National Adoption Month: Addressing Depression During Pregnancy

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National Adoption Month: Addressing Depression During Pregnancy

To say I felt depressed during my first pregnancy is an understatement. To say that my depression went untreated is also an understatement. However, considering I presented a number of risk factors for depression during pregnancy, the fact that my depression was basically ignored by those around me feels a bit like a failure of services.

As for risk factors, I could have been a poster child for Depression During Pregnancy.

  • A personal history of depression or another mental illness – Check!
  • A family history of depression or another mental illness – Check!
  • A lack of support from family and friends – Check!
  • Anxiety or negative feelings about the pregnancy – Check!
  • Problems with a previous pregnancy or birth – This was my first pregnancy, so no check!
  • Marriage or money problems – No marriage, no money: double check!
  • Stressful life events – Check!
  • Young age – Check!
  • Substance abuse – No check!

Six out of eight, and add in a side of extreme pregnancy complications due to my own health, and well, it’s easy to see that I was at least at risk for antenatal depression. Yet, not one doctor or nurse ever asked me, “Are you feeling okay? Do you need to talk to someone?” The woman parading as a counselor for the adoption facilitator I began talking to never once asked, “Would you like to talk to some other mothers who also had these same fears during their pregnancies?” No one in my family sat me down and said, “Listen, Jenna. I think you’re depressed and I think it’s affecting your decision making skills regarding this pregnancy.”

Because it did.

After surgery to place a stent in my kidney at 18 weeks, my doctor placed me on Level III bed rest. I had to quit my job as I could only get out of bed to shower. I began to panic not only about my financial situation but about my perceived inabilities as a mother.

I chastised myself all day long in my bed or on the couch watching movies on VHS tapes sent by an online friend as I couldn’t afford cable. “What kind of mother cries when she finds out she’s pregnant? A bad one, that’s the kind. You can’t do this. Look at you: You can’t even do pregnancy right. You’re biologically horrible at pregnancy, so why wouldn’t you be biologically horrible at motherhood? You’re going to fail this baby. You’re going to be a failure as a mother.” The voices in my head taunted me all day long.

So I listened.

I contacted the first adoption facilitator I found in the back of a magazine. I filled out their medical history forms to the best of my knowledge, including that I had previously been on antidepressants. Still, not one person I had contact with at their office ever asked, “Have you considered that your beliefs about your lack of ability to be a mother are signs of depression?” Instead, they preyed on my anxiety, my depressed state, my lack of support, my financial problems, and my age to help me paint a negative self-portrait—one who couldn’t be a mother.

Years later, when I found myself in therapy for postpartum depression after the birth of my second child, a son, I felt anger. I felt angry not only for the young mother who slipped through the cracks, but at myself for not being able to see; not being able to see through the anxiety or depression, not being able to see through the lies and half-truths, not being able to see my child as my own. I held on to that personal anger, the anger directed at myself, for years, much longer than I held on to the anger directed at the adoption facilitator. After all, as so many willing to dismiss birth mothers and their grief say, I “signed those papers, so it’s my decision, my fault.”

It wasn’t until sometime in the past year that I’ve been able to see that young mother with a sense of compassion. I didn’t know what I didn’t know. If you ask any person who suffered from depression, they will tell you that a period of time existed during which they simply didn’t know they were depressed. I simply thought I couldn’t be a good mother, that these thoughts were proof that I lacked maternal instinct, that maybe I’d never be the motherly type.

I’ve cried many tears for the young mother that I was in the process of healing, and yes, forgiving myself. I’m still working on the forgiving part, but I now fully understand how and why I ended up on the path of adoption and eventually relinquishing my child. I firmly believe if we offered mothers considering adoption access to legitimate mental health care resources, we’d see an improvement in the numbers of mothers who both choose to parent and, should they choose to place, feel as though it was an informed decision, not coerced by people seeking to gain from their loss.

However, while we’ve made great strides in acknowledging and providing resources for mothers and families fighting postpartum depression, ethical reform in adoption remains a slow-moving process. If we admit that mothers who are single, who maybe don’t feel worthy of being a mother are worthy of being mothers, then for-profit newborn adoption begins to make less sense. And there’s the rub.

For now, I take comfort in knowing I’m not alone, in offering hope and support to other scared mothers, and in continuing the work of forgiving myself. Maybe someday I’ll get there.

