You Aren't Wrong But You Aren't Alright-Understanding Sleep Deprivation and Postpartum Depression
Remember when you thought you were so tired before you had kids?
You know, when you worked late, partied later, and relied on caffeine to keep you going…all because you wanted to?
For parents (I wish I could say new parents but really the sleep struggles sometimes last for years), the sleep deprivation they experience can exponentially exceed anything they have ever known.
It’s no wonder that parents often report irritability, brain fog, low mood, lack of motivation, and difficulty concentrating. Also, did I mention IRRITABILITY? Add to that, the impact of sleep deprivation on immunity combined with exposure to all the germs kids bring home and parents often note during the early years that they stay sick all the time.
Here’s what parents say:
“Of course I’m cranky, I haven’t slept well in several months.”
“You would be tearful too if you were only functioning on 4 hours of sleep.”
“I can’t remember what I’m doing and I feel like having kids has made me dumb. I am making simple mistakes at work and I’m worried I will be fired.”
“All I want to do is get some decent sleep.”
“Of course, I’m worried about the baby. That's what moms do and I can’t think straight when I am this tired.”
“There is nothing wrong with me, I’m just tired.”
Sometimes, it is more than sleep deprivation. Sometimes it is postpartum mood or anxiety disorders.
When it comes to mood and sleep, it can be a vicious cycle of sleep worsening mood and mood worsening sleep. In order to improve one, you need to improve the other.
So if sleep deprivation is common in the postpartum period and sleep deprivation is known to cause many of the symptoms associated with postpartum depression and anxiety, how do you know when it is more?
Here are some red flags:
🚩Feelings of guilt of worthlessness. For example, “I can’t do anything right, I’m not a good mom. I don’t know what I’m doing, it's probably my fault the baby can’t sleep independently.”
🚩Not being able to sleep when you are tired and have the opportunity to sleep. For example, the baby is asleep, and you have chosen to rest but aren’t able to sleep (not because you chose to scroll your phone, get alone time, or do chores instead).
🚩The symptoms you are experiencing occur even when you have rested. As your baby’s sleep improves, your sleep should also improve and your symptoms of sleep deprivation should improve as well.
🚩The symptoms you are experiencing are overwhelming your coping mechanisms. Regardless of whether the root problem is sleep deprivation or depression, when you are struggling to eat, sleep, rest, play, work, or maintain your relationships OR struggling to be able to enjoy these parts of your life, it is time to get help.
🚩You aren’t sleeping but you aren’t feeling tired. Intellectually we know that sleep is necessary for life. Any time your brain is telling you that you don’t need sleep or you are only getting a few hours of sleep but still feel energized-especially if this is associated with racing thoughts, impulsive or risky behavior, or irritability, it is time to check with a healthcare provider.
🚩Thoughts of self-harm. Thoughts of “I just wish I could get some sleep” are common but thoughts of “I wish I could sleep and never wake up” or “I don’t care if this hurts me if it helps me sleep” are not ok. Any thoughts that you would be better off dead or thoughts of taking an action to end your life need immediate attention.
🚩Your symptoms are keeping you from being able to implement sleep improvement strategies. When it comes to sleep deprivation, there are several steps you can take to improve your sleep and your baby’s sleep. If your mood or anxiety are keeping you from being able to connect with your values, establish goals, make decisions, implement processes, or maintain consistent flexibility in regards to sleep training (for parents or baby), this is a sign that you need help.
What are these magical avenues toward sleep restoration?
First, examine your typical sleep schedule. What do you do to prepare for sleep? What time do you go to bed? How long does it take to fall asleep? How many times do you wake? Why are you waking? How long does it take to fall back asleep? What time do you wake up? What time do you get out of bed?
Next, consider the environmental factors that affect your sleep. Are you consuming supplements, meds, or drugs that affect sleep? Is your room cool, dark, and quiet? How much blue light exposure are you getting in the evening? Where is the baby sleeping? How often are they waking? How do you respond when the baby wakes? Do they require nighttime feedings? Who is providing the nighttime feedings-how and why? Are you using a sound machine? If you have pets, where are they when you are sleeping? Are you getting physical activity? If so, when?
Third, check in on your thoughts as they relate to sleep. Are you worrying before sleep (about sleep or other fears)? Are you waking up angry? Are you waking up anxious or worried? Are you seeking sleep as an escape mechanism? Are you confident in your decision and ability to sleep train if this is part of your plan? Are you co-sleeping and if so, what are your thoughts about this arrangement? If you are (or are not) sleep training, why? Are you and your partner in agreement about your sleep training decisions?
Fourth, now that you have identified your needs, establish your goals. Remember, sleep is simple in concept but difficult in execution once babies are involved. Goals should be grounded in your VALUES, specific, and time-limited. THE GOALS YOU MAKE SHOULD BE FOR YOURSELF, NOT YOUR BABY. For example, a reasonable goal might be: “I value fostering independence and health in myself and my children so I will work with my partner to research and identify 1 sleep training program that we will implement in the next week to begin working toward getting 8 hours of sleep most nights.” An unreasonable goal might be: “I value fostering independence and health in myself and my children so my baby will start sleeping through the night this week.”
Fifth, make your plan. When you are tired, it is difficult to think straight. A plan is essential. Plans should be step-wise, broken into the smallest steps needed to be manageable, and include components of reassessment so that adjustments can be made as needed. For sleep training (for parents or baby) to be successful, consistency is key. This means that you implement evidence-based steps and allow these steps to have time to become effective before making adjustments. CONSISTENCY ≠ RIGIDITY. Keep in mind that if something you try has been given a reasonable effort and duration, it is wise to use flexibility and make adjustments.
If parts of your plan are not working as expected or you are uncertain about how to make or implement your plan or adjustments, getting professional help can be really…helpful! This is especially true if depression or anxiety are keeping you from getting your sleep on track.