Please Be That Friend

Blog submitted by Semira Semino-Asaro, PhD, APRN, PHA Board Member

In recognition of the International Day of Friendship on July 30^th, this month’s blog focuses on the strong bond between two women whose friendship proved to be a source of strength, love, comfort and healing as one struggled with postpartum depression and anxiety.  A friend who notices, listens, and extends practical help can make all the difference.  This month’s blog contributor did all that and more and has shared her story with the hope that it can inspire all of us to be that friend.

I quickly and quietly opened the door to the hospital room, overwhelmed with excitement and joy to see my best friend Sara with her brand new baby.  She had sent me a quick text earlier in the day that said, “He’s here! Can you come up for a visit tonight?”

I can’t quite explain the mood when I walked in her room, but it wasn’t what I had been expecting.  Her baby boy was sleeping soundly in the hospital bassinet.  Although Sara did seem relieved that he was healthy, she was also feeling a little sad and frustrated.  Her birth was long and hard and ultimately had ended up in a cesarean.  Breastfeeding wasn’t going the way she had hoped and nurses were already pushing for her to offer the baby a bottle of formula.  My usually bright-eyed friend was looking a little defeated in her muted green hospital gown, looking at me with sad eyes that said, “Why didn’t you tell me how hard this was going to be?”  I assured her that nursing would get easier and that she and her husband would quickly find their groove as new parents.

A week or so went by and Sara didn’t seem quite like herself.  Her text messages were discouraging and she seemed preoccupied with minute details of life.  She was unable to sleep much, and it seemed to be taking a toll on her and her husband.  She was still struggling with nursing.  I offered to come and stay the night with them to help with the baby so that they could get some much-needed rest.  As soon as I arrived and took one look at her, I knew something was very wrong.  It was clear she had been crying (a lot) and looked as though she desperately needed a shower, and some sleep.  She said she didn’t have an appetite and couldn’t remember the last time she had eaten.  Her husband was at his wits end, unsure of how to help and feeling overwhelmed with Sara’s mood swings and her anger and frustration towards him.  I sent her husband to bed and Sara and I sat down to talk in the living room, her baby boy sleeping peacefully in my arms. It was that conversation that made me realize, my best friend was not simply experiencing the baby blues, she was dealing with an extreme case of PMAD.

Sara started opening up to me and the tears started flowing.  She told me she didn’t think she was cut out to be a mother.  She wasn’t feeling bonded or connected to her son and was avoiding holding him or spending much time alone with him.  She was having thoughts of leaving her husband, thoughts of drowning herself in her pool, she begged me to agree to take care of her son if anything happened to her. I was in shock but did my best to stay calm and supportive.  As we talked for a couple of hours, she would seem to calm down a bit and begin to think rationally for a moment, and then the next moment she would be in my lap sobbing uncontrollably again.  I had never seen my friend so broken. I was feeling scared and I didn’t really know what to do or say.  I wanted nothing more than to be able to take all of her pain away, but all I could do was be there to listen and hold her.  When it came time to feed the baby I tried my best to help her get him on the breast but it didn’t come naturally and he quickly became frustrated with trying to latch.  She looked at me and said, “I don’t think I can breastfeed.  I don’t want to try anymore.  Is it ok if I just give him formula?”  Of course, at that time I felt that eliminating at least one of the biggest stressors of the moment was probably the best thing for her.  She seemed almost relieved to hear that and asked me if I would feed him a bottle, which I did.  I told her not to worry, to get in bed and try to get some rest and that I would stay awake with the baby and would let her know if I needed her.

It hadn’t been more than an hour or so and she was up again and back in the living room in tears, pacing around and talking about how guilty and helpless she felt, how she didn’t deserve to be a mom, how she didn’t think she was going to be able to care for her son, how he deserved a better mom than her.  Some of what she said just sounded incoherent like she was in a fog and unable to focus, repeating herself over and over again and then losing her train of thought.  I did my best to calm her down and made her a cup of herbal tea.  She ended up falling asleep on the couch next to me and I just watched her sleep, hoping she would get a least a little bit of rest that night.  My heart ached for my best friend, whom I now hardly recognized.  Anxiety had taken over and there was nothing I could do in that moment to help her.  I knew that she needed serious professional help and I was determined to help her get that as soon as possible.

The next morning I reached out to my aunt and uncle, who are both psychiatrists and they were able to refer Sara to a doctor who had lots of experience with PMAD. Luckily, she was able to get in for an appointment that same day. I stayed at the house with the baby while her husband took her to the appointment.  They both seemed hopeful when they came home from the appointment that a combination of medication and counseling was what she needed to help her start feeling better.  Sara’s husband seemed to have a much better understanding of what she was experiencing and seemed more calm and gentle about the whole situation.

In the weeks that followed, Sara’s mood began to slowly improve and she began feeling more comfortable spending time alone with the baby.  Friends and family were helping with chores around the home and bringing over meals.  I spent a few more nights there in order to give her mom a break and to help Sara with whatever she needed.  Sometimes that just meant we watched television together while the baby slept.  Her appetite returned and we pigged out on our favorite junk foods together while watching funny movies.  My friend was slowly returning to the surface, and I was so incredibly relieved.  I could see she was beginning to bond with the baby as well and was slowly starting to enjoy her role as a mother.

Sara’s baby is now three years old and they have the most beautiful relationship.  We don’t talk about those first weeks of her motherhood anymore, but somehow there is an unspoken bond between us that I know can never be broken.  I am so grateful that Sara felt comfortable opening up to me and reaching out for help during that time.  I know that not all mothers are able to do that.  I urge all women to find the time to connect with their new-mom friends and check in on them.  Those first days with a new baby are so incredibly hard, and adding anxiety to the mix makes it nearly impossible.  Some ways that you can help a new mom are: helping with day to day chores around their home, reaching out by calling or texting so that she knows you are thinking of her, bringing over meals for her family, holding her baby so that she can have a shower, a nap, or a warm meal, just being a listening ear, and ultimately, helping her find professional help if she needs it and encouraging her to actually get it.  It’s not only true what they say about it taking a village to raise a child, it also sometimes takes a village to support a mother as she is born, finds her footing, and takes her first steps.