Study: Postpartum Depression Lasts Longer Than You Think

Maternal depression doesn't stop when babies get older

Study: Postpartum Depression Lasts Longer Than You Think

Sad mom

A study published in the BJOG: An International Journal of Obstetrics and Gynaecology, suggests that mothers have a higher chance of experiencing depressive symptoms four years after giving birth than in the first twelve months after their child is born.

I’m not surprised. I certainly found myself collapsing into tears considerably more when my children were four than when they were babies. During one particularly tough period, I wrote an intensity-driven post called The F-ing Fours, with images of my child’s (normal, age-appropriate) aggression freshly in my mind. After reconsideration, this post is now called Handling the "Fournado."

The study used data from questionnaires completed by 1507 women attending public hospitals in Melbourne, Australia. They answered questions at 3, 6, 12, 18 months and four years postpartum. Almost one in three of those women reported depressive symptoms during the first four years after giving birth—the prevalence of those symptoms being its highest of 14.5% when their children were four years old.

This leads me to wonder why. Why are many women feeling sadder when their child hits preschool years?

I have heard from many mothers that the difficulties common with raising four-year-olds can be an overload to the system. Toddlers certainly have their challenges, as do any phase of child rearing (let’s remember all the wonderful parts of each phase, too), but maybe we’re prepared for those? The phrase “terrible twos” has been around for a long time, but until I was in the throws of handling an aggressive, yet sweet and loving four-year-old, I had never heard of “The F-ing Fours.”

Perhaps we’re fatigued with constantly redirecting and coaching our little ones. Maybe we should coin the term, discipline fatigue. Facing backtalk, fights, “I HATE yous,” and defiance on a daily basis can wear us down. It can feel hard to look forward to a day you anticipate having battles in. This, in addition to trying to foster a loving relationship with a partner, cultivating a work-life for those who do, and forming positive connections with other children, can zap our life-energy.

I contacted researcher Tim Caulfield, author of THE CURE FOR EVERYTHING, asking if there were other studies discussing this phenomenon, which he did find. We also wondered if data correlating divorce rate percentages with age of children is available. Although we haven’t found anything concrete yet, based on anecdotal reports, I am suspicious that divorce rates are a bit higher when children are preschoolers.

So, which comes first? Does marital distress happen after children are born, leaving couples struggling to reconnect, or do the complexities of raising preschoolers cause relationships to break down? I hope to learn the answers to these questions.

It also seems that difficult interaction with preschoolers feels more personal—that they are old enough to be lashing out at us on purpose. Negative core beliefs from our own childhoods can really get triggered during this time.

Please know that even though we may be feeling our children are pushing our buttons to intentionally get back at us, they actually aren’t. It is hard to be big enough to understand a bit more, but not so big to be able to communicate that understanding. Their emotions are often larger than their ability to understand and process these.

Personally, my desire to change my own level of sadness when my children were three and four pushed me to learn more about myself as a parent and tools to managing this child-rearing phase. I put my psychotherapist hat on and dug into research, listened to clients, and sat on my friend’s couches to understand better.

It turns out that many mothers do feel ill-equipped to handle the big melt-downs preschoolers often repeatedly have, experience pressure to keep it all together, and perceive they have nowhere to turn.

I believe the first step is to increase awareness that maternal depression continues well past the postpartum phase into preschooler time. More studies need to be conducted so we can narrow down the biggest causes for sadness for mothers of three- and four-year-olds, along with the best courses of action to help.

Here are some of the strategies I suggest, which I used myself to feel better while parenting three- and four-year-olds. I believe the focus needs to be both on parenting techniques and self-care:

 Take time to consider your needs:

What is missing and what are you able to do to get your needs met?

 Schedule rest time:

Create space for meltdowns and time to recover. I found that when I told myself, “I do have time for this,” rather than the opposite, I could control my self-talk a bit better.

 Learn about managing emotions:

I have written a few posts about this: calm-down plan, managing frustration, and how to repair bad parenting moments. 

 Learn about using positive discipline:

A great resource for this is any of the POSITIVE DISCIPLINE books by Jane Nelsen, PhD. There are many wonderful books and Facebook pages about how to use positive discipline instead of punishment. 

 Talk with your partner about a shared discipline plan:

It is so important that all caregivers are on the same parenting page. An excellent book to help here is WHAT MAKES LOVE LAST? by Gottman & Silver

 Laugh. Have fun:

As Laura Markham, PhD says, “Laughter releases the same tension as tears,” so seek out things that make you laugh. I also recommend Markham's book, PEACEFUL PARENT, HAPPY KIDS.

 Courageously ask for help:

Any time you face a rough patch in life, if you find that you aren’t feeling well or need a hand up, reach for one. I enlisted the help of neighbourhood friends to play with my children so I could have time to regroup. I also really leaned on family members, therapist colleagues, and close friends for advice and strategies to do better.

