Perinatal Depression: Self-Care for Moms of School-Aged Children

woman-handing-backpack-to-childThe bulk of my practice centers on helping moms and their families move through challenges during the pregnancy and postpartum periods. Many people experience depression and anxiety during pregnancy and after the delivery of their babies. Some have endured a perinatal loss (stillbirth or miscarriage), while others are facing fertility obstacles. Some moms are entering perimenopause as they are delivering their children.

The reproductive years for a woman can definitely set up a window of vulnerability for perinatal mood and anxiety issues (clinical term: PMADs). More than 20% of child-bearing women will experience a PMAD. In addition, I am seeing a return to psychotherapy for some people who had experienced PMADs, as their children enter elementary school and beyond.

Often, all that is needed is a booster, so to speak, and a revisiting of self-care, a psychotherapy buzzword for incorporating good sleep practices and nutrition, a strong support network, exercise, and other stress-reduction interventions. The journey of motherhood is a rewarding one, but there is no question that each developmental stage brings different challenges to moms, children, and the family system as a whole.

When children enter elementary school, often moms are simultaneously relieved and heartbroken. The intensity of the baby/toddler/preschool years is now over with, and one’s children are no longer babies. In a very real sense, there is an experience of mourning the loss of that stage as a past chapter in one’s life, one that can now be revisited only through photographs and videos.

Certainly, the entrance of children to formal education is also a celebration of perhaps embracing a new stage in children’s development where the opportunity for verbal interaction increases and more family-centered activities that were formerly very difficult or impossible are now manageable (traveling, hiking, camping, bicycling, etc.). No longer are dirty diapers or packing the baby paraphernalia daily realities. Children can feed themselves and actually verbalize where their boo-boo is. In many ways, parents report a return to positive memories of their own childhoods as they share with their children special camping spots, favorite sports or pastimes, or perhaps a conversation about philosophy or politics. Children are becoming their own small people with a very clear emergence of personalities, preferences, and styles of interacting. German child development theorist Erik Erikson postulated that children during the 6-12-year age range generally develop a sense of confidence in their abilities and an emerging thrust toward industry. For many, this school-age stage is truly a rewarding chapter in parenthood.

That said, many moms of school-aged children can revisit symptoms of depression and anxiety, particularly if they have had prior episodes. Women who have experienced PMADs often need to practice shoring up coping skills and social supports in the event that symptoms of depression or anxiety resurface. For many mothers 35 and older, perimenopause (the 10 years preceding menopause) has begun. During this time, women’s hormones undergo a transformation and upheaval, not unlike the expanse of time preceding menarche (the first menstruation of a woman). Women are more vulnerable to depression and anxiety during perimenopause if they have experienced a PMAD (Sichel and Driscoll, 2000). It is with this evidence-based knowledge that women focus on revisiting self-care simultaneously as their children enter the school-age stage.

As mentioned previously, self-care can include: good sleep and nutrition, exercise, social support networks, psychotherapy (if indicated), stress management (yoga, meditation, spirituality), journaling, creative expression (through art, dance, writing, music, etc.), and good time-management practice and boundary setting. Some moms may have unresolved losses or trauma healing which would be beneficial to explore in therapy. Speaking with a psychotherapist trained in women’s reproductive mental health can be particularly helpful during this chapter in a woman’s life, to shore up her resources (both internal and external) and prevent/be proactive about any emerging depression/anxiety surfacing as a result of perimenopause and/or life stressors.

