"Are you just loving being a mommy?" my friend asked me, cradling my newborn son in her arms.
The words lingered between us as I pursed my lips and tried to figure out how to respond. My son was 4 weeks old, and I wasn't sure what I was feeling except tired, overwhelmed and numb. I knew the socially acceptable answer was a gushing "Yes! It's the best." But that felt hollow and foreign, so instead I broke the tension by saying, "Ask me on a day when I've had more than three hours of sleep."
Four long months later I was diagnosed with postpartum depression and anxiety. With the right support, education and combination of medication and therapy, I began to emerge from the dark cloud that hung over my transition to motherhood.
Even as I started to heal, I felt alone in my experience with an emotionally challenging postpartum experience. There didn't seem to be any space for me in the common narrative of motherhood. In a world of gushing Instagram posts about "bundles of joy" and "lives changed for the better," my story of grief and losing myself just didn't seem to fit into this happy mold.
Statistics say one thing about postpartum mood disorders, social media says another
I felt like I couldn't identify with the blissful messages of joy other new moms were sharing on social media, the place where I found myself spending a lot of time as I was physically homebound in the early days of learning to care of a newborn.
But while I may have felt alone in my emotionally challenging postpartum experience, I certainly wasn't: Postpartum mood disorders are one of the most common complications of childbirth, affecting one in seven new moms, according to the American Psychological Association. While the medical community and society at large have made huge strides in recognizing and treating maternal mental health conditions, there is still quite a bit of work to be done to support mothers.
"This is a huge life transition, becoming a mom. We treat it in common culture like it should just be easy and blissful and the most natural thing in the world," says Kate Rope, author of the book Strong As a Mother, a guide to prioritizing mom's health and wellbeing during pregnancy and postpartum.
After Rope's own rough transition to motherhood 11 years ago, she was inspired to normalize the range of experiences someone might encounter and to offer solutions for the way forward.
"When you're expecting a baby, you may have a ton of books on your nightstand and none of them are about you," Rope says. "A lot of them are filled with strongly worded and conflicting advice, and it's all focused on baby, almost like you're producing a product."
During pregnancy, moms are inundated with information about how best to optimize their developing baby's health, Rope explains, from what to eat, to what medications are off-limits to playing music for the baby in the womb to foster brain development. That string of advice carries over once baby is born and becomes part of a larger message that a mom's needs are secondary, she says.
"It becomes this virtue of perfection that is not realistic," Rope says. "We've decided that any cost to mom is worth enduring to reduce medical risks for baby."
Rope stresses the need to recognize that a mom's well-being is central to positive outcomes for her children, saying "we need to look at them as a unit with as much kindness and compassion for the mom as for the baby."
Rethinking the care for mothers
To start, we need increased access to mental health services and specifically, professionals who specialize in maternal mental health, says Rope.
We also need better structures in place to help identify and support moms who may be struggling: While the American College of Obstetrics and Gynecology (ACOG) recommends providers screen women for depression both during pregnancy and postpartum, that is often left to obstetricians and gynecologists. However, mothers are more likely to encounter their child's pediatrician in the early months, notes Carly Snyder, a reproductive and perinatal psychiatrist based in New York City.
Some pediatricians are catching on—in fact, it was my son's pediatrician who recognized my symptoms and encouraged me to get help. Yet, Snyder says more training is necessary to help these doctors be equipped to refer women to mental health providers.
"It can be tricky for a provider to screen, but then not know where to send someone," Snyder says. "There needs to be more general education for medical students, OBs, pediatricians. Everyone needs a basic understanding of perinatal mood disorders. It's coming, but we're not there yet."
Recognizing the link between physical and emotional postpartum recovery
One of the most common misconceptions about postpartum mood disorders is that depression is the only condition, Snyder says, when in fact people need to be aware of the spectrum of mood disorders and their symptoms, ranging from depression and anxiety to obsessive compulsive disorder (OCD) and post-traumatic stress disorder (PTSD). Any of these can develop during the postpartum period.
Even for those who may not develop a clinical mood disorder, the body undergoes several physical, chemical and hormonal changes during pregnancy, delivery and postpartum, Snyder says—and all of these changes can affect a mom's physical and mental health.
"Delivery takes a huge toll on your body, it's like running several marathons. In our country sadly, women are discharged within a couple days," Snyder says. "So that toll of delivering the baby and running three marathons and caring for the baby isn't alleviated, and then you go home and you're exhausted and it's all a lot. And for those who receive C-sections, that is a major surgery, yet we really don't give women the opportunity to heal."
Brook Bolen, a mom of one living in Asheville, North Carolina, says she felt ashamed by the anxiety and fear she experienced after her child was born, which led her to suffer in silence for nine months.
"The mainstream narrative that we have is that this is a joyous time, and I think that narrative really clouded my understanding," Bolen says. "I didn't know how individual of an experience it is and how many women struggle. I wasn't feeling that joy and it reinforced this notion that I wasn't supposed to do this, that this [motherhood] was a mistake."
Once Bolen sought treatment at the encouragement of a friend and began taking prescribed antidepressants, everything changed she says, and she was able to enjoy her baby. Her daughter is now 5 years old, and while she didn't feel she could talk openly about her experience in the beginning, she says doing so now has helped her find community.
"In the experiences I've had with other mothers, I've learned that many of them may not feel like they can say it publicly, but they will pull you aside and say thank you, I went through that too and no one talks about it," Bolen says.
For Rope, increased awareness about the symptoms of postpartum mood disorders coupled with the willingness to seek treatment helped when she welcomed her second child.
"I've gotten over the hump of thinking it's a selfish pursuit to take care of myself. I now realize it's something I have a right to as a person and that it's good for everybody if I do," Rope says. "As a mom, your mental health matters. You deserve to have the support you need."
Resources and support for postpartum mood disorders are available through Postpartum Support International or via their hotline, 1–800–944–4773.
Originally posted on Medium.