Postpartum depression can intensify when children reach three and four years of age. We need to get the word out so that moms will drop any stigmas around seeking help when they are feeling down. I do continually post free parenting resources on my Facebook page, so please do pop over there in addition to reading the books I suggested above.

If you liked this, you might also like: "How To Do Parent-Child Relationship Repair" and "How To Help Your Child Through A Compromised State."


How To Grow Kid Cooperation With The "Either/Or" Strategy

Use this simple parenting technique to get your kids moving

How To Grow Kid Cooperation With The "Either/Or" Strategy


A positive parenting strategy that works well to reduce dawdling and increase cooperation is one I call the “either/or.” This is where a child is presented with a choice to make that still accomplishes the task at hand.

Offering choices is a wonderful way to grow problem-solving skills; however, giving too many options can cause frustration. This method involves providing the child with a choice between only two options.

As Rick Ackerly states in his book THE GENIUS IN EVERY CHILD, “Humans have a natural inclination to be decision makers, to be Selves, and we adults play an important role as children experience their interdependence with the world in ever-widening circles of complexity. We have to do two things at once, (1) push back when Self is not doing what the environment requires Self to do and (2) love each Self unconditionally as we are making our demands and saying no.” (The “Self” refers to his daughter nicknaming herself, “Self” like this, “Self do it.”)

The principal behind the “either/or” is to parent in a positive way that includes firm limits, while giving the child decision-making power. When a child feels (s)he is constantly being told what to do, a feeling of counterwill can develop, which can actually push the child to do the opposite of what is instructed. The “either/or” reduces this counterwill and the associated power-struggle that can happen.

Here is how it works!

Establish two choices, both of which your child is capable of doing and are acceptable to you.

Begin your instruction with, “You may either” or “You can either.” You could also use, Are you…, Can you…, Would you…

Provide the first choice in age-appropriate language, like this: “You may either get into your car seat on your own...”

Say, “OR.”

Follow that with the next choice, like this: “You may either get into your car seat on your own, or I will lift you.” *Do not add an “okay?” or “please” at the end of this, as it changes the statement to a yes/no question, where the child can shout, “NO!”

Ask for him/her to choose, “You may either walk here to put your shoes on or I will carry you. Which do you want?” or “Which is your favourite?” or “What is your pick?”

If the child refuses to choose, you could make a game of it, “I bet you can’t choose before I count backwards from 6” (close your eyes). Or something fun like, “Are you either getting into the car walking or like a rocket?" (quickly pick him or her up and shoot her out the door while making rocket sounds!). You could also use another either/or like, “Either you are choosing or I get to. Do you want to?” This could be simplified as, “You choose or I will.”

As with any parenting strategy like this one or the very helpful “when/ then,” children are more apt to respond if they feel connected with you. Keeping your child’s attachment tank full each day will improve cooperation. Also, using transition signals and fun with younger children will increase the odds of getting your little one to follow your lead.

Here are some wonderful examples of how parents from my Facebook page community use the “either/or” in their daily lives:

  • “Can you do it yourself or do you need me to help you?”
  • Our 2.5yo is still relatively new to using the potty, so "We're going in the car. Do you want to use the potty now or after I get the baby ready?" works better than "We're going in the car. Time to use the potty!"
  • “Do you want to change your diaper in the living room or the bedroom? Do you want water in the pink sippy cup so that you can carry it or in the green cup and you can sit at the table?” Lots of opportunities to use the either/or with my 2-year-old!
  • Oh, and when the answer is "no," to both choices (and there is no other option—I will let my daughter contribute her own acceptable choice if she thinks of one), I give her the "Either you can choose, or I'll choose for you" option. It doesn't prevent a meltdown, but it does give me a firm line to hold. Sometimes, it spurs a grudging choice, sometimes she'll rush to pick the opposite of whatever I've chosen for her, and sometimes she fights me all the way. But I feel much more confident and in control than when I'm just bossing her around and she's defiant, which helps me respond to any meltdowns with empathy.
  • “Do you want me to start brushing your teeth or do you want me to finish up?”
  • “We're leaving the playground in one minute. Would you like to go on the slide or swings one last time?”
  • “When we cross the street/parking lot you can either hold my hand or get buckled into the stroller/in the grocery cart.”
  • “Either you can pick out your own clothes or I can pick out clothes for you.”

“Either/ors” also work really well when it is time to eat. Registered Dietitian, Sarah Remmer, had these two examples to add:

  • “Would you like to have carrot sticks and dip with dinner or steamed broccoli with melted cheese?”
  • “Would you like your peas mixed into your macaroni or on the side so that it doesn't touch your macaroni?”

These are two examples I often use: “It’s tidy time. You may either pick two songs to clean up to or I can set the timer to 10 minutes. Which one?”

“Bedtime! Are we getting upstairs doing the crabwalk or backwards?” Then, “EEK! How do you do the crabwalk up stairs?” (I change up the two options each day, which in itself has become a game.)

