NICU moms with PPD don’t have to suffer in silence
The most common complication after childbirth isn’t hemorrhoids or having separated abs — it’s postpartum depression. PPD affects 10-15% of new moms, but moms with babies who spend time in the NICU after birth are at an even higher risk of PPD. In fact, one study found mothers of preemies are 40% more likely to develop PPD, compared with the general population. And it’s not just moms who suffer when their new baby doesn’t leave the hospital with them. Dads with babies in the NICU also feel the psychological impact. In a group of 35 new dads, 60% showed elevated depressive symptoms at the time their baby first began their stay in the NICU.
There are several reasons why parents of NICU infants are at a higher risk for PPD. When the NICU is involved it’s because the baby was born prematurely, had health complications, or often both. The uncertainty of what lies ahead can cause huge amounts of stress on new parents. “A NICU parent’s brain – the part that is activated in times of stress (fight or flight) remains in a constant elevated state of alertness, Jaime Malone, M.A., LPC of Insight Counseling and Consulting tells Scary Mommy. “The brain needs periods of rest and repair, but these parents don’t have that opportunity, contributing to generalized anxiety disorder.”
Many NICU births are a result of something not going according to plan during delivery. Feeling disappointment in how your birth played out is normal and very common. But Malone cautions that having a traumatic birth is also a risk factor for PPD, as well as PTSD and acute stress disorder.
Not being able to provide all of your baby’s care due to their medical limitations can further contribute NICU moms developing PPD. You envision doing everything for your newborn — bathing them, feeding them, dressing them in the tiny clothes you’ve stored in their carefully planned nursery. Instead the NICU can mean limited visiting hours, lead wires instead of onesies, and not knowing what you can do to contribute to their care. “Moms are generally looking to the nurses and other medical staff to be told what they can and are advised to do, as opposed to when they are at home and get to make choice in caring for the baby,” says Malone.
There’s no way to ensure that you won’t have PPD, but there are steps you can take to possibly reduce the severity of your symptoms. Kimberly Hershenson, LMSW, tells Scary Mommy you can be on the lookout for PPD even before you give birth. She suggests noting your potential risk factors, such as having a history of depression prior to or during pregnancy, lack of support from partners or family or fear or doubts regarding the new role as parent. She also encourages pregnant women to adopt healthy habits like getting adequate sleep, eating a balanced diet, exercising, reducing stress and letting go of guilt.
In addition to knowing your risk factors and being healthy, there are other things NICU parents can do to help minimize their stress.
Talk to your partner
“Parents are sometimes concerned with sharing their thoughts with their spouse or partner because they worry it will further burden the partner’s stress – it tends to do just the opposite,” says Malone. “If we are alone in our worries, we feel even more isolated and more at risk for PMADs.”
Become BBFs with your baby’s medical team
NICU doctors and nurses are very knowledgeable about the work they do. That’s fantastic news for your baby’s care, but sometimes it can lead to the use of terms you don’t fully understand. Asking for clarification doesn’t make you a bad parent. “Feel comfortable to ask as many questions as you need. And to ask them again if you forget or don’t understand,” advises Malone.”Turn to your medical team – not the internet – to ask questions specific to your baby. This is truly the case where ‘there is no such thing as a dumb question!'”
Take care of yourself
“Many parents feel a need and a desire to spend all the time they can with the baby,” says Malone. “This is understandable, however, it’s not necessarily sustainable, particularly if the baby is going to be in the NICU for an extended period of time. Any new mom has to learn how to care for herself so she can care for the baby.” Self care can be anything from going to the gym, seeing some friends, or just enjoying a new book. And if you really can’t bear being away from the hospital, there are things you can do for yourself while you’re with the baby to bring some balance to your day. Malone suggests listening to a podcast or audio book while holding the baby, or if hospital guidelines allow, invite a friend to come visit with you in the hospital.
PPD has a wide range of symptoms. As Hershenson explains, “Depressed mood, severe mood swings, severe anxiety, intense irritability and anger, uncontrollable crying, difficulty bonding with your baby, thoughts of harming yourself or your baby, feeling guilty or inadequate, lack of interest in things you used to enjoy, insomnia or excessive sleeping, inability to take care of oneself such as showering, eating, getting dressed,”are all signs that you may be suffering and in need of help.
A doctor or psychiatrist can provide you with medications that can help, and there are medical options available to moms who are breastfeeding, so don’t be afraid to ask. Cognitive Behavioral Therapy (CBT) is another highly recommended too for treating PPD. “CBT focuses on the patterns of thinking, behavior, and emotional responses that are associated with stress, anxiety, depression and negative thinking.” explains Hershenson. “Clients learn techniques to recognize and change these unhealthy patterns to improve daily functioning and life satisfaction. For example, if a common thought is ‘I’m a terrible mother’ a CBT therapist will ask you to think about the evidence against this thought: your baby is growing, when your baby gets sick you call a doctor, etc.” Joining a support group at your local hospital for NICU parents is another great way to help understand your feelings and improve your PPD symptoms. For new moms who don’t have transportation, childcare or even the desire to leave the house for therapy or a support group meeting, there’s Hand to Hold, a nonprofit organization that matches new parents of preemies with a mentor parent who’s child was in the NICU to lend support from someone who’s been in your exact situation. There’s also a NICU support podcast with episodes that explain how to advocate for your baby in the NICU, tales of hope and discussion on handling the complex emotions of parenting a newborn that’s in the hospital. Hershenson reminds us that PPD may seem impossible to overcome in the moment. But just like your baby will eventually graduate from the NICU, there is a light at the end of the tunnel for you too. “Remember, just because you may need medication or therapy now, doesn’t mean this will continue for the rest of your life as PPD usually goes away within six months to a year with treatment.”
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