Understanding Mental Health Risks During the Fourth Trimester with Dr. Pooja Lakshmin

“We underestimate just how much women are conditioned to take care of others, and how that conditioning impacts our capacity to receive help.”

Nyssa speaks to women's mental health specialist and perinatal psychologist, Dr. Pooja Lakshmin, about the biggest 'unmentionables' surrounding women's mental health and how to help yourself and those you love who are suffering from postpartum depression.

We Asked: What are the biggest ‘unmentionables’ you hear when it comes to women’s mental health? What are the most effective steps to overcoming those taboos, in your opinion?

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Over the past decade or so, as a culture, we've become more open about the hardships of motherhood. We all know about the sleep deprivation, the fatigue, the feeling of perpetual guilt . But, there is still a tremendous amount of stigma that comes with seeking professional help — whether through therapy or with medications.

We underestimate just how much women are conditioned to take care of others,

and how that conditioning impacts our capacity to receive help. This modeling begins in childhood, and interestingly, I think through early adulthood, many women are able to get by being the care-taker and emotional fixer in their relationships. Then, motherhood hits. The postpartum period is when women are particularly vulnerable to developing a mood or anxiety disorder.

And so, in a culture that says women should be strong, independent, and resilient at all costs, admitting you need help feels like you're a failure. Spending time and money on your own well-being is at best, indulgent or frivolous and at worst, selfish — when the truth is that facing depression or anxiety takes tremendous strength and courage.

One of the most effective ways to overcome this is to surround yourself with other women who value their own emotional well-being,

and distance yourself from those who shame you for prioritizing your mental health (e.g. the "friends" who say "But, you're not REALLY depressed!?")...

There are a couple evidence-based steps women and families can take [if they're concerned about postpartum depression and other Perinatal Mood and Anxiety Disorders).

First, if you have a prior history of depression, anxiety, or bipolar disorder (whether during the perinatal time period or not), that puts you at a higher risk for developing postpartum depression.

Research shows that approximately 40% of women with a history of depression will go on to develop depression during pregnancy or postpartum. That number goes up if you go off of antidepressant medication.

So — if you have a history, make sure to talk to your doctor.

See if it makes sense to stay on your antidepressant medication. Get back into therapy for extra support. It's also important to recognize that about 30% of mom's who will develop a perinatal mood or anxiety disorder see symptoms in pregnancy. Having depression or anxiety during pregnancy puts you at higher risk for developing postpartum depression.

Finally, we know that both sleep deprivation and lack of social support are implicated in postpartum depression. Starting in pregnancy, make a plan for how you can get 4-6 consecutive hours of sleep postpartum. It needs to be consecutive for your brain to get the benefit. I know it sounds daunting to aim for 6 consecutive hours of sleep with a newborn. Even if you can't get this anchor sleep every night, 2-3 times a week is better than nothing.

Social support is also protective — so if you have family or friends available, reach out. Make a list of the meals your family lists, send out errands that can be done. Never say no to help. Ask your OB's office for recommendations for support groups. Postpartum Support International also has chapters in every state, and offers help with referrals and support groups.