Updated: Mar 15, 2020
Listen to this episode.
"Put your oxygen mask on first before assisting your child." If you've ever flown with your children, you're familiar with this instruction. It turns out, the FAA is really onto something here: this annoying and yet critical reminder is actually quite applicable to motherhood beyond the context of a flight - can you see how?
Jessica Mostaffa is a Licensed Professional Counselor (LPC) with a passion for serving women, which is highlighted by her love of perinatal mental health. Today she joins me to talk about the unfortunate truth that most women are ill-equipped for the emotional and psychological changes often experienced following childbirth and throughout motherhood. Jessica wants all mothers to know that you aren’t alone, and to help you assemble your very own 'mama's-mental-health toolkit.
In today's episode, we discuss:
Preparing for postpartum
Baby blues and postpartum depression
Cognitive Behavioral Therapy as an alternative or supplement to antidepressants
If you're struggling, thinking in terms of baby steps
Pleasurable activity lists
The underestimated link between your body and your brain
Tweaking daily activities to make space for self-care (stop to smell... the soaps!)
A better alternative to asking a struggling friend, "how can I help?"
The process of finding yourself again if you're feeling lost
Preparing for Postpartum is Less Popular Than Preparing for Birth, Not Less Important
Having a baby is like planning a wedding: everyone gets excited and busily plans for 'the big day.' There is significantly less intention and investment, however, around building the skills needed for the marriage and lifetime of commitment that follows, and the same is true of postpartum.
Baby Blues or Postpartum Depression?
The Baby Blues typically last until about ten days postpartum. If you are continuing to experience symptoms two weeks after giving birth (14 days), this is no longer the baby blues: this is postpartum depression and/or anxiety.
Postpartum depression is more than hormonal. One of the risk factors, so to speak, for postpartum depression is if you have experienced depression or anxiety previously. You can have a preventative approach or effectively mitigate symptoms by proactively preparing for what's to come: getting resources/ support, strategies, and/or skills in place can be very helpful if you are, in fact, going to experience those symptoms again.
Cognitive Behavioral Therapy (CBT) as an Alternative (or Supplement) to Antidepressants
The foundation of cognitive behavioral therapy says that all the things that we do - so all of our behaviors and all of our thoughts - affect our feelings, and vice versa. In other words, our behaviors, thoughts and feelings are all linked together. In CBT, we often look at a specific situation and pull apart the layers:
What were you feeling in your body
What were you thinking in your head
What were you acting on, and what were your behaviors looking like
As we start to shift our behaviors, our thoughts shift with them, and then our mood can shift. We can start to tweak the things that we do and the things that we think in a way that profoundly changes how we feel.
"I'm feeling really depressed and cannot get out of bed,"
You summon the profound strength it takes to just sit upright and place your feet on the floor.
Maybe this 'simple' (actually monumental) step starts to change the thoughts in your head: "Well, maybe that wasn't so hard," or "maybe I can make it to the bathroom to brush my teeth."
Stop thinking about the whole big picture of all that you have to do in the day and all you want to accomplish and all the responsibilities that lie ahead of you - it's debilitating. Start instead with one small step in the direction you ultimately need to or want to go: "Can I get to the bathroom and splash some water on my face, or brush my teeth?"
This completed goal leads to a feeling of accomplishment, which changes our outlook on the day.
Small shifts like these can have huge impact.
We're all capable of doing things even just a little bit differently to change our mood.
If You're Struggling, Think in Terms of Baby Steps
We tend to set goals with big end-result goals without breaking down the individual steps to get there, and if we only think about the end goal, we're often left feeling like we failed, like we can't do it, like it's impossible. If you think about it in terms of a ladder, maybe we've gotten to the first rung of the ladder and because we're not to the top yet, we don't credit ourselves for getting to that rung.
Breaking down the baby steps can be a really beneficial way to know what you need to do next, and to feel accomplished at each step on the way. Again, if I can sit up, let's really cheer lead ourselves for that, because that was a big thing. If I can get to the bathroom and brush my teeth, then we should be happy dancing for ourselves. It feels kind of silly, we think, "Well we don't need that." yet we do that for children. How easily we celebrate the baby steps for a child, and we forget that along the way somewhere for adults. If you're really struggling, and you're really having a hard time, then let's celebrate brushing our teeth the same way we do when our toddler does it for the first time by themselves.
Know Your 'Pleasurable Activity List'
A pleasurable activity list is a concrete, on paper (or on your phone) list of things that bring you joy, that make your heart grow three times bigger, that let you escape some of the negative and some of the heavy. Distraction as a tool for 100 percent of the time of course isn't ideal (this is called avoidance), but having some things to distract you from that 'hole' that people describe being in can really be helpful. The idea is to make some of those tough moments more tolerable, more bearable, and actually joyful. Plus, when we feel joy, our hearts open up to more empathy for others: so this practice is not only good for you, but it's also a gift to those around you.
When you're brainstorming your list, be sure to choose accessible things, meaning things that can go with you anywhere. This way, when you're standing in line at the store and it's taking waaaay longer than it ought to, you have a way to immediately combat the frustration right there in the that moment. An example of something you may include on your list is 'savoring' specific joyful memories or past experiences.
How it works: Do a quick body scan. "My irritation is growing, I might need to help myself feel better." Viola! Here enters your pleasurable activity list!
