What Coaches Need to Know About Postpartum Depression

By Dr. Lisa Lewis
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Your clients who have or who will have a baby are amazing. These women endure a 40-week metamorphosis to grow a human, involving constantly changing size and shape, as well as increasing their blood volume by approximately 50 percent, their estrogen production exponentially, and the world population by 1.

These women have experienced a powerful series of events that will impact them for the rest of their lives. Women not only have to recover from the physical and psychological journey that is conception, pregnancy and childbirth, but they also have to acclimate to becoming the caretaker of a delicate, dependent life.

Babies do not come with a sleep schedule, and demand food at all hours of the night and day. Combine these demands with recovery from pregnancy and childbirth, and you, as a coach, are working with a resilient yet vulnerable client.

Some of your postpartum clients may lose contact with you after having a baby, others may be eager to return to the gym for self-care, and many may be somewhere in between.

Wherever your clients lie along this spectrum, it is important for you to be familiar with not only the physical health of postpartum clients, but also mental health.

After a stressful event, and during times of change and transition, all of us are vulnerable to mental health symptoms, including anxiety and depression. Having a baby encompasses both of these risk factors, and it is normal for women to experience negative thoughts and feeling just after having a baby — what’s commonly referred to as “baby blues.”

The Office on Women’s Health reports that most women experience baby blues in the days or first two weeks after giving birth.2

If negative thoughts and feelings persist beyond the first few weeks after childbirth however, your client may be experiencing postpartum depression (PPD), a clinical mental health condition that requires medical attention. Several common symptoms of postpartum depression include:4

  • Feeling sad, helpless, or overwhelmed.
  • Having no energy or motivation.
  • Eating or sleeping too little or too much.
  • Having no interest in the baby.
  • Having thoughts of harming oneself or the baby.

Eleven and a half percent, or approximately one in nine women experience postpartum depression in the United States.

Negative emotional states postpartum exist along a spectrum, from healthy and expected, to rare and dangerous. At any point along this spectrum, you can be supportive in your role as coach.

Although it is not within your professional role to screen for and diagnose PPD, basic education around postpartum mental health and responsiveness to your clients’ presentation will help you to be effective in your role and help your clients to recognize and address mental health concerns that may present themselves.

Below are three basic rules to keep in mind regarding postpartum mental health, paired with recommendations for your response as a coach:

1. Baby Blues Are a Normal Part of Postpartum Recovery

If you have a strong rapport with your client who’s just had a baby, she may be in touch with you via text, phone, or email. This is an opportunity for you to be a source of positivity and support.

If your client expresses feeling sleepy, exhausted, teary, overwhelmed, or a variety of other things that seem perfectly reasonable to you in light of her recent experience, tell her that! It can be normalizing, validating, and reassuring for your client to hear “Of course you’re feeling a little sad and fatigued, you just had a baby!”

Be Supportive and Flexible

If your client expresses anxiety about “getting back” to the gym or “in shape”, reassure her that there is plenty of time for all of that, but that the first days and weeks after childbirth are a good time to be gentle with herself, and recover properly.

If your client truly enjoys exercise and wants to work out to have some “me time,” to do something she loves, or to have a break from time with the baby, be flexible. Coming to the gym and walking on the treadmill may be more than enough activity for a new mother, while others may ask to perform more demanding exercises.

Your goal should be to facilitate enjoyment of the movements in safety, and you can achieve this by being flexible with exercises you choose, their duration and intensity.

Furthermore, your flexibility with session regularity, cancellations, and other impediments to training is extremely helpful during this time! There will be days when your client would benefit much more from a nap than a training session.

2. PPD Is Common and Requires Intervention

Familiarize yourself with the signs and symptoms of postpartum depression. You can find these on several websites, such as:

Be Knowledgeable and Accommodating

If your client tells you about some concerning symptoms and it has been more than two weeks after she’s had the baby, encourage her to talk to her doctor. Let her know that although you’re not a medical professional, it sounds like her mood may be impacting her well-being and her experience with her new baby.

You can also provide your client with additional information and education so that she can learn more, using the resources listed above, which you can easily text or email to your client.

In addition, be as accommodating as possible during this time. Your client may need to stop her training anywhere from a month up to a year, or she may need to cancel sessions or reschedule at times that are inconvenient for you.

Although it is important for your own professional boundaries and the financial success of your business to maintain rules regarding session cancellations and no-shows, you may want to seek creative ways to help your clients prioritize their mental health.

Clients who are struggling with being communicative and attending sessions may benefit from your being open to “freezing” memberships, for example.

3. Postpartum Psychosis Is Rare, but Dangerous

Postpartum psychosis occurs in only 0.1 to 0.2 percent of all births, but it is dangerous and requires response from people around the new mom experiencing its symptoms. These symptoms can include:3

  • Delusional thinking or strange beliefs
  • Hallucinations
  • Paranoia
  • High irritability
  • Thoughts of harming oneself or the baby

Be Responsive to the Signs

If you notice any of these symptoms, you should not only talk to your client, but you should also communicate with her emergency contact or spouse, to ensure she receives immediate medical attention.

Not all of your clients will experience baby blues, and most of them will not develop postpartum depression or psychosis, but being familiar with the signs and symptoms, and having some techniques for responding, can help you to coach with competence and confidence.

On the other hand, all of your postpartum clients can benefit from your support. Being empathetic and supportive is especially important during the physically and mentally taxing time that is recovery from childbirth and the transition to caring for a new person.

Your coaching with these clients should aim to provide a safe, enjoyable training atmosphere, with as much flexibility and compassion as you have available.

Keep your pregnant and postpartum clients safe, healthy, and strong.

85% of women will have a baby at some point in their life. If you work with women, you work with pre- and postnatal women.

Whether your clients are currently pregnant or have already had their baby, they’ll have questions about everything — how to exercise safely in each trimester, which foods they should and shouldn’t eat, how to exercise the right way post-pregnancy.

And they’ll look to you for the answers.

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About the author:  Dr. Lisa Lewis

Dr. Lisa Lewis is a licensed psychologist with a passion for wellness and fitness. She earned her doctorate in counseling psychology with a specialization in sport psychology at Boston University, and her doctoral research focused on exercise motivation. Lisa is also a certified drug and alcohol counselor and has taught undergraduate courses as an adjunct professor at Salem University, Wheelock College, and Northeastern University in courses including exercise psychology, developmental psychology, and abnormal psychology. Lisa currently works as the associate director of a college counseling center in Boston, MA, and she has a small private practice in the nearby town of Brookline.

References

  1. Ko JY, Rockhill KM, Tong VT, Morrow B,. Farr SL. (2017). Trends in Postpartum depressive symptoms – 27 states, 2004, 2008 and 2012. MMWR Morb Mortal Wkly. Rep., 17, 153-158. https://www.cdc.gov/mmwr/volumes/66/wr/mm6606a1.htm
  2. Office on Women’s Health Postpartum Depression Fact Sheet. Office on Women’s Health, US Department of Health and Human Services. https://www.womenshealth.gov/files/documents/fact-sheet-postpartum-depression.pdf
  3. Postpartum Psychosis. Postpartum Support International. http://www.postpartum.net/learn-more/postpartum-psychosis/
  4. SeePPD.com. Talk About Postpartum Depression With Your Loved Ones. https://www.seeppd.com/wp-content/uploads/2018/11/Talk-to-Your-Loved-Ones-Discussion-Guide.pdf

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