Excellent self-care/women’s mental health books and websites include:

  • Sichel and Driscoll (2000), Women’s Moods: What Every Woman Must Know About Hormones, the Brain, and Women’s Health
  • Barnes, Diana Lynn and Balber, Leigh (2007), The Journey to Parenthood: Myths, Reality and What Really Matters
  • Dunnewold, Ann (2007), Even June Cleaver Would Forget the Juicebox: Cut Yourself Some Slack (And Still Raise Great Kids) in the Age of Extreme Parenting
  • Kleinman, Karen (2005), What Am I Thinking? Having A Baby After Postpartum Depression
  • Brizendine, LouAnn (2007), The Female Brain
  • Brizendine, LouAnn (2011), The Male Brain
  • Northrup, Christiane (2012), The Wisdom of Menopause: Creating Physical and Emotional Health During the Change
  • Northrup, Christiane (2010), Women’s Bodies, Women’s Wisdom: Creating Physical and Emotional Health and Healing
  • Domar, Alice and Dreher, Henry (2001), Self-Nurture: Learning to Care for Yourself as Effectively as You Care for Everyone Else
  • Louden, Jennifer (2005), The Woman’s Comfort Book: A Self-Nurturing Guide for Restoring Balance in Your Life
  • Patton Thoele, Sue (2001), The Courage to Be Yourself: A Woman’s Guide to Emotional Strength and Self-Esteem
  • Patton Thoele, Sue (2008), The Mindful Woman: Gentle Practices for Restoring Calm, Finding Balance, and Opening Your Heart
  • Hayhouse.com: positive affirmations, self care, meditations
  • Postpartum Support International: postpartum.net (resources for pregnant and postpartum women and their families)
  • Postpartumprogress.com (blog by Katherine Stone)

© Copyright 2013 GoodTherapy.org. All rights reserved. Permission to publish granted by Andrea Schneider, LCSW, therapist in Pleasant Hill, California

The preceding article was solely written by the author named above. Any views and opinions expressed are not necessarily shared by GoodTherapy.org. Questions or concerns about the preceding article can be directed to the author or posted as a comment below.

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  • Townes

    Townes

    August 1st, 2013 at 11:10 AM

    My youngest child is getting ready to go into middle school this fall and I have just had this real sense of dread and anxiety all summer knowing that this last stage of childhood really is getting ready to end for her. I know that she says that she will be my baby forever and I know that technically that’s true, but she doesn’t quite realize just yet how strongly that need to spread her wings and fly will become very very soon and she will not really want to be with her parents after a while. I am happy for her as I know that she is so excited to start this new phase and meet new friends but I am sad too because in a blink of an eye we will be graduating and heading off to college and I will truly have that empty nest that I have been simultaneously anticipating and dreading for so long.

  • cindy

    cindy

    August 1st, 2013 at 8:00 PM

    Have heard my mom talk about how it is both painful and nice when children are growing up, painful because one stage has passed and will never be back and happy because a new stage arrives…

    well I think life is always like that. things change, life stages change. there is nothing you can do about it. you only have two choices-lament over it or embrace and enjoy it. I tell my mom this same thing… and we have had quite a few very interesting conversations on the subject.

    Well getting back on topic, I think women do need to take good care of themselves at such a stage especially because a mother is so involved into everything about her children and this sort of a change in childhood stage can bring about a flood of emotions… that combined with the hormonal changes is a big deal!

  • stell blake

    stell blake

    August 2nd, 2013 at 4:23 AM

    I know that it’s a little bittersweet, but this is really the time to let the little ones fly. They won’t learn who they really are until we give them that little tast of freedom. I know that’s scary, and I have done it before and will be doing it all over again in the fall, but believe me, the changes and the growth that you will see in them makes that little separation so very worth it. This is the chanmce to allow them to become that responsible little person that you have wanted to see them become, find their strengths, see them shine. Don’t we want this for our children? I don’t think that there is a parent alive who doesn’t want this.

  • Debra

    Debra

    August 3rd, 2013 at 8:07 AM

    Sorry, but if you are sad about elementary school oh just you wai til they go off to college. Then you are definitely gonna have to watch the tears roll!

  • Andrea Schneider

    Andrea Schneider

    August 8th, 2013 at 3:27 PM

    If interested in learning more specifically about PMADs (perinatal mood and anxiety disorders) please see my prior articles specifically on the topic…the notion of life stage transitions can impact mood health as well…motherhood is a constant state of adaptation, adjustment, growing, and loss, and rebirth…it’s a beautiful journey and not without challenge…moms and dads deserve the support in the juggle dance of life

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