The Tot Q&A: Are you suffering from postpartum stress & anxiety - TheTot
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The Tot Q&A: Are you suffering from postpartum stress & anxiety

Acupuncturist & Holistic Women’s Health expert, Josie Bouchier, answers your questions on how to manage postpartum stress & anxiety.

QA-STress
Photo by Syrie Wongkaew

Having a baby is a huge deal that can have a big effect on you physically and emotionally. While welcoming a new baby into your family is really exciting, we also know that it can turn things upside down. You may feel exhausted, moody, anxious, stressed and even sad. It’s ok. We want to hear your about your experiences and we are excited to have Acupuncturist & Holistic Women’s Health expert, Josie Bouchier @JosieBouchier, here to answer your questions on how to manage stress and anxiety in the postpartum period.

 

Q: amberlina3: Even though I’m completely exhausted (3 month old still waking every 2-3 hours at night), I get sad and anxious thinking about going to bed, because I dread being woken up. I exercise when I can, avoid my iPhone at night, etc, but still have a hard time going to sleep some nights.

A: @amberlina3: It sounds like you have some qi, yin and blood deficiency which is preventing you from being able to fall and stay asleep when you have the opportunity. All women lose qi, yin, and blood when they give birth, and one of the main symptoms of that picture is the “tired but wired” feeling, as well as feeling sad and anxious.

Some foods you should try adding into your diet that will nourish your qi, yin, and blood are: warm, cooked foods that are easy to digest; warming spices like black and white pepper, cardamom, ginger, cinnamon, cloves, nutmeg, orange peel, and fennel; root vegetables, well-cooked grains, clean animal protein, fish, eggs, dairy, bone broth or veggie broth, green leafy vegetables, black beans, beets, cherries, red grapes, raspberries, mulberries, blackberries, blueberries, string beans, asparagus, seaweed, and tofu. One of my favorite practices to improve sleep and reduce anxiety is to have a foot bath right before bedtime. There are several acupuncture points on the feet and ankles that also help to improve sleep, and warming those points in a bath will gently stimulate them. It doesn’t have to be anything fancy, just fill a pot that your feet will fit into, or buy a basin from the drug store, and fill it with water warm enough that it feels like you’re stepping into a hot tub. Sometimes I like to add epsom salts and/or a couple drops of lavender essential oil for an extra luxurious experience.

You can also try doing some gentle stretching before bed and sprinkling a couple drops of lavender or jasmine essential oil on your pillow to help you fall asleep. Engaging in strenuous exercise is not going to help in this scenario, it’s just going to make you feel more depleted. You can try gentle exercise like walking, restorative yoga or Tai Chi, but nothing that makes you feel exhausted afterwards. I would also strongly encourage you to find an infant sleep consultant to see if there are any solutions to getting you longer stretches of sleep at a time. For example, having your partner do a feeding at night or hiring help like a night nurse a couple nights a week, or bringing your baby into bed with you so you can sleep while you feed, etc. Those may or may not be solutions for you, but I wanted to illustrate that there are lots of options that might be worth trying. Sleep consultants are worth their weight in gold!

Q: gingerlovely: I have a 2.5 year old girl and a 5 month old boy. I’m still fully breastfeeding but about to start weaning. I loved breastfeeding my first but have found it a much harder commitment with my second because it takes me away from my other child and makes me less flexible. I’m irritable a lot and this makes me impatient with my toddler where having patience is key! I would say both my babies have been easy in that they sleep well and aren’t cry babies but I’m feeling worn out and down a lot of the time. My husband tries to give me breaks but they’re never long enough to fully recharge. I do a post natal fitness class and lots of walking. What else could I try to improve my resilience?

