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Woman sitting on a couch talking to a therapist

What you should know about therapy for perinatal mental health

Woman sitting on a couch talking to a therapist2

June 16, 2020

By Nicole Arzt, LMFT

All women experience ups and downs when adjusting to motherhood. Having a baby undoubtedly changes your world. Even if you feel adequately prepared for the changes, life with your little one brings unforeseen challenges.

Therapy can help you navigate these new struggles, fears, and insecurities. It can also provide support and reassurance during this vulnerable time. Let’s get into what you need to know.

What is therapy like for postpartum depression and other PMADs?

While almost all women experience some baby blues after giving birth, many mothers also experience symptoms of postpartum depression, anxiety, or OCD. While these disorders can feel frightening and lonely, they are treatable. Seeking professional help can offer support, education, and relief.

While all therapists have different styles, you will begin your treatment with a thorough assessment of your life circumstances. Your therapist will discuss your family history, past mental illnesses, medical history, and your current therapy goals. Together, the two of you will create a treatment plan focused on what you want to achieve in therapy.

Talk therapy typically consists of exploring your feelings and processing relevant stressors. Your therapist will listen to your current struggles and might suggest new ways of interpreting your thoughts. For example, if you believe that you are a bad mother, your therapist might encourage you to challenge and reframe that thought into a more realistic one.

Therapists also usually offer healthy coping skills for managing your emotions. For example, if you tend to withdraw when you feel stressed over the baby, your therapist might discuss journaling, meditating, or expressing how you feel to a supportive loved one.

Finally, therapy is about feeling supported and understood. Therapists strive to provide compassionate, nonjudgmental environments for their clients. Since many mothers feel alone in their distress, therapy can provide a safe and validating refuge.

How do you know if you need to see a therapist?

You don’t need a specific reason to see a therapist. Simply wanting to strengthen your self-awareness is enough of a reason to seek help. However, a few red flags indicate you may need professional support. These include:

  • Persistent sadness throughout the day
  • Lack of interest in the baby
  • Appetite changes
  • Sleep disturbances
  • Thoughts of harming yourself or the baby
  • Disinterest in relationships, hobbies, or other things you used to enjoy
  • Constant worry about the baby
  • Physical symptoms like panic attacks, nausea, or hot flashes
  • Disturbing intrusive thoughts that impact your daily functioning
  • Compulsive behaviors to reduce the obsessive thoughts
  • Marital conflict and distress
  • Feeling resentful towards your baby

Some symptoms can and do dissipate with time. However, if symptoms persist for longer than 2-3 weeks, they could indicate a perinatal mood or anxiety disorder.

Do I need a referral for therapy?

Typically, you don’t need a referral for therapy. If you plan to pay out-of-pocket, you can simply contact a therapist and begin the intake process.

However, if you plan to use your health insurance, your primary care physician may refer you to a therapist who is in-network with your policy. Most insurance companies will only cover mental health services if your condition meets medical necessity. Therefore, in some cases, you may need a referral.

Can I bring my baby to therapy?

Most therapists specializing in perinatal mental health will welcome you bringing your baby to session. You and your therapist will discuss this topic before beginning treatment.

Some mothers have no choice but to have their babies accompany them to their sessions. Others prefer to arrange for childcare so they can focus exclusively on themselves.

Should I try online therapy?

Online therapy offers convenient and accessible treatment for people struggling with a variety of mental health conditions. It is becoming a popular option, and it can be attractive for mothers who struggle to leave the house with a new baby.

Some therapists provide online therapy as part of their practice. Typically, they charge the same fees for their online services as they do for their traditional services. Other therapists work for third-party applications like BetterHelp or Talkspace. These subscription-based applications allow you to sign up for month-to-month messaging and web-based therapy.

Online therapy is similar to face-to-face therapy. However, it is usually not recommended for people in severe distress or people with crisis issues, such as having the thoughts of harming oneself or your baby, that warrants a higher level of care.

If I see a therapist for PPD, will they take my baby away?

Therapists are mandated reporters. If they do believe you are in imminent harm of hurting yourself or someone else, they may need to break confidentiality to ensure your safety.

However, having intrusive thoughts is not the same as having an active plan, means, or intent. While most mothers experience intrusive thoughts, most don’t have the desire to act on them, unless they are struggling with severe psychosis.

Your therapist’s job is to support, guide, and encourage you during this time. You will never be punished or judged for your feelings!

Sources
https://americanpregnancy.org/first-year-of-life/baby-blues/
https://www.nimh.nih.gov/health/topics/psychotherapies/index.shtml
https://www.verywellmind.com/what-is-online-therapy-2795752

Nicole Arzt is a Licensed Marriage & Family Therapist with nearly a decade of experience treating women's issues related to parenting and family dynamics, complex trauma, and substance use disorders. She is the proud mama of her newborn son.

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