Redefining Us

25: Breaking the Myths and Stigma Around Postpartum Depression with Courtney Miller

• Stephanie Konter-O'Hara • Season 2 • Episode 25

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Postpartum depression doesn’t just affect the birthing parent, it can impact the entire family. In this conversation, therapists Stephanie Konter-O’Hara and Courtney Miller break down what postpartum depression actually looks like, why it can appear months after birth, and how the right support can make all the difference.

We debunk harmful myths and share practical tools for bonding with your baby, improving communication with your partner, and reclaiming your sense of self. Stephanie and Courtney share from both their expertise and empathy. Whether you’re navigating postpartum depression yourself or supporting a loved one, you’ll walk away with new insights, hope, and a reminder that you are not alone.

About Courtney: Courtney works with clients of all ages-from young children to elders-work with and overcome the difficulties that life may bring. She has experience working with groups, families/couples, and individuals. She has experience in treating eating disorders, bullying, depression, anxiety, DV, divorce, substance abuse, grief, sexual abuse, and LGBTQ, among others. Courtney's approach is rooted in the belief that everyone has the power to change, they may just need the help in finding it. Her foundation is in Cognitive Behavioral Therapy, Play Therapy, Dialectical Behavioral Therapy, and Existentialism. Courtney obtained her Master's degree in Marriage, Couple, and Family Counseling at Walden University. She has advanced training in adolescent bullying and DV/sexual abuse.

Connect with Courtney - https://wellmindedcounseling.com/meet-the-broomfield-colorado-therapist-team


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SPEAKER_02:

Welcome to Redefining Us, where we explore sexuality, identity, motherhood, and mental health to help women thrive authentically. Let's break free from roles that limit us and create a life where you can truly be yourself. Welcome back to Redefining Us. Today we have a guest with us, Courtney Miller, who is a therapist on the Well-Minded team. That's the practice that I own in Broomfield, Colorado. Courtney is a newer mom, and she works with children and elders to overcome difficulties that life may bring. She has experience working with groups, families, couples, and individuals, and has experience in working with eating disorders, bullying issues, depression, anxiety, domestic violence, divorce, substance abuse, and sexual abuse, among other concerns that people may be facing. And I'm really excited for you to listen to this conversation that we have about postpartum depression and all of the intricacies of postpartum mental health concerns because they are diverse. But today we're focusing primarily on postpartum and how it's different from other mental health issues that can develop in postpartum. I hope you have a great listen and welcome feedback. If anyone has any further questions about this topic, be happy to do other episodes that are in the same vein. So let's get into it today. Welcome back to Redefining Us. I'm your host, Stephanie Cantor O'Hara. I'm a licensed professional counselor, and I have with me today Courtney Miller, who's also a licensed professional counselor in Colorado. So welcome, Courtney.

SPEAKER_01:

Hey, I'm Courtney Miller. I'm a licensed therapist.

SPEAKER_02:

So we're here to talk about postpartum depression and potentially other postpartum mental health concerns. So let's just kind of dive right in. A lot of people have heard of baby blues and postpartum depression, and I was hoping you can share with the listeners what are the differences? How does someone know when they're experiencing one thing rather than the other? Of

SPEAKER_01:

course. So everyone knows, or at least a good portion of people know, that right after they have a baby, they go home. It's exhausting because you're Body has completely changed. You're getting hardly any sleep. So for the first couple of days, you might be crying because of exhaustion. But then after a couple of days, it slowly wears off. Postpartum depression is something that will continue on. And so if it continues on for more than a couple of days, that's the first sign. If you are not finding any enjoyment, if you're not feeling like you're connecting, With the baby, which usually it sounds harder than it actually is, you'll see that baby smile or wink at you. And if you're thinking, okay, why am I not actually enjoying this? How am I not experiencing this? That is also a sign. And if you feel like nobody else is getting this, that's understandable. But I just want to let everyone know that there are people out there that you can talk to. There are group, part groups. There's also therapies for this. One of the best is cognitive behavioral therapy where you are taught to challenge these thoughts and realize your strength and helping get over that, realizing what you need to do to believe in yourself again. Also, one of the benefits is to relax, slowly start gaining your strength back. And another big sign is that if you are feeling where you are wanting to hurt yourself, a lot of people feel that postpartum depression is where you are feeling that wanting to harm the baby, which, yes, it can. But a lot of people don't realize that one of the biggest symptoms of it is wanting to hurt you. So I wanted to really focus on that state that that is you can reach out to a therapist. You can also reach out to 988 and gasp with them about it. They will understand. They will walk you through it. They will help you find ways. One of the best is to relax, to find social support, which if you can think of it off the top of your head, as soon as you start being at home with that baby, that is one of the best. Is it like your significant other, friends? family anything and then maybe you can work something for them to come and take care of that baby throughout the day so that way you can slowly get some time for yourself slowly be able to start eating healthy again being able to walk outside and you will be able to feel if that is starting to go down you're feeling starting to go down and you're able to enjoy your life again If you're able to actually feel like you're connecting with that baby. If you're able to communicate with your significant other. And when you look in the mirror, remind yourself that you are not in the wrong. Tell yourself something positive about yourself every day. That you brought this baby in. And that you are trying to get through this. Tell yourself something that you love about yourself. Something positive. And at the end of the day, trying to think of one positive thing that you got through.

SPEAKER_02:

Young, I was going to say one of the biggest protective factors, which are kind of highlighting here, Courtney, for people to recover from postpartum depression is this feeling that you believe in yourself, this what's called self-efficacy. But basically, the protective factor is believing that you can recover and believing that you can do the job of being the baby's parent. Usually having that internal strength and believing in yourself is one of the best protective factors for postpartum depression and helps move people to recovery after experiencing it. Another thing that I wanted to touch on, you mentioned the 988 number. The great thing about that are those people are available 24-7. So even if you have a therapist, you probably can't call them at 2 a.m. during a A night waking. But if you needed to talk to someone right then and there, 988 is available 24-7. So just wanted to state that for people who maybe are not familiar with 988.

SPEAKER_01:

Yeah, that is one of the best things because those babies do cry and wake you up at all times. But at night,

SPEAKER_02:

yeah. And I feel like most people tend to have their darkest thoughts about... suicidal thoughts or thoughts about harming the baby late at night when they're alone. And so having a resource to tap into during those harder times is really important if you're struggling from postpartum depression.

SPEAKER_01:

Exactly. I did want to cover on when you're feeling like you're able to get back out there, start working, this may still follow you. It might be a lot easier but it might still follow you work may be very difficult but i want you to really focus on you and let you know that you are still getting through it that work doesn't really understand what you are doing maybe if you have to communicate with them see if you can come up with a plan with your therapist about going in there slower because when you're getting through this it's The hardest time is always when you find out that you have it and you find out what you're going through. Once you start working up, start climbing up, it starts getting a little easier. You start noticing the changes. You start noticing that you've got grasp on everything, that these people are behind you. And even the people at work will be behind you if you just let them know that you might need a little bit of help.

SPEAKER_02:

Yeah, I think asking for help is definitely really important, not just from a therapist, but also maybe your co-workers or your boss. And hopefully it'll be understanding, but I think giving them context of why you might be showing up to work not as your best self could be helpful in some cases. And if you don't feel like it's a safe place to bring it up, hopefully you have an HR department that can help you navigate the situation. I think another really important thing to recognize about postpartum depression is if it Unfortunately, the highest risk of maternal suicide is between 8 and 10 months because they believe, quote unquote, that they should feel better by now, even if they got diagnosed with postpartum depression earlier on. And so this idea of I'm still not better happens. tends to lead to people feeling more suicidal. So I think it's important to name that so people continue to go to therapy and do cognitive behavioral therapy and continue to reach out to their supports because it may take longer than you want to feel better when you're experiencing depression. Depression is one of those mental concerns that can linger. And so giving yourself grace is really important. because it may not just be like, oh, I've started seeing a therapist. I feel better now. You know, it's some work. So coming to therapy weekly would probably be really beneficial for a person in this position.

SPEAKER_01:

Stephanie, I like how you said that, how you were talking about how depression can take a long time. I highly suggest that people suffering from this focus more on the word depression, not necessarily on postpartum, because when people hear postpartum, It's like, okay, it's after you have a baby. A couple of months after, I should be fine. And they don't even see the word depression or know what that word means. But depression can last for years or it could just last for a couple months. Every person is different. It depends on how you work with them. If you ignore it, it could last longer. It could get worse if you act on it every day. I highly suggest that you take the work on the homework and skills that your therapist suggests. Or tell the therapist the truth and everything because therapists will not judge you. Those kind of things that will really help a lot and help you get control of it.

SPEAKER_02:

Yeah, I think what you just kind of highlighted is really important. The more open that you can be in therapy, the better. Unfortunately, there is a lot of stigma around mental health, not just specifically postpartum, but I think it's exacerbated sometimes in postpartum because a lot of women have this fear that if I share that I want to hurt myself or if I share that I'm really depressed and having a hard time functioning, that someone's going to want to take my baby away from me or I'm not a good mother. And saying those things out loud can be really triggering to people. are triggering to think about and also triggering to maybe say to people who are not professionals, but therapists who are trained in perinatal health will be able to identify the difference between, oh, this is a thought that I just am feeling, not a thought that I'm going to act on. and be able to differentiate that. And hopefully the likelihood of someone wanting to take your baby away is significantly reduced when you're speaking to a professional.

SPEAKER_01:

I like that you brought that up, Stephanie. One, because professionals know the difference. They know what is a sign that they need to take the baby away. And they know what the difference is that people are just thinking differently. But I also wanted to bring up how society views this, how society thinks of postpartum depression. Because most of the time these women are hurting themselves or wanting to hurt themselves, not that baby. They're wanting to help the baby and that's why they're harming themselves because they feel that they can't. But because of media, everybody views it differently.

SPEAKER_02:

Yeah. I was going to speak to that. Oftentimes people, when they think of postpartum depression, I think there's this confusion around postpartum psychosis and postpartum depression. Sometimes when people experience postpartum psychosis, which is more delusions and hearing of voices or believing that they're getting commands, that leads to harming a child. And that is an emergent situation that you definitely need to get help with, because if you're feeling those things and thinking those things, you should get help in order to prevent that from happening. But I think in mass media, there's confusion between postpartum depression and what depression looks like compared to postpartum psychosis.

SPEAKER_01:

Yes, exactly. And

SPEAKER_02:

being able to know the difference, again, is something a professional can help you decipher. And most people... They're experiencing postpartum depression. I believe it's such a small number. I actually think I have it here that outlines how many people experience postpartum psychosis. It's one out of a thousand women. So that's a pretty small number where I believe the percentage of women who experience postpartum depression is one out of five women. So the likelihood of psychosis is much smaller, right? If you would just look at the numbers. So I just wanted to say that I think media can confuse those two. Definitely. And

SPEAKER_01:

I'm glad you put that up because that confuses everybody. They automatically think that someone's got that if someone is showing that.

SPEAKER_02:

Yeah.

SPEAKER_01:

I think

SPEAKER_02:

there's a lot of alarmists. That happens because everyone, of course, wants the best for the child. And there can be heightened anxiety around those types of concerns because taking care of children, obviously, is everyone can understand the importance of that.

SPEAKER_01:

I guess my thought, and of course, this is open for everybody's opinion, everybody's choice. But once you get into getting to know your therapist, getting to know everything that's going on, Maybe you could be open with your significant other, your family about the stuff you learn. Or even bring your significant other into a session or two. So you guys can learn everything together. So that is completely up to you. Everybody, they have different opinions about that. But I think that way they would definitely be behind you and trusting you. It would be a lot easier at home.

SPEAKER_02:

Yeah, I think both people having access to the same information would most likely create more unity between a couple. And so, yeah, a psychoeducation session with you and your partner going to your therapist would help. alleviate maybe some of your partner's fears about your depression. I think that could be hugely helpful, as well as the therapist could help guide the partner on ways to support you while you're experiencing postpartum depression. Exactly. I wanted to say, like, when you alluded to this before we jumped on the call, that postpartum depression impacts the whole family. or even just perinatal mental health disorders impact the whole family. So the whole family, especially the adults involved, obviously it's different for an infant. The whole family should be involved as part of the solution, right? So going back to your suggestion of bringing the partner in, it could be really helpful to get marriage and family therapy during the postnatal time because oftentimes, As people know, Courtney referenced, you're usually sleep deprived in early days of postpartum. And when people are sleep deprived, they're usually more emotional and they usually have more intense experiences because they're not getting access to proper sleep, which usually helps them restore and relax. And so conflict often arises in couples during postpartum, whether the client has postpartum depression or not. or whether the woman or the birthing person has postpartum depression or not, it could be a really valuable tool to get couples counseling in the postnatal time in order to help navigate that huge transition. Most couples go from being a couple and just being couple, couple, couple, couple, and then suddenly they have a child and now they need to figure out this whole new way of relating to each other because now there's this whole other human being a part of the dynamic. It's not just the two of you anymore.

SPEAKER_01:

That is very true. And I think the person going through postpartum depression, it's also harder to connect, communicate at the time. So with family counseling, it helps them be able to communicate easier, have them feel like in a professional way, help the communication feel like they're being heard. And the same for the significant other. and they would even be able to try things to help everyone think, okay, maybe we can take care of the kid this time, you can do it this time, and even try to spend certain times every day together. Yeah,

SPEAKER_02:

I think that's a really good point, making an effort to connect with people each other because I think sometimes there's a lot of importance trusted upon connecting with a child and yeah that is very valuable and the two of you are still a couple so reconnecting in that way can go back to that support factor that Courtney mentioned. I also wanted to highlight just because I thought this is really interesting in my learning about perinatal mental health and this might be interesting to you Courtney if you didn't already know this is that Postpartum depression can also impact fathers. And 10 to 15% of fathers even experience postpartum depression because they're oftentimes feeling like, I don't know how to do this. I'm incompetent. I don't know how to be a dad. I'm just now in this new role. Where is my identity at? Who am I now in this relationship with my partner now that this child is here? So, yeah, I think... going back to the importance of family and couple therapy. It's not just the mom that's going through a change. It's also the father. So there's such a value, I think, in really being a team and working together. Obviously, the incidences of fathers having postpartum depression is less than birthing people slash mothers. But I just wanted to point that out because I thought that was really fascinating when I was learning about postpartum depression is that men can also experience it as well.

SPEAKER_01:

That's awesome, Stephanie, that you're Able to say that. And it might be less, but I wouldn't think, I mean, I don't know if this is right to say, but I don't know if it's any less difficult. I always say it's in a different way. I mean, because the women are carrying the baby, but the guys are having to go through, or I should say the significant other is having to go through the difficulties just as much as the mom is. Yeah. The change in themselves. Yeah.

SPEAKER_02:

Yeah, women are definitely experiencing more hormonal changes. Men are experiencing similar changes when it comes to roles and responsibilities and identity and who am I now? Am I good enough? All of those concerns that usually present themselves with depression.

SPEAKER_01:

Yeah. That's very interesting. When was that figured out? When

SPEAKER_02:

did they begin doing research on that? Yeah. So there's a... whole organization called UnityPoint Health that has done some research on this. And yeah, they have a website that goes to what are the risk factors? What are the common symptoms of how postpartum depression shows up differently in men compared to women? So women usually have peak symptoms around two to three months, while usually men have more postpartum depression closer to the year mark of the child and men tend to show more anger and risk-taking behaviors when they're experiencing postpartum depression compared to women tend to display more hopelessness feelings of loss of interest guilt and crying so it even shows that differently which I think is really interesting as far as the way that people experience depression differently

SPEAKER_01:

that is very true it's never the same for anybody This is definitely something we'll have to let everybody know. Yeah, hopefully people that are listening to this podcast will share with other people. Yeah,

SPEAKER_02:

and I think it's important for Farrahquist to know that mom's going through a lot and so is partner. And then, therefore, the relationship is going through a lot. Just kind of going back to the importance of couples counseling in postpartum.

SPEAKER_01:

Definitely. I did want to say something to back up a little bit from what I was saying that it's difficult sometimes for the mom to really connect with the baby when she's going through it. All that I want to say is that all you need to do is hold that baby. I know it's difficult for you, but the baby is feeling that and it's still getting attached to you. So as long as you're not going through postpartum psychosis and thinking of hurting the baby, then it's perfectly fine what you're doing. Even after you talk to a therapist and stuff, it may even help you once you find ways to handle it.

SPEAKER_02:

Yeah, I think it's important to remember there's something called mirror neurons. And if you're experiencing difficulties attaching to the child, the child's only desire is to attach with you as the parent. And so it's important to remember that sometimes there is this sense of, I don't want to hold the baby. I'm scared. I'm nervous. I don't know what I'm doing. I'm a failure. I don't know how to do this as a mother. And I would encourage you to remember that even though it's difficult, there is a strong correlation between avoiding a feeling or avoiding a problem and how long it lasts compared to trying to approach the problem and face your fears. When this avoidance comes up, whether it's in this depression or for another reason, we really find ourselves as humans struggling. What's a good word? Like reestablishing our fears over and over again. Oh, look, I'm not a good mother. That's why I'm not holding my baby. Therefore, I'm a failure. Where if you continue to avoid those beliefs and those thoughts will become stronger and stronger. Where if you potentially employ what's called opposite action of DBT, where you approach the situation, even when you want to avoid it. you could find yourself oh look I can actually hold the baby and I can actually help the baby and I can actually do these things that I was afraid that I wasn't going to be able to do so it's a little bit of reverse psychology almost on yourself like oh I'm terrified of doing this thing and therefore your brain's like avoid avoid but what is actually going to be helpful to overcome that is to approach the situation and do your best to not avoid something that is helpful. And again, those mirror neurons that exist between you and your baby will eventually help soothe and regulate both of your nervous systems to help form that attachment.

SPEAKER_01:

That's exactly what, yeah, that's perfect. I know a lot of people They have to do stuff slowly. So I'm trying to think if this would be a good time to maybe if they just have to like always want that baby in the crib, maybe do it a little more each day when that fear comes up instead of automatically putting the baby down. Just try and hold the baby for a couple minutes longer than the day before and congratulate yourself every time they notice that. Yeah. Don't blame themselves if they're not able to handle it that day because everybody's able to make mistakes.

SPEAKER_02:

Yeah, this is a great time to ask for support from your partner. Maybe your partner has more confidence in their ability to do a task, whether it's hold the baby or feed the baby or whatever the task might be. Maybe they do it and then they walk you through how to do it and then maybe they watch you do it. There can be a lot of ways to titrate or slowly introduce you to an experience that you're afraid of. It's all about getting support. Again, something a therapist could even walk you through. Maybe it's about the objective is you want to be close to your baby and be attached to your baby. And part of that is holding your baby. So maybe day one, Courtney said you hold your baby for five minutes more than you did the day before. And then maybe the next day you hold your baby for 10 minutes more. And so... Yeah, I guess going back to this idea that seeking therapy during this time is really helpful because there's so many things, unfortunately, that are so brand new that you might find yourself in this fetus mindset, which then prolongs the depression.

