I drove circles around the OB office for what felt like hours. I left 30 minutes early to drive these circles just to try and get my baby to fall asleep so that I could have a minute of silence during my follow up appointment.

Finally asleep, I carefully lifted the car seat carrier out of the car and tiptoed into the waiting room. Upon walking in, her eyes popped open and so did her little mouth. The sound of her cry quickly filled the corners of the waiting room.

Disappointed, I pulled her out and sighed. The ladies at the front desk said, “Oh my goodness I could just squeeze her she is so cute!” I promptly handed her over the front desk to the receptionist. I said “Please, do!” And took my paperwork to my seat. The lady looked at me surprised, but also thrilled. Summer was then passed around from stranger to stranger while I sat in the waiting room, eyes watering, staring at the wall, feeling utterly tired, disconnected, and like a failure.

I did not know what I needed then. I did not know my diagnosis then. It was only 6 short (but long) weeks after Summer’s birth. Nevertheless, the signs and symptoms of PPD were all too obvious. In fact, looking back on these little moments, I had a textbook case of PPD. Ironically, during that appointment I was screened for PPD and brushed off the diagnosis as sleep deprivation and fatigue. They wisely flagged my chart, noting my obvious symptoms.

When I reflect on my recent journey through PPD and what, exactly, pulled me across the battlefield with some remnants of hope, I can remember a few key moments – a few key people – who were instrumental in my survival. It was not just medication. It was not just prayer and Scripture. It was not just therapy. It was layered moments sprinkled across time.

I’ve compiled a list of 10 ways to support someone struggling with a perinatal mood disorder based on my experience and the experience of others who I interviewed.

Please engage this list noting that everyone’s experience is unique. What was helpful to me, may not be helpful to others. And what is helpful one day, may not be considered helpful the next day. The foundation of becoming a helpful support person is made first by acknowledging that you cannot fix this problem. Your loved one is suffering from an illness that is deeply emotional and biologically driven. You must acknowledge that this condition is not his or her fault, it is not your fault, it is simply the reality of your loved one’s situation. The key is to listen and observe with a thoughtful and patient posture, understanding that the victim may not be able to communicate his or her exact needs during this fragile time.

1. Listen

The most powerful moments during my journey that I can remember are those in which my dear friends, my family, and my partner simply listened to me complain. They listened to me cry in despair and hopelessness. They did not interject with platitudes, alternative ways of thinking or even Scripture. They simply listened and stood witness to my hardship. They simply felt sorry for me. Though this may feel like a helpless method of support, it’s actually one of the greatest blessings to those struggling with PPD. The truth is, unless you’ve been there, you will not understand. It’s often better to simply listen and allow space for catharsis.

2. Sympathy

A strong support person is one who can stand in the gap of a loved one’s hopelessness and simply feel bad for him or her without trying to fix things. Read Friends who Leave Rocks for an example of how my friends did this for me. It’s okay to simply sit as a love one cries and say, “this is just so unfair and sad. I’m so sorry you are going through this,” without providing tangible help. Often times, those words of sympathy are more powerful and healing than changing diapers, doing laundry, or bringing a meal.

Do not compare your personal history to his or her current situation! That is not always helpful. The loved one who is suffering needs to feel the hardship of their unique situation without feeling compared to your past adversity. Do not rely on pleasantries such as “this too shall pass” – “it gets better” – “the days are long but the years are short” – “your baby is healthy, and that’s what matters,” etc. Not only are these phrases impersonal, they are honestly not helpful and can produce more shame and guilt than hope and healing.

3. Connect with Therapist

The resources provided through this blog are helpful for identifying a local therapist. While you can provide a special space for listening and sympathy, a therapist can provide professional intervention that will help your loved one find their voice and strength in the midst of PPD. If you call PSI at 1-800-944-4773 and leave a message indicating your need for a list of therapists in your area, you will receive a call back from a person who can help connect you to therapists.

I recently called this number for some assistance and within 24 hours I was connected to 3 separate experts who helped broker the system and connect me with the top professionals in my local area. This website may help you navigate local options: http://www.postpartum.net/get-help/psi-warmline-english-and-spanish/

4. Permission

Your loved one needs to know there is permission to feel and think the unexpected. Those suffering with perinatal mood disorders are often plagued with guilt and shame for the hidden thoughts and feelings that lurk within. Provide a safe space for him or her to admit the unthinkable to you without feeling judged or shame. Let them know it’s okay to feel like hurting their baby sometimes and that it’s okay to admit that they hate their role as parent in that exact moment. Let them feel what they feel and say what they think, even if it’s dark and scary.

If he or she admits to thoughts or actions of self harm or harming the baby, be sure to connect them to a professional that very moment, or drive them to the local emergency room to discuss their situation with a professional. Remind him or her that these thoughts and feelings are not coming from within, but are being caused by an illness and bio-chemical imbalance. Show him or her my entries on PPD/PPPD and help them connect the dots and become informed.

5. Presence

Simply being physically present with your loved one during this time is powerful. I had a friend who popped by, sometimes unannounced, and let me stay in bed while he did the dishes or just watched TV in my living room. Knowing that he was downstairs and willing to help or listen if I needed him was so comforting. Knowing that I could just wander downstairs and watch TV with him without having to talk to him was sweet and literally life saving.

I often just needed a witness to my hardship without having to narrate my every thought and feeling. Offer a quick text to your loved one during the day: “I’m at Chic-fil-a with the kids, what can I bring you?” – “I’m running by Starbucks, what do you want?” – “I’m just hanging out today and thought I’d swing by we can watch TV or just chat” – “I’m taking the kids to a park, want to walk with us?” –Randomly drop off a little note with flowers, a chocolate bar or bottle of wine…it’s the little things that remind him or her that you are there as a witness to their hardship, and a friend regardless of their appearance or attitude.

