First Steps for the Momma with PMADs

Dear Momma,

You’re probably reading this article because you don’t feel good, whether you have an official diagnosis of something like postpartum depression or not. I’ve been there. To say it’s no fun is an understatement. I’m so sorry you’re feeling like this. This is not what motherhood is supposed to be like. The Fall, sin, and spiritual warfare all make it difficult. But it is not the end of your story. The road may be long, but there is a way out.

That’s true long-term as we think about the hope we have in Christ and how one day all things will be made new, but it’s also true for the next months of your life. Your suffering is real: you are not making it up, nor do you feel this way because you’re ill-equipped to be a mom or are just less sanctified than other mothers. The genuineness of your pain is the bad news. The good news is that it’s something that can be healed.

But where to start?

There are so many choices, but after having been through PMADs three times myself and talked to numerous other women about their experiences with them, I think there are four key things to do first.

1.    Pray

Before you do anything else, pray. God may feel really far away right now. I know how that feels. But Christian momma, no matter how you feel about him, his affections for you do not waver, and he knows what you need (Matthew 6:8). Take a moment to talk to him about what you’re going through. Tell him how you feel—about him, about yourself, about your baby, about anything else. You can be brutally honest with him, like the Psalmists were:

• My God, my God, why have you forsaken me? Why are you so far from saving me, from the words of my groaning? (Psalm 22:1)
• I say to God, my rock “Why have you forgotten me? Why do I go mourning because of the oppression of the enemy?” (Psalm 42:9)
• My heart is in anguish within me; the terrors of death have fallen upon me.
  Fear and trembling come upon me and horror overwhelms me.
  And I say, “Oh, that I had wings like a dove! I would fly away and be at rest.” (Psalm 55:4-6)
• You have put me in the depths of the pit, in the regions dark and deep…

But I, O Lord, cry to you; in the morning my prayer comes before you.
O Lord, why do you cast my soul away? Why do you hide your face from me?

(Psalm 88:6, 13-14).

If you don’t know what to say, know that you have the Holy Spirit interceding for you with groanings too deep for words (Romans 8:26). You also have the Holy Spirit dwelling in you, to teach you and to remind you of all that Jesus has said (John 14:26). You are not alone in your pain, and the One who is closest to you is the One who made you, saved you, and will continue to help and heal you.

2.    Tell someone

The more we keep our difficulties to ourselves, the more they often fester and grow. It’s so easy to not say anything, especially when we hope that what’s troubling us will go away quickly or we fear what others will think of us if they really knew what we were thinking.

Please, tell someone about your depression, anxiety, or other PMAD, whether that’s bipolar, OCD, PTSD, or psychosis. Find someone you trust and talk to them. Maybe it’s your husband, your mother, your friend, or your doctor. You don’t have to say more than you’re comfortable sharing. It can be as simple as “I’m really not doing well,” to as complex as telling them the details of your intrusive thoughts or desire to escape.

Tell someone just to share the burden, but also tell someone who can help you or guide you to further help. I know it’s hard. It’s probably the most vulnerable thing I’ve ever done. It’s also the most valuable. If others don’t know how you’re hurting, they can’t support you or help you get well.

3.    Alleviate Stress

I know this seems ridiculous. You just had a baby, and on top of that, you’re overwhelmed by your mental health. Sometimes, alleviating stress can feel more stressful than it’s worth. And sometimes PMADs paralyze you such that change feels impossible and accepting certain kinds of help is your worst nightmare (when my anxiety was really high, it was hard to let others hold my baby, much less take care of her while I slept!). But do what you can. Here are some ideas in different areas:

1. Food: order take out, use paper plates, use grocery pickup, ask someone to start a meal train for you.
2. Baby care: get a swing, wear baby in a carrier, don’t worry about bathing the baby (they really don’t need it often!), let someone else feed the baby (even if it means pumping!).
3. Housework: do the bare minimum, hire help, ask friends to come clean your bathroom, ask your husband to do the dishes, ignore the dust on the bookshelf, forget making your bed.
4. Other: say no to playdates and events if they make you feel worse, say yes if they help. Remember that sleep is one of your most important needs—take every nap you can get and go to bed early! 
   

4.    Take a Step Towards Healing

There are many treatment options for PMADs, which is great, because it means there is a lot that can help! But it’s also overwhelming, because now you have a lot of information to sort through. While you will require something specific based on your individual circumstances, a number of proven things can help you feel better. Here are eight—pick just one and try it for a week as a first step towards healing. If it doesn’t help, try another.

1. Go for a walk
2. Get some sunshine
3. Deactivate social media
4. Unsubscribe from the news
5. Ask your doctor to check your iron, vitamin D, vitamins B6 and B12, and thyroid (T3, T4, TSH, and antibodies).
6. Cut processed foods like sugar and white flour
7. Pick a Psalm and meditate on it to calm your mind and fill it with truth
8. Scrutinize your thoughts: are they true? What is true? What does Scripture say?

Much of this may seem too simple to be effective. Most of it certainly doesn’t seem super spiritual. Your spiritual health is a vital component of mental health, and you cannot neglect it! But in pregnancy and postpartum, your physical needs are at an all-time high as you grow, birth, recover, and nourish a baby. Many times, by prioritizing sleep and nutrition, destressing, and focusing on what is true, you will find at least some relief.[1] If you think about it, this is what happened with Elijah’s depression: he slept, ate, drank, and then God helped him see what was really going on (1 Kings 19:3-18).

So rest. Feed your body nourishing foods. Feed your soul the comfort of God’s Word. Make use of your community. Seek a doctor’s care. And in time, you well be well.

Press on, momma. Your Shepherd is watching over you.

Practical Takeaways

• Pick one person to tell about what you are struggling with. When and how will you do so?
• Pick one other thing from this essay to try as soon as you turn off the computer. Be really specific, and follow through.
  • Pray honestly
  • Do something to alleviate stress
  • Try one of the eight steps towards healing (Go for a walk, get some sunshine, deactivate social media, unsubscribe from the news, ask your doctor to do some bloodwork, cut processed foods, meditate on a Psalm, scrutinize your thoughts).
• If you’re supporting a momma with PMADs, consider doing one of these things with her to help her implement them in her life. You can even come to her with some suggestions and ask what would lift her up the most.

---

[1] Medication may also be a helpful tool! This is something to talk over with your doctor, not do on your own, however.