A: @gingerlovely: Although breastfeeding for as long as possible is good for baby, it’s not always good for Mama. I think you’re going to feel a lot better once you wean. In Chinese medicine, breastfeeding can deplete your qi, yin, and blood – all of which you need to feel energized, resilient, and emotionally stable. Try incorporating these foods into your diet that will help replenish your qi, yin, and blood: warm, cooked foods that are easy to digest; warming spices like black and white pepper, cardamom, ginger, cinnamon, cloves, nutmeg, orange peel, and fennel; root vegetables, well-cooked grains, clean animal protein, fish, eggs, dairy, bone broth or veggie broth, green leafy vegetables, black beans, beets, cherries, red grapes, raspberries, mulberries, blackberries, blueberries, string beans, asparagus, seaweed, and tofu. Another thing that can contribute to further depleting your qi, yin, and blood is strenuous exercise. I know it feels counterintuitive in a culture where we are taught to think that working harder will give us more energy, but the opposite is actually true, according to Chinese medicine. Instead of exercising more to improve resilience, try exercising more gently and engaging in activities that feel nourishing and replenishing, like walking, restorative yoga, or Tai Chi. A good rule of thumb to know whether an activity is nourishing or depleting you, is to pay attention to how you feel afterwards. You should feel energized, not exhausted. Sometimes a nap or a meeting with a close friend might make you feel more nourished and energized than going to an exercise class! As a side note, the weaning process is another hormone adjustment and can be a bit of a bumpy ride emotionally and physically. Acupuncture and herbs prescribed by an acupuncturist can help the weaning transition go more smoothly and help you to feel like yourself again.

Q: pandimalBoth my son (22months at the time) and I had colds when my 2nd son (now 3 months old) was born. Dr. told me to wear a mask and keep the boys separated. I have never been OCD or afraid of germs before, but knowing that my newborn could get ill from me or my son threw me into a spiral of constant bathing and washing my hands and changing into clean clothes. I sought help and no longer feel the need to constantly sanitize everything. Therapy helped a lot! However I just went back to work and my production has decreased a lot and am now having to start supplementing. The guilt of not being “all breast” is hard, but I know supplementing is the best way for my son to get the best nutrition he needs.

A: @pandimal: Absolutely! You are doing an incredible job, Mama. I know it’s hard when you have to supplement with formula, but even a little breast milk is beneficial for the baby. If you’re interested in increasing your milk supply, you can try adding foods into your diet that are known as “galactagogues” which is a fancy word that means foods that have been shown to increase your milk supply. Some of these foods include: garlic, oatmeal, fennel, chickpeas, dark leafy greens, nuts and seeds, ginger, papaya, cumin, anise, and turmeric. It is thought that galactagogues make your milk taste better so the baby latches longer and sucks harder, thus increasing your milk supply. If the issue is something else, such as a tongue-tie, or incorrect latch, or stress levels in the mother, consulting with a lactation specialist will help get to the root of those problems. Stress levels in the mother are an important consideration with breast milk supply. The hormone in the body that allows the milk to flow is called oxytocin, also known as the “love hormone.” When you are feeling stressed, it’s difficult to access those lovey-dovey, warm and fuzzy feelings that help your milk to flow, and so it could be that you have plenty of milk but it doesn’t matter because it’s not flowing. Trying to get in touch with feeling “in love” will help unblock your milk supply and let it flow more freely. You can do this by watching a romantic movie, cuddling with your partner or baby or an animal, or even taking a quiet moment to visualize pink light in the center of your chest while you focus on thoughts of people you love with all your heart. Another thing you can do to help unblock the energy and blood flow in your chest, that will help with milk supply, is to massage your breasts and chest area. Always use a clockwise, circular motion, and use enough pressure that it feels pleasurable, not uncomfortable. Acupuncture and herbs prescribed by an acupuncturist are also extremely helpful for increasing milk supply and reducing stress levels in the mother.

Q: christahatescheese: I got an IUD shortly after my son was born. He’s now 11 months old. For a while I’ve been feeling like I’m unable to feel emotions, and was blaming it on the IUD (I’m under lots of stress at work, had personal stress, and a dying family member.) I talked to my OB and they let me know that’s not a thing. I’m also seeing a counselor, not sure if it’s postpartum or what. Hoping for a non-drug based solution.

A: @christahatescheese: I’m glad to hear you’re seeing a counselor, but make sure he or she is a good fit for you. If they’re unable to help you gain clarity about your situation or connect you with proper support and resources, it might be a good idea to look for a counselor who’s a better fit. Preferably, someone who specializes in postpartum recovery and/or grief and loss. It sounds like you have the perfect storm brewing of stress, grief, and postpartum. If you’ve reacted similarly to IUD or other forms of birth control in the past, then it’s possible the IUD (hormone-based, not the copper) could be contributing to that feeling of numbed emotions. But it makes more sense to me that it’s your mind and spirit’s way of coping with a high amount of stress all at once. Coming out on the other side of this might mean that things get worse before they get better, as you process and start to feel your feelings again. And that’s a good enough reason to keep the feelings at bay. Our protective mechanisms are so smart! So, I think making the decision to move forward into an uncomfortable healing process will help you to feel your feelings again. This definitely needs to be done in the presence of a skilled professional, whether it’s an acupuncturist, counselor, or therapist. 