The Underestimated Link Between Your Body and Your Brain
Your physical symptoms may have non-physical origins. What's happening in the body affects the brain and vice versa. Until we start to include mental health as part of our health and wellness plan, we're missing a component, because mental health is health.
What is happening in your body is sometimes an indicator of what's happening in your brain and the memories associated therein. So often a pain or an ailment in our body can need both physical and mental resources and support to heal.
We often believe that in order to be a good mom, we have to put our children and family first. Here's the shift that, more than cognitively knowing, we need to feel in our bones and truly believe: "If I'm going to take care of my children and family, I have to put myself first." Because when you start doing things for you, even three minutes a day, to fill your bucket and build your bubble, it's a game-changer for you and everyone connected to you.
When you give to yourself, you actually have more capacity to give to others.
As women, as moms, we're giving all the time, all day long, a little here, a little there. Those sweet cups that we're pouring into have holes. It's not like you ever pour into your kids enough, where they don't need anymore. It's constantly like slow draining and they're gonna come back to you and need something else. And the dog is going to need something else, and your sister is gonna need something else, and those people in our lives who turn to us to be supported, they take from us, too. So if we do not fill our bucket, at some point how will we ever be able to pour into theirs.
'Building your bubble' is just a different phrase for how do you make sure you have what you need. How do you make sure you're setting boundaries, how do you make sure you're receiving what makes your heart happy and makes you tick so that you can be healthy and well?
Stop to Smell... the Soaps!
'It's not that you don't have the time, it's just that it's not a priority' (source unknown). Ever notice how much time we can spend scrolling on Pinterest, then say we don't have time for other things? If you were to purposely set aside and schedule three minutes for yourself, could you find the three minutes for that?
If that doesn't feel possible, how can you tweak the things you're already doing? Jessica shared about one mom with whom she worked who was adamant that she couldn't even find 60 extra seconds: she couldn't modify 'just' (it's all subjective) 60 seconds in her day to add in something for her. For this woman - as is true for you and I and everyone - her perception is her reality, she knows best, and she is and forever will be her own expert. So, Jessica asked for a copy of this client's daily schedule, and realized that her time in the shower may be an optimal opportunity: the client shared that she'd usually spend her showers thinking about her to do list, and constructing plans and mental lists for her day. Rather than adding in another thing for which she didn't feel like she had time, Jessica asked her to change her thoughts while she was in the shower. The woman renamed them her 'mindful showers.'
She felt the warm water on her skin, and she smelled the scents of her favorite soaps and shampoos. And if the thought of a to-do popped into her mind, she tried to say, "In this moment, I'm just going to focus on the shower." That became one of her favorite self-care moments of the day. It didn't cost her any extra money, and it was built into something she was already doing anyway. She didn't feel like she had to rearrange her very busy schedule. Instead, she just tweaked her thoughts around that time, and that change had great benefits for her.
Better Than Asking "How Can I Help?"
The more we can do to eliminate the negative stigma around mental health, therapy, and reaching out for resources and support when we need them, the better. All the 'yuck' that happens in our soul when we wonder what to say or what to do or how to help a friend who is struggling, comes from that negative stigma. We are worried that we are going to offend; worried what they are going think when we bring it up, because we feel we are 'not at that level yet' in our relationship. It's uncommon to ask, "I'm really wondering if you would benefit from talking to a therapist." Yet if someone said, "I've been having headache, after headache, after headache," we would probably be quick to ask if they have been seen by a doctor.
The research is starting to suggest not asking, "How can I help?" The person you're asking isn't always in the right mind space to tell you, or to know. Action-oriented things can feel supportive to people, like if you handed somebody a business card or shared an Instagram feed and said, "I found them helpful." By making an easy action accessible, you're saying "I care about you and here is something I can offer." When we're in that dark place, we're not accessing our executive functioning, so we're not accessing our frontal lobe and that wide spectrum thought, or that outer peripheral stuff isn't there for us. It's like wearing blinders and seeing a very narrow path of what's right in front of us. So when we can start to help others and remove those blinders, or expand those blinders, and just bring some more into what they're seeing, that can be really helpful. We can't leave it up to the person in that hole to see what's around them, because they're in a hole. So instead we can toss them a ladder, a flashlight, a book they can read while they're down there, etc.
Finding Yourself Again
Again, it's the blinders that make us think we see all of the options, but when you're in that hole, you cannot. Reaching out and trying something different will change how you're feeling. Sometimes we can reach for the wrong thing (there are coping skills that actually make our situations worse), but it changes how you're feeling. It might take a couple of tries to find the right thing that is healthy and a positive choice for you. We hope that you can find the capacity to try, because it can profoundly change the place and state that you’re in right now.
“I can remember a time when I wasn’t this way.” Jessica's goal with all of the moms with whom she works is to help them get closer to that person that they identify with missing: the levels of happiness, the levels of joy, the levels of interest in doing things, the levels of interest in interacting with other people and friends and family. We have memories of when it wasn’t so bad; let's get back towards that.
Jessica Mostaffa is a Licensed Professional Counselor (LPC). After receiving her Bachelor of Arts degree as well as her Masters of Science degree from the University of Kansas in Lawrence, Kansas, she has 12 years of experience walking alongside people on their journey to better health and wellness. Additionally, she is endorsed as an Infant and Early Childhood Mental Health Specialist.