When I first met with my doula, Kim, I told her that I wanted her to be on the lookout for signs of postpartum mood disorders after I gave birth. PPMDs include postpartum depression, made famous by celebrities like Brooke Shields, and postpartum anxiety, less discussed and diagnosed, but also frequently co-morbid with PPD.
I had never had a mood disorder, but I have a very long history of mental illness in my extended family. At one point my whole immediate family was on antidepressants. For me, it was because I had heard about its appetite-suppressing side effect and wanted to lose weight. I told my family’s psychiatrist about that and he wrote me a prescription, no questions asked. I took the pills for a year until I realized I wasn’t losing weight and any appetite suppression was me willing myself not to eat rather than true appetite suppression.
There was something about pregnancy that was making me feel a bit unhinged despite the lack of true mood disorder in my personal medical history.
Prior to getting pregnant, I underwent a seriously rigorous graduate program. I got my degree in Organizational Development, which had a big basis in humanistic and organizational psychology. I got this degree alongside a cohort getting a Master’s to become therapists, so there was a lot of internal “work” and soul-searching to find what events and situations would cause us to be triggered (getting inappropriately emotionally involved in a situation and losing the ability to help clients because of internal trauma).
As a result of all this internal work, I walked away feeling emotionally wrung out. I could process feelings quickly and went from crying all the damn time to crying only when digging deeply into childhood traumas with my therapist. I could identify what was problematic for me emotionally and quickly address it so I could stay present in the moment with clients or friends.
When I got pregnant, I felt like my ability to emotionally regulate got waylaid. I was still processing feelings well and swiftly, but I occasionally had outbursts of crying that didn’t have a root reason. Lots of people brushed this off as typical pregnant woman stuff, but I was unwilling to accept this as a justification for how I was feeling. I knew hormonal moodiness from my teenage years and this didn’t quite feel like that.
Giving birth to my son was very different than I had anticipated. There was a long hospital stay that ended in me being induced 5 weeks before my due date. The birth was not traumatic in the sense that I wasn’t listened to or had an experience largely different from what I wanted. It was traumatic in that we walked out the hospital without our son, as he had to be in the NICU for anther week and a half, and had to make the massive adjustments that come with parenthood a full month before we thought we would have to. I don’t know if that month would have actually changed how we dealt with parenthood, but it felt like a world of difference at the time.
We brought Ronan home when he was 10 days old, just over 5 1/2 lbs. The first few 6 weeks were totally typical of what you hear about parenting a newborn. Lots of funny sleep patterns, staying at home a lot while our little preterm baby’s immune system caught up to him, and doing all we could to keep him and us comfortable. It was a miserably hot summer and recovering from childbirth and pregnancy in a house that was 80* was not comfortable.
After 6 weeks, I had my first taste of a day at home without my husband’s help. I managed ok in that my son was still alive at the end of the day, but I was stressed and started to understand why a lot of moms need a glass of wine at the end of the day. My drug of choice was ice cream and so I ended the day with my husband, Andy, with a milkshake in one hand. “Ended the day” is a hysterical phrase to me because with a newborn there is no real end of the day. It’s all a constant cycle of eat, sleep, soothe, diapers, etc.
When Ronan was 10 weeks old, Andy went back to work. The week before he was scheduled to start I was reliably having a meltdown at 4p every day. It would usually come as I was tending to some menial task like a diaper change and I would start to anticipate his return to work and the long stretch of hours ahead of me with just my son. I found I would stand in his nursery tears welling in my eyes, my heart rate picking up, and a feeling of hopelessness as I thought about my life being an endless cycle of bottles, diapers, and an inconsolable baby.
Ronan was prone to fits of crying. Not colic, just 15-30 minutes of eardrum-rattling wailing. Usually the poor kid was uncomfortable because of his immature digestive system no knowing how to pass gas or poop. This is when I would panic even more. Usually I could rock him for about 10 minutes before I would need to pass him off to Andy, who could hold him, despite the screaming, until it stopped.
