PND Recovery: Self-Help Strategies - by Dr Shari Read
Speaking from experience, one of the most useful things to come to
terms with when recovering from postnatal depression is to remember that
everyone, depressed or not, has bad days. And just like PND, these bad days do
not last forever. It is a matter of taking them one at a time.
Allow yourself the time to recover from this experience and don’t
expect too much of yourself.
Sometimes it might be helpful to pretend that someone else is
there, saying the things that you are saying to yourself in your mind “I should
be better by now”, “Why can’t I cope when everyone else is fine, I must be
stupid or crazy”. If another person had said some of the things I’ve said to
myself in my mind I would probably have slapped them (or at least wanted to!).
Why do we beat ourselves up, insist that we must be perfect, ‘the
best mum’, ‘the best partner’, “I shouldn’t have said that”, “I should have
worn something else” and on and on.
Now is the time to let go of some of the rules you have for
yourself, the ones you would hate if someone else tried to impose them on you.
Now is the time to nurture yourself as lovingly, gently and kindly as you do
your children.
- Begin on a good day.
- Decide on a time during
the day when you are going to be ‘mindful’ of the things you say to
yourself in your head. An hour is plenty to begin with.
- Every time you become
aware that you are being unkind, critical or hard on yourself notice it,
maybe even write it down somewhere.
- Then, think about or
write down an alternative way of talking to yourself. Think about how you
would speak to your partner or child or a relative or close friend who had
been having a hard time lately. What would you say to them in the same
situation? Try saying this to yourself. Does it feel different? What does
it do to your mood?
If you become aware at any time in the future that you are saying the unkind thing to yourself again, remember back to the alternative message and offer it to yourself instead. With time and practice you might notice that the little voice inside your head is much more useful than it used to be.
Other useful things to try to help yourself recover from PND:
-
establish or re-establish a close friendship outside of
your home so you have someone to talk intimately with;
-
join a group that provides you with a social network of
some kind (eg. mother’s group, women’s group or playgroup);
-
take care of yourself, including nutrition, exercise,
physical health, get regular haircuts or waxing or whatever helps you feel
‘well maintained’;
-
learn and practice relaxation techniques;
-
try different therapies, hypnotherapy, massage,
homeopathics, if one doesn’t suit try a couple more till you find what works
for you;
-
avoid hangovers and low blood sugar levels (ie. don’t binge
drink and eat regularly);
-
do something nice for yourself everyday (suggestions: take
a bath, buy yourself some fresh fruit juice or say something nice to yourself
eg “gee I did a really great job of dinner tonight, I’m quite a good cook”);
-
practice knowing when and how to ask for help.
Accepting yourself is
having respect for who you are right now. Your past experiences and the things
you have learnt about yourself (right or wrong) have brought you to this place
you are in today. If you can accept your feelings on the basis that they are a
product of the interaction between yourself and your environment (including
other people), you will be able to move towards having greater control over
your responses to things around you.
When you give
yourself permission to have honest feeling, things will become more manageable
and soon enough it will be within your power to make changes. It is okay to be
angry if you are mistreated in some way and it is good to feel happy when
things are going your way. In a way, accepting yourself is like being your own
best friend, complete with consistent, reliable, unconditional love.
Try the following
meditation as part of the process of accepting yourself:
Spend some time imagining that you are the person you would like to be.
If you want to be free of any anger, fear or anxiety, imagine that you are
already happy and free of these unwanted feelings.
1. Use
a physical relaxation technique to go deeply into relaxation (try the rapid
relaxation from an earlier PANDSI newsletter). Allow yourself to become quiet
and still. Just before sleep or first thing in the morning are excellent times.
2. Create
every detail you can in this future moment when you are totally at ease and happy
with who you are. The colours, the emotion, the smells, the physical
sensations. Make it real! Your subconscious does NOT know the difference
between a real and an imagined event.
3. Put
yourself into this future moment and feel it as a NOW moment; that is, pretend
that you are totally accepting of yourself right now; how does it feel? Use any
insight from this experience to understand how to get from where you are to
accepting yourself. Do this by collecting information about yourself, your reactions,
emotions and behaviours in this future moment and using them to guide you towards
this goal.
4. Look
back at the past from this future moment. Notice what it feels like to know
that the old or unwanted experience is in the past. Allow yourself to feel as
if that experience happened long ago and focus on how good you feel about this
new experience.
5. Do
it again. Spend just five minutes once or twice a day in this state with this
new belief and it will begin to plant the seeds necessary to create change. It
will help to quiet the self-defeating inner voice that used to try to tell you
that you weren’t acceptable, and you will notice changes in your physical body
that will support the mental change.
