Postpartum depression (PPD) is a stealthy condition. I nearly missed it. I was visiting a close friend who had given birth to her first child about a month earlier. As I cradled her little boy, he let out a tiny perfect baby yawn and my heart melted. “You won’t believe what he just did,” I gushed, as my friend emerged from her bedroom. “It was the most adorable thing!” I expected her to rush over and investigate the cuteness I’d just witnessed. Instead, she held up her hand in an “I can’t even” sort of way, stumbled into the kitchen to get some Advil and went back to bed.
I was dumbfounded. Why isn’t she more excited? Why doesn’t she seem connected to him? Though unspoken, my judgment blinded me from seeing what her lack of joy really indicated. A couple of months later, she was diagnosed with PPD and I realized how completely unsupportive I’d been.
In those early weeks and months, new mothers need lots of help. A fair number of them—7.5 percent, according to Health Canada—experience depressive symptoms in the exhausting postpartum period. As soon as I realized my blunder, I took some overnight babysitting shifts so that my friend could get some rest and helped whenever I could. Whether you’re a friend, sibling or neighbour to a mother with PPD, here are some ways that you can be supportive.
1. Make it about her—not the baby
When you visit, don’t just ask about the baby. “Tell yourself, ‘I need to leave this interaction understanding how she is really feeling,’” says Stacy Thomas, a Toronto psychologist who specializes in women’s mental health. That means showing up (more than once!) prepared to listen and making the conversation about her every single time. You shouldn’t be doing more talking than she is, either. Make it safe for her to share any feelings that she is having, even if they don’t make much sense.
“Let her know that she is able to hold two ambivalent emotions at once,” adds Carol Peat, a labour support provider and educator in London, Ont. “She can love this tiny human with all her heart yet feel like today really sucks.” Your job isn’t to make those emotions disappear; it’s to make her feel heard.
2. Stop trying to solve her problems
We often try to cheer up others by disputing their emotions. But comments like “What are you talking about? You’re a great mom!” are actually counterproductive. “It won’t make her feel like a great mom,” says Greer Slyfield Cook, a social worker in the Reproductive Life Stages program at Women’s College Hospital. “Instead, it invalidates her feelings and can even trigger feelings of guilt.” Instead, echo the mother’s concerns with statements like “It sounds like you’re really worried” or “That must be really hard.” If you’ve experienced anxiety or depression before, even unrelated to pregnancy, offer up your own story to show that you understand what she is going through. Because women often feel alone when experiencing depression, it can be helpful to hear other women share their experiences.
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3. Offer to go to doctor’s appointments with her
This isn’t about keeping her company; it’s about being her advocate. She will likely have a team of practitioners to follow up with during the first year, but these postnatal checkups are usually focused on the baby, so Mom’s needs and concerns could get overlooked. Ask if you can tag along to those appointments if her partner can’t attend. “This isn’t to undermine her,” says Thomas, “but to bring up anything that feels off for her, in case the doctor doesn’t ask.” If she isn’t on board, though, do some research on her behalf. Find out what mommy support groups or therapists are available in her community.
4. Quit asking what you can do and just start doing it
It may be well intentioned, but saying “If you need anything at all, I’m here” to a sleep-deprived and depressed mother isn’t very helpful. It puts the onus on her to figure out what she needs, which she may be struggling to understand. Be specific and direct in the help you offer. If she isn’t sleeping when she gets the chance (a warning sign of PPD), ask if you can take the baby off her hands while she naps, showers or goes somewhere for a few hours. If there’s an older child in the picture, offer to do daycare pickup or drop-off. And, because she may not be eating regularly, arrive with her favourite food when you visit.
5. Celebrate her successes
Another indicator of PPD is when small victories don’t have any impact on how the mother feels. For example, maybe she managed to get her baby to sleep but there’s no one around to recognize her achievement. “Infants can’t praise you for feeding them,” says Peat, who makes a point of throwing routine dance parties when her clients’ babies gain weight. Maybe the mother finally got her baby to latch, maybe she actually ate breakfast today or maybe she just isn’t feeling like a huge failure for the first time in a while. Whatever the triumph, find a fun way to celebrate with her.
6. Look outward for your own support
If you’re a close relative or friend of the mother, you might be providing significant emotional and practical support on a daily basis. But by constantly looking out for her, you may soon find yourself in need of someone to lean on as well. In this situation, the best thing you can do is look outside for that help. “Don’t tell the mom, ‘I’m so worried about you, I couldn’t sleep last night,’” says Slyfield Cook. “It’s not an equal playing field when someone is depressed, and the support can’t be reciprocal.”
Postpartum support comes in many forms. I know the next time I’m needed, I’ll be there in whatever way I can without judgment.