Once or twice a week I work for a very special organization called NITZA, The Israel Center for Maternal Health. Located in Jerusalem, it provides psychological, physical and emotional support for women with postpartum depression. While I have observed that there are similarities between the women who come to NITZA, there are no concrete rules. A first-time mother is just as likely to come to the clinic as a woman who gave birth to her sixth child. The source of the depression could be hormonal or chemical, or it could be due to a past trauma that surfaced in the birth or to a traumatic birth experience. Some women are overwhelmed by too many responsibilities and tasks, and others are used to being in control of everything and then find out that life suddenly requires a flexibility that they just don’t feel they have. There are women who are poor, women who are comfortable financially, and women who are well-off. There are no rules except that all these women need help, and I admire all of them for coming to NITZA to find it.

Last week NITZA sent a woman named Simaleh to me for a reflexology session. I told Simaleh to take off her shoes and stockings and lie on the massage table. I grasped her feet firmly and gave them a good squeeze before I started to work on them. Her whole body went limp and relaxed into the bed. She sighed, “Ahh, that feels good.”

As I worked on her feet, Simaleh started to talk. She told me that she felt like she was having a nervous breakdown. She felt like she was falling apart and quickly losing herself. She told me that she felt desperate and at a loss. She also felt guilty. Simaleh and her husband had waited nearly five years to have children. She expressed to me how she used to feel so connected and spiritual and now she just felt mechanical. How could she have these feelings and thoughts after receiving such a blessing? I heard panic and desperation in her voice. Then she told me that she hadn’t slept in months. The baby, now six months, still nursed 24 hours a day. Not only did the baby nurse all day and night, but Simaleh had a terrible time nursing and always had infections. She so much wanted to attach to her baby and nurse her, but it was just too much and too physically painful. She saw lactation consultants, and her husband tried to help her, but they couldn’t help. She felt like her baby was devouring her.

Simaleh finished her story, and I kept working on her feet. Holding them tight I told her, “Simaleh, you need order. You need to get your baby out of your room and into her own room. You need a routine and a schedule. At sixth months you can start adding solids into her diet, and you don’t have to nurse her more than every four hours. Simaleh, you need to feel grounded. You need to go outside and take walks or take the baby to the park. You need to see people and get out of your home. You need to pray, at least just once a day, and feel reconnected. And if the nursing is causing such pain, you need to wean her.”

“But I so much want to be an attached mother!”

“You are! But being an attached mother requires being a mother! You can’t be a mother to your baby if you are falling apart. You can’t give if you have spent everything that you have!”

When Simaleh left I gave her a to-do list:

  1. Move baby into her own room.
  2. Scheduled feedings (with some flexibility of course).
  3. One walk or outing a day.
  4. Prayer at least once a day.

The next day Simaleh called me. She had moved the baby into her own room, and the baby had slept eight hours straight on her own. She was trying the four-hour feedings, and she already felt like a human being again. I was happy to hear her news, but skeptical that this was all that Simaleh needed. A few days later she called me back with more practical questions. Things were still going well. Later this week, we will have another session, and I know that G‑d willing, Simaleh will get better. She already feels more grounded and stable.

Infant sleep routine

There is a tradition in the nation of Israel that during the morning prayer service, the priestly tribe, the Kohanim, bless the congregants. Kohanim remove their shoes before ascending the platform to say the blessing (Rosh Hashanah 30-36). The obligation to remove their shoes is one of the nine decrees made by Rabbi Yochanan ben Zakkai. There is a discussion among the commentators as to why they do this (Mesechta Sotah 40a). One opinion holds that they do this out of respect for the congregants who shouldn’t have to see the Kohanim’s muddy shoes. Another opinion is that the decree was made to protect the honor of the Kohanim who might be falsely accused of not participating in the blessing when they had to tie their shoes. If these reasonings are beyond you, don’t worry, they are beyond me too; but one thing struck me when I first saw the Kohanim taking of their shoes before blessing the congregation in synagogue. It’s the same thought that came to me when I read in the Torah that G‑d told Moshe to “take off your sandals, for the place where you are standing is holy ground (Exodus 3:5).”

What’s the thought?

In order to connect, in order to give, in order to attach, you have to be connected to the ground. If a woman doesn’t get any sleep, if she has no physical or emotional strength, if she doesn’t eat properly, then she can’t be a source of blessing. She can’t give because there is nothing to give. You can’t be lofty and spiritual, you can’t be nurturing and attached if you don’t have feet that are touching the ground.

Postpartum depression is scary. Sometimes it comes out of nowhere, sometimes it’s a slow build-up that unfortunately wasn’t caught before it spiraled out of control, but thank G‑d, I have seen so many women who, with the right physical and/or emotional and psychological support come out of it, and even come out of it very quickly. I have seen these women regain their footing on the ground.

By Elana Mizrahi

Reprinted from Chabad.org