For many of us, the challenge in
accepting ourselves is in overcoming the self-defeating belief that we aren’t
good enough. If you are never quite satisfied with your achievements, always
aiming at perfection to the point that it drives others a bit nutty or
intolerant of small mistakes that you might make then you are probably one of
the many carrying around this belief about yourself – I’m not good enough.
Getting back to the idea of being
your own best friend, start talking to yourself as kindly as possible, as if
you were talking to a young child who you love or a wonderful, close friend.
Every time you hear that old voice in your head criticizing and judging you
harshly, ask them to be quiet and start listening to your friendly inner voice.
It wont take too long to overcome the old habits and start accepting yourself –
warts and all!
Practice loving kindness towards
yourself as well as others.
Dr Shari Read
Using Reflection to Guide Your Journey out of Depression
The
journey through and beyond postnatal depression isn’t an easy one, however,
there are many positive outcomes that can arise along the way. One of these can
be a process of learning about yourself and becoming aware of the way you
think, act and feel. This process is aided by the art of reflection. Reflection is an activity in which people
'recapture their experience, think about it, mull it over and evaluate it' (Boud,
Keogh and Walker, 1985). Theorists have identified three key aspects to
reflective thinking: ·
Returning to experience – remembering
or re-experiencing past events in your mind can help you to identify things
which may have led you to feel happy or distressed. When you use reflective
thought to go over past negative events see if you can identify those aspects
of the event that may have contributed to you feeling bad. In time you may
start to see patterns in experiences that result in you feeling bad which will
help you to identify things that ‘trigger’ bad feelings. Once you have
identified your triggers you can start planning for how to avoid them or
minimize their impact on you. On the other hand, when you use reflective
thought to identify and go over positive experiences it can help you to be
aware of and appreciate the good things in your life, sources of support,
guidance or pleasure. Spending time just thinking about the good things in your
life can help you to reconnect with positive thoughts and feelings and help to
lift your mood. With time you can develop a habit of thinking constructively
about negative events and thinking regularly about good things and prevent
depression from returning. · Attending to
(or connecting with) feelings - this has two aspects: using helpful
feelings and removing or containing unhelpful ones. Using helpful feelings in
reflective thinking allows you to remember the good aspects of an experience.
Often when people are depressed they use a form of selective attention that
leads them to focus on and remember only the negative aspects of an experience.
Try this: return to a seemingly negative experience in your mind and then think
about alternative ways of interpreting events or things that people have said,
what else might they have meant or how might you have misunderstood them? When
you can think of an alternate explanation, then allow yourself to experience
the feeling that goes with this new interpretation of the situation. If you
can, repeat this exercise finding a new way of looking at the situation and
then explore the emotion that goes with this way of looking at things. Soon you
might find that you have actually replaced the original feeling and thoughts
with a new, more helpful emotion and memory of the experience. Another thing to
try when you are experiencing negative emotion is to stop in the middle of the
experience, acknowledge your emotions and ask yourself, “how is this feeling
helping me right now? Is it useful to feel this way?” Once you get used to
reflecting on your experience of emotion you will find that you will have much
more control over your feelings and moods. · Evaluating
experience - this involves re-examining an experience after the emotion attached to
it has passed or at least become less intense. When there is distance between
yourself and a negative experience it allows you the space to look back and see
what the experience actually meant to you and what you might take from it. Buddhists
believe that in every experience, positive or negative, there is a lesson to be
learnt. That is not to say that bad things don’t happen, just that the way we
choose to remember and think about those events can help us or keep us stuck
feeling bad. Reflective thinking can help you to identify something positive in
most experiences, perhaps the experience helped you to practice patience or
tolerance or provided you with an opportunity to identify a trigger for feeling
depressed. The more often you practice this aspect of reflective thinking the
more you will notice that you are able to interpret and remember events in such
a way that they do not trigger negative emotions. Please
bear in mind that the use of reflection is not helpful in remembering and
thinking about all experiences. Where there has been trauma or grief, for
example, please look after yourself by talking with someone who can nurture and
support you in working through this negative experience. In summary reflective thinking has three parts: Through
the use of reflection most aspects of depression can be reinterpreted as just
another step in your journey to recovery. Looking back can help you see how far
you have come already, it can help you to be gentle with yourself during times
of set back, and it can be very helpful in sharing with others to help them along
their journey. Reference Boud, Keogh and Walker, (eds.) (1985). Reflection. Turning experience
into learning, London: Kogan Page. 170 pages. Good collection of readings
which examine the nature of reflection.