Navigating Postpartum Depression and Anxiety as an Expat

Baby_mom

As most parents know, nothing can truly prepare you for what it will be like to bring a child into the world and be charged with raising that tiny, vulnerable creature into adulthood. After reading a dozen books, endlessly questioning my friends with children and buying more baby supplies than anyone could ever need, I thought I was prepared. But, strangely enough, when the nurse put my son in my arms, I couldn’t have felt more unprepared. Somehow, we parents work it out. Our children survive our initially clumsy attempts at diaper changes, feeding and bathing. We navigate the challenges of early parenthood that we could never have anticipated. However, this learning curve is a rocky road, one that leaves many (if not most) feeling overwhelmed, frustrated and perpetually longing for a nap.

Yet, today I write about those parents who feel all of those things but to a degree that is difficult to articulate. Those parents who may, on one hand, feel like what they are experiencing is “normal” adjustment but on the other, suspect their struggle is different from those of their peers, and as such, may be reluctant to voice what they are feeling. It is my hope that this post serves to do a few things:

  • Elucidate differences between the more typical (I want avoid saying “normal” as there really is no such thing) early parenthood experience and symptoms of postpartum depression and anxiety (PPD/A) that might warrant extra attention and treatment
  • Discuss how being an expatratriate might exacerbate early parenthood difficulties
  • Assure any suffering parents that they are not alone- that help exists in the form of effective treatment by a professional or by accessing resources available in our community

Symptoms of PPD/A

Listed below are symptoms that characterize the general experience of postpartum depression/anxiety. Keep in mind that not all of the symptoms might apply or that the symptoms may be somewhat different for you. I provide the list simply to increase general awareness.

For at least two weeks at a time following the birth (or adoption) of a baby, you experience some of the following:

  • Depressed mood (most of the day, almost every day)
  • Inability to find pleasure in the things you normally enjoy
  • Not wanting to eat or overeating
  • Not being able to sleep, not wanting to sleep, or wanting to sleep all the time
  • Feeling physically tired or aching to the point that your level of activity is markedly different from normal
  • Feeling physically wound up so that you feel as if you can’t sit still
  • Lack of energy or fatigue nearly every day
  • Intense feelings of inappropriate or excessive guilt and worthlessness
  • Difficulty concentrating and making decisions
  • Thoughts of harming yourself or someone else
  • Racing thoughts
  • Constant worry
  • Frequent or constant resentment of your partner or child

And most importantly

  • The way you feel consistently interferes with your normal functioning (e.g., decreased socialization, inability to manage responsibilities, decline in hygiene).

The Expat Experience: Feeling Alone in the World

Living in a foreign country far from family and friends can serve to exacerbate feelings of being isolated and alone. There may be fewer sources of support to help you remain balanced and able to care well for yourself in conjunction to you caring well for your baby. There is less access to people who might remind you of your personal resources and help you combat thoughts of worthlessness and hopelessness, people who know how to encourage and praise you when the going gets tough. Not to mention the difficulty involved in simply accessing community resources when you do not speak the native language. Feeling tongue-tied is just one more obstacle to picking up the phone and getting help. Furthermore, expat parents often come to a new country for a work opportunity and having a baby can change or eradicate the existing support network that was provided by simply being at work. Depending on your parental leave situation, all of the sudden, you are out of the office and plunged into life as a mom or dad, which is likely quite different from the work environment.

Just to put things in context, clinical psychologists and other health professionals commonly use a scale called the “Social Readjustment Rating Scale” to measure the degree of stress in a person’s life. To give you a taste, “pregnancy (#12)”, “addition of a new family member (#14)”, “change to a different line of work”, “change in sleeping habits” and “change in working conditions” are among the top 30 most stressful events in life. And this list does not even include “Adapting to a new culture in a different country – far from friends, family, and all that you know”! When a person experiences a certain amount of stressful life events in a year, they are more vulnerable to illnesses. And make no mistake: PPD/A is an illness. It is a condition involving daily suffering from which it can seem like there is no reprieve.

You are not Alone: How to Get Support and Support Yourself

As with any health condition, the best chance you have of it improving is if you take steps aimed at healing. For instance, if you have a cold, you rest, drink fluids and avoid going for a jog in the rain. And just like taking care of a cold, there are treatment options for PPD/A that show excellent efficacy. And the things that work range from intensive psychotherapy paired with medication to the simple implementation of self-care activities that your pre-baby self might have done without thinking. Those self-care activities might include things like exercising regularly, meeting weekly with a friend for coffee and a chat, or ordering take-away food rather than cooking. Doing these things does not make you less of a parent. In fact, taking care of yourself is one of the best things you can do for your child.

