In the process of becoming or being pregnant or having had a baby, people can develop perinatal mental health symptoms like:
- anxiety,
- depression,
- obsessive compulsive disorder, or
- psychosis.
Collectively these are called perinatal mental health issues. This can complicate further an already complex situation. As the support person of someone experiencing perinatal mental health issues it can be a sensitive space to find yourself. There are many things you can do to make this path easier for yourself and the person you are supporting.
If you have received an alert about your loved one from the WACPPS Support Me App.
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Education
Understanding symptoms can make you feel more empowered to help.
It will be useful for you to know what the signs and symptoms are that your partner/friend/family member is experiencing. You could seek out education from health professionals or online from reputable sources, but this learning should also be from the person experiencing the perinatal mental health symptoms. Each individual’s experience is unique, and they are the expert. Only learn to the level that you feel comfortable with; you do not have to try and know everything.
Look on Beyond Blue or Lifeline websites for a guide and ask your loved one what they experience, they are the expert. You don’t need to know everything. Just get an idea.
Becoming a parent and learning the new skills involved can have a huge impact on tiredness and emotions, so it can be hard to know if some symptoms are specific to becoming a new parent or if they are mental health related. If they are causing distress and impacting function, then they are important despite their cause.
Its normal to feel uncomfortable having open conversations about things like self-harm. You are not responsible for fixing this. Be present, listen and direct people to resources/services. You can ask for help finding services. Try their mental health worker, their GP, the hospital emergency department, or lifeline. PANDA have a range of services that could be useful.
Make sure you get support too, from friends or services.
Communication
As with most things communication is a key component of supporting anyone. There will be an ongoing conversation with your partner/loved one looking at how you both communicate and developing these skills. You can explore love languages, how to communicate assertively, honest communication, and how you communicate under pressure. Do you have role models who communicate in effective ways? What can you learn from them? Have you learned to communicate from poor role models and how can you unlearn some of these lessons?
Try to hold onto the idea that you are two people working against an issue, not against each other.
Be purposeful in your conversations. Each conversation should start with clear guidelines. What are you hoping to achieve? Are you both able to deal with a conversation right now? Are there distractions? You could consider using cards to identify the purpose of talking, simply stating, listen or problem solve. Not everything needs to be or can be fixed, sometimes a brain dump and feeling heard is just as effective in improving how you feel.
There are many complex emotions of guilt and shame attached to “failing” around becoming a mother specifically, so people may be reluctant to talk honestly to loved ones and might find it easier with a professional or someone they don’t know personally. This is not a rejection of the support person although it may feel like it. There will be many things they will discuss with you and usually as people work through their experience, they will become more able to vocalise their feelings.
Some key areas for strong communication include:
- Energy and capacity can be severely reduced when parenting and when experiencing depression. Parents may meter out their energy over the day, so communicate if you will be delayed in being available to help or take over care tasks. The parent may need to adjust their plans or request other help to ensure they have the energy and capacity to manage the day.
- If you are pointing out a recurrence of symptoms, especially if the person experiencing them has not noticed or accepted them occurring. You may not be able to remove all arguments, but they can be minimised if you have agreed strategies in advance for these conversations.
- A positive strategy is to make a relapse prevention/management plan, where you identify symptoms together and what action will be taken when different levels are reached. Work out together which symptoms are important to get onto, with timeframes. What reduces function or causes distress? What will you do? Plans could include speaking to a GP, taking medication, planning self-care strategies such as exercise, or social contact or pulling in other support people and scheduling regular conversations.
- Medication can be another tricky conversation, with many people having strong opinions on taking medication during pregnancy or breastfeeding. It is useful to remember that there are two equally important people in this dynamic, the parent and the child. The parent being able to carry out the roles and activities that are important to them is equally as important as the child’s interests. Doctors and health professionals have access to information on the safety of medications and can discuss in detail the pros and cons of utilising these as part of a package of care. This will be a personal decision and there are no right or wrong answers.
What are both of your love languages? Are you able to respond in a way that allow each other to feel understood?
Can you learn and unlearn patterns of communicating that will improve your relationship?
Get used to checking if people have the energy to talk.
