In my clinical experience with mothers who have survived postpartum mood and anxiety disorders, the idea of having another child brings both hope and trepidation. Women fear a repeat of a postpartum period filled with worry, exhaustion, guilt and at times despair. I have heard women echo fears that they are forever 'broken,' burdens, even frauds as mothers.
However, I have seen those same women victorious over their fears when they manage to walk through pregnancy, birth, and the early years of their babies' lives armed with a plan for wellness. With a plan, compassionate and collaborating doctors and support, over 90% of my moms who are PPD/PPA survivors have subsequent postpartum periods of at least 1 year without relapse of depression, anxiety, bipolar disorder-related mania or psychosis or hospitalization.
Take a look at the basic outline below for a starting place to a happy and healthy pregnancy, even after a history of postpartum depression or anxiety.
*If you happen to become pregnant unexpectedly, you can still have a meeting to discuss the treatment approach to prevent mood and anxiety relapses. See your OB/GYN and psychiatrist immediately. Don't wait!
Meet once a month with your psychiatrist and possibly twice a month with your counselor/therapist. Follow-along with the schedule your OB/GYN determines is appropriate for you.
In each psychiatry appointment, make sure you tell your doctor:
How your mood is more days than not in a given week.
How long it takes you to fall asleep, and if your sleep is inexplicably interrupted or is interrupted by thoughts/worry.
If the content of your thoughts is changing to things that seem odd, uncomfortable, or if you notice you are perceiving things differently in your environment than you normally would.
If you notice a drop in your interest or motivation to prepare for the baby. Note: This is not the same as a drop in energy which is expected at certain times during pregnancy.
Between weeks 28 and 32 (if not before), have focused sessions on:
Your support system/support plan. Who will be helping you?
Breastfeeding vs. Formula-feeding plan. Feeding complications are a risk factor for PPD/PPA, so try to be flexible.
If you will start/restart medications and when?
Let us hear from you! If you are a woman that has successfully completed the postpartum period without a recurrence of depression or anxiety, how did you do it? Inspire someone!