You’re a partner, a family member or a good friend. You can see that the new mother is not herself and hasn’t been for some time. How do you tactfully suggest that she seek assistance from a health professional? And how do you bring this up without making things worse?
There is no one strategy but here are some options to consider. Many of these recommendations are drawn from the book Living with a Black Dog by Matthew and Ainsley Johnstone.[i]
1. Seeking advice
It is useful to consult someone with experience and knowledge of perinatal mood disorders. Why? First, it helps to have a better grasp of what you think is happening. Secondly, it can make your own thoughts clearer before you broach the subject. Thirdly, it helps you decide what you want to get out of the discussion. How you come across to the mother-to-be or the new mum is very important; ideally she’ll see you as a strong, reassuring presence and gain a clear view of what you would like to see happen and the acceptable alternatives.
Many people are concerned that to intervene is to be intrusive. If a friend was showing signs of a physical problem you would probably express concern, so raising your concern about an intimate’s mental health issue should not be viewed as crossing a line—rather, it demonstrates that you care.
You probably know the situations when you feel most comfortable together. Or you can create a time when you can talk together without pressure or interruption. Decide how far you want to press the subject—there’s likely to be resistance or denial at first. If it’s too difficult, now that you’ve opened up the subject, you could suggest a future time for raising your concerns again.
3. What to say and how
You can let her know what you’ve noticed and why you’re concerned. You are a familiar contact to her, but that may not make it any easier to raise a sensitive subject that’s so close to her sense of self and her competence. Paradoxically, the fact that she has lost her bearings and you have noticed may initially make her alarmed and defensive.
What she will want is your support. Try to take things at her pace and respect her point of view. Validate what she says and try not to reassure by minimising her distress. Listen attentively and resist giving advice, let alone judgement. If she has lost touch with reality, you can convey that you understand that what she is experiencing is real for her but that you see things a different way—and that consulting a professional is a step towards reducing her stress and sorting things out so that she can enjoy motherhood.