The Six Stages of Postpartum Depression
Recovering from postpartum depression is, unfortunately, a pretty hard process to get through. It’s not like you can take antibiotics and ten days later you’re all set and ready to go. The process of recognizing, getting treated for, and recovering from postpartum depression can take months and months.

Yes, I know. That completely sucks.

I was thinking about the experience of going through postpartum depression as seen through the lens of the famed “5 Stages of Grief,” the process people go through when dealing with grief and tragedy. Developed by Elisabeth Kubler-Ross, a Swiss psychiatrist who wrote the book On Death and Dying, the stages are:

  1. Denial
  2. Anger
  3. Bargaining
  4. Depression
  5. Acceptance

According to Wikipedia, “Kübler-Ross originally applied these stages to people suffering from terminal illness, [but] later, to any form of catastrophic personal loss (job, income, freedom). This may also include significant life events such as the death of a loved one, divorce, drug addiction, the onset of a disease or chronic illness, an infertility diagnosis, as well many tragedies and disasters.”

Could we look at the process of going through postpartum depression and postpartum anxiety in a similar way? I think so. And I think it might help moms understand what they’re going through a little better.

The Six Stages of Postpartum Depression

  1. Denial: This must be what new motherhood is like. I’ll be alright. It can’t be postpartum depression, because I’m not mentally ill. I’m sure it will wear off soon. I just need more sleep.
  2. Anger: Nobody understands what I’m going through. Why me?! This is supposed to be a time of joy. I don’t deserve this. I don’t want to have to take medication. I don’t want to go to therapy. I shouldn’t have to call a doctor. This is not fair.
  3. Bargaining: If I just exercise more and eat better I’ll be fine. If I take vitamins. If I could just get to the point where the baby sleeps through the night, I’ll be okay. If I get closer to God and pray more, this will surely go away. I just need to work harder.
  4. Depression: I should just leave my family. I’m bringing everyone down. They all would be better off without me. My poor baby doesn’t deserve a mother like this. I’ll never get better so there’s no point in going on.
  5. Acceptance: What’s happening to me isn’t normal and I can’t ignore it anymore. It’s not my fault. It is okay for me to talk to a doctor. It’s okay for me to ask for help. I can take medication or go to therapy or do whatever is necessary for my health and that of my family. Postpartum depression and anxiety are temporary and treatable with professional help.

When it comes to PPD, I have to add a sixth stage. The stage that comes after acceptance, after the treatment, after the time when you start feeling better—but aren’t 100%. I call it the post-traumatic stress disorder, or PTSD stage, because even after a year of getting treated and getting better, it took me another year just to get over the trauma of what I went through and become comfortable with motherhood.

6. PTSD: I still worry that PPD will return. I’m constantly looking over my shoulder. Every time I feel bad I’m convinced that I’ve gone back there. I feel like I’ve lost a lot of confidence in myself and I don’t know if I’ll ever get it back. I worry I hurt my child in the long-term because of how I was when he was a baby.

It takes a while, but you’ll get past the PTSD too. At that point, finally, you reach complete recovery. You are able to experience the joy of motherhood. You are able to believe that you are truly over PPD. You feel the love that was always there, buried by PPD, for your child, and you trust that you are better and that you are a good mom.

Kubler-Ross believed that not everyone would necessarily experience all the stages in the exact same order or even have all of them. She felt that most people would go through at least two of the five stages, and that it was possible to switch back and forth between them. I imagine the same is true for postpartum depression.

My favorite part of the Wikipedia entry on the five stages of grief is something I want you to consider carefully. To make a point, I’ve replaced the word “grief” with “postpartum depression.”

“Significantly, people experiencing (or caretakers observing) the stages should not force the process. The [postpartum depression] process is highly personal and should not be rushed, nor lengthened, on the basis of an individual’s imposed time frame or opinion. One should merely be aware that the stages will be worked through and the ultimate stage of ‘Acceptance’ will be reached.”

Don’t compare your timeline to others. Don’t expect that you should be better before your time. Don’t give up. You will reach acceptance, and recovery. You will get there.

Note: This article won a 2011 Media Award from Mental Health America, given “in recognition of journalistic excellence in coverage of mental health issues.”

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