Managing Fears of Spiraling Back Into Depression

There are times when I am in certain situations now, that I feel like I may fall back into postpartum depression. Even after women have been treated, postpartum depression increases the likelihood of depression in the future.¹

Stress is a huge trigger

Not surprisingly, it happens at crucial moments and stressful situations where emotions are heightened. When it feels like the universe is testing me.

The bizarre part of it is it can happen at any moment. It can be something more serious like your child getting the stomach virus 12 hours before a business trip and your husband is stuck at work in the operating room. Or something less serious but equally as testy, depending on the day, as your kid needing a diaper change as soon as you are about to leave the house and you are running late. (It feels important to let you know that not all of my problems revolve around my kids' bodily fluids.)

I often wonder, am I on "the other side" of PPD?

Fear of falling back into depression

Optimistically speaking, I feel like I am on "the other side." I am really far away from where I was when I was in the thick of it.

Realistically speaking, how do we truly know? What needs to happen for us to no longer "have PPD"? Is it related to our kids' age? Is it when you no longer need medication? Is it when your therapist says let's not meet every week but every month? The questions go on and on.

Postpartum depression isn't black and white

I haven’t come up with a solid answer, but I try to remember where I have been and what I am doing today. For me, it's about my reaction and my outlook on life. If the universe is testing me, what am I going to do about it?

I am so thankful for my therapist as she has provided me with so many tools for coping. I'd like to share a few things that help me, especially when things get harder.

How I avoid a PPD spiral

Worst case scenario vs. best case scenario

If you love to catastrophize every situation – thinking of the worst possible case scenario every single time – welcome to the club. I think this is a personality trait because I have never been able to not think of impending doom.

Now that I have accepted this, that's where I start. But it's never where I finish. After thinking of the worst case scenario, I try to think of the best possible case scenario and then a lot of scenarios in between. Nine of out 10 times, we end up somewhere in the middle. It takes practice, but it really helps with your outlook.

Setting expectations

Or, I need to have absolutely zero expectations. If you haven't realized yet, I tend to be on the extremes of things. This is something that being married to someone in a surgical profession taught me.

If you have no expectations, you can't be disappointed, right? Well, that’s really hard to do. We will always have expectations. Much like the scenarios example, thinking of an array of expectation options can be helpful.

Noticing how my PPD was showing on the outside

My boys are everything to me. Even before they were born all I asked the universe was for patience with my kids. I wanted to teach them compassion and empathy, to be decent humans. I also wanted them to see me as a calm, reliable, caring human. PPD put a huge wrench in that.

I can confidently say that the wrath of my irritability, the rollercoaster of emotions, and the angst I felt weren't ever directed at my children. (They were mostly directed at my husband and mom, I love you both so much.) But I also know it affected them. When your 3-year-old asks you if you are okay more than once, it makes you look inward.

Treating myself and others as I do my kids

My therapist asked me a simple question that changed everything: Why do you not treat yourself (and others) with the same grace and patience as you do your kids?

In all honesty, my first thought was, "Because we are all adults, and we should know better." After thinking about it more, I realized that the thing about PPD symptoms is that they come out of nowhere. For most of us, we don't even know if it is happening to us. You feel like you should know better, but it's uncontrollable.

I control my reactions and my outlook

Our lives don't change regardless of which stage we are in with PPD. Most of us are still the holders of the mental burden of our families. We are the doctors, the pharmacists, the nannies, the chauffeurs, the cooks, the cleaners, the entertainers, the night shift, and the event planners.

I try to focus on my outlook and how I react to things. How much I forgive myself for the past also has helped. So far it seems to be working well.