How To Help Your Child Through A Compromised State

Eight Ways To Reduce The Stress Of Parenting A Toddler 

I invite you over to my Facebook page, where I provide free parenting support and resources. 


What To Do When Your Child Hits You

Reduce hitting behaviour in children with these ten steps.

What To Do When Your Child Hits You

It can be incredibly hard to stay calm when our own children hit us. Both our instinctual physical defense system and intense emotions can get triggered in a flash!

I remember the period when one of my children hit me almost every day; I became scared of him, trying to steer clear of where he was. We know that children can feel it when we pull away so although it can feel hard to do, the key to reducing hitting is to connect more with our aggressive child.

Here are ten steps to reducing hitting behaviour in your children:

The first thing to do when our child hits us is to FREEZE.

Remembering our calm-down plan can feel impossible when we are hit. The feeling of pain will automatically trigger the “reptilian brain,” which is the part that makes our heart pound, breathing quicken and stomach flip. It is common to think that our child is out to get us. This part of our brain can hijack our good reason, making us scream or be rough with our child.

We need to take time to calm our fight-or-flight reaction, then help our child do the same. My calm-down plan in this case is to tell myself, “freeze sister” and then I count back from 11 to -1 by 2s (this odd number makes it easier for the brain to focus more on counting and less on shouting). It’s okay if you have to step into another room to regroup, as long as your child is safe.

Stop your child from hitting you, others or objects.

I grab my child’s arm when I see a hit headed my way. I do that firmly, yet gently and say, “No hitting. I will make sure you don’t hurt anyone.”

Remind yourself that your child is having a hard time “self-regulating.”

Self-regulation is our ability to assess a situation, which we find overwhelming and respond in a way that helps us calm down. John Hoffman wrote this wonderful document about self-regulation, which I suggest all parents read.

Respond thoughtfully with a limit statement.

Get to eye-level with your child and speak to her in a gentle voice. First comment by setting limits for your child’s behaviour by using a statement that includes:

1.     How you feel

2.     Validations of her feelings

3.     Explanation that the behaviour is unacceptable.

Something like this, “My arm is sore… you hurt me. I can see that you are angry. I won’t let you hurt me or anyone else. Hitting people is not okay.”

Consider where the hit came from.

Take a moment to ask yourself, What happened in her world to prompt the hit?

Is she: Disappointed? Upset that plans have changed? Not going to get something she really wants? In a compromised state? Missing you? Feeling you are too hard on her?

Identifying the source of the hit will tell you what the first feeling is. Anger/frustration is the second feeling, which likely provoked the hit.

Help your child identify the first feeling.

Use empathy to help your child work on the feelings behind the hit. For example, if your child hit you because she was sad her friend couldn’t come over, shine a light on that emotion. Talk about how you would feel like this, “I understand you are sad because Anna couldn’t come over. I feel sad, too, when I am excited to play but can’t.”

Accept if you have had a bad parenting moment and your child is angry with you.

If you did something that may have angered your child, talk to her about that situation. I wrote more about how do that in this piece, How To Do Parent-Child Relationship Repair.

Make it safe for your child to feel the first feeling.

When a parent is calm, understanding and patient, it is easier for a child to connect with the intense feelings inside her. Keep chatting with your child about the situation, focusing on feeling words. Once your child feels you are there for her and not going to make her feel badly, she will likely become sad, which is the usual culprit for hits.

Be a detective, asking questions about what is upsetting her, although steer away from “why” questions with younger children, as they don’t usually have answers to that even if the reason for the hit is apparent to you.

Talk about “mixed feelings.”

This is when you use a statement to explain to your child that it is okay to be angry, but at the same time, you know that hitting a person hurts him/her and that is NOT okay.

Make a plan to stop the hits next time.

With younger children, I use the term “angry bubbles” like this, “Next time you are full of angry bubbles and they turn your mad into mean, what can you do to make sure those bubbles don’t form into a hit? Let’s make a plan.”

With a toddler, try, “Hits are for pillows, not people,” or “No hitting, hurting, or throwing.” You can make a poster and draw symbols for those words. I explain more about how to react to toddler hitting in this piece, as it is a natural instinct to hit, and our job as parents to calmly train them not to. 

With older children, you could talk about how the brain works, specifically how to reel in the reptilian brain when it hijacks us. Consider different options to stopping the hits/throws/shouts that will actually work. Remember that this is a work in progress so keep repeating this process until the brain builds the bridge between the “freaking out” part of the mind to the rational part.

Here is an excellent example of a script to use when an older child hits by Laura Markham, PhD.


If you are looking for something to read on this topic, I suggest Positive Discipline by Jane Nelsen, PhD or Peaceful Parent, Happy Kids by Laura Markham, PhD. The book The Whole-Brain Child by Dr Dan Siegel and Tina Payne-Bryson, PhD will help you understand more about the brain and how to teach your child about how his/her brain works.

Also, I invite you over to my Facebook page where I post free parenting resources.