PPD therapy experiences?

[Anonymous]

I just had my first PPD therapy session and I was very underwhelmed.

Others who have gone through this, what was therapy like? What did you talk about? What was the therapist’s approach? Did you find it helpful? How long did it take for you to see improvement? Did you also do meds? If so, which did you think was more impactful?

I’m struggling every day and being told to eat better and journal just feels... both unhelpful and unlikely. I haven’t even showered in three days. Trying to figure out if I need someone new or I should just give it some time and a shot.

[Anonymous]

Bump

[Anonymous]

We talked about how I felt. Sometimes we strategized about how to tackle an issue, sometimes I cried. I found it helpful. I enjoyed having a dedicated time to talk about and work on how I felt. Everything else in my life at that time was about someone else - kids, husband, my staff, my boss. Have you told the therapist that you can't even find time to shower so you have no idea how to make the time to journal or eat better? That way they can either respond in a way that's helpful or they don't and it's a clear sign that you need to find a different therapist.

I ended up going to a psychiatrist too and got on Lexapro, which helped me. I liked my therapist right away but hated my psychiatrist. I ended up finding a different one.

I think both were impactful. The Lexapro helped me get out of a fog so that I could act on the things I discussed with my therapist. I was too overwhelmed and anxious otherwise.

[Anonymous]

You need medication. PPD is a physical hormonal imbalance. You can't fix that with talk therapy.

-therapist

[Anonymous]

I did not think my PPD therapist was very good, but no (about 3 years out) I am still glad I went.

To respond to the recommendation of medication, I think you should definitely explore this but not everyone can take medication or responds to it well. I chose not to take meds for my PPD because of a previous experience with antidepressants and anti-anxiety meds that was very scary (led to suicidal thoughts). Since my PPD involved self-harm, I was uncomfortable with it and decided to rely on therapy alone.

However, the therapist I found who was focused on PPD issues seemed to treat my issues generically. It was like "I have seen many women with PPD, this is what helps, do that." Therapist "fit" is always challenging but this felt like a structural issue, like she was not really listening to me or what I was saying. However, some of the generic advice she gave me was still helpful (there are some universal truths with PPD) and it was good for me to spend 50 minutes every week just focused on myself. I credit my therapy with helping me figure out a key question with regards to return to work, and also with pushing me to find a mom's group as an informal source of support. Those wound up being really important parts of recovering from PPD for me.

So I guess the question for me would be "is this hurting?" Definitely explore medication if that's an option for you or you haven't already. But even if the therapy doesn't feel like it's working now, it might have positive effects. I'd give it a chance, even if it doesn't feel like it's doing much. It's hard to be objective about this stuff while in the middle of dealing with PPD.

[Anonymous]

Anonymous wrote:You need medication. PPD is a physical hormonal imbalance. You can't fix that with talk therapy.

-therapist

Any decent therapist would know that medication isn’t just going to fix things. It is most effective when paired with talk therapy.

[Anonymous]

Anonymous wrote:

Anonymous wrote:You need medication. PPD is a physical hormonal imbalance. You can't fix that with talk therapy.

-therapist

Any decent therapist would know that medication isn’t just going to fix things. It is most effective when paired with talk therapy.

Of course, but you can't fix a hormonal imbalance with talk therapy. This is a physical issue, not a psychological one.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:You need medication. PPD is a physical hormonal imbalance. You can't fix that with talk therapy.

-therapist

Any decent therapist would know that medication isn’t just going to fix things. It is most effective when paired with talk therapy.

Of course, but you can't fix a hormonal imbalance with talk therapy. This is a physical issue, not a psychological one.

I really hope you are not the PP therapist. If you are, you should know that while a hormonal/neurotransmitter imbalance can be one of the contributing factors for PPD/PPA, another contributing factor can be the immense life change that becoming a mother is. It's not necessarily a clear cut issue. Medication is only going to help so much if you're aren't addressing underlying issues.

[Anonymous]

Anonymous wrote:I just had my first PPD therapy session and I was very underwhelmed.

Others who have gone through this, what was therapy like? What did you talk about? What was the therapist’s approach? Did you find it helpful? How long did it take for you to see improvement? Did you also do meds? If so, which did you think was more impactful?

I’m struggling every day and being told to eat better and journal just feels... both unhelpful and unlikely. I haven’t even showered in three days. Trying to figure out if I need someone new or I should just give it some time and a shot.

One of the most helpful things to me was the whole story about running the dishwasher twice. Basically a women experiencing depression told her therapist she got overwhelmed by all the dishes in the sink with stuck on food and that it was too much to wash them and then load. The therapist replied run the dishwasher twice or even three times. If the dishwasher sucks or it doesnt work after 1x then try twice. The goal is to accomplish one thing a day no matter what "rules" are broken. Dont want to shower because its too much - lay in the shower or sit. Eating better- have a friend deliver whole foods and pick out some foods. Literally take the therapist time and order groceries together. Say I need help accomplishing the food part before I can do the eat part. Get frozen entrees x100 and some fruit. Eat PBJ uncrustables with some cut up vegetable tray items for the week.

