year postpartum) with a mama who has been in remission from a PMAD for at least a year. The commitment is a 6-month period; think of it as having a private weekly support check-in with another mama who has been in similar situations before. Sometimes it’s nice to just have another mom friend who “gets it.” (But to be more accurate, dads can also join this program! I’m just going to refer to the moms more.)
This is actually the program that I volunteer for in PSI; I am a Mentor to a new mama. After climbing out of the darkness, I realized I had survived a harrowing ordeal for a reason–to help destigmatize maternal mental health, or ALL mental health for that matter. I needed to give back and make sure other new moms did not fall as hard as I did and that they had a proponent in their court. I was actually hoping my health organization that I worked for would start a program like this, but PSI is ever forward-thinking and leads in maternal mental health matters.
The coordinator for this program did an amazing job matching me with my Peer who is currently going through a lot of the same issues I had during my own PPD journey. We both had breastfeeding issues and huge insomnia problems, coupled with anxiety. The cool part is that we actually don’t even live too far apart, considering we have Mentors from all over the country and even internationally! We actually met up recently after her baby turned 1 and our families were both fully vaccinated! The coordinator interviews all Mentors and Peers who apply to make sure everyone understands the program and can commit the proper time and dedication.
Now, this isn’t a crisis program or for people who currently have suicidal ideation. Since this is a longer program to commit to, it’s really for mamas who know their diagnosis and are seeking professional help but are stable enough and could use the extra support and an extra weekly resource to keep them on the right track in the baby’s first year. Mentors are definitely not meant to replace or be a therapist, but they can certainly provide insight and resources to finding good therapists and show their peers how to navigate the PSI website too.
PSI Chat with an Expert
I learned about Chat with an Expert during my Mentor orientation when the coordinator made sure we knew how to utilize the PSI website and resources. I wish I had known about this when I needed help because it seems like such a great program.
Every Wednesday, moms can join the free 1-hour Chat with an Expert program to connect with other mamas in a small group led by a PSI expert, a rotation of licensed mental health professionals trained to work with women in the perinatal period. So it’s not just any licensed mental health professional; they really try to tailor it to mommies, which I think can be hard to find and definitely a specialty area.
You can see the schedule ahead up time from now through the next 5 months. However, unlike the support groups, you do not need to register beforehand and it can be completely anonymous. But they do limit the call to the first 15 callers.
Chat with an Expert for Moms
https://www.postpartum.net/get-help/chat-with-an-expert/
Every Wednesday
Chat Number: 1-800-944-8766
Participant Code: 73162
And if you’re wondering, well, what if I’m a dad who needs help and support. Yes, dads and partners get “postpartum depression” as well–1 in 10 to be specific. And there is a specific Chat with an Expert just for dads (and partners) on the first Monday of every month at 5pm PST, facilitated by a male psychologist. Again, only 15 callers on the line and no need to pre-register or give your name. The number to call and participant code is the same as above. Click here for more information on the chat facilitator.
Just keep in mind, these free sessions are not meant to take place of any needed visits to healthcare providers and are not therapy sessions. But I think they sound like they could be helpful if you’re on the fence about what kind of help to get and doubting if therapy or medication can even be helpful. This is your space to ask about resources, symptoms, treatment options, and general questions about PMADs from someone who actually deals with this population.
Provider Lists for Perinatal Professional Help
It can be kind of daunting thinking about seeking professional help because you might have no idea where to start or you might be feeling like a “failure” that you are even at the state where you need to ask for professional help. But trust me, it takes nothing more than the utmost strength to admit your vulnerabilities, swallow that humble pie, and ask. for. help. Break the stigma, please.
That being said, finding the right provider can be just as important as seeking out the help. The wrong provider could potentially make things worse. So if it doesn’t feel right, and you don’t feel like you are being heard, trust your gut. I know that’s hard to do when your world feels like it’s crumbling, but a good therapist should not be making things worse and they won’t be offended if you don’t feel the pairing is the right fit. These are professionals trained to not be offended!
