A candid, open, and honest look at the struggles new moms go through when
they suffer from postpartum depression.
On the laundry list of mom-to-be and new-mom taboos, postpartum depression
(PPD) has earned itself a spot on the very top. Despite being relatively
common, postpartum depression is widely misunderstood. It affects as many
as 10 to 20 percent of new mothers and briefly impacts approximately 70
to 80 percent in the form of the "baby blues," a less severe
and short-lasting condition.
"Like all mental illness, there's so much stigma and stereotypes
that surround postpartum depression that make it difficult for a new mother
to reach out for help or admit that she might be struggling," says
Crystal Karges, MS, RDN, IBCLC, a maternal health specialist at Crystal
Karges Nutrition who experienced postpartum depression herself. "Many
of the symptoms of postpartum depression are commonly misunderstood or
mistaken as part of 'new motherhood,' when in fact, it may be
a more serious illness at hand that warrants professional interventions."
Much of the discrepancy between what postpartum depression looks like and
what it's actually like comes from the way it is portrayed in the
media and society, especially on social media. We're used to seeing
one of two extremes—the over-the-moon happy mom who feels beyond
#blessed to be gifted her precious baby and who enjoys every single moment
#nofilter, and the deeply broken new mom who cannot stop crying because
her world has been turned upside down. The reality, however, is that there's
an entire spectrum of symptoms lying in between that are far more subtle—and
many of them are specific to the mom experiencing these symptoms. In other
words, the symptoms are not always a one-size-fits-all.
This is why the term Perinatal Mood and Anxiety Disorders (PMADs) is quickly
becoming the standard denomination when discussing maternal mental health
conditions. "PMADs refer to a group of mental health symptoms occurring
before and after childbirth and persisting up to one year or longer that
are characterized by changes in mood that can interfere with a woman's
ability to handle day-to-day tasks, including bonding with her infant," says
Patricia De Marco Centeno, M.D., a reproductive psychiatrist and the medical director of
Maternal Mental Health Program at Hoag Hospital in Newport Beach, California.
To better understand how symptoms of postpartum depression manifest—and
what they're really like—we reached out to real women who've
suffered and survived PPD. Here are the most common symptoms of PPD, based
on their experiences.
Anxiety
A large majority of new mothers feel anxious and panicky, and these feelings
can be quite intense—not only because of the hormonal fluctuations
following the birth, but also because of the impact of bringing a new
life into the world and the responsibility that holds, says Elyse Weinstein,
M.D., psychiatrist and co-chair of the Mental Health Department for Kaiser
Permanente in San Rafael, California. For Rebecca Conklin, mom of four
from Tampa, Florida, managing her anxiety and stress level was a daily
battle. "If the baby cried, my heart would start racing, and just
driving in the car with her would send me into a panic attack," she
says. "If something unexpected happened, no matter if it is big or
small, I would find myself amid a panic attack."
Kristin White, a mom of two from Gig Harbor, Washington, also suffered
panic attacks caused by postpartum anxiety that were so debilitating they
sent her to the ER on a few occasions. "I constantly worried about
irrational fears such as a fatal car accident, my son being kidnapped
by a babysitter, or me dying and leaving my son without a mom," she
says. "I did recognize that these were not normal thoughts, but at
times they would manifest themselves into an endless record of spinning
thoughts."
Loss of Interest in Hobbies or Activities
Many new moms suffering from postpartum depression find themselves less
likely to engage in activities that they once found enjoyable, such as
running, yoga, journaling, spending time with friends, or getting their
nails done. Of course, participating in many of these activities is more
challenging when you're caring for a new baby around the clock, but
a more severe reduction in interest in them is worrisome. "If a new
mom used to have plenty of energy and joy with what she did, but now cannot
feel any joy doing any of the things she used to enjoy, it is a sign of
PPD," says Mary Ann Block, D.O., P.A., medical director of The Block Center.
Vanessa Gordon, a mom of two from Sag Harbor, New York, had no interest
in talking to or seeing anyone and ignored phone calls, emails, and direct
messages when she first became a mom. "I had no interest in anything
fun because I felt like I was not worthy," she says. "Even celebrating
a friend's birthday two weeks after my baby was born was difficult—I
ended up not showing up because I felt unworthy to have a friend."
Irritability and Mood Swings
It's hard for anyone to stay level headed when they're sleep-deprived,
however sharp and drastic mood swings and a feeling of not being able
to control one's emotions often signals postpartum depression, notes
Dr. Blocker. Gordon describes this as feeling like everyone was expecting
something from her. "Anything could set me off, from my baby needing
a changing and my needing to get up right away to being told 'you
need some sleep' combined with 'you should get someone to help
you out,'" she says. "Any disagreement, big or small, triggered
this irritability."