I would troubleshoot about what I would do when he wasn’t around and had to acknowledge that sometimes I would just have to stomach my crying baby.
I had a session with my therapist around that time and told her about my daily crying jags and new ennui over the major shift in my life. I told her I was nervous about snapping one day. I didn’t know what that meant exactly, but whatever it was I didn’t want to do it. She told me to keep an eye on it and to schedule a follow up with her soon.
I got screened for PPD at each of my postpartum appointments, which were held at 1 week postpartum to assess my blood pressure, 5 weeks postpartum when I had some strange spotting, and 6 weeks postpartum for the normal 6-week follow up. Nothing was noteworthy to me, nurses, or my OB, but, again, something seemed up. I had a hard time finding the words to describe the feeling of off-ness I had without causing my concern to be brushed off as typical new mom stuff.
About a month ago I met with my therapist when Ronan was 14 weeks. I described the continued off-ness, the anxiety, and, a new symptom, being unable to go back to sleep after middle of the night feedings. Ronan was waking 2-4 times a night. My husband and I would alternate who would tend to him and I found that when it was my turn, despite being exhausted I would lay in bed, toss and turn, and think about nothing of great consequence, just couldn’t fall back asleep. I had a migraine at one point from the lack of sleep, which is tricky when you have an infant to care for at the same time.
“I think I have some sort of postpartum depression,” I said. “Though it’s not nearly as bad as what I read about. I don’t want to harm myself or Ronan. I just feel a little crazy all the time and really tired. More than what I should be feeling from lack of sleep.”
“I think you may be right,” she said. “I think you have some mild postpartum depression. Let’s figure it out.”
1 in 7 women experience PPD. These are the women who often have the more severe symptoms that don’t fit into the narrative of new mom anxiety or hormones.
How many have a milder form of PPD like I do but receive no acknowledgement for their suffering? We hear a lot of moms describe the feeling of losing themselves; their sense of self disappears as they reorient around this new being. It is the starkest shift that will ever happen in a woman’s life, and we think we have a sense of what “normal” looks like. “Normal” is feeling overwhelmed, undersupported, untethered, and anxious. But, I find it hard that despite these words describing what is “normal,” we don’t react to them with more mobilization. Have we normalized a woman’s sense of disconnect after childbirth? What sort of sexism would you call that where women’s experiences of overwhelm and anxiety is considered “normal” and ok? I feel that if any woman expresses these feelings (ever, not just postpartum) she should be met with resources for support and care, not a brush off as that being “normal.”
I’m a resilient and resourceful woman. I have a loving and supportive husband and a gracious and caring family and friends who are family. If I had these feelings even with all of this, what do women with less experience?
I also have an amazing amount of self-awareness, yet despite my description of feeling off, it wasn’t until I said out loud “I think I have postpartum depression” that someone finally took notice.
Since declaring that, I’ve made some adjustments. My diet and exercise habits have shifted and I routinely lay down for a cat nap every day while my son is sleeping. I wouldn’t do this before for fear I’d miss him waking up, but I lay down with the intention of closing my eyes for 20 minutes, often on the couch next to the swing in naps in, knowing that if he needs me he’ll let me know. I also meditate (almost) daily, even if just for 5 minutes. I make it a priority to take a shower. And, my personal favorite, I keep the sink clear of dishes. I think my mental state is appropriately reflected in my kitchen.
But it took a few weeks of concerted troubleshooting to figure this out. Troubleshooting with an infant sucks. There’s no space for self-reflection and with PPD I found that I felt I needed to do laundry more than sit and take a breath. Now, we affectionately call our laundry basket “the second closet” and I feel better, though not fully recovered.
I know that at some point I will feel fully in myself again, probably when a full night of sleep comes along again. Until then, I rely heavily on this new label to remind me that I can’t help my son unless I help myself and take extra permission to slow down even more than having a new baby requires.