So you’re going to have a baby. You expect a big life adjustment. You know your hormones will be in flux. You get that there won’t be a whole lot of sleep. But you’d never expect the feeling of heaviness, the obsessive thoughts, or the resentment.
Once the baby is born, it can be hard to tell what is just the average adjustment to motherhood and what is postpartum depression.
You keep thinking, "I should be so grateful. So many people would love to be in my position. Women have taken care of babies for thousands of years. We’re supposed to be ‘naturals’ at this. What is wrong with me that I find motherhood so hard?"
Well, maybe nothing is wrong with you. Maybe it’s totally normal to have a difficult time adjusting to devoting your every single thought, action, and motivation to someone else.
Maybe it’s normal to feel the stress of having a creature entirely dependent on you as a food source every two hours – even throughout the night.
Maybe it’s normal to feel a bit overwhelmed by the fact that last week you could come and go as you pleased and this week (and for the next dozen years or so) every plan you make has an additional consideration.
Or maybe something is wrong - not with you, but with hormones in your body. According to the National Institute of Mental Health (NIMH), postpartum depression (PPD) is most common in the first three months after giving birth and occurs in about 15% of births. That’s more than one woman in ten suffering from PPD. And depending on the severity of your PPD, the risk of it happening with a future birth can be anywhere from 30-70%.
After my first baby, I experienced what I would call an extended case (two months) of the baby blues. And since the baby blues are supposed to only last two weeks, maybe I did have mild PPD.
In addition to the tough adjustment to motherhood that we all experience, I had a terrible time breastfeeding. I squirm when people talk about how breastfeeding is "the most natural thing in the world."
My body naturally produced enough milk for a small village of babies. It took professional intervention from my doctor and a lactation consultant and months of effort before my supply regulated and the pain and infections stopped. So, yes, breastfeeding came naturally to me after about three months of doing it.
When the feeding got easier, it felt like the joy of motherhood finally opened up fully to me.
I think my experience with feeding is a microcosm for all of motherhood with a new baby. To suggest that knowing how to be a mom to a baby is instinctive is to suggest that it’s easy – like breathing or knowing when you’re hungry. That doesn’t give motherhood the respect it is due. It takes tremendous effort and self-sacrifice to be a good mom to a new human.
What’s normal new mom stuff and what’s postpartum depression?
A lot of women with PPD go undiagnosed for too long because they don’t recognize they need help. Many of the common symptoms of postpartum – feeling overwhelmed, crying more than usual, losing interest in activities you used to enjoy, being exhausted or quick to anger – are also normal symptoms of being a new mother.
When you have a newborn, everything is new and different so there is no normal. All of the descriptions below are things I felt or my friends felt with new babies. Some of us had severe postpartum depression and needed medical help, some of us had baby blues and needed extra support, and some of us were experiencing what turned out to be our "normal" adjustment into the life-transforming role of mother. Some of the adjustments we were all dealing with included:
- You can’t sleep. You’ve got to imagine all the terrible things that might happen to your baby so you can prevent them all.
- You feel anti-social. It’s just too much effort to clean up the house and yourself for friends to come over and too overwhelming to take the baby out of the house.
- Everyone thinks their babies are so beautiful and you think yours looks like an alien.
- Yesterday your husband tried to tell you about this funny video he saw on Facebook and you became inexplicably enraged at the way he moved his mouth.
So how do you know which of these are normal thoughts and emotions in the transition into motherhood and which are thoughts and emotions that indicate PPD?
When do you need help?
You need help for all of it – no matter what degree of adjustment or level of sadness or overwhelmedness you feel, you need help from your support system at the least.
But the following symptoms are strong signs you need a doctor’s help and may be dealing with postpartum depression:
You have obsessive thoughts of hurting your baby or yourself (even if you know you never would). A friend of mine experienced this and was too embarrassed to tell anyone (shame can also be a symptom of PPD) until she saw a news segment discussing this exact symptom of postpartum depression.
You don’t feel the bond or connection with your baby you hoped you would after knowing him for a couple weeks.
You feel like your anger, exhaustion, anxiety, or sadness prevent you from caring for your baby the way you would like to.
I think this quote from the NIMH website is especially important: "Postpartum depression does not occur because of something a mother does or does not do." It’s something you have out of no fault or failure of your own. It’s not a sign of weakness or lack of mental strength any more than having cancer would be.
You are at a higher risk for PPD if you have previous experience with depression, have a traumatic birth experience (also be on the lookout for symptoms of posttraumatic stress disorder, or PTSD), your child has special medical needs, and/or you feel a lack of help or emotional support.
How do I get help for PPD?
You can’t control postpartum depression by yourself. You need a doctor’s help with medication and/or therapy to cope with it, and you can use online resources to find support for PPD close to you.
Even if you don’t have the specific symptoms above, you may be suffering from PPD. Many women experience the "baby blues" for a couple of weeks after giving birth, but severe symptoms of depression or symptoms that last longer than the first two weeks postpartum could be signs of PPD.
If you aren’t sure what you are experiencing is normal, talk to your doctor.
Lay it all out there. Tell her exactly what you are feeling. She’s seen and heard it all and will likely know how best to help you if you need medical help.
If you sense your doctor is being dismissive, ("Ah, everyone feels that way after having a baby") and your symptoms don’t improve or get worse, talk to her again, let your partner speak to her about what he sees from his perspective, or even search for a new doctor who will be more understanding.
We can be grateful and love our babies while recognizing that the transition into motherhood is huge and difficult and we need help to navigate it. And sometimes we need a doctor’s help to navigate it.
Talk about what you are going through. Join a breastfeeding support group. Join a mom group (even if it’s just on social media). Ask for help. Tell your partner or anyone else supporting you what you need. Let other people take care of your baby (even if they don’t do it exactly the way you do) so you get a break. Get away sometimes. Let friends come over and do not clean the house before they come. Nap shamelessly.
Take care of yourself so you can better take care of your baby.