SPEAKER_01:

Yeah, definitely. And I think every time you make a step closer, it'll help it. I think if you... This help works for me with any... form of depression if you view it as like a monster I also do this with the kids that I work with view it as a monster every time you're feeling the depression kick on think okay is the monster bigger than me right now or am I bigger than the monster what color is that monster so when you feel it it's like one object and you have an easier way of thinking okay What do I need to do? How hard is it going to be for me to overcome this monster? What else do I need to do to be taller than this monster? Instead of feeling it all over your body and not knowing what it is, not knowing how to overcome it or what to do. And then every day as you do stuff, take a step back and think, okay, how big is this monster right now? How close am I to being taller than it? So think of things like that. And even if it's always there, one of these days you'll be able to be taller than it.

SPEAKER_02:

Yeah, I like that imagery of removing that I am depression or I am the monster to, oh no, this monster is separate from me and I can function knowing the monster exists, but it still has its place and it's going to change. And I'm going to change in the relationship rather than feeling like you've over-identified with the monster. I really like that, Courtney.

SPEAKER_01:

Exactly, because if you start feeling like you're no longer depressed, you may become wondering who you are and needing to have it back.

SPEAKER_02:

Yeah, I think you're kind of speaking to this idea that now you've created this relationship with your depression and think that it needs to be there because it's a part of you. Somehow in that process of believing that your depression needs to be a part of you, you over-identify it. with it and then you become depressed again, whereas you separate it from yourself. You can have a different experience with it.

SPEAKER_01:

Yeah,

SPEAKER_02:

I really like that idea of a monster. I was kind of picturing Scully from Monsters, Inc., like a big blue and purple monster. And if I envisioned it that way, too, it made it less scary. Because like, he's scared of Scully from Monsters, Inc. It's just like a cute, cuddly, furry monster.

SPEAKER_01:

Yeah, or the cookie monster from Sesame Street. Yeah, that's a good one too. Yeah, I'm going to have to ask the kids that I work with to think of it like that.

SPEAKER_02:

Yeah, it kind of makes it a little more lighthearted too. Maybe turn it on its head a little bit rather than a scary monster. As a newer mom, I've been watching a lot of Sesame Street and it's making me think about how even Elmo technically considers himself a monster. Like all of the characters to some extent. I think that look like Elmo or Cookie Monster are technically monsters. Who's afraid of Elmo? Elmo is everyone's best friend.

SPEAKER_01:

Yeah, you look so happy. Who would be scared of it?

SPEAKER_02:

Yes. But anyways, we're getting off the topic. So... Yeah. Is there any other things that you think the listener should know about postpartum depression or potential resources that they should tap into to help them with their postpartum depression?

SPEAKER_01:

I do want to say that definitely besides 988, definitely talk to their therapist about it and or talk to their OBGYN. about referrals or other things that could help them. Because I know, depending on how high it is, some might need medication. So they can definitely talk to somebody about it. Always be open with how you're feeling instead of just wondering. So definitely look into that.

SPEAKER_02:

Yeah, I think it's an important piece to mention is that sometimes depression is... so heavy that you might need medication support. And that's definitely something that a physician can help assess with you. Yeah. Last resource that I wanted to give only because I really like this organization is Postpartum Support International. We're based out of Oregon and they have a lot of free groups that women can join. So I definitely recommend going to psi.org, I believe. Great organization and that can support women in finding support. Or it's postpartum.net. Sorry, that's what their website is. Anyways, all of that information will be in the show notes. Thank you so much for coming on today, Courtney. Courtney's information will also be in the show notes if you want to work with her as a therapist. She works at Well-Minded Counseling. So yeah, thank you so much for everyone tuning in. Thank you for tuning in to Redefining Us once again and share with other people so other people can continue to listen to Redefining Us and we can get into more listeners ears. If you follow us or subscribe or leave a comment or review, that'd be greatly helpful for other people to find us and also just for me to get some feedback. What do you guys want to hear me say? What do you women care about hearing? I'm totally open Thank you so much. So you can be in the know with all the things that are happening in the Redefining Us community. Once again, thank you so much for listening and keep being awesome.