You are clawing yourself out. There is no ladder with really nice sturdy steps. There are hands reaching for you but I know how scary that can feel because 1)you might drag them down with you 2) you are so heavy that they may pull away 3) you dont even have the desire/energy to form thoughts on what you need.

I need you to determine one thing you are going to do every day this week. What do you remember that made you feel whole- A shower? Being outside? Listening to music in the car? Eating breakfast/having coffee in quiet with fresh flowers? Those memories are there and when you find one thing do it every day this week. That is your only must. And if you complete it say to yourself I am proud of you. And if the day goes by and its 10pm at night and you just want to sleep- tell your partner I need to do this. Crawl if you must.

The brain builds on repetition. Sometimes we need medicine to help our brains light up the pathways, right now its dark. But even if the pathways are lit you still have to take the steps. Im PROUD of you for recognizing where you are. You want to feel better. It wont be easy or linear but there is a part inside of you fighting and thats your momentum out.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:You need medication. PPD is a physical hormonal imbalance. You can't fix that with talk therapy.

-therapist

Any decent therapist would know that medication isn’t just going to fix things. It is most effective when paired with talk therapy.

Of course, but you can't fix a hormonal imbalance with talk therapy. This is a physical issue, not a psychological one.

I really hope you are not the PP therapist. If you are, you should know that while a hormonal/neurotransmitter imbalance can be one of the contributing factors for PPD/PPA, another contributing factor can be the immense life change that becoming a mother is. It's not necessarily a clear cut issue. Medication is only going to help so much if you're aren't addressing underlying issues.

I had postpartum psychosis due to lack of sleep and a hormone imbalance. I was hospitalized and immediately improved upon starting Zoloft. Do you think talking about how I don't have any me time anymore would have helped?

[Anonymous]

As a therapist I understand the limits of therapy. CBT can't stop the oxytocin crash. Would you tell a man with a broken arm not to take pain meds? This is just misogyny, the expectation that a women should be able to "think" her way out of a massive physical shift taking place in her brain.

[Anonymous]

I found a combination of medication and therapy helpful, but nothing worked immediately. A single session wont fix everything.

[Anonymous]

Anonymous wrote:As a therapist I understand the limits of therapy. CBT can't stop the oxytocin crash. Would you tell a man with a broken arm not to take pain meds? This is just misogyny, the expectation that a women should be able to "think" her way out of a massive physical shift taking place in her brain.

As someone who has never had PPD/PPA or clinical depression/anxiety, but is interested (I’m one month postpartum with #2 and planning on having a third; my sister in law also had crippling PPD/PPA and she took a very high dose of Zoloft throughout her pregnancy/postpartum): what do you mean by oxytocin crash? Why do only some women get PPD/PPA if we all have the same crash postpartum? Do we all not have the same crash?

[Anonymous]

Anonymous wrote:As a therapist I understand the limits of therapy. CBT can't stop the oxytocin crash. Would you tell a man with a broken arm not to take pain meds? This is just misogyny, the expectation that a women should be able to "think" her way out of a massive physical shift taking place in her brain.

No, what is mysogynistic is expecting a woman to just take a pill and get on with things. You have very black and white thinking for a supposed therapist. No one said therapy alone is adequate for PPD. Medication combined with therapy is extremely effective. That is the point being made, and what you seem unable to grasp.

[Anonymous]

Anonymous wrote:

Anonymous wrote:As a therapist I understand the limits of therapy. CBT can't stop the oxytocin crash. Would you tell a man with a broken arm not to take pain meds? This is just misogyny, the expectation that a women should be able to "think" her way out of a massive physical shift taking place in her brain.

As someone who has never had PPD/PPA or clinical depression/anxiety, but is interested (I’m one month postpartum with #2 and planning on having a third; my sister in law also had crippling PPD/PPA and she took a very high dose of Zoloft throughout her pregnancy/postpartum): what do you mean by oxytocin crash? Why do only some women get PPD/PPA if we all have the same crash postpartum? Do we all not have the same crash?

We don’t all have the same crash. It’s very individual. I had intense baby blues from the immediate post-partum hormone drop, then felt great for two months, then developed PPD, got better, then had a PPD relapse at 14mo when my baby weaned.

And despite what PP said, PPD is rarely just hormones. Like anything mental health related, it’s likely a combination of hormone imbalance AND environmental factors. For me, there’s no question that isolation, lack of support, and a couple external events led to or exacerbated my PPD. I think the hormones made me vulnerable, but the external factors pushed me over the edge. Of course, everyone is different and for others the hormonal imbalances may play a bigger role.