This Isn't What I Expected

Notes on healing postpartum depression

by Karen Kleiman, MSW, LCSW

Postpartum Psychosis: Scary but Treatable

Postpartum psychosis can emerge suddenly, bringing with it alarming symptoms and much confusion to all who are impacted by it. I worry terribly about the few new mothers who suffer with severe symptoms of psychosis, who might not get the help they need, or get it early enough. Read More

Countertransference: When Is Yours Mine?

Meeting Lyn and Rob was hard from the start. I knew from her phone message that they had lost their dear son after nine months gestation, during delivery. It never gets any easier even after years of hearing one very sad story after another. "He was perfect," she sat close to her husband in my office and shook her head in disbelief. Read More

Can We Prevent Postpartum Depression?

Most women who experience postpartum depression, at some point or another, wonder, why did this happen? Our best answer to this is that a number of factors combine to put a woman at risk for depression after childbirth, some of which are hormonal, biologic, genetic, environmental and psychological. Read More

I Just Need to Sleep! (Or Could You Be Depressed?)

New mothers are tired. There aren't many guarantees in this business but that's one of them. New mothers do not get enough sleep. It's irrefutable and universal. To further obscure the picture, sleep problems crossover between cause and effect variables with respect to postpartum depression. Read More

A Note to New Dads

You might not want to hear this, but if you're not feeling so hot since having a baby, it's possible that you may be experiencing symptoms of depression. A study by Paulson (Paulson, J. Pediatrics, August 2006) reported that 10% of all new dads experience symptoms of a clinical depression after the birth of a baby. That's one out of every ten dads! Read More

10 Tips for Setting Boundaries and Feeling Better

1) Say no.

Really. If you're tired, if you'd rather not, if you feel overwhelmed, if you're not in the mood. Say no. You don't need to justify it. You don't need to blame yourself for letting someone else down. Give yourself permission to just say no.

2) Say yes. Read More

Scary Thoughts: Offering Your Support

If you are trying to understand and support a loved one who is struggling with scary thoughts, it can feel overwhelming and frightening. How do you know if her thoughts will lead to action? How do you know if her thoughts are an indication of a serious mental health concern that requires immediate and aggressive intervention? Read More

Postpartum Depression: Is Misinformation Just Annoying or Can it Be Dangerous?

...Should well-respected, highly-accomplished experts stop promising women that they can prevent postpartum depression by buying their books, or taking their course, or by simply seeing things differently? Read More

Good Things Are Going to Happen: Adaptation and Healing

"Good things are going to happen." These words are hand-painted on a ceramic plaque which hangs on the wall in our waiting room. In part, it's decorative, but in truth, those of us who work there secretly expect subliminal rejuvenation. It's part of the magic. Read More

Why Women Should Learn to Ask For Help

Can a woman's predisposition toward asking for or not asking for help can actually influence the course of her depression? Read More

The Paradox of Control: Learning to Let Go

One of my greatest responsibilities, in my role as therapist to postpartum women who try desperately to keep pace with their own unrealistic expectations, is to simply tell them they don't have to do that anymore. They can stop working so hard. They can learn from their mistakes. They can stop looking so good. They can make a mess. They can learn to live with imperfection. Read More

Lessons From My Mother: Loss and Love

My mother lost one of her best friends yesterday.

Over the course of recent years, this has become a sad but predictable occurrence. No one is surprised when their 80 yr old parents start burying their lifelong friends.

It's a pain I cannot imagine. Read More

Why Are We Still Fighting About Breastfeeding?

I try very hard to keep an open mind and not to judge when others have opinions that differ from mine. My effort to do so is in line with my professional pledge to support and guide without judgment and it is also in keeping with my strong personal belief that people are entitled to their own opinion.

That is, unless I think someone could get hurt. Read More

Asking for Help: What Gets in the Way and Why?

Women tend to take better care of everyone else than themselves. Most women readily confess that self-care is on the bottom of their "to-do" lists. Mothers, in particular, are inclined to sacrifice their own needs while maintaining intense focus on the needs of their children. Read More

PPD? Questions & Tips for Postpartum Women

To physicians and other healthcare practitioners: If you are not asking these questions of each postpartum woman, you do not know how she is feeling:

To postpartum women: If your healthcare provider is not asking you these questions, take this list with you and be sure they know how you are feeling: Read More

Why Can't This Just Be Funny?

Learning to laugh during difficult times... ah, not an easy task. Read More

Therapy: Show Up and Throw Up

One of my clients started off her session the other day by expressing her concern that she would be fired from therapy, "You're not going to kick me out of therapy, are you?" she asked, as she settled herself into her comfy spot on the couch.

"Why would I kick you out of therapy?" Read More

Living with Yourself and Unpredictability

Most of us tend to be hard on ourselves at one time or another. But for women who are going through postpartum depression or anxiety, the impulse to judge oneself harshly is intensely magnified. Decisions feel impossible to make and then, once made, women often beat themselves up with constant rumination and guilt. Did I do the right thing? What if such and such happens? Read More

Small Steps You Can Take To Feel Better Now

Below is a list of self-help suggestions that may ease the sting of your symptoms throughout the course of your recovery. Keep in mind that you may not feel well enough to do many of the things listed here. They are, however, reminders, that you continue to hold more power than you think you do, over the way you feel while you are healing. Read More

Postpartum Botox: Are You Kidding Me?

It takes a lot to stun me these days. Read More

PPD: 12 signs your partner may not be as supportive as you think

There are a number of ways your well-intended, loving partner may interfere with your healing process, without meaning to.

1. He says you are "strong" and you don't need to take the medicine that was prescribed for you.

2. He thinks therapy is too expensive.

3. He asks how long you have to keep going to therapy. Read More

Are We Asking the Right Questions? Screening for Postpartum Distress

It is estimated that 50% of women with postpartum distress have symptoms that remain undetected (Peindl, Wisner, & Hanusa). A likely explanation is that this results from women's disinclination to disclose and providers' lack of screening knowledge. Read More

Marriage, Laptops, and a 50/50 Proposition

I bought a new laptop that didn't work.

I've known, for over fifty years, that I should keep the original box of expensive items, and I'm certain I did, but I have no idea where it is. It's in one of those "I'll-leave-it-in-this-safe-spot-so-I'll-always-know-where-it-is" places. Uh-huh. Right. Anyway... Read More

Get OUT of My Head: Does Thought Suppression Work?

Scary, unwanted negative thoughts. Our instinct is often to push them out of our head. Read More

Motherhood and Loss?

So by now, we all know that the miracle of motherhood can be exhilarating, overwhelming and challenging all at the same time. Postpartum women often report how incredibly guilty they feel when they confess some of the things they are thinking. "why did I even have this baby?" "I miss my old life" "my life will never be the same again." And so forth. Read More

For Dads: What To Do, What Not To Do When Your Wife Has Postpartum Depression

You just had a baby. Your wife has postpartum depression. Are you making things better or worse? Read More

10 Things to Avoid if You've Just Had a Baby

Some of the things that you may instinctively default to right now, may actually interfere with postpartum recovery. Be careful. Be smart. Make good choices. Take care of yourself. AVOID: 1) Caffeine 2) Alcohol 3) People that make you feel bad... Read More

OMG...Having Another Baby After Postpartum Depression?

One woman contemplates her baby's demise. Another one has her name splashed all over the newspapers detailing the gruesome and deliberate manner in which she saved her children from their fate on earth by helping them find their way to heaven. And still another leaps to her death leaving a note behind reminding her loved ones that their lives will be fuller without her here Read More

Guilt, Motherhood and the Pursuit of Perfection

Ah, the pursuit of perfecting mothering. How much is too much? What if it's not enough? What kind of damage will I impose on my children if I do it the wrong way? Whatever the issue, whatever the question, whatever the proposed solution, mothers have, for decades, backed themselves into a no-win corner. It's never enough. Or it's not right. Not exactly. Read More

Baby Blues or Something More?

You've just had a baby. You might be floating around on cloud nine basking in the glow of your new precious gift. Or you may be exhausted, irritable, disappointed and anxious. Or, you might be experiencing some combination of both ends of the spectrum. If this is your first baby, it's hard to know what's "normal." Is this what other new mothers feel? Read More

Karen Kleiman is founder and director of The Postpartum Stress Center, a treatment and training center for prenatal and postpartum mood and anxiety disorders. She is the author of several books on postpartum depression.

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