So how can you find the right provider more quickly? There are providers who are more specially trained to work with perinatal mood disorders, some who work with both women and men as well. These websites below are more reputable for the providers they recommend, who are specialized in maternal mental health.
- I definitely recommend the PSI Provider directory, as you can search in your area and it will locate therapists near you. The directory search can also be filtered in many categories so you can narrow your search to find if a certain insurance is taken or what languages are spoken or even more techniques/specialities the therapists may be trained in. And if you can’t find anyone in your area, you can call the PSI HelpLine at 1-800-944-4773 to have someone help you find a provider that may not be in their directory.
- The second provider directory that I recommend is from The Postpartum Stress Center (PPSC). Providers on their provider list have all successfully completed the 10 or 12 hours intensive post-graduate training course that PPSC offers for therapists. They also can consult with Karen Kleiman, MSW, LCSW who is an international maternal mental health expert for over 32 years now. She’s the author of many influential books on PMADs that I’ll refer to in the next few sections too!
- I have not personally used this site, but PPSC recommended Postpartum Progress for provider searching as well. If you are located in New York, you may also check out providers from Postpartum Resource Center of New York.
Postpartum Stress Center
The Postpartum Stress Center (PPSC) was founded by Karen Kleiman, MSW, LCSW in 1988 as a place to counsel pregnant and postpartum women with PMADs. Their office is located in Rosemont, PA, but Karen Kleiman’s reach into the maternal mental health world is far and wide with her training programs through PPSC for providers (therapists and physicians) to specialize more in supporting and treating PMADs and her books.
I am not as familiar with if they took referrals to see non-local patients previously, but it does appear they are practicing teletherapy in times of COVID-19, so they can see you remotely during this time. I believe I would feel very confident that I were in good hands with therapists who work here or have been trained here. It couldn’t hurt to see if they take your insurance should you feel you wanted to see a therapist here. The website itself also has some great FAQs for moms, families, and professionals wanting to learn more about PMADs.
This is Not What I Expected
I can’t say enough good things about this book by Postpartum Stress Center founder, Karen Kleiman. TL;DR–one of the best books you should read if you’re a mom with PPD trying to understand why this happened to you and how you can get better.
When I was pregnant, my husband got us the Kindle book version of What to Expect When You’re Expecting to both read. To be honest, I never finished the book and while my husband did, he skimmed a big chunk of it. That book is very informational and a classic–but it’s long and frankly quite a lot of information. (Sorry, Heidi Murkoff if you ever read this–I’m a huge fan, and thank you for commenting on one of my IG posts once!) If you are someone who needs to learn about everything and cover your bases, please read it. However, I think Karen Kleiman’s book This is Not What I Expected is the direct and essential counterpart to Murkoff’s book and reads much easier. It should be just as much a necessary read.
I think I focused a little too much on the pregnancy part of my journey; and I think many women do. It had been so hard for my husband and I to conceive that keeping my pregnancy viable and healthy to the end was such a huge concern and preoccupation in my mind. I’m sure many women are scared of miscarriage, of pregnancy complications, of delivery complications, of delivery–for crying out loud. I hired an amazing (albeit expensive!) doula to make sure I had the best birthing experience ever. And I did–thanks to her! But really, I should have also focused on what was going to happen after a baby arrived.
Because the delivery of a baby is not happily ever after–it’s happily ever beginning.*
*Pearls of Jasmine — Mommy Pearls
What comes in those postpartum months is the real hard work; breastfeeding is the real event you should worry about instead of pushing a fetus into this world. This is Not What I Expected is something I wish I had read either before delivery or at least when I started to notice symptoms of depression and wondered what the heck was going on. Granted, women don’t go into pregnancy thinking they could ever get postpartum depression. But it’s also like, no one ever climbs into a car thinking they’ll get into a car accident today. You still wear your seatbelt, right?
