by Natalia Hals, CD(DONA), LCCE
It really grieves me to the core to think about the taboo around postpartum depression. Even the name weighs heavy when compared to “the baby blues”. According to the U.S. Department of Health and Human Services, depression is a common problem during and after pregnancy. Research tells us that up to 16% of women will experience postpartum depression.
But when you are battling PPD yourself, knowing that even one other mother has experienced PPD can mean the difference of acknowledging it and seeking help. I have a sneaking suspicion that the number may be larger but this is a subject that women are often ashamed of. Whether it is the fear or being seen as weak, not appreciating the gift of a new child, or fear that there may be some other mental illness that hasn’t been uncovered, it remains hidden. I can tell you from experience that things that are hidden like this seldom go away on their own.
A dear friend of mine asked me about the difference between postpartum depression and the baby blues. In answering, I hope to remove the unnecessary shame and loneliness that goes along with PPD. Here was my response:
I can tell you from experience. I had PPD with Riggity and Poots and the baby blues with Beaner. They are very different. I will underline the symptoms:
After I had Riggity I had to go back to work 6 weeks postpartum. I was a walking zombie and it wasn’t because of lack of sleep. Riggity was one of those rare babies that slept through the night early on. I wept on and off, I was clearly so unhappy that every one would mention it. I was not interested in any of the things I used to be, including friends. I started isolating myself – not wanting to see anyone because it was too much work or caused anxiety. I was not my self and it wasn’t getting better as the months went on. Her father worked evenings and I would have Riggity every night after work. I was exhausted and would come home, feed her (she was bottle fed) and I would sleep on the couch until morning. She would be in a playpen next to me (even though she had her own nursery…I didn’t feel like taking her there and I wasn’t so quick to attending to her). I truly loved her and felt so blessed to have her but I was disconnected from her because of how I was feeling. Unfortunately, I didn’t know what to look for at the time and it took my mom at about 6 months postpartum to plead with me to talk with my doctor.
When I was pregnant with Poots my doctor was aware of my previous PPD and we developed a plan; to look for the signs, be accountable (she came to see me before I went home after having Poots and she sat down and talked with Hubs and I about what to look for) and also we discussed what were some options if I were to have it again; counseling, prescription medication, diet, combo of all.
When PPD appeared with Poots, hubs was the one who pointed it out to me. Sometimes when you are experiencing PPD you start to think it is normal because you are living in it everyday. I stopped returning phone calls, declining visits and invitations (after the postpartum period). I stopped sleeping (I would stay up almost every night watching television). I was disconnected from hubs and the kids. I would be holding Poots but not engaging with her (zombie like). My oldest and hubs shared their observation with me; I always had this blank stare and they would be talking to me and I would look right through them. I would go from not eating to eating too much. I was exhausted, completely exhausted. I had overwhelming fears and anxiety about myself, the kids, hubs.
I’d seen my doctor for my yearly check up and she asked me how it was going and I cried my eyes out. She said that my appearance looked different, my eyes were distant and I was not the same happy person I was a year previous. She’d said exactly what hubs had just told me (which led me to schedule the appointment) and I knew she was right.
I believe I waited too long to be treated. I had just lost my mother and thought I was heavily grieving and that was the reasons for my symptoms. I also thought it was something that could be reasoned and prayed away, a positive attitude and strong-will would help me overcome it. I eventually agreed to try some medication and after two weeks or more started I started to see more clearly and not walk around with my head in the cloud. I also started to see a counselor to process some things. Both helped. Again, I wish I wouldn’t have waited so long.
With Beaner, I had the baby blues. We were on alert and looking for PPD because of the hard pregnancy, traumatic labor/delivery I’d had. The baby blues felt like an emotional roller coaster that came and went around the second week. It was intense when it peaked and I had one melt down when I was feeling overwhelmed with healing, nursing, lack of sleep and my hormones had tanked but after that things settled and started to feel normal.
The difference with Beaner. I had been seeing my counselor the last few weeks of my pregnancy and started to see her once I was out and about (about 6 weeks postpartum). I discussed my disappointments and fears candidly and didn’t hold anything in. Also, with my doctor we tested my blood levels and made sure my iron and vitamin d levels were good. I immediately started taking supplements postpartum, started lowering my expectations with what the house should look like, accepted help when offered, slept when hubs was home (that meant earlier bed times) and when my mother in-law came over. I allowed my body the time to heal without having a time-table as to when I should be doing things and I cried when I felt like crying and I talked about things that bothered me instead of holding them in. I, hubs, my doctor and my counselor (haven’t seen her since June) have all been keeping an eye out for any symptoms and so far so good. That doesn’t mean I haven’t had days when I’ve felt like I am the worse mom, or wife, or not doing everything right or woke up feeling overwhelmed with everything. The difference is that feeling comes and goes, it doesn’t linger like it did in the past.
The best way I can describe PPD is: I felt like I was on an island that was once a part of the shore. I could see myself drifting farther and farther away from the shore and no one could reach me and I couldn’t reach them.
Another description: I was falling deeper and deeper in a black hole. I had my arms and legs stretched out to try to keep from falling but I was still falling, some days super fast and some days I was trying to stop the falling with my finger nails, barely holding on. Either way, I felt alone even though people were around me, and scared, anxious and unhappy.
By the way, all of this was going on and I loved my kids and hubby so much I could hardly stand it. The good news, kids are sooooo forgiving and resilient. They love their mamas so much that any mistakes along the way are forgiven. In spite of my rocky start with Riggity is really unbelievable how much she loves me. Poots thinks I am a rock star. I have to lock myself in the bathroom sometimes because they all want to hang out with me (this is even after spending all day with them). I am not saying this to brag about myself because like I said, I am not perfect. I still make mistakes and lose my patience and have challenging days but kids are pretty forgiving and resilient if your heart is in the right place.
A few things:
When you are pregnant or have just had a child you are exhausted for very normal reasons, the weepys can come from being exhausted. And you are right to feel overwhelmed. It is a lot to take on and a lot to learn. Be patient with yourself, friend. Patience with yourself as a mom and with your body. Don’t expect to know exactly what to do right away and all of the times.
Don’t feel guilty if you find that you do have PPD. It is nothing you did wrong, nothing you can control with will power and like any other illness if there were treatments available no one would judge you for using them.
Practical notes: Have someone to take babes while you sneak a nap, take a soak, have some quiet time. It will make you a better mama if you get as much rest as you can, stay hydrated and nourished. Stay connected to your partner and be honest about how you are feeling. Even if it is continuing to communicate about how all of the changes are affecting you both, snuggling up to a comedy or doing more if you feel up to it (don’t feel bad if you don’t).
Accept help when it is available; food, cleaning, errands. Breathe and when you are feeling overwhelmed acknowledge it and stop and think what do I need to be doing right now, or today? It may be just getting back in the bed with baby and counting her little fingers, smelling her hair, listening to her breath or eating a soulful meal, taking a stroll or a nap. Pace yourself, there is no pressure. You are the perfect mom for your child(ren) even if you are dealing with PPD.
If you suspect that PPD may be creeping up see your doctor or midwife ASAP, they have a test you can take. There are many options and the sooner it is dealt with the sooner you can experience this first year in all the beauty and clarity it was meant to be experienced in. Not through a fog and a veil of tears.
Natalia Hals is a birth and postpartum doula and a childbirth educator. You can find her at A Woman’s Design.