Postpartum depression (PPD) is a relatively common problem, affecting between 10-15% of women after delivery. In addition to affecting maternal mental health during a critical time in a woman’s life, there are a number of downstream effects associated with undiagnosed or untreated PPD such as impaired bonding with the baby, shorter duration of breastfeeding, and marital difficulties. Being that such a significant percentage of new moms struggle with symptoms of PPD, it is can be wise to begin implementing interventions prior to the birth of your baby that can help reduce your risk of experiencing PPD.

What Are My Chances?

There are many factors that can increase your risk of experiencing PPD. According to The U.S. Preventive Services Task Force, women with a history of depression, depression during pregnancy, a history of child abuse, or even a family history of depression are at an increased risk. In general, women with histories of depression are at a three-fold increased risk for PPD (25%-30%), for women who specifically experienced depression while pregnant, the risk for developing PPD is as high as 75%. If you have experienced PPD in a previous pregnancy, you have a 50% chance of experience PPD in subsequent pregnancies. Other risk factors include recent stressful life events, inadequate social supports, poor marital relationship, low self-esteem, childcare stress, and difficult infant temperament.

Counseling That Works

There are a variety of effected and well researched counseling treatments and interventions that have been shown to reduce the risk of postpartum depression and anxiety. Many of these treatments involve providing mothers with practical support and strategies for managing problems that may arise during the postpartum period (such as sleep deprivation and crying). Here are some more specifics!

Mindfulness-Based Cognitive Therapy

Mindfulness-based cognitive therapy (MBCT) combines cognitive-behavioral techniques with mindfulness strategies in order to help individuals better understand and manage their thoughts and emotions in order to achieve relief from feelings of distress. MBCT involves practicing meditation and yoga, and learning mindfulness-based strategies for changing the way you relate to negative thoughts and improving self-care. This intervention is designed specifically as a prevention program for women who are at elevated risk for postpartum depression due to having experienced depression in the past.

New Baby 101

What Were We Thinking (WWWT), and yes, it is really called that, is a psychoeducation treatment protocol used to prevent postpartum mood and anxiety disorders in first-time mothers. This supportive intervention provides extremely practical help with common struggles faced during the newborn phase. For example, WWWT focuses on strategies to respond cognitively (rather than emotionally) to your baby crying by building skills to respond actively and effectively to your baby, rather than you constantly dreading or trying to avoid the crying. The various strategies used in this intervention lead to increased confidence and competence and reduced depression, anxiety, and adjustment disorders in new mothers.

PREPP (Practical Resources for Effective Postpartum Parenting) focuses on the relationship between new moms and their babies. This intervention provides a supportive relationship with a professional counselor where mothers are encouraged to explore their own childhood and how it informs their parental identity. Psychoeducation about the postpartum period and various mindfulness techniques aimed at helping mothers to cope better when their babies are distressed and/or unsoothable are also included.

Interpersonal Therapy

Interpersonal therapy (IPT) identifies four basic problem areas which contribute to postpartum depression. The counselor helps the mother determine which area is the most responsible for their symptoms and counseling is then directed at helping the mother deal with this problem area. The four basic problem areas recognized by interpersonal therapy are:

Unresolved Grief

In normal bereavement, the person usually begins to return to normal functioning within a few months. Unresolved grief is generally grief which is either delayed and experienced long after the loss or distorted grief, in which the person may not feel emotions, but instead experiences other symptoms.

Role Disputes

Role disputes occur when a new mom and significant people in her life have different expectations about their relationship.

Role Transitions

Depression may occur during life transitions when a person's role changes and he doesn't know how to cope with the change, this is especially common during the transition to motherhood.

Interpersonal Deficits

This may be an area of focus if the mom has had problems with forming and maintaining good quality relationships.

Overall, IPT focuses on the development of effective communication skills to manage relationship conflicts, expectations about motherhood, stress management, development of a support system, maintenance of healthy relationships, goal setting, and psychosocial resources for new mothers.

Getting Help During Pregnancy

If you have identified with any of the risk factors mentioned above, getting started in the counseling process prior to the birth of your baby can help reduce your risk of developing postpartum depression or anxiety. All of the treatments and interventions mentioned here are only a few of the ways that counseling can help women who are experiencing perinatal or postpartum depression. Libby Marler, LPC-Intern has experience and specific training in helping women in their transition to motherhood, reach out today to schedule an appointment and begin experiencing relief from your symptoms!