The book is intended to be for moms who are experiencing PPD or for family and loved ones of someone suffering PPD. But to me, my PPD symptoms started pretty much at the beginning–maybe about 2 weeks into my postpartum phase. I would not have had the time or energy to be reading this book then. I think I escalated 0 to 100 pretty quickly in a matter of weeks and that would not have given me the ability to read this valuable book while I was so caught up with learning how to breastfeed and pump among a bunch of other problems I won’t disclose here.
By the time I may have gotten to this book, it could have been a little too late. And so, I say that if you can read What to Expect When You’re Expecting, then you can and you should at least skim some of This Isn’t What I Expected too and learn about warning signs and symptoms. If you feel you are in my boat and do not have the time for a book, then I recommend Good Moms Have Scary Thoughts that I describe in the next section.
Reading This Isn’t What I Expected after having postpartum depression, anxiety, and insomnia was a bit like reading a strangely accurate autobiography. I would nod yes, yes, yes to all the things Kleiman described about the symptoms, the stigma, the guilt, the shame, the isolation, the utter feeling of hopelessness and dimming of your light as you once knew it. I think Kleiman does a fantastic job of describing PPD/PMADs in a way that is relatively easy to understand and try to empathize with. There’s even a chapter for partners of women with PPD, and I thought it would have been very helpful and encouraging for my husband when we were in the thick of it.
Lastly, I know this is getting long, but reading this book while in remission was a really good validation for me yet again that everything I went through was not my fault. It again highlighted how REAL of an illness PPD was and how incredibly sad that women still feel they have to suffer in silence, even after almost 20 years between the lapse of the first edition of this book in 1994 to the update in 2013. It’s still helpful even if you are done admitting you have PPD because it provides comfort in knowing the reasons behind your symptoms and re-affirmation that you are hardly alone.
Good Moms Have Scary Thoughts
One of Karen Kleiman’s most recent books that came out in 2019 is absolutely phenomenal and reads more like an illustrated informative picture book. Good Moms Have Scary Thoughts is a visual compilation of the campaign #SpeakTheSecret where moms shared their “scary thoughts” and deepest, darkest secret feelings about motherhood. These were things that you would not expect to hear a mom say about her experience– that she just wanted a break, that she was terrified of being alone, that she resented her partner for getting to sleep while she was solely responsible for feeding the baby.
Through an illustrative approach, this book is so easy to read and touches the core of all the unspoken, unglamorous, non-curated side of motherhood. There are simple activities for moms to do to consider how to ask for help or list out her resources as a reminder of where to seek support when she feels alone. I highly recommend this book to all moms, PPD or not. In This is Not What I Expected, the author mentions that even though 1 out of 5 women get a PMAD, 1 out of 2 women find that motherhood is NOT what they expected at all.
You don’t need to even really have a PMAD to appreciate Good Moms Have Scary Thoughts. This book highlights all the hard moments of being a parent and the things you don’t hear about in the media or that you feel you have to hide from your friends or else you’d be perceived as a “bad mom.” The fact is you will probably wonder why you ever wanted to be a mom at some point. And that doesn’t make you a bad mom. It just makes you human.
In general, Karen Kleiman has written a bunch of really great books for moms, therapists, clinicians, dads, etc. One book I’d be interested in reading is What am I thinking: Having a baby after postpartum depression because that’s totally my next stage of wondering how one has a second child after such severe PPD in the first place…
Meditation and Mindfulness Apps
When I saw one of the therapists I was assigned in my intensive case management team, she seemed too young and green. She definitely wasn’t a mother and the most she could relate to me was that she had always suffered from anxiety. But when I described my issues with insomnia and how I couldn’t shut off my brain to sleep, she knowingly (and annoyingly) nodded and said, “You need to do mindfulness.”
At first, I kind of rolled my eyes at her. This young 20 -something year old who was getting married next month and even inadvertently told me she never wanted kids (ugh!) thought that if I just meditated a few minutes a day that I would be able to fall asleep?! Okay, yea, come back and tell me that when you have had a baby.
