Figuring out I had perinatal mood and anxiety disorders (PMADs) brought both relief and confusion. Now I had a reason for why I felt so awful, why intrusive thoughts plagued me, or why my anxiety didn’t settle down with basic helps. I wasn’t crazy, making stuff up, or failing as a wife and mother. Like everyone, I needed sanctification, but my experiences with PMADs were something more than just me and my sin. Knowing my suffering had real, treatable, and temporary reasons made the load easier to bear.
But now there were a million questions to answer. Although awareness of PMADs is low, a google search still turns up an overwhelming number of options for treatment. What kind of counselor should I see, and where and when? Would I take medication, and if so, what kind? Was my current doctor or midwife equipped to help me through this or did I need to find a doctor experienced in PMADs?
The questions are endless, and the fog that often comes with PMADs can make sorting through next steps seem impossible. Because PMADs are different for every woman, questions and treatment will vary. What worked for me may do nothing for you. There are no quick-fixes, and determining the most effective treatment will take time and wisdom. But after processing PMADs three times, I found that the initial questions I asked were the same every time. Most women need further help, but for some, just addressing these questions can provide much relief. Support teams can also use these questions to encourage women with PMADs towards healing.
How will you nourish your body?
You’ve just grown and birthed a new human being (or are still growing one, if you’re experiencing PMADs while pregnant). This requires your body to be well-nourished. While there is debate about which foods are most nourishing, there is also some consensus: empty, processed carbs like white bread, sugar, and heavily processed foods are less nutritious than whole foods. Focus on replacing these with complex carbohydrates. Now isn’t the time to be cutting calories or going on restrictive diets such as keto.
Figuring out what your body needs often includes a trip to your regular doctor to test for any deficiencies. Vitamin D, vitamin B, and iron deficiencies are common postpartum, and may be connected to PMADs. Thyroid imbalances also mimic or contribute to postpartum depression. If underlying deficiencies and imbalances aren’t addressed (including by medication if applicable), other helps may strengthen you, but will not lead to healing.
Exercise also nourishes our bodies in its own way. While you’re heavily pregnant or newly postpartum, light walks may be all you can do, but as long as your doctor supports it, exercise can do wonders for your mood. Exercise feels impossible when you hardly have enough strength to get through the day, but in the right amount it can actually boost your energy.
Changing your lifestyle during pregnancy or postpartum is overwhelming. However, it can make a big difference, even if it seems too simple to be effective. Pick one or two changes to make and make a plan so that you can stick with them.
How will you receive support?
What you need and who can help will look different for every woman. Think about what is difficult for you and where you are overwhelmed, then brainstorm what could help. Things like buying more ready-made foods and using paper plates simplify life, and don’t have to be long-term unless you want them to be. But people are a crucial part of support. Some may find all they need within their churches, while others may need paid support like postpartum doulas, physical therapists, and more. Who can help lighten your burdens and address your specific needs?
My husband has done the dishes ever since our second child was little. My mother-in-law regularly babysits. I had a team of women from church who knew what I was struggling with and could call or text whenever I needed prayer. They also had permission to ask me directly how I was doing with PMADs. I’ve also talked with trusted mentors, received counseling, and gone to physical therapy.
Asking for help is hard. We like to think we can or should be able to take care of our children by ourselves. But other mothers have not raised their children alone, and you don’t need to either. If you’re in the church, God has provided you with a community designed to help you grow through the storms of life (including PMADs) to Christlike maturity. It’s right, not shameful, for the family of God can come alongside you as you raise your little family.
What is your view of God?
The way you view God isn’t often the root of PMADs, but it is a factor in how you suffer. What you believe about God may not be how you actually feel about Him. While we may say that God is good, anxiety may tell a different story. PTSD may lead us to believe God has abandoned us. Our depression may make us think that God is angry with us, and that feeling only makes the depression deeper.
When I had PPD when our second was a baby, it felt like there was a barrier between me and God. My prayers felt useless, and even the Psalms were dry at best. As this continued and my circumstances worsened, my view of God became twisted. I knew that God was sovereign, but doubted His goodness because I was suffering so much. Yet I clung to the thought of Jesus in Gethsemane. The Father might be mean to not remove my suffering in His sovereignty, but Jesus understood what I was going through. Theologically, I knew that was wrong and would have told you so. But it was my functional view of God. Even when I addressed it, the damage was long-lasting, as the struggle to view God as good in a unified way fed anxiety when I was pregnant with our third.
At other times, it has been through the help of other people that I have been able to see the disconnect between what I think about God and how I feel about Him. These have been people who cared enough to read between the lines in our conversations and gently, compassionately speak into my view of God. Every time, it has relieved my pain and given me strength to suffer well.
What’s your self-talk?
Like our view of God, our self-talk and what we preach to ourselves reveals what we truly believe. This can be key in uncovering our view of God, but it can also be an important tool in pushing back on mood disorders. Journaling has helped me immensely here. As I write what I’m thinking, I can see more clearly where I am believing lies and can then work to replace them with truth. Writing down what I’m thinking and feeling can also reveal what my actual symptoms are and where I need help.
Through journaling, I realized that while I said I didn’t feel like a failure, my inner grumblings accused me of all sorts of things. I usually believed them, too. Only once I had acknowledged these thoughts could I counter them with reality if they were false, and the truth of Christ’s forgiveness and the Spirit’s work in me if they were true.
Philippians 4:8 was helpful to me in processing my self-talk (albeit cliché). Whether I was anxious, ashamed, or depressed, asking if a thought was true (and the others, but usually “true”) was a powerful weapon.
Addressing nutrition, support, view of God, and self-talk may not cure your PMADs, but these can bring a significant amount of healing, and will also give you a clearer idea of what you need in and from your doctor and counselor. As I nourished my body, simplified life and received help, grounded my view of God in Scripture, and took every thought captive, my PMADs did not immediately go away, but I had a framework for fighting them and saw progress and eventually, complete healing.
The Sorrows of Eve 