In the mean time, you can also try Bach Flower Essences, which are one of my favorite non-drug based therapies that help to heal the emotions. You can buy them online or from most natural health food stores. Flower essences work similarly to homeopathic formulas; they come in liquid form in dropper bottles and can be administered throughout the day, a few drops at a time under the tongue. Each flower essence addresses a specific set of emotions, so read through the label on each bottle and choose 1-3 that feel like they match what you are experiencing. Instead of putting drops under your tongue multiple times a day, you can also try putting a few drops in your water bottle each time you refill it, so that you are getting a small dose every time you take a sip of water throughout the day. This is a method that works well because flower essences are odorless and tasteless, and then you don’t have to remember to take them as frequently. As you go through your healing journey, something else you may want to investigate is your digestion. 95% of our happy hormone, serotonin, is produced in the gut. This means that if our digestion is not working properly, it can have a huge effect on the state of our happiness. This is true in Chinese medicine as well. A healthy digestion looks like 2-3 well-formed bowel movements per day that contain no undigested food; no gas, bloating, heartburn, or nausea; and a moderate appetite that’s not too low or too ravenous. If you feel like your digestion could use some healing, you can start with eating mostly warm, cooked foods that are easier to digest than cold, raw foods. In addition, you can try adding probiotics and digestive enzymes into your daily routine, as well as avoiding inflammatory foods like gluten and dairy. Another thing to consider is that our emotions are stored in our body, so a great way to get more in touch with our emotions is to get more in touch with our physical body. This could mean doing some gentle yoga or stretching, Tai Chi, or simply walking – any physical activity that brings your attention to your body. Just make sure it’s not strenuous exercise that makes you feel exhausted afterwards. Also, be sure to check out two really helpful articles on The Tot called Postpartum Depression: An Overview and How To Treat Postpartum Depression.

Q: It’s hard going from being a completely free and independent person to having to be on everyone else’s schedule! I am having a hard time coping with that. And, unfortunately, with time it’s not getting any easier. Penny (my daughter) is 10-months old. I don’t feel sad as much as I do anxious and worn out. Having a baby is hard. 

A: @andreabacon12: I can totally relate! As mamas, we are constantly multi-tasking, putting everyone else’s needs ahead of our own, ticking things off our to-do lists, and generally managing the unexpected chaos of life. Needless to say, many of us live in a constant state of stress and anxiety. Thankfully, there are a few helpful practices you can do to ease the anxiety and exhaustion of motherhood. First, I’m going to teach you one of my absolute favorite breathing techniques that will instantly stop the flood of stress hormones in the body faster than any drug. This breathing technique can be life-changing. It’s one of the easiest and most effective things you can do. Plus, you can do it anytime, anywhere, and no one will ever know. Let me explain how elegantly this works. Your nervous system is divided into two parts, voluntary and involuntary. The voluntary nervous system is in charge of things like moving your arm when you reach for that morning cup of coffee. Or when you hit the snooze button in the morning — thanks voluntary nervous system! Your involuntary nervous system is in charge of things like telling your stomach to digest your food, telling your fingernails to grow, alerting your immune system to fight off a cold. Our body miraculously performs these tasks daily whether or not we think about it. The involuntary nervous system is further classified into your sympathetic and parasympathetic nervous system. In other words, your “fight or flight” response, and your “rest and relaxation” response, respectively. So, how do we activate that “rest and relaxation” response if it’s part of our involuntary nervous system that we have no control over? Well, I have really good news, there’s a loophole! Your breath.

Your breath is the only action in the body that happens whether or not we think about it, AND we can control it if we want to. Here’s what you do:

  1. Several times throughout the day, check in with yourself to see how you are breathing. Are you breathing shallow breaths from your chest? (Probably) Or deep breaths from your belly?
  2. If you’re breathing shallow-chest breaths, take a moment and place your hand on your lower abdomen, under your belly button. Take a breath in and push your hand outward. Exhale and let your hand come back toward your body as your belly deflates. Try it again:  Inhale, belly inflates and hand goes out. Exhale, belly deflates and your hand comes back down. You just flipped the switch in your brain to activate your “rest and relaxation” response and you instantly got rid of nasty stress hormones that were circulating throughout your body.