Define the purpose of communicating, to listen or problem solve. Sometimes having a brain dump and feeling heard is the best.
It can be really hard to identify your needs and ask for them to be met. Be patient and if your loved one retreats, encourage them to keep practising.
You can be the buffer between your loved one and people who are not helpful right now. Let them know you have their back and will advocate for them.
Some unhelpful things for your loved one to hear include:
Was it love at first sight? Bonding can take a long time for all parents, and this can cause feelings of guilt.
You must be so happy/grateful for a healthy baby. Again, creates feelings of guilt and shame about not reacting as expected.
You should join a class. Very hard to do with low mood or anxiety.
You should try this oil/food etc. People need evidenced based medical help with mental health disorders.
Some helpful communication could be:
- How are you adjusting?
Watch their behaviour and ask if they are struggling?
Checking in guilt free.
We cannot read minds, try to avoid assuming what people want, think, or need and ask them to tell you. Remember they may not be able to. Sometimes you need to just do practical, helpful stuff.
What is helpful? /Practical Help
What is helpful to your loved one? Make a list of specific tasks together if possible or with your support system if your loved one isn’t up to it. Get them to tell you how they like things to be done.
Allow them to keep control of tasks that are important to them, you can still keep them company and assist them to do the task.
Can you provide transport or childcare to allow your loved one to attend to things they prioritise?
Can you help them to set up online services to reduce their workload?
Help them find a support system such as a playgroup, if they feel able to go.
Support for carers
Learning the parent role and how to support someone else is a tough gig. You are going to need support too. We all do. We weren’t meant to do this parenting stuff in isolation. We really do need a community to make it happen.
Both of you need to identify your support networks. You can’t be everything to each other, different people can meet different needs. People will have different roles such as the practical help, the emergency contact, the listening ear, the hugger, the “let’s go for a run” person, the “give me the baby while you shower” person. If you don’t have a well-developed support network, think about who is around you and what are their experiences? Are there other new parents at your work? Is there a parent and baby group you can attend? Could you get to know your neighbours better? Are there podcasts or online forums that you could join? Do local mental health services have groups you can attend?
Individual time
Individual time is vital to maintain your sense of self, however it needs to be negotiated within the responsibilities occurring. Short periods of time doing something important to you or to directly improve your own mental health is necessary. Equally so for your partner. Consider using a planner together to map out some time and pull in other people to assist in making this happen. A strong sense of self and personal wellbeing will greatly improve how you both feel, and the teamwork involved in making it happen strengthens bonds. Having fun is an important component of a balanced life so insert as much of this into the plans as you can.
Couple time
It is vital to remember you are people who love each other; you are not co-workers. Whilst the dynamics of your family may look very different, and your time may be less available, you are still a couple. Sit together and think about what you have always done that maintains your intimate relationship. It could be physical contact like hugs or foot rubs. It could be movie night or sitting with a drink putting the world to rights. Brainstorm how you can still make these things a priority, even for a short time each day. It is tempting to divide and conquer with tasks, but maybe getting less done but having a bubble fight together during bath time is time better spent.
As friends or family members the above advice is still relevant. How did you maintain your relationship previously? Who was the organiser or instigator of time spent together? You might have to step into this role and be creative about how you can spend time together if your loved one has reduced capacity. They may repeatedly decline contact or back out at the last minute. Keep checking in even though you are disappointed. Assume it’s not personal, instead it’s a symptom of experiencing poor mental health. Your continued contact will be very reassuring. Be upfront and ask how you can be helpful. Be guided by your loved one and remember this change in dynamics will be temporary. Make sure you are taking care of yourself and are meeting your social and support needs with your network.
Supporting someone through becoming a parent and experiencing mental health issues is not easy. Take care of yourself and accept help and support. We really do need a community and can’t do it all alone.
What it feels like for you?
Try not to take their symptoms personally, they may cancel on you or not respond due to lack of energy or anxiety.
Talk about how to reorganise your relationship, you may need some changes in responsibilities. You might have to initiate more and change the ways you spend time.
Calls, texts or facetime might be easier than face to face catchups for a while.
Make sure you have time with supportive people and doing activities that build your mental health.
Resources
Education & Support Systems:
Communication Skills:
Medication:
Community Support:
