Postpartum mental health

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Re: Postpartum mental health

Post by Wondering on Fri Mar 20, 2015 1:19 am

I think I had (have?) postpartum anxiety.

Which no one ever talks about. Only postpartum depression, not PP psychosis (worse) or PP anxiety (not as bad).

Stupid hormones. Blarg.

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Re: Postpartum mental health

Post by kath on Fri Mar 20, 2015 2:34 am

*jedi hugs*? Thread maybe?
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Re: Postpartum mental health

Post by reboot on Fri Mar 20, 2015 9:14 am

Wondering wrote:I think I had (have?) postpartum anxiety.

Which no one ever talks about. Only postpartum depression, not PP psychosis (worse) or PP anxiety (not as bad).

Stupid hormones. Blarg.

Postpartum anxiety is not uncommon: http://psychotherapy.com/mom.html
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Postpartum mental health

Post by Wondering on Fri Mar 20, 2015 1:50 pm

reboot wrote:Postpartum anxiety is not uncommon
article wrote:Occurs in up to 10% of postpartum women.

You and I have different definitions of uncommon. Wink


But:
article wrote:
Postpartum Obsessive-Compulsive Disorder

Occurs in approximately 3-5% of childbearing women.
 

  • Symptoms include:  presence of both repetitive obsessions (intrusive and persistent thoughts or mental images) and compulsions (repetitive behaviors performed with the intention of reducing the obsessions), as well as a sense of horror about these thoughts.
       
  • The most common obsession is thoughts or mental images of harming or even killing one's own baby.

Holy crap, yes! My mental images were all of accidental harm or death, not intentional, by me or someone else. And I was constantly checking that she was breathing when she was asleep, so that sleep when the baby sleeps thing? Baloney.

article wrote:Postpartum Obsessive-Compulsive Disorder is the most under-reported and under-treated disorder of childbirth, since these symptoms are horrifying or embarrassing to the mother and she may fear that others will think she is a risk to her child.
Just that they'll think I'm crazy and therefore not to be listened to about anything.

The whole running strain in that article about husbands not helping isn't true, though. My husband was off work for 2 months. He did everything because I had a physically hard recovery and could do very little.

But I think postpartum care is practically non-existent. This theory that you should be all healed in six weeks is a joke. And what they screened for at my six-week check-up was: "Are you having thoughts of harming yourself or the baby?" "Um, no." (not said: the baby being harmed is my greatest fear). "Okay, then." I didn't even know this was a thing until a friend of mine was talking about how she was diagnosed with PP anxiety and what she was going through, and I said, "Oh, I do that, too! Is that a thing? Why did no one ever tell me this is a thing?"


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Re: Postpartum mental health

Post by Guest on Fri Mar 20, 2015 2:19 pm

There's an interesting narrative about pregnancy and childbirth that we have as a culture, and it can be very, very hard if you're not living it exactly:

Pregnancy: morning sickness, fatigue, have to pee a lot, weird cravings, otherwise fine.
Childbirth: Long and painful
Immediately postpartum: deliriously happy, instant bonding
Later postpartum: Exhausted, but happy and maternal.

It took a concerted effort to introduce the idea of postpartum depression into the conversation, and even with that, it's still looked at a bit askance. Other feelings that don't fit the narrative tend to make us feel uncomfortable.

True story: when I had my first baby, they put him in my arms, and my first thought was, "Oh, god, what did I do? This is wrong." While he was in the womb, it was amazing and magical, but now here's this... person-thing, and I don't know what to do with it! It took days before he started to feel like my baby, to whom I could attach a real name without thinking about it. I wasn't depressed, I didn't want to hurt myself and him, but I felt intensely disconnected from him.

Years later, I was writing a fanfic where a character was having a baby, and I said, "What the hell; putting this in," and had the new mother comment to her husband that the baby didn't feel like hers. It was a premature birth, and low-level traumatic, and it seemed right, but I was worried about backlash or making her seem unsympathetic.

I got several responses from people who were so relieved reading it, because they thought they were the only ones who had felt that way.

There's a real isolating effect to the One True Cultural Narrative, because we have no idea how common our "deviant" experiences are. We need better birth stories in our public eye.

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Re: Postpartum mental health

Post by reboot on Fri Mar 20, 2015 2:21 pm

Yeah, I think the husband thing was excerpted from the dissertation.

We do have different concepts of "common" because to me one out of every 10 mothers is pretty common. In AZ about 86,300 women give birth each year so that would be 8,630 women a year.

You are 100% right that postpartum care, especially mental health care is terrible and people are even more dismissive of mothers' emotions than women's emotions, so I totally hear you on that.

For support from people who know pp anxiety, try Postpartum International They have good resources and a care referral network
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Re: Postpartum mental health

Post by Wondering on Fri Mar 20, 2015 4:29 pm

Ugh, I have so many thoughts about this in regard to what both of you have said, but they're all interconnected and jumbled together.

1) I've found that talking to other women in my real life about these issues usually negatively affects my mood from irritation to feelings of isolation. Mostly because:
a) most other mothers do not have a husband/partner who is doing equal work like mine is. Their narratives are so foreign to me, and I find we have nothing in common.
b) I had a Type 1 diabetic pregnancy and no one gets this. No one. Only another Type 1 could.

2) We treat pregnancy and pregnant women horribly in this country. No paid maternity leave. Which leads, I think, to a lot of the problems postpartum where you're pressured to get back to normal. Get back to your job. Feel all better after six weeks. Feel like you should be able to handle everything all by yourself after six weeks. Maybe eight if you had a c-section. But you're still not paid for the time off!

3) We don't, as a society, listen to women. We dismiss their emotions, their stories. We call them crazy. My husband distinctly does not do this. But even with him, who is the only person in the world I trust implicitly, I couldn't bring myself to tell him about these mental images and near-panic I was feeling until two months in.

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Re: Postpartum mental health

Post by kleenestar on Tue Mar 24, 2015 4:39 pm

Oh my god, I also have the "I have to walk on eggshells" thing when talking to other new mothers! For me it's doubled because I have a fully participatory partner AND a ridiculous amount of maternity leave (five months paid, three months unpaid) AND my partner is working half-time AND he doesn't even start that until the end of this month. It really throws how badly most mothers get treated into sharp relief.

Unlike you I've had a great postpartum experience - but where I don't get believed is about how awful my pregnancy was. "Aww, did you have cravings and need to pee a lot?" "No, actually, I was in the hospital four times a week and spent most of the rest of it curled up on the couch." "That's okay, it'll probably be fine when you have your second!" "ARE YOU SHITTING ME I AM NEVER DOING THAT AGAIN."

Anyhow, I just wanted to tell you that I'm here and I'm listening and I will take what you say seriously, because you don't have to conform to the popular story.
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Re: Postpartum mental health

Post by reboundstudent on Tue Mar 24, 2015 5:11 pm

I have no experience or words of wisdom, sadly, but can offer sympathy and an ear?

*Jedi hugs to all the new moms struggling with, well, pretty much everything. You guys are all amazing. You birthed a human! Respect forever*

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Re: Postpartum mental health

Post by Wondering on Tue Mar 24, 2015 8:58 pm

kleenestar wrote:Oh my god, I also have the "I have to walk on eggshells" thing when talking to other new mothers! For me it's doubled because I have a fully participatory partner AND a ridiculous amount of maternity leave (five months paid, three months unpaid) AND my partner is working half-time AND he doesn't even start that until the end of this month. It really throws how badly most mothers get treated into sharp relief.

Oh, that's fantastic leave! Good for your employer for providing that.

kleenestar wrote:Unlike you I've had a great postpartum experience - but where I don't get believed is about how awful my pregnancy was. "Aww, did you have cravings and need to pee a lot?" "No, actually, I was in the hospital four times a week and spent most of the rest of it curled up on the couch." "That's okay, it'll probably be fine when you have your second!" "ARE YOU SHITTING ME I AM NEVER DOING THAT AGAIN."

Yes! I am never doing that again. Nope. Not. Never.

I'm sorry you were in the hospital four times a week with yours. That's sounds awful. I had four appointments a week the last trimester, but only one of them was in the hospital.

My pregnancy was pretty miserable. Just the fear that everything I ate would do something to my blood sugar that would damage my baby. Well, not just what I ate. What I didn't eat. How much I exercised. How much I didn't exercise. Just every waking moment. And insulin is a hormone, so just being pregnant messes with it.* I had a neighbor say to me during the pregnancy, "Oh, well being pregnant is great! You can eat whatever you want!" I just about lost it.

And then I suffered from debilitating sciatica for the last two months. And for months after the birth, too. I'm still not fully recovered from that. Although nobody seemed particularly interested in me talking about how bad that was afterwards, either, so for a long time I thought that was normal, too, and I just had to grin and bear it with the help of some physical therapy.

kleenestar wrote:Anyhow, I just wanted to tell you that I'm here and I'm listening and I will take what you say seriously, because you don't have to conform to the popular story.
Thank you! I really appreciate that. It feels...not so lonely?

reboundstudent wrote:You birthed a human!
Damn straight, we did! Grin


So, just a general question for the moms. How do you worry about your baby? I assume worry of some sort is normal, but mine is not and is excessive. What does your worry feel and look like to you?




*Just as basic info, high blood sugars at the start of pregnancy lead to birth defects. Low blood sugars at any point can cause brain damage. High blood sugars in the latter half can make the baby's stomach bigger than the head so that the baby won't fit out the birth canal.

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Re: Postpartum mental health

Post by kleenestar on Wed Mar 25, 2015 12:48 pm

I'm mostly pretty laid-back, but I will occasionally (maybe once every two weeks?) have what feels like a sudden, factual, concrete realization that something is terribly wrong. For example, we took the baby on a car trip. An hour away from home, I suddenly realized that we'd left the baby in her carseat on the sidewalk. This was factually and demonstrably untrue - I could turn my head and see the carseat - but I had to physically lean over and touch the baby's hand to make myself relax again.
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Re: Postpartum mental health

Post by Caffeinated on Wed Mar 25, 2015 8:11 pm

I had a very good visit with my midwife today. I've been feeling a lot of anxiety this pregnancy (although I'm not sure if it's more than the previous two or not, my memory is a little fuzzy). Last night I woke up at 2am again with the feeling of dread that either I or the baby were about to die and it was because of something I'd done wrong or some symptom I'd missed. It was reassuring talking to the midwife about it, both because we discussed the actual physical things that my anxiety has seized on and she said they're very unlikely, and also because it was good to just talk about the anxiety. She said that it's common to feel this way, and mentioned the feeling of helplessness during pregnancy can really contribute to anxiety in people who are prone to it, and it was just really a good talk.

It's interesting, I'd never really considered pregnancy as a time of feeling so helpless. (I mean, it never occurred to me back when I was a never-been-pregnant person.) But it is. It's weird. So many things change, and those changes are out of my control. My body is different. My emotions are different. The way I'm treated out in the world is different. Things that I could do without a second thought require a serious effort and actual planning. And of course, there's the waiting, the not knowing from day to day when this baby will be born.

All three pregnancies, and both newborn periods so far, I've had anxiety related nightmares. It's the same theme in all of them, that someone is trying to get into my home or has gotten in and is there to hurt my family and I have to try to protect them. It's been a bunch of variations, but always it's the same dream in a new disguise. I think it's to do with feeling physically weak and vulnerable plus feeling the intense responsibility for the baby.
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Re: Postpartum mental health

Post by Wondering on Thu Mar 26, 2015 5:11 pm

Oh, see, my anxiety is mostly centered around SIDS. Which has unknown causes. So you can't really avoid it, you know? And things that are out of my well-planned control stress me out. So, I get the theme of a particular type of anxiety, like being vulnerable. Outside-my-control anxiety totally fits my personality.

kleenestar wrote:I'm mostly pretty laid-back, but I will occasionally (maybe once every two weeks?) have what feels like a sudden, factual, concrete realization that something is terribly wrong. For example, we took the baby on a car trip. An hour away from home, I suddenly realized that we'd left the baby in her carseat on the sidewalk. This was factually and demonstrably untrue - I could turn my head and see the carseat - but I had to physically lean over and touch the baby's hand to make myself relax again.

I would not have handled this that well. Wink

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Re: Postpartum mental health

Post by Caffeinated on Sun May 03, 2015 4:23 pm

Yesterday I read about a baby dying of whooping cough and his parents setting up a memorial charitable awareness kind of thing and then being viciously attacked by anti-vaxxers. The baby in the story was 3 weeks old when he got sick and dead by 4 weeks old. My baby is 3 weeks and 5 days old. I just had tears pouring down my face as I read this thing. It is so damn scary to know how easily this tiny person could be taken away.
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Re: Postpartum mental health

Post by Wondering on Thu May 07, 2015 1:35 pm

I get that, Caffeinated. I had to start blocking any trending Facebook news about dead or dying babies because, apparently, Facebook figuring out I have a baby now means I want to read those stories?

Btw, congrats on your new baby!

Nashville is doing a postpartum depression storyline with one of the main characters. I'm not sure how I feel about it, because it's TV and they rarely ever handle anything well/correctly, but then I've read articles talking about how PP depression needs more mainstream attention.

Which, does it? I feel like I hear about PP depression all the time (just not anxiety or psychosis). But I realize my group of friends and acquaintances and the internet sites I read and visit may be more attuned to women's health issues than the standard population.

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Re: Postpartum mental health

Post by Wondering on Tue Sep 22, 2015 4:27 pm

So, a mere six months later....

I have an appointment to see a postpartum counselor.

Why am I kinda scared?

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Re: Postpartum mental health

Post by reboot on Wed Sep 23, 2015 1:09 am

Wondering wrote:So, a mere six months later....

I have an appointment to see a postpartum counselor.

Why am I kinda scared?

Because it is new and unknown and you fear something might be really, really wrong? So kind of normal *Jedi hugs on offer if wanted*
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Re: Postpartum mental health

Post by Wondering on Wed Sep 23, 2015 12:36 pm

Yeah, unknown. And partially, if I get some sort of official anxiety diagnosis, then I worry people won't take me seriously when I express concern about things. Like, "Oh, whatever, that's just your anxiety." Having my thoughts and emotions dismissed makes me really angry.

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Re: Postpartum mental health

Post by Prajnaparamita on Wed Sep 23, 2015 2:11 pm

Hey Wondering, I just wanted to say that I really understand where you're coming from here. I have an anxiety disorder, and I've had people in the past use it against me--for instance my ex boyfriend, whenever I came to him with a problem or a concern about his behavior, would tell me stuff like "oh it's all in your head, it's your anxiety disorder", which was really awful as it led me to blaming myself for everything and feeling voiceless, as everything I brought up got thrown back in my face with his gaslighting. But one of the things that I've realized is that friends and family who love me and are truly good people for me do not behave like that at all, and when I am anxious they don't dismiss me and say stuff like that. Even if I'm in a state where I'm wildly irrational, which sometimes happens as a result of my anxiety, they listen to me and ask how they can help improve the situation. Regardless of whether its a concern that comes from a real place or its a concern that comes from the warped worldview of anxiety, they still want to help me and make things easier for me, and in both cases they respond with empathy and listen and see what they can do to help. For example, I have a lot of irrational anxiety about being late for anything. My friends understand this, and don't make a big deal about it but when they're with me they'll try to find a way to make sure we show up for things earlier, as that makes it easier for me to be able to enjoy the experience. Whether it's a rational or irrational fear, they still want to help. The thing about shitty people who would try to gaslight you and invalidate you though is that they'll find a way to do it, diagnosis or no diagnosis--instead of anxiety they might dismiss you due to being a woman and thus overly emotional, or anything else they think they can latch onto. It's just the sorry truth about that kind of person.

Another thing that I found actually a benefit of having an official diagnosis (and I'm not saying I think you have one, just if you end up being told by a professional that you have one and that feels accurate to you) is that slowly it has helped me gain some distance from my anxious thoughts. Rather than having irrational anxiety fears all over the place and being like "AAAHHH I AM THINKING ALL THESE THOUGHTS AND THEY MUST ALL BE ABSOLUTELY TRUE BECAUSE I KEEP THINKING THEM" I was (slowly, gradually) able to start being like "Okay, I think these are anxious thoughts that I'm having, and even though right now they all feel super real and scary I know that they're probably not all real (because anxious thoughts generally aren't.) Now is there some way that I can recognize that they're probably not real and not helpful for me right and put them down for a bit so they're not constantly weighing me down?" For me, recognizing that I have an anxiety disorder which sometimes floods me with disturbing intrusive thoughts (which if I remember correctly is also something you've experienced, right?) is to identify those intrusive thoughts as what they are, validate them (because even though they're not real, they often originated from a place of real fear inside of me) and then that allows me to put them down and let them go for a bit. For example, when I went on vacation to California recently, I started to have incredibly disturbing intrusive thoughts about how the Big One was going to hit, any second now. Just randomly through the day I would become convinced that it was going to hit any day now, maybe even today, and I was going to die horribly. It was making me miserable and unable to enjoy anything about our vacation, because the more I tried to push it out of my head, the stronger it came back, making me convinced that I needed to panic, right now. But eventually I recognized it as my anxious thoughts, and I told my mom what was happening. By talking it through with her, I was able to validate the fact that I was scared of a big earthquake happening, and of course it's rational on a certain level for fear for the safety of the people of California who live in major cities along the coast that don't have adequate earthquake and tsunami prevention measures, there was nothing in that particular moment that I could do about it, and the panic that I felt like I needed to fear about the issue every time it came up in my thoughts wasn't actually going to help me or anyone else around. And eventually, that let me let go of the anxious thought.

Another thing about intrusive thoughts that I found helpful is my therapist's explanation of what causes them. According to her (and obviously I can't say this holds true for everyone but it seemed really accurate to me) is that they're a result of a chemical spike in the brain that causes the sensation of fear even though there was no stimuli that would result in fear. Because the brain feels afraid but isn't sure why it should be, it comes up with something to be afraid of--in my case, suddenly being convinced California is going to get that giant earthquake/that someone is secretly watching or filming me/that Slenderman is standing outside my window at night, ect ect... I know pregnancy and childbirth (and the aftereffects) release a shit ton of hormones into the body that can really confuse and destabilize things, and I imagine that could manifest as sudden spikes in fear, that your brain latches onto and turns into a paranoia that something could end up happening to your child. I don't know it if would be helpful at all to try and see your intrusive thoughts in that way, but perhaps understanding and identifying them might help take away some of their power?

I hope the appointment goes well and it provides you some relief at the very least

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Re: Postpartum mental health

Post by Wondering on Wed Sep 23, 2015 3:33 pm

Prajnaparamita wrote:Another thing about intrusive thoughts that I found helpful is my therapist's explanation of what causes them. According to her (and obviously I can't say this holds true for everyone but it seemed really accurate to me) is that they're a result of a chemical spike in the brain that causes the sensation of fear even though there was no stimuli that would result in fear. Because the brain feels afraid but isn't sure why it should be, it comes up with something to be afraid of--in my case, suddenly being convinced California is going to get that giant earthquake/that someone is secretly watching or filming me/that Slenderman is standing outside my window at night, ect ect... I know pregnancy and childbirth (and the aftereffects) release a shit ton of hormones into the body that can really confuse and destabilize things, and I imagine that could manifest as sudden spikes in fear, that your brain latches onto and turns into a paranoia that something could end up happening to your child. I don't know it if would be helpful at all to try and see your intrusive thoughts in that way, but perhaps understanding and identifying them might help take away some of their power?

That actually would make me feel terrible. Being told that there's nothing real at all behind my concern for my child's safety and well-being, that it's all just some chemical spike in my brain and I made it all up to deal with the chemical spike. That's the sort of thing I'm worried about being told. That would make me feel worse about myself. Sad

My baby is safe and healthy, and maybe she would be even if I hadn't taken all the precautions I had about that, or maybe she wouldn't, but she's certainly not been harmed by any of them. And I really, really don't want to be told that I need to stop being so concerned about my child. Or ranting about anti-vaxxers. Or getting on my mom's case for her utter lack of food safety procedures when she makes food. "Yeah, sure, Mom, I'm perfectly okay eating and having you serve the baby that uncooked salad you chopped up with the same knife you used to cut the raw chicken."

Mostly, I just want someone to talk to. I have so many thoughts and feelings about all of this and it's all intertwined with other aspects of my life, and when I try to talk to real life people about them, it's basically disorganized word vomit, and it's either way too much for someone else to process, or they can't figure out what particular issues I do want to talk about because there are so many at once. So, having someone who I can dump all those thoughts on and start to organize them will be a huge benefit for me.

So, I guess I'm anxious about going to talk to someone about anxiety. LoL.

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Re: Postpartum mental health

Post by Prajnaparamita on Wed Sep 23, 2015 5:55 pm

Oh Wondering, I'm so sorry what I said made you feel invalidated, I didn't intend it that way at all. Let me try to rephrase it somewhat--the fear that you have for your child's safety is a rational fear. I believe that every good parent holds that fear within them, because that's what it means to love and care for your child--you want to protect them and ensure their health and safety. And right now you the caregiver to an infant--a tiny, helpless human being that needs your protection. That's just a fact. However, it is entirely possible to have a real and rational fear, AND also have a anxiety response to that fear that prevents you from productively dealing with that fear and impairs your quality of life. As a mother, you have every right to want people to practice good food safety while preparing food for your child, and be angry at people who put their child's and others' health at risk for refusing to vaccinate. However, from the posts you've written, it also sounds like you've been struggling with mental health symptoms that have impaired your quality of life and ability to function.  

Either way, it does sound like being able to talk to a trained person about this would be helpful for you, and I hope that appointment goes well.

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Re: Postpartum mental health

Post by Wondering on Tue Sep 29, 2015 8:34 pm

Hey, Prajna, no worries. I'm not feeling invalidated by what you said. You're a stranger on the internet sharing your experiences. What I'm worried about is the official therapist making me officially feel officially invalidated by the sorts of things I said. So, hopefully that won't happen, and I'll see how it goes.

For those of you who have done this therapy thing before, what's to be expected at an intake appointment? Is it mostly just talking about what my issues are that bring me to therapy? An hour seems like a long time for just that. I wasn't asked anything about this at all on the phone when I called. Just: "Did you have your baby less than three years ago, Do you have any other health issues being treated by a doctor, Is there domestic violence in your home, Are you having thoughts of self-harm or harming the baby?" And lots of stuff about my insurance. Wink

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Re: Postpartum mental health

Post by eselle28 on Tue Sep 29, 2015 9:27 pm

I haven't done postpartum therapy, but I've seen therapists for other reasons. You'll probably fill out some forms, and you'll probably also talk about things like past and current mental and physical health issues and medications you're currently taking. How long that conversation is depends on whether there's much in your case to talk about.

Beyond going over the issues that brought you to therapy, it wouldn't be uncommon in an hour long first appointment to ask more specifically about what your triggers might be, who your support people are, if you've found anything that helps even a little, and that sort of thing. I think everyone I've been to has at least asked some basic details about my life, like what I do for a living, who I live with, and other basic details. In your case, I suspect they might ask some practical details about the history of your pregnancy, parenting obstacles you might have faced, your baby's health, and so on, so they at least have an inkling how you might be different from other people who have similar issues. This is sort of style dependent, but I've been asked to talk about myself free form - like generally what my story in life is - sometimes. I always assumed that was the person trying to get a bit of a read on who I am, how I communicate, and that sort of thing. Also depending on style, you may be given a short homework assignment at the end of the session.
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Re: Postpartum mental health

Post by Wondering on Tue Sep 29, 2015 11:11 pm

Homework? Gah!

Surprised

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Re: Postpartum mental health

Post by eselle28 on Tue Sep 29, 2015 11:51 pm

Sorry, I didn't mean to drop a scary revelation! This is a technique some therapists use. I was just surprised the first time I ran into it, so I wanted to mention the possibility of it. An assignment might be something like, "What are three goals you'd like to achieve from this counseling?" or, "Count the number of times you were anxious about your baby since the last session," or, "Describe one time you were anxious since our last session, and what happened between feeling like that and feeling more at ease."

Again, this is just some therapists. I actually tend to like ones who use techniques like that and seek them out, so I have no clue how prevalent they are generally.* Once I got asked to look over some online reading material and if I could come back with some thoughts with it. It might also be just, "Come next week/month!" It sounds like you've been assigned someone, so it's not really clear what will happen. I'd say in general just expect some bits that are like the beginning of seeing a new doctor, some that are focused on getting at least a bit of a sense of who you are as a person, and some sort of talk of follow up.

*I've also primarily seen therapists for ED and comorbid depression. Techniques may differ, and my approximations about what you might be asked may be very far off. (I mostly figured replications of my own homework might be a bit out of place here and even less helpful.)
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