Wondering When It Gets Easier, Mama? Why it's harder than you imagined to mother an older infant +7 tips to help you through

Your baby is 6 months old. Perhaps 8 or 10 months. You thought you'd "have it together" by now. Or at least feel like a version of your former self. You've managed to piece together some semblance of a routine and take care of the basics- you go food shopping, hit the park after the second nap occasionally. But you feel anything but together. 

You crossed the threshold into motherhood many moons ago, tho some days it feels like it's harder than the first week after you brought your baby home. You knew the media's portrayal of moms was too good to be true, but this?! You had no idea how hard it could be. 

As a mother of 2 and a psychotherapist specializing in maternal mental health, i spend a lot of time reminding my clients (and myself) just what an enormous transition motherhood is. 
 

Reasons why parenting hasn't gotten easier, yet

Becoming a mother is the biggest transition a woman goes through in her adult life. Many women I see in my support group and my private practice struggle immensely with the loss of self, figuratively and literally. There's no way to prepare for the jolt that assaults the mind and body as you pour every ounce of energy into another human, selflessly abandoning your own basic needs like sleeping, showering, using the bathroom and eating to ensure the health and wellness of your baby. Let me unpack that for you. 

Sleep

The average infant isn’t sleeping through the night at 6 months, despite the myth that society continues to perpetuate about sleeping like a baby. It's just that, a story. Babies. Don’t. Sleep. At least most or many don't sleep well at this age. It's not uncommon for older infants to routinely take 30-minute naps. And wake 2-4 times a night. Or more.

As you well know, if baby doesn't sleep, mom doesn't sleep. Lack of sleep is correlated with both depression and anxiety. Sleep deprivation makes life harder, which is why it's is used as a method of torture! 

Many new moms anticipate they'll have time to clean the house, prep dinner and maybe take a shower when their baby naps. Never had they considered the reality of holding, wearing, bouncing or driving their tired or crying child to try and induce sleep and eek out a 30-40 min nap here and there. That downtime you imagined to effortlessly have-- poof! Being a parent is a sacrifice for sure; you knew that cognitively of course. But when you haven't been able to put your child down to nap since they were two weeks old and it's 85 degrees outside and your walking up and down the street so they'll fall asleep-- it's real. 
 

Relationships

Many women I work with share how struggles with their partners seemingly erupt out of nowhere. Relationships that previously had no cracks feel like they're crumbling. As I prod and question I learn more about the communication gap and the resentment that builds when responsibilities fall on the shoulders of one person more than another. When needs go unmet, feelings of not being appreciated, thought of, cared for and loved begin to grow.
 

Identity Loss

It's not unusual that during the very early stage, if mom is breastfeeding or recovering from birth she spends many weeks at home, bonding with her newborn.  But often, I hear that as partners return to work and resume regular social activities, mom feels more isolated from friends, society and her former identity. She's no longer working and no longer engaging in the activities that previously identified her as the person she though of as herself. Instead she's counting poop diapers and bouncing a baby on a ball so she can maybe check her email or do something for herself if she can get the baby into a bed. 
 

Overwhelm

These aren't unusual issues to face as individuals and couples transition into parenthood but they shouldn't be ignored. So many moms I work with talk about the overwhelm kicking in at this stage. They think it should get easier by now. That having a routine should help. But the sicknesses and lack of sleep bookended by full-time jobs and no babysitter leave little time for breathing let alone a date with her partner.

When we have no time to play, to connect and to nurture ourselves, life feels hard. When you've been going and going, devoting all of your energy to learn about this new incredibly important member of your family, to meet their every need, it's intense. 
 

Small steps towards change

When you reach the point of feeling overwhelmed, of questioning how things will get better and why they feel harder every day, it may be time to consider making some small changes. Here are 7 recommendations I often make to families I work with that are struggling during this stage of their transition to parenthood:

1. Open up. Communicate with your partner. Share your feelings, your expectations, desires. Let them know how they can help you feel more supported during this ongoing transitional time. As much as we might like to have married a mind-reader, relationships are built on communication that must be fostered.
2. Get more sleep. Discuss your sleep needs with your partner. Try and develop a plan to get more sleep if you think you aren't getting enough. If you're getting less than 5 hours in a night, that's not enough for most.
3. Eat well. Make sure you're eating well. Three meals plus snacks.  Balanced meals with adequate fats and proteins are important, especially if you're breastfeeding.  
4. Move. Walking is a great place to start.  Physical exercise has been shown to release endorphins, which naturally trigger positive feelings helping to reduce levels of depression and anxiety, and can actually help prevent depressive symptoms. 
5. Get outside! Being in nature is not only restorative but can improve your positive outlook on life and your ability to cope and recover from stress and illness.
6. Schedule breaks. Schedule time for you, even if you have no hobbies, don't play sports and have no interests that come to mind. Schedule a time for you to do whatever you choose. Regularly.
7. Connect with others. Join a support group of other new moms. Find a way to connect with people and activities that you enjoy and bring joy to your life. 

And lastly, ask for help! If you're not sure if what you're experiencing is part of the normal transition to motherhood or something more, like postpartum depression or anxiety, I encourage you to reach out for help from a therapist trained in maternal mental health. Many people are surprised to learn that they can develop a perinatal mood or anxiety disorder at 6, 8 or even 12 months postpartum. Here are some of the symptoms of perinatal mood or anxiety disorders (aka postpartum depression or anxiety). 

It's not realistic nor do I anticipate that someone would adopt all of these changes at once. I'm a strong believe that small acts change lives. See if you can find just one thing from the list above that you can do this week to help improve the way you are feeling. What will it be? Make a commitment! I'd love to hear your plans for change in the comments. 