But actually, after using some of these apps, I did discover that mindfulness and meditation can be helpful. The problem is, it’s not a quick fix. Time is really what you need to be cured from your PPD. That’s not to say that these tools can’t help long term. For me, I had a lot of anxiety and PTSD from a certain insomnia episode that I won’t go into.
Even now, a whole year and a half later, I still get some anxiety about whether I will fall asleep at night and if I wake up in the middle of the night, will I be able to fall back asleep? So now, I use my apps, and even though I still have this unwarranted nagging anxiety that this will be the night I relive my worst nightmare, I have always fallen asleep in the end. I also try to meditate once a day and make it a habit. The thought is that you need to slow down during your day and not try to unwind and unpack it all at the end of the day–which is how the insomnia can take hold.
- Calm – This is my preferred app mostly because I like the background soothing noises of rushing water or whatever you choose as your sound background. The visuals are really appealing and it helps me relax at night. I like doing the “Daily Calm” which is usually around 10 minutes and guided by a narrator during my lunch hour. Or sometimes I’ll put on a face mask and while I’m waiting for it, I’ll turn on the Daily Calm. They also have less guided meditations and other variations, even 7-day challenges for sleep, anxiety, stress, etc. There’s nice music “sleepscapes” and you can even listen to sleep stories read by celebrities like Harry Styles or Matthew McConaughey.
Personally, I really like the 30 day How to Meditate series by Jeff Warren. He really breaks down what meditation truly is for, and it has made me appreciate that it’s not just about sitting around trying to breathe and empty your mind. It goes beyond that, exercising your equanimity brain muscles.
You can try 7 days for free before paying for a subscription. They usually have sales on yearly subscriptions. BUT, WAIT.
If you are a member of Kaiser Permanente, right now you can get a year of Calm FREE! You really have nothing to lose, so take advantage of it now while you can!
- Headspace – This is the other popular meditation app that a lot of people like to use. I personally don’t like it AS much as Calm because it is a little more monotonous for plain for me. But the no frills app and interface might be what you like! They also do have a section for Sleep, but I felt there were more resources and exercises in Calm.
It is usually also subscription-based but you can try 2 weeks for free. The monthly and annual fees are similar to Calm but they have student and family pricing that’s cheaper too. Calm does have a lifetime subscription fee too, which can be a nice option. Headspace has also pulled some FREE meditation guides for workplaces.
EFT Tapping
During one of my regular therapy sessions (once I found the therapist I liked most), my therapist asked me if I had tried “tapping” or EFTs. I was puzzled and answered, “Well, I took tap dance in fifth grade…?” She laughed and explained about EFT, or Emotional Freedom Technique. This is an alternative treatment for people with physical pain or emotional distress by “tapping” with your fingertips on acupressure points.
My therapist led me through a session of tapping in her office, so I could have an idea of what to do on my own and then she suggested if I wanted more guidance to look up Nick Ortner on YouTube. It was very simple to do on my own and we found my “sweet spot” where we evaluated together that I felt most relaxation from tapping there. She suggested whenever I felt anxiety arising to just keep tapping there and repeating the mantra in my head, “Even though I have these feelings of anxiety, I deeply and completely accept myself.”
Fast forward a few months, and COVID-19 happens. All these companies are offering health care providers access to free mental health tools and my good friend tells me to look into the “Tapping Solution App.” I knew exactly what tapping was and then to my great surprise, it was created by the Ortner family–exactly the one my therapist had recommended me to look up on YouTube (which I never did…oops)! They were offering 6 months free to healthcare workers, teachers, first responders, and mental health workers, but I’m not sure if they still do it now. However, you can get free Coronavirus Stress and Anxiety Collection for free. Just download the app to access it!
I think the app is really excellent and guides you through tapping exercise very clearly and effectively. On nights when I had sleeping issues, sometimes I would do tapping instead of my Calm app. To be honest, it has been one of my favorite tools to use for insomnia and anxiety. Sounds a bit crunchy, but you have nothing to lose by trying it! If anything, you can check out the YouTube videos online. Nick Ortner and Dr. Mark Hyman (Director of the Cleveland Clinic of Functional Medicine) also wrote a book called The Tapping Solution.
As a side note, I did also try acupuncture for my insomnia and anxiety. I have to say it did help relax me, but I never knocked out or fell asleep during an acupuncture session. Tapping is a less “invasive” way of getting some of the same benefits without using needles, although I have to say my fear of needles and acupuncture was unwarranted because it didn’t hurt. I’m a believer in acupuncture now too.
EMDR International Association
If you’re crazy (or cool!) enough to have read all of my postpartum depression series, you might recall from the third post in the series that I talked about doing EMDR, or eye movement desensitization and reprocessing, with my therapist. I also saw them feature this technique on Season 16 of Grey’s Anatomy, which I was so excited to see and recognize! EMDR was a tool that my therapist also introduced to me that could help me process some of the trauma and PTSD I had from my postpartum depression and insomnia. It is actually really important to unpack that trauma and truly process it to move on fully.
Luckily for me, my therapist is actually trained to do EMDR, which is another certification some therapists will opt to get. Not all therapists or psychiatrists know how to do it, and I was very fortunate that mine just happened to be trained and helped me do a few sessions. I do feel that after our first session, I was somehow able to sleep more peacefully and easily than I had in months.
The PSI Provider Directory also has providers list out if they do EMDR, which can be a helpful way of finding someone who practices it. My therapist also recommended that people can look on EMDR International Association to learn more about EMDR and find a specially certified EMDR provider.
Motherhood Understood
When I was starting to get back into social media again after staying away for a month because I literally could not give a rat’s tail about everyone else’s life while I was withering away, I found Motherhood Understood.
I started following more mommy accounts that resonated with me and again reassured me (while also astonishing me) that other moms also felt so much of the same feelings I did during my PPD. This was one account I kept coming back to. Motherhood Understood was a great space for sharing all these moms’ unique PMAD stories and their experiences with medications, therapy, or even hospitalization in their own words. There were even some stories about moms who had suicidal ideations and attempts and lived to tell about it. (Trigger warnings are always noted.)
While I do love this story-sharing space and community on Motherhood Understood and hearing how similar and also how different all these PMADs can be, the one thing I did wish I saw more of was a wider representation of women of color on this website. I know they’re out there, and they’re probably too ashamed to share their stories publicly. But it’s definitely a start, and I have great respect for the mamas who were brave enough to share their stories to help others. We need to hear them to break the stigma.
You can also sign up to get a really great free “Mother’s Manual for Postpartum Mental Health” sent to you. I think the founder did a great job creating this and it’s a fantastic tool to have when you’re trying to decide how to get help and work your way through your feelings. It’s kind of like a CliffNotes version of This Isn’t What I Expected that can help you pinpoint symptoms that might fit under certain PMAD diagnoses and figure out how to get help.
I hope that any or all of these resources might prove useful to you if you think or know you have a PMAD or to a friend/loved one who does. I feel lucky that I was able to be introduced to a lot of these resources, although they did take some time and trial and error to test out and see what was worth pursuing. By writing this all down, I hope I’m able to help another mama more quickly get to the best resources I have found through my 1.5-year journey. Please always remember that you are not alone, you are not to blame, and that with help, you will be well again!
And with that… I conclude this way too long and detailed article of my resources. But if you haven’t noticed by now, I just write a lot of detail in general. 🙂
xoxo,
Jas
P.S. Please help me pin this article so more mamas can find it!
Jasmine, you have bravely cataloged and shared your suffering, and I’m sure your story and resources you’ve found will give courage to someone to find hope. Thank you for you.
Would you mind sharing the insomnia medications that worked for you?
I hope you can live a healthy life.