Postpartum depression and postpartum anxiety are very common among new mothers, affecting an average of one in six. Severe forms of postpartum depression can make motherhood seem intolerable, and a small percentage of those who experience postpartum depression also experience postpartum psychosis or subsequent issues like postpartum OCD.
New mothers who are experiencing these symptoms should consider postpartum depression cognitive behavioral therapy for the well-being of the mother and the child, helping to ensure a healthy relationship and good Bond early on. Thankfully, postpartum depression and subsequent disorders can be managed with cognitive behavioral therapy and, in some cases, the addition of medication to a CBT plan.
Understanding Postpartum Depression
Postpartum depression can take place at any time within the first 12 months of giving birth. Symptoms include things like:
- Feeling overwhelmed
- Feeling guilty
- Not feeling a bond with your baby
- Appetite problems
- Sleep problems
- Irritability
- Sadness
- Crying
- Emptiness
- Numbness
- Lack of interest in your baby
- Thoughts of harm to yourself or your baby
Note: Not all women who have postpartum depression experience all of these symptoms, and the symptoms can fluctuate over time, with certain symptoms manifesting during one occasion and getting stronger during another.
It’s not uncommon for women with postpartum depression to experience racing thoughts, overwhelming anxiety and worry that is difficult for them to control, feeling pressured to constantly be doing something, and worrying that they may have gone crazy.
Thankfully, cognitive behavioral therapy is a short-term treatment that usually consists of an average of 12 sessions. It can help you identify these unhelpful or negative thoughts and feelings and the subsequent triggers that cause them.
Then, you can learn to change your behaviors and your automatic thoughts. As a mother, this can be something as simple as getting out of your house, finding activities that make you happy and scheduling time for them, doing things like exercise, or having social engagement.
You can also learn how to better communicate with your partner or spouse and get the right type of help when you need it at home or with the baby.
What is Cognitive Behavioral Therapy (CBT)?
Cognitive behavioral therapy is a form of talk therapy or psychotherapy, which is grounded in the idea that your thoughts directly control your emotions and, by extension, your actions. The more you are able to make changes with regard to thoughts, the more you can achieve changes in emotions and actions.
Some examples of CBT changes women can achieve include the following:
- Changing the way you act, like choosing to ask for help when you need it instead of isolating yourself;
- Changing the way you feel, like reducing depression or anxiety;
- Changing the way you think, like learning to remove self-defeating thoughts about motherhood;
- Changing the way you deal with issues, like sticking with a medication routine for postpartum depression.
When you work with a therapist, they will help you focus on your current situation and find solutions to problems in the present rather than reflecting on the past. By learning more about your personal beliefs or views about your life rather than your personality traits, this type of therapy can help you gain better control over your life and replace certain thoughts or actions that are not working well with things that are more supportive.
How CBT Helps with Postpartum Depression
The main mechanism of action behind cognitive behavioral therapy in treating postpartum depression is to help you recognize which automatic negative thoughts are controlling how you think, feel, and behave.
Specific CBT techniques used for treating PPD
Many of the specific CBT techniques used for treating postpartum depression Center on recognizing automatic negative thoughts and replacing them with positive ones. These automatic negative thoughts can take the form of things like:
- Catastrophizing: This is where you commonly consider the worst possible outcome to be the most likely even though it’s not.
- Mind reading: This is where you assume you know what everyone else around you is thinking and that it’s often negative.
- Perfectionism: This is where you focus on being perfect, and let that perfectionism lead to feelings of guilt and failure.
- Emotional reasoning: This is where you think that if you feel an emotion, it must be true.
- All-or-nothing thinking: This is where you don’t have room to compromise.
- “Should” statements: This is where you get mired in thinking you “should” be able to stop something or “should not” admit you are depressed.
- Jumping to Conclusions: This is where you assume or jump to conclusions about everyday situations.
- Labeling: This is where you label yourself.
- Dwelling on the Negatives: This is where you dwell only on negatives and not on positives.
When you work with a cognitive behavioral therapist, they will help you utilize certain homework assignments in between sessions, like journaling and reflection exercises where you can figure out which of these automatic negative thoughts you struggle with. The more you recognize them, the better able you will be to utilize positive replacements.
Let’s look at some examples:
- Instead of thinking, “My friends will think I’m making excuses,” postpartum depression cognitive behavioral therapy can help new mothers replace that thought with a positive one, such as “I will tell them what I have to, and their perception of me does not matter. They will still love me if they are really my friends.”
- Instead of thinking, “Everything is too much, and my life is terrible,” new mothers can think, “My thoughts shape how I feel. So I can choose to think positively and remember that people are out there wishing and praying for the things that I might be taking for granted.”
- Instead of thinking, “I am having a horrible day,” cognitive behavioral therapy for postpartum depression can help new mothers change that thought to “Not every day will be great, nor was every day great before having a child. But I can do one small thing to make today better.”
- Instead of thinking, “Everyone is judging me and disappointed in how I am handling my new baby and my home,” new mothers can change their thoughts to “Satisfying the vision or view of other people about what my life should or should not be is not my job here. My job is to be a loving mother and to love myself.”
- Instead of thinking, “I am not getting better and things are not getting easier fast enough” new mothers can change their way of thinking by replacing that with, “no matter how slow my growth is, it is still growth. I will get better and things will get easier with time so long as I keep trying.”
- Instead of thinking, “I don’t know anything about being a mother” new moms can change their thought to “Knowledge comes with time and effort. I will continue to learn as I go.”