In addition to practicing this breathing exercise as often as possible, I would strongly encourage you to see an acupuncturist who specializes in women’s health and/or postpartum recovery. Acupuncture and herbs prescribed by an acupuncturist can help restore your energy and relieve anxiety, giving you more stamina and peace of mind to handle the challenges of having a ten-month-old. Oftentimes, mamas in the postpartum phase, which lasts about two years after baby is born, exhibit signs of what we call in Chinese medicine, qi, yin, and blood deficiency. Eating these foods can help replenish and nourish your qi, yin, and blood thus giving you more energy and making you feel more even keel: warm, cooked foods that are easy to digest; warming spices like black and white pepper, cardamom, ginger, cinnamon, cloves, nutmeg, orange peel, and fennel; root vegetables, well-cooked grains, clean animal protein, fish, eggs, dairy, bone broth or veggie broth, green leafy vegetables, black beans, beets, cherries, red grapes, raspberries, mulberries, blackberries, blueberries, string beans, asparagus, seaweed, and tofu.

Most of all, be kind to yourself and know that you are doing an incredible job mothering a tiny human. One of the best ways to be kind to yourself is to speak kindly to yourself in your mind. Don’t beat yourself up or be overly critical, judgmental or use harsh words. When you’re feeling anxious and worn out, ask yourself what you would do or say to a close friend who was feeling the same way. You would probably tell them they’re doing a great job, that it’s going to be okay, and to go take a nap or a bubble bath, read a good novel, or ask for a foot rub from their partner because they deserve all of it. And so do you. Know that you deserve to fill your cup and prioritize it in your schedule. Make a list of ten things that make you feel peaceful and nourished and choose 1-3 to put on your schedule every week, and then DO them. When you feel nourished and calm, your whole family benefits.

Q: lindseynaglieri: I always thought we’d be those parents whose baby fit into their lives, and not whose lives revolved around the baby. That significant change, and loss of freedom, has been difficult to accept. How do you maintain who you and your partner once were? Our daughter is 2 months old and we’re still not ready to leave her with a babysitter.

A: @lindseynaglieri: I totally understand where you’re coming from, I felt the same way! My husband and I didn’t feel comfortable leaving our first daughter with a sitter until she was 10 months old. You are in the very intense phase of having a two-month-old, and I promise things will not always be this intense. Your daughter will need less and less of your full attention and energy, and you will start to regain more and more independence and who you and your partner once were. I know it’s hard, but try to give yourself some breathing room and permission to let things be as they are right now, knowing it won’t always be this way. I’ve found one of the best ways to give yourself some breathing room is to repeat a mantra in your head when you start to feel overwhelmed, stressed, or anxious. A mantra is a positive phrase that begins with an “I statement.” My favorite one is “I allow.” Another good one is, “I trust.” You can even say them together, which sends the message to your mind, body, and spirit that you trust things won’t always be this hard, and that you can relax into the reality of the situation without feeling the need to resist it or fight back. I would also encourage you and your partner to come up with a “stay close” plan. Whether it’s having a quiet dinner at home together while baby is sleeping, watching an episode of a show or movie together, or just snuggling on the couch for a few minutes. Think of 3-5 different activities that make you feel closer with your partner that don’t require a sitter, and make sure to schedule them into your calendar. Aim for one small activity a day, like snuggling on the couch, that’s easy to accomplish, and one bigger activity once a week, like having dinner together. For me, if it’s not in my calendar, it doesn’t happen. So, scheduling each activity is an important step.

Q: nicbasic: Definitely, like others are saying, the loss of your own personal independence and freedom in a sense is really hard to cope with. I am happy and love my baby boy (14 months now) but feel like I could never do this again. He was a really poor sleeper for the first 12 months so that definitely added to the anxiety.

A: @nicbasic In my clinical experience, I have noticed that it takes mamas at least two years to fully recover from giving birth and raising a little one. But there are definitely some key practices you can do to recover sooner and more completely in your body, mind, and spirit, so that you can have the confidence and wherewithal to make the right decision for you and your family of whether or not to have another baby. Taking a high quality multivitamin and fish oil make a big difference in postpartum energy and anxiety levels. I often advise my patients to remain on their prenatal vitamins six months up to two years after giving birth, especially if it contains iron which can help replenish the blood loss. (Once blood levels are adequate, I then recommend switching to a regular adult or women’s multivitamin.) The reason I recommend vitamins during the postpartum phase is because it can be unrealistic for mamas to expect to get all the nutrients they need from a well-balanced diet when they have so much going on.

