ASK FOR HELP: It can be a matter of life and death

I don’t have a problem asking for help.

That’s partly because, for example, :

• I don’t pretend to be strong and independent if I’m not feeling that way at the moment (Honey, will you go with me to my mammogram, I’m nervous).

• I don’t worry about what others might think (Yes, I am happy to make a fool of myself and embarrass my adult children if I have an irrepressible need to express something that I am not happy about.

• I am unimpressed if my own healthcare providers think I’m a pain (I know this is the third time I’ve called in two days, but no one has gotten back to me. Why has no one gotten back to me?)

• I don’t think twice about asking for something that others who have more class or consideration wouldn’t ever say aloud (Excuse me, could you please take this back?)

• I don’t mind if others perceive me as weak or incapable or needy even when I am perfectly able to do someone on my own (I would rather not do this myself, can you come? help? assist? Whether it’s folding the king size sheet or going to a medical procedure.)

I am also not afraid to confront a medical provider or client if I think they are misinformed. It’s important for me to get accurate information out there. It’s also important to me to make sure postpartum women feel cared for.

I’ve been told over and over, again and again, by postpartum women in distress, that it feels good to meet with someone who actually gives a sh*t.

Here is the point:

I am good at getting (most of) my needs met. However, I am certain all of this would be more challenging, if not impossible, if I were thwarted by an incapacitating symptoms of an emotional illness.

This takes me to my work with postpartum women who often have difficulty expressing what they need. Symptoms get in the way. Clarity is compromised. Women with postpartum depression and anxiety are often scared into silence, paralyzed by their thoughts, their panic, their fear of judgment, and their shame. Furthermore, after decades of promoting awareness and educating medical providers, misinformation continues to permeate the healthcare system. Sometimes, I will lean in and enable her (contact her doctor with her permission) if I feel her incapacity to do so is hampered by symptoms. Typically, I prefer to support and empower her voice to speak on her own behalf.

Today, women should be reassured that healthcare practitioners are beginning to listen and they are starting to ask the hard questions. Some women are taking the leap forward and jumping in, hoping they have found a safe place to land. Others, understandably, remain tentative. Asking for help when one is not one hundred percent confident that the recipient of the request is in a position to help, is risky. A risk that women with postpartum depression are in no mood to experiment with, nor should they be expected to.

Asking for help means:

1. Find the provider you feel safe with. (before or after you talk to your partner)

2. Express yourself (details, feelings, thoughts, fears, symptoms, panics, worries, guilt, hopelessness, for example)

3. Be specific about what you are most worried about.

4. What do you think you need from your provider? How do you think they can help you the most?

5. If you are afraid to hear their response to your disclosure (medication, therapy, dismissal, patronizing response, blank stare, referral to psychiatrist, their own anxiety), ask anyway. This is about you, not them. They may not be right about what they recommend. Or, they may be. Listen to the options they provide. Write them down if you need to.

6. Asking for help is easier when it comes from a place of strong self-esteem and worthiness but these emotional states are not readily accessible to women with postpartum depression and anxiety.

7. Remember that you can be fearful or reluctant, and feel fragile or terrified yet still ask for help. Do not surrender to the anxiety that makes you hesitate to ask.

How to ask for help

1. Take a deep breath.

2. Believe that you deserve to feel better.

3. Remember that your provider is there to help you.

4. Start with an introductory statement: I need to talk to you. Or, Can we talk about something I’m worried about? Or, I need a couple extra minutes of your time.

5. Come up with a sentence that feels comfortable for you. Practice it ahead of time. Say it out loud. Here are some examples:

   • I don’t like the way I am feeling.

   • I don’t feel like myself.

   • I think I might be depressed.

   • I think I have way too much anxiety right now.

   • I am having thoughts that are scaring me.

   • I need a referral to a therapist who specializes in the treatment of postpartum depression and anxiety.

   • I am feeling bad.

   • I’m not sleeping, I have no appetite, I’m scared all the time, I can’t think straight.

   • I have a history of depression and I’m familiar with this. I am not okay right now.

   • I need help for the way I am feeling right now.

6. Your provider should sit, listen, and follow up with a few questions.

You should leave with referrals, resources, and a clear next step.

7. If your provider responds poorly—dismisses you, minimizes you, rushes you, or makes you feel worse - acknowledge that you tried… and find another provider.

The Bottom Line

Many of us are working tirelessly to educate providers, advance awareness, change systems, and build better pathways for help. Still, postpartum women remain their own best advocates.

Let someone you trust know how you are feeling and thinking.

Postpartum depression and anxiety are very treatable.

No matter how bad your symptoms are.

No matter how scared you feel.

No matter how hopeless it seems.

Be informed.

Find your safe person.

Talk about it.

It doesn’t matter what others think.

It doesn’t matter if you are embarrassed. (push through that. Tell yourself you are worth this effort)

It doesn’t matter if other mothers look like they’re doing fine.

What matters is that you get the help you need.

Ask for help.

And if you don’t get the help you need?

Ask again.

Ask someone else.

Do not stop until you find someone who understands—

and actually gives a sh*t.

Karen Kleiman