There is a term used in psychology called “role transition”, which essentially speaks to a period of big change and stress, that if ignored can lead to depression and other forms of psychological tension. This could be why many women experience depression along with the huge hormonal and bodily changes that pregnancy brings.

A good thing to remember during this transition is that no matter how much you wanted or planned for a baby, the huge identity shift you’re going through can make you feel completely discombobulated and out of control. This is very normal. But it can be helpful to know that the strong negative feelings associated with this change can be mitigated. And one way to do that is through interpersonal therapy (IPT), which is a type of therapy designed to help people going through huge transitions.

So what exactly is interpersonal therapy (IPT)?

IPT is a structured framework involving these four steps:

Name what’s upsetting you. Sometimes we may feel low, unhappy or stressed without really knowing the reason why. If you feel like you’re unable to put your finger on what’s bothering you, it can help to talk with your partner or a friend who can relate. If you prefer privacy, another option is to journal about how you feel. Just naming and writing down the feelings can help to open up self-awareness and an understanding of what the underlying issue is.
Express the identity change. Once you have identified your sources of stress, think about how your identity has been disrupted. Is this situation causing you to feel like you’re losing yourself? In what ways do you feel like your identity is shifting and how is this impacting the rest of your life? Putting it into words can help you better understand why this situation is challenging and what part of you you feel like you’re losing.

Acknowledge and accept your feelings of distress. Negative feelings can provide valuable signals about what’s going on in our lives. It’s important to recognise and honour your feelings no matter how trivial they may seem, which is the first step to working through them. Some powerful ways to honour and move through your emotions include crying it out, meditating, doing yoga, punching (or screaming into) a pillow, or having a rant into the ear of a trusted friend or family member. Use these ways of expressing your emotions until you release some of the frustration and accept what you cannot change.

Devise a plan for how to adapt to this new situation. Once you have identified the identity change that is at the root of what’s upsetting you, you can start to find a resolution. It’s not about trying to bring back parts of who you once were but instead looking forward, towards the “new you,” and adapting your values and priorities to this new identity. You are essentially writing a brand new chapter of your life and a new chapter of your new identity.

So how can IPT help during pregnancy?

IPT can support women to adjust to this new big life transition of becoming a mother. While IPT can help prevent depression, it cannot protect you from the inevitable grief that comes with saying goodbye to certain experiences that you may never be able to recreate exactly. And nor would you want it to. Grief is a natural and healthy part of moving into another major transition and it deserves to be honoured. The main cause of depression is the building up of unexpressed and unprocessed emotions; IPT teaches you to honour and acknowledge your emotions which can shift some of the gloomy heaviness you’re feeling. It’s our resistance to a situation that causes suffering. The moment you can say “yes” to and accept the situation for what it is, the smoother your journey will be.

It can be challenging to face the huge changes that pregnancy brings, but if you are not willing to look squarely in the face of these inner and outer changes, you won’t figure out how to support and hold yourself along the way. You are being given the chance to become your own best ally and to hold yourself through this challenging time so that you will come out stronger and more resilient than before.

What is interpersonal therapy, and how can it help me during pregnancy?

IPT can help with major life changes, says Unii.