One of the other best things you can do to physically recover from giving birth is to focus on rehabilitating your pelvic floor and internal abdominal muscles. Too often, these areas are not addressed after giving birth, and women suffer from symptoms like urine leakage, painful intercourse, and chronic lower back pain when they don’t have to! Some resources I love for learning exercises to accomplish this rehabilitation are Katy Bowman’s website and books, as well as the MuTu System with Wendy Powell. As important as it is to feel recovered physically, it’s equally important to feel recovered in your mind and soul. Our culture is obsessed with “bouncing back” after having a baby. We hardly give ourselves room to acknowledge the grief of losing our old lives and our old selves and to honor the monumental rite of passage of giving birth and raising a little one or ones. Rites of passage can be painful and full of turbulence, while at the same time being breathtakingly beautiful. It’s important to validate both of these experiences for yourself. This can look like going to therapy to process any residual anxiety, anger, birth trauma, or resentment; talking to other mamas about their experience and exchanging resources and support; or simply giving yourself credit for doing one of the most challenging things you’ll ever do in your life. For most women, myself included, part of the recovery process also involves gaining back some of your independence. Independence doesn’t mean abandoning your family’s needs, it means taking care of your own needs so that you will be a better mother and partner. Everyone wins. What are some activities, practices, or hobbies you used to do before baby that filled your emotional and spiritual cup? Think about whether you can begin to incorporate some of those practices, or a version of those practices, back into your life on a consistent basis. For me, my monthly book club with my close mama friends was my life raft during the early years following the births of my daughters. Carving out time to be alone and writing a journal was also hugely helpful for me to feel more autonomous. For every woman, what brings them a feeling of independence will be different. It could be as simple as taking a 10-15 minute walk alone once a day, or it could be joining a rock-climbing gym once a week (most gyms have childcare!). Do what brings you joy, what fills your cup, and what makes you feel, even in some small way, like your old self again.

Q: saintjSince baby, I have trouble leaving the house because I’m constantly worried she’ll get sick. I’ll push an elevator button, for example, then immediately sanitize. I was never like this before baby and have been an ICU nurse for 13 years but now I’m worried about going back to work for fear of what she’ll be exposed to through me. 

A: @mrs.saintj: Being concerned with your baby’s health and exposure to germs is completely normal, but when it interferes with your ability to carry out daily tasks such as leaving the house, it’s worth considering professional advice and possibly treatment. See if it helps to calm your worry about your baby getting sick if you take proactive measures to boost your baby’s immune system. Depending on his or her age, you could look into an appropriate children’s daily multivitamin and probiotic, both of which can help the immune system to function more optimally. You could also look into taking him or her to get regular pediatric acupuncture treatments using a method called Shonishin. Shonishin is a pediatric acupuncture practice where no needles are used, and nothing penetrates the skin. Shonishin treatments are excellent for keeping babies healthy. If taking these preventative measures doesn’t seem to calm your constant worry, you may want to look into getting more help. Obsessive Compulsive Disorder (OCD) is considered the fourth most common mental health issue, affecting 2-3% of the population, where pregnant and new mothers are the most susceptible due to the dramatic shifts in hormones that occur in the body during that time. It’s thought that the changes in hormone levels can trigger gestational OCD during the pregnancy or postnatal OCD within a year after the pregnancy, either for the first time or if there’s a family history of mental illness. The first line of treatment commonly used is called Cognitive Behavioral Therapy (CBT), which is a short-term, goal-focused form of therapy that has been found to be incredibly effective. Medication can also be extremely helpful. Acupuncture and Chinese herbs are wonderful complimentary treatments to CBT and western medication as it can help nourish and support what we call Spleen Qi, which usually becomes depleted after giving birth and can contribute to obsessive thoughts. Here are some resources for you to get more support, clarity and answers to your questions:  Anxiety Disorders Association of America (240-485-1001www.adaa.org), the Obsessive-Compulsive Foundation (203-315-2190www.ocfoundation.org), or the Obsessive Compulsive Information Center (608-827-2470www.miminc.org/aboutocic.html).

Josie Bouchier L.Ac., M.S., Dipl. OM (NCCAOM) is an acupuncturist, women’s holistic health expert, writer, and mom living in Colorado with her husband and two daughters. Through her blog and online programs, she empowers women all over the world to conceive, have a healthy pregnancy, and get their body back after baby. Josie is currently working on a new book based on her most popular online program, Fertile Woman. Find out more at josiebouchier.com.