Frequents Crying Episodes
Sudden bursts of crying are often associated with new motherhood, in part
due to hormonal imbalances associated with the weeks after childbirth,
but they tend to last longer in women with postpartum depression. In addition,
many times mothers with postpartum depression find themselves crying for
no substantial reason at all. Of the many things that made Karges cry
after she had her baby, the majority were things that wouldn't have
ever bothered her before, like being out of milk or not being able to
find something she was looking for. "I would just burst out into
tears and feel completely overwhelmed by my emotions."
Anger and Rage
Along with feelings of irritability, many moms note feeling intense moments
or even hours of rage. Karges explains that this symptom is quite common
and rears its head in an angry episode often directed toward oneself,
other family members, or even the baby. White even found herself directing
anger at random people she'd come across throughout her day. "If
someone didn't reply back to my email at work, I felt disrespected
by a cashier at the grocery store, or my husband didn't load the dishwasher
correctly, I would feel the fire inside of me and just want to hit and
scream," she says. "Unfortunately, my son experienced some of
this rage when he wouldn't do 'normal' toddler things like
getting into his car seat."
Feelings Disconnected From Your Baby
A lack of interest for the baby or intense anxiety around the baby can
be some of the most distressing symptoms to both the mother and family,
explains Dr. Weinstein. "It is hard for all concerned to understand
that these are symptoms and not an indication of one's ability to
mother," she says. "They speak to the level of depression and
lack of ability to function and can also occur due to the profound lack
of sleep and the anxiety that occurs with PPD." Kargas describes
feeling as though she was just going through the motions of caring for
her daughter and her needs, but not feeling emotionally connected to her.
"So often I had heard women describe the immediate love and affection
they had for their babies, and that never occurred for me," she says.
"Instead of knowing that I was, in fact, struggling with a serious
mental health issue, I blamed myself for being a bad mom."
Intense Guilt
It's typical for mothers and new parents to be critical of themselves,
explains Dr. Weinstein. "They imagine wanting to either emulate what
their own parents did or do it differently than how they were parented,"
she says. "The mom can feel defeated like she's not doing anything
right." For Anna Yam, Ph.D., a perinatal mental health specialist
at Bloom Psychology who suffered postpartum depression firsthand, guilt
was the hardest symptom to swallow. "I felt guilty for wanting to
take time away from my baby and for not having enough energy to provide
her with 'proper stimulation,'" she describes. "I felt
guilty for not 'enjoying' her early babyhood."
Conklin too remembers feeling immense guilt and shame—specifically
after the times where she'd yell or become aggravated with her husband
or children. "It became a vicious cycle that caused me to sink deeper
into depression," she says. "The more I felt out of control
with my emotions, the more I felt I was failing my kids."
Lack of Sleep - or Too Much Sleep
Most new moms have difficulty sleeping, especially in the first few months;
however, Dr. Weinstein explains that some new mothers have sleep issues
that are due to depression or anxiety. "Either their body just won't
let them sleep or their mind can't take a rest, which may cause them
to worry more and ruminate about the smallest things," she says.
"This can be quite distressing and interfere with functioning."
Although White didn't have trouble falling asleep, she remembers waking
up every three to four hours even when her baby was sleeping just fine
in his crib. "I would wake up with anxiety, always thinking about
what I needed to do and hypothetical what-ifs (what if my baby died, what
if my husband left me, what if I have cancer)," she says.
Changes in Appetite
"When any person is depressed or anxious, they can either overeat,
out of nervousness or to make themselves feel better, or lose their appetite
altogether," explains Dr. Weinstein. "Their upset state takes
their appetite away, and in some cases, it may be that they are not taking
care of themselves because they lack motivation and energy to do so."
White found herself eating more than usual and drinking several cups of
coffee in an attempt to mitigate her appetite. "I would use naptime
as an excuse to eat a second lunch in front of daytime talk shows,"
she shares.
For Gordon, this manifested itself in an inability to eat meat due to immense
feelings of guilt when doing so. "It was so bad some days that I
could hardly pour myself a glass of juice, getting up out of bed was a
true feat."
Feelings of Hopelessness and Isolation
Many new mothers suffering from postpartum depression express feeling as
though they're on their own island—that their loved ones simply
don't "get" what they're going through. To add to the
issue, PPD symptoms make it difficult for new mothers to connect or even
communicate with their loved ones. Emily Merriman, a mother of three from
Chicago, felt as if no one would understand what she was going through.
"I didn't want to leave the house or talk to anyone in fear that
they would feel something was really wrong with me," she says. "Even
when friends said they understood, I felt they couldn't possibly know
what I was feeling."
How to Get Help
Despite how common postpartum depression is—especially the less severe
symptoms of "baby blues," too many new moms suffer alone or
feel ashamed. "Every woman will experience symptoms differently,
so it's critical to reach out for help or talk to someone if you feel
like something is not right," says Karges. "You may feel worried,
embarrassed, ashamed, or scared about admitting symptoms that you are
experiencing, but remember that these symptoms do not define who you are
as a woman and a mother." Professional help and resources are available
to support you through your journey that you can better enjoy early motherhood—don't
be embarrassed to ask your obstetrician or child's pediatrician for
referrals. After all, caring for you and your baby is their job.
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