After giving birth to her first child 11 years ago, Ontario mother Leigh-Anne Mosselman-Clark thought she understood why she had been so depressed during the first weeks and months of parenting.
Her son “had some really serious health issues,” she told HuffPost. “He was in the hospital for quite a while, so I just pushed my needs to his side.”
But two years later, when she gave birth to her second child and experienced the same symptoms, they pointed to another cause: postpartum depression. This time, her midwife suggested she consider cognitive behavioral therapy (CBT).
Mosselman-Clark started working one-on-one with a therapist, and “I was fine with that,” she says. “But I kept thinking, ‘I don’t want to talk to doctors about this, I want to talk to people…I understand that.'”
She eventually found a group CBT program, which she credits with helping her recover from her depression. She said group dynamics are important, “having empathy and compassion and not feeling guilt or shame.”
She believes the group’s camaraderie was the ideal antidote to the feelings of isolation that accompanied and exacerbated her depression. A few years later, when she heard there was an opportunity to train as a peer leader for this type of group, Mosselman-Clark enthusiastically applied.
What is postpartum depression?
According to the Cleveland Clinic, up to 75% of birth parents experience sadness or mood swings in the weeks after giving birth. This temporary emotional downturn is commonly referred to as the “baby blues” and is thought to be caused by the rapid drop in hormone levels that occur after birth. However, for 1 in 5 women and those who are about to give birth, these feelings of sadness persist and they are diagnosed with postpartum depression. (It’s important to note that fathers, adoptive parents, and other non-pregnant parents can also experience postpartum depression.)
Therapy and medication can be effective treatments for postpartum depression. In fact, the FDA has just approved the first pill specifically designed to treat this disease. But with so many people affected and the current shortage of mental health providers, patients often face significant delays in receiving treatment. Additionally, some new parents are reluctant to talk about their symptoms because they feel embarrassed or stigmatized, further delaying care.
It is an effective treatment.
Given the need for compassionate, evidence-based care that can meet these high needs, peer-delivered group CBT is a treatment option that can be scaled to meet the needs of many patients. We provide.
The group led by Mosselman-Clark was part of a study conducted by researchers at Canada’s McMaster University to evaluate peer-led CBT groups as a treatment for postpartum depression.
Participants were identified using the Edinburgh Postnatal Depression Scale. Those who scored 10 or higher, indicating possible depression, were given entry into the study.
“People with symptoms at that level may still have a lot of difficulties, but their symptoms may not be severe enough to qualify them for services,” said Professor of Psychiatry and Behavioral Behavior. , explains Dr. Ryan Van Lieshout. in neuroscience at McMaster University and one of the study’s authors.
Participants were then randomly assigned to either join the CBT group immediately or join the CBT group 9 weeks later. In this way, researchers were able to compare the results of the group that received the treatment with those of the group that had not yet received the treatment. During this period, participants in both groups received “treatment as usual,” which sometimes included individual meetings with therapists and other health care providers. “Health care services used outside the group were comparable in the two groups,” Van Lieshout said.
The original plan was for each group to meet in person, but due to the pandemic, they ended up meeting entirely online via Zoom. In each of the nine weeks, the group met for two hours. The second hour focused on weekly discussion topics of interest to new parents, such as sleep. The first hour “focused on the core skills of cognitive behavioral therapy,” Van Lieshout said. He called these “traditional parts of CBT.”
Cognitive behavioral therapy is an evidence-based treatment aimed at changing thought patterns. One of these strategies is called cognitive restructuring, where “people learn to identify thoughts that may lead to changes in their mood,” Van Lieshout told HuffPost. Ta. Once you are able to identify the thoughts that make you feel anxious, sad, or depressed, you are taught to “balance” that “intense self-talk” with other thoughts, thereby improving your mood and reducing your anxiety.
Van Lieshout says that for people with postpartum depression, thoughts such as “I’m not good enough,” “I can’t do this,” and “I’m not a good mother” express their own inadequacy. It is said that there are many cases.
Mosselman-Clarke explained that participants were taught multiple ways to “balance” this idea with another. One technique is to imagine what you would say to your best friend in a similar situation. “We’re much harder on ourselves than we are on the people we care about,” she said.
For example, thoughts of inadequacy may be balanced out by thoughts such as, “I am able to meet my baby’s needs.”
“What I love about peer CBT is that we teach them to be their own therapists. After all, they are telling themselves these things. They Some people write their balanced thoughts on their phones, write them on paper and post them on the fridge, take screenshots of them, and some even write them on their mirrors.”
Professor Mosselman-Clarke said some participants were skeptical about these types of actions and were surprised to find that their relationships with their babies and partners improved after performing them.
At the end of nine weeks, “those treated immediately experienced clinically significant improvements in postpartum depression and anxiety,” Van Lieshout said.
“Patients in the treatment group were 11 times less likely to meet diagnostic criteria for a full-blown major depressive episode at the end of treatment compared to patients in the control group,” he continued.
Participants were evaluated both at the end of the nine-week cycle and three months later, and the researchers found that the observed improvements did not disappear.
Given how common postpartum depression is and how great the need for services is, Van Lieshout said this study will help “recovered peers understand the need for treatment that women really deserve.” We believe that our results show that this has the potential to help bridge the gap between availability and availability.
The healing potential of group dynamics.
Peer-delivered therapy has also been used to treat other mental health conditions, such as substance use disorders, but there is a clear case for its use in postpartum depression as well. Groups can help combat the feelings of isolation that new parents may face. Hearing from peers that they are not alone in their feelings and that recovery is possible can also bring hope to patients.
“It was amazing to see how women came together around a common purpose, a common problem, and how they helped and supported each other,” Van Lieshout said.
“The most powerful people in helping people recover are the other members of the group,” he says.
Van Lieshout believes this group dynamic, combined with structured, evidence-based CBT therapy, creates a treatment that offers the “best of both worlds.”
Van Lieshout wants expectant parents to know that postpartum depression is a common problem. “It’s not a weakness. It’s something that develops as a combination of biology and environment, and it can happen to anyone.” Equally important, effective treatments exist and they don’t necessarily last long-term. He said people should know that it is not a treatment that needs to be continued.
Mosselman-Clark has this to say to new parents and parents-to-be. And it’s okay to say you’re not okay. There’s no need to fake happiness. ”
“It’s not a failure to ask for help,” she added.