- Instead of thinking, “I didn’t accomplish enough today,” new mothers can think, “Not all days are the same. I did what I could today, and that is good enough.”
In each of these examples, you can see how CBT and postpartum depression work to resolve patterns of automatic, negative thoughts that have a detrimental impact on how a new mother thinks, feels, and acts. These CBT techniques for postpartum depression can help put psychological distance between a negative thought, too, ensuring that it does not define a new mother’s reality.
Consider this:
Mary is a first-time mother. She has wanted to be a mother her entire life, but now that she is one, she is struggling with postpartum depression and does not feel qualified. She is struggling with automatic negative thoughts like “everything is too much, and my life is terrible.” The more she lingers on these thoughts, the more likely she is to feel terrible all day. Each time another household thing doesn’t get done because she is busy tending to her baby, it increases the negative thoughts like “I didn’t accomplish anything today,” and each time her baby cries, no matter what she does, she thinks, “I don’t know anything about being a new mother.”
All of these automatic negative thoughts get reinforced throughout the day until, by the end of the day, Mary feels terrible about herself and her new baby. She lets these automatic thoughts lead to things like mind reading, where her husband comes home from work and looks at the house, and she believes she can read his mind, and she believes (based on those negative thoughts she has had all day) that he is thinking what a mess the house is, how she didn’t get anything done, and since the baby is (still) crying, she isn’t a good mother.
In reality, her husband was thinking his wife looked tired so he was looking around the house to find something he could do to quickly help her, like picking up the dirty clothes or doing the dishes. He was bringing his own feelings of automatic negative thoughts to the situation, because he felt guilty about working all day while his wife was home with the baby.
Now, in Mary’s case, the use of CBT for postpartum depression would help with short and long-term issues. In the short term, it would help her recognize the moments that she has those thoughts and place distance between them, reframing them with something more positive. The more she uses the reframing CBT techniques for postpartum depression listed above, the less likely she is to continue developing negative emotions and negative behaviors throughout the day.
Long-Term Benefits of CBT for Postpartum Depression
In the long term, someone like Mary who seeks out postpartum depression cognitive behavioral therapy will be able to enjoy long-term recovery and prevent relapses with regard to her postpartum depression.
Working with a qualified therapist gives new mothers like Mary an opportunity to build resistance and develop coping strategies that can be used whenever symptoms reappear. This provides resources to manage depression for any subsequent children or any other forms of depression that might take place later in life.
Tangentially it also provides the skills to enhance mother-child bonding and improve family dynamics. If you consider the example of Mary above, if she were to utilize cognitive behavioral therapy, it would help her avoid things like mind reading which, in turn, would help her be more communicative with her partner, and less likely to lash out unexpectedly or emotionally based on negative automatic thoughts that she brought to the table.
Integration with Other Treatments
CBT and postpartum depression treatment can be easily integrated into other treatment plans as well.
Combining CBT with medication for postpartum depression
One of the most common combinations is cognitive behavioral therapy and medication for postpartum depression as mentioned, while one in six women experience postpartum depression or anxiety, a few of those experience severe symptoms that can lead to subsequent issues like postpartum psychosis.
Women who have a history of mental health disorders, especially depression, are at a higher risk of developing postpartum depression.
In these cases, the use of antidepressant medications can help control immediate and severe symptoms, while cognitive behavioral therapy can provide the tools to manage symptoms in the long term.
The role of support groups and family therapy
Cognitive behavioral therapy for postpartum depression is more effective when individuals have their families there to support them. Family therapy can be an effective way for new mothers to communicate their needs and for family members to learn how to better support a new mother.
Support groups are especially useful because they provide a place for new mothers to find social support and a network of people who are experiencing similar situations. While a family member like a spouse might be able to sympathize with a situation and be loving and supportive, other women who have gone through postpartum depression can truly empathize, and for some new mothers, this can make all the difference.
Holistic approaches to treating PPD alongside CBT
Holistic approaches to treating postpartum depression alongside cognitive behavioral therapy should also be explored. Holistic approaches are things that can help manage triggers of symptoms like stress. Some holistic approaches for new mothers can extend to yoga, particularly postpartum yoga. There are different forms of postpartum yoga depending on the way in which you gave birth.
These forms of gentle exercise can also be combined with meditation and mindfulness practices. For some women the most effective holistic approach is to find opportunities to get outside, to utilize self-care techniques, and to build on things like support from friends and family that empower new mothers to set time aside for simple walks in their neighborhood with a friend or to set a sleep schedule with their partner.
Finding the Right CBT Therapist
When you look for postpartum depression cognitive behavioral therapy, it’s important that you find a qualified therapist who specializes in postpartum depression. Just because an individual has experience working with cognitive behavioral therapy does not mean that they specialize in working with new mothers.
You should also ask your potential therapist several questions about things that are most important to you, including:
- Their main method of communication
- Whether they have flexible services for things like Telehealth appointments, which can be particularly important to new mothers
- How accessible their appointments are
- How long the sessions last (most CBT treatment plans average 12 weeks)
Don’t be afraid to meet with them for a consultation and to see how you get along with the potential therapist. As a new mother, it can be terrifying to be vulnerable and admit the negative emotions or shortcomings you might experience in another person, which is why it’s important that you build a trusting relationship with the therapist you choose.
Conclusion
Postpartum depression is a serious and all too common condition. If you are struggling with symptoms of postpartum depression, cognitive behavioral therapy can offer significant relief in the short term and the long term. As a new mother, don’t be afraid to seek help and support so that you can improve your overall mental health and strengthen the bond with your child.