Carolyn Kagan is a Licensed Clinical Social Worker and psychotherapist. She owns Alliance Therapy Practice here in Stamford. She is a maternal mental health specialist, has advanced training in treating perinatal mood and anxiety disorders and also serves on the board of Postpartum Support International’s Connecticut chapter. Carolyn partners with women before, during and after pregnancy to develop practical skills to capture the most joy in their transition to motherhood. You can learn more about her in our August Meet A Mom!
Please keep in mind, the suggestions contained in this column, are merely that, and should not be substituted for diagnosis and/or treatment by your own medical professional.
How soon after beginning treatment for PPD do moms usually begin to feel better?
Postpartum depression is highly treatable but how long it takes to experience improvement depends on a variety of factors. In the realm of therapy some of those factors include but are not limited to: the type of therapy, the frequency of sessions, the quality of the therapy and the goodness of fit between the provider and the client. In several of the studies that I’m currently reading participants report a decrease in symptoms after an average of 6 to 12 sessions of Cognitive Behavioral Therapy (CBT). Learn more about CBT in question 4 in August’s column, here. However, therapy is not the only treatment option for postpartum depression. Click here for some of my other suggestions in question 5 in July’s column.
I’m curious, does how a baby is delivered impact a mom’s risk for postpartum depression, vaginal vs. c-section?
The particular way in which a baby is delivered has not been proven to have an impact on whether a woman will experience postpartum depression. However, if the experience was traumatic, did not meet the mom’s expectations, if the recovery is complicated and how she thinks of herself through the experience; is what makes more of a difference. For instance, if a mom has the belief that a vaginal birth is superior and then has to be rushed into an emergency c-section and therefore experiences this as a failing or a loss of control, then that could potentially create a risk factor for developing postpartum depression or any other perinatal mood and anxiety disorder.
Since I had a baby 10 weeks ago, I’m struggling to get back to my nutrition and exercise routine and have been feeling pretty down. Can that struggle impact how I’m feeling?
Congratulations on the brand new baby! The first few weeks and months can be such a special time but can also mark a difficult transition that makes some yearn for the routines of our past selves. Seeking to focus on your nutrition and exercise is a great way to do that, while hopefully also honoring the tremendous feat that your body has just accomplished. I’d suggest meeting this next challenge with some gentleness, flexibility, reasonable expectations of yourself (plus your new situation) and a ton of grace to minimize any struggles you might encounter.
I noticed you offer both individual and group therapy. How do I decide which is right for me?
Individual therapy and group therapy are both great options, some women I work with do one or the other and some decide to utilize both. Either option can give you the chance to gain a deeper understanding of your experience, learn healthy coping skills and provide opportunities for acceptance and validation. Deciding what the best option for you depends on your needs and personal preferences. If you’re looking for privacy and a more personalized approach then individual therapy would suit you but if you’re looking for social connectivity and want to build a community, then group therapy would be the best fit.
Since having my baby, I’ve had a really hard time sleeping… even when the baby is sleeping. Could that be a sign of a mental health issue?
Before deciding if there’s an issue, I’d first pay close attention to your sleep hygiene to see if your environment is even supportive of quality sleep and if not, what can be done to bolster your ability to achieve that. This can include an awareness of your use of caffeine, how/when you incorporate physical activity, what you eat and when, your exposure to natural light and your use of devices, which is an important consideration in this day and age. If you’ve worked consistently to develop a healthy routine around the above factors and still have difficulty sleeping, then talking about it with a medical provider could definitely benefit you.
I’m pregnant and worried about PPD. Would seeing a therapist before the baby is born help?
Absolutely! There are many women who make therapy a part of their prenatal care regimen because approaching this major life transition can bring up a lot of complex feelings. While there are some obvious ones like excitement, there might also be some worry and ambivalence about what to expect. Your mental health is critical to your well being and your baby’s, especially if you have a personal or family history of anxiety or depression. Starting therapy in advance can help you manage your stress and help prepare you for what’s to come.