How can CBT help with Postnatal Depression?

It is thought that 10-20% of new parents develop Postnatal Depression. Research has even found that between a third and a half of women start to develop PND in their pregnancies (this is sometimes referred to as antenatal depression).

For more information on what to look out for, click here to view my other blog on The Difference Between Baby Blues & Postnatal Depression.

I have also written a blog about CBT, what it is and what to expect. You can read that here.

This blog is going to look at how CBT can help you overcome Postnatal Depression.

As many of you know, I am passionate about helping new, existing, and expectant parents to overcome their mental health difficulties using high-quality CBT. I am lucky enough that all my referrals in my private practice are from pregnant or postnatal mum’s who are struggling in one way or another with anxiety and/or low mood and I am dedicated to helping those I work with feel better about themselves and their pregnancy’s/new baby’s.

Lots of parents struggle with the demands of pregnancy and/or having a baby. Below is a list for some of these.

Things new mums can struggle with

  • The tiredness, not knowing if baby will sleep and when they will wake up
  • The adjustment of having a new baby to look after who is entirely reliant on you for its every need
  • The need for baby to be close to mum constantly for the first few months
  • Establishing breastfeeding and accepting just how often baby needs to be at the breast in the early weeks and months
  • Taking baby out, especially when their partner is back at work and mum must take her baby (and older children) with her with no other help
  • Keeping up with the housework
  • Maintaining an exercise regime
  • Having time away from their baby’s
  • Not having time away from their baby’s!
  • The distance that can be created with their partner
  • Worries about whether their partner still finds them attractive
  • Resentment at their partner for “having a break” at work whilst mum is at home looking after the children all day

This is not an exhaustive list, and many mums can struggle with other aspects of pregnancy, birth and parenthood too. Can you relate to any of these struggles? How did you manage them?

CBT is a very practical, active therapy where we would look at what things you are doing that are helpful (such as going for a walk with your baby, or meeting a friend for coffee and cake) and those things that perhaps aren’t so helpful (such as not going out at all, clock watching when trying to get to sleep, & excessively checking your baby that they are ok). These unhelpful behaviours may be more common in the early days and weeks but should eventually return to normal. There is no pressure to get out the house every day and meet up with people when you’ve just had your baby and you need to rest and recover to heal physically and emotionally. Doing too much too soon can hinder that healing process, however not doing much at all for many months after your baby's birth because of anxiety or lack of motivation will likely contribute to you feeling worse in the long run. The reason for this is that you just end up cooped up all day with your baby, your anxious mind, and your lack of drive to tackle the day.

One of the things I love about working with mums is seeing the changes they make. It is so rewarding seeing them notice unhelpful patterns that they may have got stuck in and making meaningful changes to break the cycle. The result tends to be improved mood and decreased anxiety levels.

CBT can help you to gradually, and at your pace, build in activities, and not just the boring, mundane baby stuff (let’s be honest the monotony can be soul destroying sometimes!), but also the things we value and enjoy and that give us a sense of pleasure or satisfaction. When you have a baby, your whole routine goes up in the air, but things should settle down eventually and you, your baby and your family will find your own routine that suits you all. However, lots of parents can struggle getting the balance right and end up doing too much of the mundane stuff and neglect the very important "me time" activities. My free Managing Mood Guide is something you could use to try and help you address this.

Something the guide doesn’t cover, but that CBT sessions can, is addressing the certain “blocking thoughts” that can get in the way of us doing these activities. Often, thoughts like, “what’s the point in going out, I won’t enjoy myself and will just be pulling everyone else down,” and “if I go to the baby swimming class, I won’t cope if the baby doesn’t like the water, and everyone will be looking at me and judging me.”

CBT can be creative in helping you to test some of these ideas and worries that you may develop. The best way to test them is to go to the situation you are worried about and see what actually happens, then compare it to what you thought would happen. Doing this can help you learn how the world really works, rather than living your life in accordance with your anxious thoughts as if they are completely true.

Another really helpful thing that CBT can address is the expectations you place upon yourself and to compare those with what other people typically do. We can do this in what we call surveys, which is a way of seeing what the consensus is about certain things. I remember working with a mum who felt bad about the fact she didn’t cook all her baby’s food from scratch and that she would feel guilty if she didn’t go out with her baby every day. These expectations she had for herself were making her feel bad and keeping her stuck feeling low when she was unable to achieve them.

We devised a survey to ask other mum’s what they feed their babies of the same age and how often they go out with their baby. The consensus was that it didn’t matter what baby ate, as long as they ate something fairly healthy, and that most mums didn’t go out with their baby every day. This was helpful for the mum in therapy to see that maybe she was placing too much pressure upon herself. We worked on trying to lower those expectations slightly, and over time, my client felt less stressed and pressured and more relaxed about what her baby ate and how often she took him out.

There are lots of other ways that CBT can help with mum’s who are struggling with anxiety or low mood, whether you are thinking about having a baby, you are trying for one, you are pregnant or postnatal. Once we know exactly what your situation is, we can put our heads together to decide on the best tools and strategies to use. Have you had CBT for Postnatal Depression before? How did you find it?

Useful Links:

Treatment - Postnatal depression - NHS (www.nhs.uk)

Perinatal depression | Mind, the mental health charity - help for mental health problems

CBT Register UK | The online register of CBT therapists for the UK and Ireland

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