When talking to clients, I often refer to the airline safety guidelines requirement that, in the event of an emergency, the adult should put on their own oxygen mask before helping their child put on his. Our children need us to take care of ourselves first because otherwise, we cannot tend to their needs.

It can be unbelievably hard to reach out for help when you have no energy to pick up the phone or feel overwhelmed by cultural differences or believe that you should just grit your teeth and “get through it, it’s normal.” If increasing self-care activities does not diminish the symptoms or if it is just too daunting to embark on these changes alone, it is important to enlist the help of a professional.

To get started, here are some links to online support resources:

To those parents living abroad who are struggling with early parenthood, please know that you are not alone and you are not without hope. There are many parents and professionals who share your experience and who can help you feel more empowered. Enlisting the support of your partner, a compassionate friend, a group of other parents, a medical doctor, a health practitioner or a psychotherapist can transform your experience of parenthood while enriching the relationship you have with yourself and your child.

(Image courtesy of David Castillo Dominici / FreeDigitalPhotos.net)

Mindful Work: 6 Ways to Bring More Intention and Value into Your Work Life

It can be tough to clock in when you are mentally clocked out.
It can be tough to clock in when you are mentally clocked out.

Someone (possibly Woody Allen) once said that “showing up is 80% of life.” Which makes me wonder- what is the other 20% about? Lugging our bodies into the office or to run our household day after day is necessary and the job usually gets done. But, what about beyond that? It makes sense that having our minds show up a bit more at work can increase our effectiveness as well as other aspects of our work experience.

Many of us do not fully enjoy our jobs or some of the tasks required of us as part of our position. Some of us may feel that the company for whom we work promotes ideas or products that run counter to our values.  These discrepancies between behavior (i.e, showing up to do work you don’t enjoy or don’t believe in) and values (i.e, living a healthy life, doing work that benefits those in need, contributing to the greater good) make us feel uncomfortable. The resulting dissonance can make us question ourselves or even impact our mood. However, I want to suggest an alternative way of thinking about this real difficulty.

Even when your professional position or responsibilities do not match some of your more obvious life values, think about the ways in which your work does support your values. For instance, perhaps you value commitment and loyalty which is satisfied when you do your job and assigned tasks to the best of your abilities just because you said you would- even when you’d rather not. Or perhaps you value family and your job helps for you to support that family. Others may value personal growth and even though your job responsibilities themselves do not feel as if they complement this value, perhaps the very act of continuously showing up, doing something difficult and still living a fulfilling, balanced life in spite of it all is a challenge that helps you to grow.

Connecting to what you value and committing to valued action is one way to bring intention and mindfulness to your work life. It provides the opportunity to “clock in” more fully and bring more of yourself to the activities in which you choose to engage. Ultimately, it brings you out of autopilot and into the driver’s seat of your life.

Here are a few other suggestions for bringing more mindfulness into your daily responsibilities, whether you work in the home or outside the home:

1.) Place a “mindfulness bell” in your schedule. This is a routine cue which reminds you to check in with yourself- like every time you start up your computer or walk to the bathroom or make your coffee. And checking in with yourself just means  finding the breath, seeing what is present in thinking/feeling/the body and then proceeding from a more mindful place.

2.) Take yourself out to a mindful lunch. At least once a week, eat lunch quietly and without conversation. Focus on the sensations of eating and the sensory qualities of the food. Choose foods with different textures or temperatures and whenever the mind wanders, just gently bring it back to the meal.

3.) Try “falling awake” after lunch. During that post-meal period of lowest energy, take 15- 20 minutes to settle into the body and feel the sleepiness in your body. Each time you feel yourself falling asleep, explore that feeling and use that as an opportunity to be mindful of these very vivid and surprising sensations.

4.) Walk mindfully throughout the day. If you have time to walk, you have time to walk mindfully. As you walk around the office, tune in to the sensations of walking including the various parts of the feet involved in the movements of walking. When you sit back down, take a moment to notice the feeling of warmth or looseness that may be present in the muscles after moving.

5.) When you get stuck, zoom out. If you find yourself getting stuck in a particular way of thinking or reacting, take a step back. Close your eyes and just notice what kinds of thoughts are present. Notice how big they feel or how quickly they go racing across the movie screen of your mind. Remind yourself that for the moment, you are simply observing your mind and there is nothing else that needs to be done.

6.) Practice mindful listening. When you want to bring more of yourself to a moment, use the voice of a speaker (whether in a meeting or conversation) to anchor you to the present. Just as you might with the breath, notice when your mind has wandered and gently escort your attention back to the voice.

I hope some of these ideas may help you to bring 100% of yourself into your work life and, ultimately, into any moment.

 (Image courtesy of jesadaphorn / FreeDigitalPhotos.net)