6. Patience

There will be moments that you want to clap your hands and yell, “snap out of it!” But you must remind yourself, this is not your loved one’s fault. This is not coming from a self-destructive disposition, spiritual weakness, or simply sleep deprivation. This is an illness. Just like you wouldn’t ask a friend with diabetes to “snap out of it,” you cannot ask a friend suffering from PPD to “snap out of it.”

Healing and recovery is a process that will involve layers of intervention and time. Let your friend or family member know that it’s okay to take 10 steps forward and 7 steps backwards. Let your loved one know that you are not leaving him or her, and that it is normal for healing to take weeks, months or years.

Take care of yourself as a support person! If you need to see a therapist, do so (preferably someone educated in perinatal mental health). You will only be a strong support person if you are able to care for yourself and create a separate space to vent your frustrations and feelings regarding the situation. 

7. Consistency

The individual suffering with a perinatal mood disorder will usually not want company. They will not want to leave their house. They will not want other people to come to their home.

One of the most helpful things I had during my hardest season with PPD was a friend who stopped by on the same day, at the same time, every week, to discuss life. We asked each other hard questions about life, relationships, and our friendship with God. And we were both vulnerable. I didn’t feel like the only broken one, or the patient, or the weak friend, or a victim. I simply felt like a fellow broken human, in need of God’s redemption and the presence of community.

As my friend talked through her personal struggles and opportunities for growth, I felt empowered as there was a space for me to speak into someone else’s world. I also felt permission to be broken and in progress alongside her during a very hard season.

8. Help

Not everyone may be quick to admit that physical help around the house is necessary to make it through PPD. The laundry, dishes, walk the dog, cook a meal, sweep the floors kind of help. I think what becomes most difficult to a person suffering with a perinatal mood disorder is finding the energy to come up with specific ways to help.

It may actually be more helpful for you to show up and simply say “I’m going to go fold some laundry.” Or to let them know, “I’d like to come Wednesday at 10AM to empty your dishwasher and take your trash out. I can also walk the dog if that’d be helpful. Let me know if there’s anything else I can do, if you’d rather me not do one of those things, or if a different day or time would be better…” Just be awkwardly forward. It’s honestly most helpful and loving, even if it feels pushy.

Let the loved one know he or she can stay asleep while you’re there and that they can just leave a key under the door. Remember research shows sleep can be the most effective intervention for PPD.

9. Prayer

Prayer can move mountains, break bonds, heal the sick, raise the dead, restore hope and life…prayer is the tool God gives us for partnering with Him in change. Pray for your loved one! Just as God will heal someone suffering from cancer, or the flu, He can and will heal your loved one from PPD! Pray that He would turn this season to good, as only He can!

I will never forget my friend simply putting her hand on my shoulder before she left my house and without closing her eyes, or asking to pray, she simply acknowledged His presence and said “Jesus, you are hope and you can make this better. Please make this better for my friend.” And that was it. I didn’t feel instantly healed…but I believe something supernatural shifted in that simple moment. Because God is good and powerful and kind. Pray for your friend.

10. Encourage

Let your loved one know what they are doing well, and let them know often. “I’ve never met someone as persevering as you! It’s amazing you’re living through this difficulty with such beauty.” Or, “I’m so impressed by your ability to know what you need and admit it to others. I want to be more like you in that way.” Or, “you are just so strong! Watching you mom/dad through this illness with such tenderness toward your baby is challenging and inspiring!” Or, simply, “How in the world did you manage to shower today? Way to go!! You’re awesome!”

It’s these little words of encouragement that can breathe a little bit of hope and strength into your loved one’s heart, even if he or she doesn’t acknowledge it in the moment.

10 Dont’s – 10 of the more damaging things you can say or do:

1. Don’t deny or belittle the diagnosis
2. Don’t discourage medication or therapy
3. Don’t blame the individual
4. Don’t blame sleep deprivation
5. Don’t criticize his or her actions during this fragile time
6. Don’t abandon him or her
7. Don’t compare your personal history to his or her current situation
8. Don’t ignore the signs of PPD
9. Don’t ignore comments alluding to self-harm or self-hate
10. Don’t avoid direct questions

Personal Update:

We have welcomed our newest member, Samuel, into our family.

He was born on 11-30-17 at 5:14 AM weighing 8lb 8oz and is just precious. I may type out his birth story at a later time, if people are interested in reading that…

So far, this experience has been so different from our last birth/newborn experience. God promised us this would be a healing experience, and it sure has been so far.

At this point, I am not experiencing symptoms of PPD, at least not to the same degree as I did last time. I, along with my providers, have been extremely proactive this time in light of my history.

I can’t help but applaud Westside Women’s Care and Lutheran Medical Center for how attentive and engaging they have been in terms of my history with PPD. Every medical professional has asked me direct questions about my thoughts and feelings this time, and they have been so encouraging and compassionate in my care. They have continued to initiate follow-up processes to try and help me have a better experience this time. I am just so thankful.

Thank you to all of my readers for your thoughts, encouragement and prayer! I had hopes of doing one more entry in this series entitled “Reconciling Faith and PPD,” but I am not sure if this season will allow me the time necessary to pour into that particular post. Just know it’s in my heart and mind to write something along those lines in the future.

For now, I’m gong to take a bit of a break and write when I can or when I find it therapeutic, that way I can be present with my family in these precious days. I may re-post some of my more popular entries on social media just to keep things moving.

Love you all and Happy Holidays,

Ashley