I received a very upsetting phone call yesterday. The mother on the phone was distressed. She had been experiencing severe postpartum depression since almost immediately after the birth of her child. She knew she had risk factors that made her vulnerable, so she had spoken to her doctors about this before and during her pregnancy. She was therefore able to recognize the signs and reach out for help when her baby was just three weeks old. Sadly, here is where things went awry.
The therapist she met with was not properly trained nor experienced enough to address these issues. As a result, their work together was simply not helpful. However, this mom did everything she could to help herself. She was committed to her therapy, and attended weekly sessions for a year hoping for improvement. Now, a year later, she still suffers greatly, but has exhausted her budget for therapy. She called me to see if we could meet, for perhaps only one time, because she couldn’t afford to continue treatment.
When I hung up the phone, I felt such heartbreak for this mom. I have seen how hard it is for women to make the initial phone call asking for help. I’ve received calls from worried fathers, grandmothers, and other physicians when the mom just wasn’t able to do it for herself. Here is a case where she did exactly what we are trying to educate women at risk to do- she asked for help. That alone, is an act of courage and determination. It occurred to me, to consider what can we or should we do when asking for help isn’t enough? We need to help moms learn how to ask for the right help. Certainly, there are circumstances where the options for therapy are limited by geography or finances. That is not the situation we are discussing here. The mom I spoke with had to make a choice amongst treatment providers.
When you receive a referral for a therapist, here are 3 questions that will help you to make sure you are getting the best help available. If you don’t feel comfortable asking these questions, have someone else do it for you.
1. Can you tell me about your education and training in working with perinatal mood and anxiety disorders?
You want to hear that the therapist has some education and training in maternal mental health. This may include coursework while he or she was in graduate school, or perhaps there were post-graduate training opportunities. The therapist’s expertise should be
specific to postpartum issues, not merely related to depression and anxiety in general. Look for affiliations with national advocacy or support groups, such as Postpartum Support International or the 2020 Moms Project.
2. Can you tell me about your experience working with women with perinatal mood and anxiety disorders?
Has the therapist ever worked with women that have these issues? If so, for how long? Ideally, you would like to find a therapist who has had prior experience. I feel forever indebted to the amazing women I have had the honor of working with. They have taught me so much more than can be learned from textbooks or in classrooms. I have been able to draw on their experiences to help many other women in similar situations. If you have a beginning therapist, ask if they have sought supervision with a more senior therapist.
3. What is your approach to treating my pospartum depression (or anxiety or OCD, etc)?
This is key! You want the therapist to have a treatment plan. Recognizing that no two women will present with the exact same experience, an effective treatment plan won’t be one-size-fits-all, but should have a clear purpose, goal and direction. With postpartum issues, having concrete and specific short-term goals can help you to feel more competent and self-assured. Long-term goals can help you to feel that you are moving toward reclaiming yourself in this new chapter of your life.
Unfortunately, there are no guarantees in therapy. As we have seen lately in the news, a woman can make all the right choices: identify she needs help, find a competent professional, and she still may not win her battle against postpartum depression. Those cases may receive a disproportionate amount of attention in the media, decreasing our faith in the possibility of recovery. It is far more likely that a woman who seeks out help and finds appropriate care will find relief from her symptoms, learn adaptive ways of coping and communicating, and feel empowered to confront the new challenges in her life.