If you're reading this article and thinking about a friend or loved one, you can help them get the support they need. If you'd like some tips on how to do that you might find this article useful. If you're in San Diego, please feel free to reach out. I maintain a private practice in the Banker's Hill neighborhood where I women struggling with infertility, loss, and pregnancy and postpartum mood and anxiety disorders.. I offer a free 30 minute in-person consultation to find out if I'm the right therapist for you. Postpartum Support International (PSI) is a national organization that maintains a warmline and a list of trained providers specializing in Maternal Mental Health.  If you’re in San Diego, CA, The Postpartum Health Alliance is our local chapter of PSI and a wonderful resource.

You Think Someone You Love Has PPD? Why YOU Need to Speak Up!

Last week I got together with a new friend, Shelly, for a walk. When she learned more about the work I do with new and expecting mothers, the worry poured out of her. Shelly’s sister-in-law (SIL) had a baby 8 months ago, and she’s concerned about her. She's tired, irritable, incredibly anxious and doubting herself all the time (Yes, these are also symptoms of PPD--scroll to the bottom of this page for other symptoms you may not know about). Specializing in Maternal Mental Health, it’s par for the course to hear about sisters, friends, daughters and co-workers who are struggling with Postpartum Depression.

One in seven women deal with Perinatal Mood and Anxiety Disorders (PMADs), so really, it’s no surprise to hear about it so often. The thing that routinely does surprise me, however, is the hesitation many people share about approaching those they love with their concerns. This was Shelly to a T.  She felt close to her SIL, but was apprehensive about recommending that she seek out some support.
 

Hesitant to offer support?

The more we talked the more I understood what was getting in Shelly’s way of reaching out.  Shelly's the mom of a toddler and seems to have it together-- or together enough. She has a stable partner, family close by, a new business she’s passionate about; she’s confident and happy in her life. Her SIL, on the other hand, lives far from family and is further isolated by her husband’s current deployment with the Navy. She has a history of depression and other risk factors associated with PMADs.

By the end of our walk, I had a pretty clear grasp on Shelly’s hesitation to reach out to her SIL. She didn’t want her to feel judged, or less-than, by addressing concerns about her ability to cope with the adjustment to motherhood: A transition that has come fairly easily for Shelly. Shelly was also concerned about providing the right kind of support. With a history of depression, it was routine for family to jump in to “help” her SIL, and make everyday tasks easier. Her depression would subside for a bit and then the pattern would repeat. While a supportive family can be ideal in helping someone through their recovery, professional treatment may still be needed to address issues that may be contributing to the depression on a deeper level. Shelly wanted to help but she wasn’t sure how to do so effectively.
 

Why it’s important for YOU to speak up

If you don’t speak up, the person you love might not get the help they need! Many women suffer in silence. Too many.  More than 20 percent of moms are diagnosed with PPD. However, a recent study by BabyCenter shows that 40 percent don't seek the medical help they need due to feelings of embarrassment, guilt and the expectation that they can get over it without professional help. There are many risks to mom and baby if postpartum depression or anxiety goes untreated.

RISKS OF NOT GETTING HELP WITH PPD

• Risks to mom

  • Lower quality of life
  • Decreased ability to function at home or at work
  • Risk of recurrent depression
  • Suicide

• Risks to baby

  • Insecure attachment to mother
  • Interference in cognitive development

• Family stress and discord

• Decreased care or neglect of other children

• Loss of job/income

Also quite common is that women don’t even realize that what they’re experiencing isn’t normal! Just today I saw a third-time mom who started to recognize in my office that she had probably struggled with postpartum depression with her first two children without knowing. Sounds unbelievable but it’s true. The messages that women hear about motherhood reinforce that it’s natural, easy. That yes, you may be tired, but that’s normal. There’s a lot of grey area and it’s not always crystal clear whether what you’re experiencing is a normal adjustment to motherhood or something more serious.  So if you notice something doesn’t seem right in someone you care about—Say something!
 

What to say to someone with Postpartum Depression

Shelly is a great example of someone who really wants to support someone they love, can identify their struggle, and for various reasons isn’t sure how to help. The reality is, it may not be the easiest conversation to have. But I find that women who are struggling are usually relieved to learn that there’s help available and that they don’t need to suffer in silence. Here’s a few suggestions of how to start the conversation:

1.    Be direct

It’s important to be empathic, but it’s most important to be direct. Let her know that you’re worried about her; she doesn’t seem like herself. Let her know it’s normal, lots of women (1 in 7!) deal with PPD. It’s not uncommon for many women to go undiagnosed. Don’t let her slip through the cracks!

2.    Be genuine

Speak from your heart. Let your love and care shine through. If she’s struggling to care for herself or her baby, this is serious. Remember, she’s not choosing to be neglectful, she’s struggling. You know she wants the best for her baby, for her family. Help her get the professional support she needs.
 

3.    Be available

Make time for her. Once you connect her with people and resources she needs to improve her mental well-being, she will still need lots of support from people in her life who love her. She is vulnerable. Bring her food, go for a walk, watch her baby so she can take a shower. Keep her company.

If you or someone you know is struggling with a Perinatal Mood or Anxiety Disorder, please reach out for support. PMADs are very treatable. Postpartum Support International (PSI) is a national organization that maintains a warmline and also list of trained providers specializing in Maternal Mental Health.  If you’re in San Diego, CA, The Postpartum Health Alliance is our local chapter of PSI and a wonderful resource.