Moms and Medication
Interview with Laura Markham
A recent study out of An International Journal of Obstetrics and Gynaecology points to maternal depression being higher at four years after birth than at any other time during the first twelve months after childbirth. When your child came into the world, did you feel that overwhelming sense of responsibility? And that was only the beginning….What is it about motherhood that triggers anxiety and depression? Laura Markham, Ph.D., shares her insight into the growing trend of women turning to medication after becoming mothers. — Laurel Moglen, Managing Web Editor, TMC
What about being a mother can cause women to feel depressed?
Women are twice as prone to depression as men. This may be partly physical (hormonal, thyroidal), partly genetic, and it is probably partly also environmental. Women are not as powerful as men in our society and they can find themselves in situations that feel disabling. We know that women are more prone to depression if they don’t experience their partner as supportive, for instance. We also know that women are more likely to respond to stress by getting depressed.
Motherhood can be stressful in and of itself.
First, there’s the stress of being out of control, because as every mother knows, you can’t control another person, even when they’re only four.
Second, there’s the guilt, and the fear that we’re failing. We know that parenting our children well is important — the stakes are very high. We know we aren’t perfect. No one is, and every mother can tell you a litany of things she wishes she had not done or said. And in our society, we don’t get much support to parent, even while we’re expected to do it perfectly. So it’s easy to doubt ourselves, to feel guilty, to wonder if we’re damaging our children.
Third, there’s the isolation and the feeling that you never get your needs met. Many women are so busy just trying to get everyone through the schedule that they find themselves running on empty. And isolation is a contributor to depression.
Hormones, genetics and stress combine to create depression.
Stress can be caused by:
- Lack of support
- Inability to soothe a colicky baby
- The isolation of being alone much of the day with a child
- A child with special challenges
- Spacing babies close together
- Breastfeeding challenges
- Financial stress
- Unplanned pregnancy
- Perfectionism, self-blame
- A disappointing birth experience
What are the signs of maternal depression?
Maternal depression doesn’t always look like depression.
Some signs are:
- Intrusive thoughts of hurting your child or yourself
- Excessive worry about your child’s well-being
- Lack of energy
- Disrupted sleep patterns
- Difficulty concentrating
- A feeling of emptiness
- A loss of interest in activities once enjoyed
- Feelings of guilt or shame
- A loss of appetite or a tendency to overeat
- Thoughts of suicide
What are ways in which moms can tackle the depression?
- Exercise is the first thing to try. Put the baby in a jogging stroller and walk or run. Put the baby in a sling, put on music, and dance. Or get a sitter and go to the gym by yourself. Movement shifts your body chemistry out of the depressive state.
- Connect with other people, especially mothers who help you feel better. One of the problems with parenting is the isolation.
- Talk to someone who helps you feel better. It really helps to dispel the guilt and shame and fear that you aren’t a perfect mother, because no one is. This can be a friend, but if that doesn’t help, don’t hesitate to see a professional.
- Force yourself to do things you enjoy, even if all you want to do is stare at the wall. Even if that means getting a sitter, or asking a trusted adult to look after the kid/s for a bit.
- Watch a show or movie that gets you laughing. You’re actually shifting your body chemistry.
- Find ways to take care of yourself, even if that means getting a sitter.
- Confront your own inner negative self-talk. Cognitive therapy is designed to help you manage your thoughts better and has proven to be very effective in treating depression because it helps you notice and interrupt those self-critical, pessimistic, and fearful thoughts that get entrenched in tape loops in our minds.
- Mindfulness practices have also been proven to be very helpful with depression, like meditation, or listening to audio recordings that increase your awareness, transforming your inner voice. That said, it can be very hard to get started on a meditation practice, so consider Mindfulness-Based Cognitive Therapy, which teaches clients various mindfulness practices and gives you a therapist to talk with. It has been found to be as effective as medication.
Do you feel medication is a viable solution?
How important is to use talk therapy in correlation with meds?
Research shows that the combination of talk and meds is usually more effective than either by itself.
People who are depressed have a different body chemistry and brain activity than people who aren’t depressed. But that doesn’t necessarily mean the depression is solely physiological. We now know that stressful life circumstances–and maybe more importantly, certain ways of interpreting and responding to those life circumstances– can lead to the changes in body chemistry and brain activity that we experience as depression.
So to help someone who is depressed, it’s very effective to intervene with mindfulness-based cognitive therapy (MBCT), which will help the person change the way they’re interpreting and responding to the circumstances of their lives. For instance, someone who is subjecting herself to negative self-talk and feels powerless and helpless may well get depressed. MBCT can help her interrupt that cycle by noticing how she’s talking to herself and how she’s perceiving things, in a way that makes her feel more powerful. She will find that she’s more able to take charge of her life and her relationships and make positive changes, and naturally she begins to feel happier.
Sometimes, when people are very depressed, it can be hard for them to use therapy initially. Medication can help jumpstart the therapy by changing the person’s physiology. They start feeling more hopeful and capable of taking control of their life, and they can make better use of the therapy.
Why not just the medication by itself?
It’s always more useful for the person to develop more effective coping mechanisms and ways to handle their thoughts and emotions. Otherwise, they’re always vulnerable if they don’t have the medication.
Could you talk a bit about the stigma associated with using meds to help anxiety/depression? Is there a stigma?
Most people who have not suffered depression don’t understand it. We tend to think the depressed person can just decide to feel better, the way someone who is not depressed can. And yes, feeling better is a choice when you’re in a normal frame of mind and physiology. But when you’re depressed, you don’t always have that choice. Your body and your brain are functioning in a depressed way.
So there can be a stigma about being treated for depression, as if the person is taking the easy way out, or making a big deal about nothing. But in my opinion, those judgments from other people would have no power with us if we didn’t feel the stigma ourselves. In other words, if we think there’s something shameful about taking medication, we’ll likely feel judged, because we’re judging ourselves. But, if we can accept that depression and anxiety are medical conditions that need treatment, then who cares what someone else thinks? Just like any medical condition, medicine can be used to help heal us.
Laura Markham, Ph.D. is the author of Peaceful Parent, Happy Kids: How to Stop Yelling and Start Connecting. She’s worked as a parenting coach with countless parents across the English-speaking world and runs AhaParenting.com, the website of Aha! Moments for parents of kids from birth through the teen years.
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