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When Postpartum Depression Makes You a Stranger to Yourself

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for p p dSeeing someone struggling through postpartum depression and anxiety cracks my heart wide open. I don’t care if I’m a stranger to them or not, I want to take their hands into mine and tell them to trust me.

I want them to believe me when I tell them I have been where they are, in that frightening place when you’re filled more with fear and pain than strength. When you look in the mirror and don’t recognize the person looking back.

I want them to listen when I say that I have lived in the skin they are in now, when you are not who you used to be.

I have walked through those days, those hard days, when you’re too frightened to look anyone in the eye because you don’t want them to see straight through to the dark despair and hopelessness that fill your head.

I have been there. The days of pulling clothes out of the closet and letting them fall over my body, wondering where the person is who used to wear them. I remember sitting in the driver’s seat of my car and it didn’t feel like it belonged to the person who now sat there.

These days are anything but easy. Living through postpartum depression is harder than we can ever explain. We struggle to give words to the choking jumble of our thoughts. We want to be heard, but when someone asks us to tell them how they can help, we can only break down in tears.

Postpartum depression is a wall that hides our strength from us. It won’t let light in so we are unable to see how tough we are. The dark clouds of this time block the real view, the one that would show our determination to get better.

We are still there, behind the empty sadness in our eyes, there is the fight and fire we need to recover. We are imperfect in this life, we are lost, confused and we are more scared than we have ever been. When our lives become survival for one moment at a time, our souls can’t rest to see the beautiful spirit of survival that lives within us.

I want those in the heartbreaking midst of postpartum depression to trust me, as hard as it is. We need to believe that inside we have what we need to make it through. It’s a leap of faith, a desperate grab at hope, but it’s necessary.

I want them to hear this message of hope, so that they fight, so that they keep fighting. Because it is the promise of hope that someone asked me to believe in during my own postpartum depression, that saved me.

You will see this through to the other side.
You’re not alone.
You will find yourself again.

Someone once promised me that I would be myself again. I was too scared to believe that who I once was, was still there. What if I wasn’t going to get better? What I would have told the frightened new mom that I was back then, would be this, You may feel like you’re in a thousand irretrievable pieces right now–too broken beyond anything that can be made whole again. But believe that you will heal.

You will find happiness again. The numbness will lift one day and you will hear yourself laugh. The sound of it will surprise you so much that you’ll laugh a second time from the joy of it. You will look in the mirror one morning, and this time the eyes you see back will dance and shine. And you will come back stronger than you ever thought you could be.

You are still there, inside.

Even if now you feel lost, scared and alone, you are there.

Please let my words here be the ones that take you by the hand and hold you until you are back home again. Reach out, ask for help, don’t stop until you feel you are getting the care you need. Believe that with time, professional care and treatment, and the support of your PPD community, that the help you need to find the way back to you again will be there.

The incredible you that you used to be is still there. You will find yourself again. And just as I did, you will smile again.

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Antenatal depression and antenatal anxiety: Jen’s story

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antidepressants pregnancyI struggled with undiagnosed antenatal depression and antenatal anxiety.  I felt like such a fraud.  My husband and I had planned for this baby.  I should have been overjoyed and glowing.  Instead I walked around in a fog of self-hatred, irritability, and unrelenting worry.  My internal monologue consisted of, “I should be happy, dammit!” Why couldn’t I enjoy this pregnancy?  It was my final pregnancy, and we were giving our nearly three-year old daughter a sibling.  Where was my pregnancy glow?  Why did I feel like all I did was complain, vent and whine?

Why couldn’t  I relax?  I felt so much pressure to get my oldest potty trained before the new baby arrived.  I felt like all loose ends needed to be tied up.  I had to finish my toddler’s baby book before the new baby arrived.  I had to make sure I was exercising daily.  I had to maintain a tight control on my blood sugar.  I had gestational diabetes with my first pregnancy, so I spent my final pregnancy watching my food intake.  Every time I heard a comment about “eating for two”, I wanted to rage.  I did not have that luxury of eating whatever I wanted.  The meal plan made me miserable.  If my numbers weren’t within the expected range, I immediately panicked.  I was terrified that my daughter would struggle with complications from my gestational diabetes.  Not even the ultrasound showing a healthy twenty week baby girl diminished those fears.  I felt like I had no right to complain or worry.  I knew what to expect.  I needed to just suck it up and deal with it.

Like postpartum depression, antenatal depression looks different for each mama.  My lovely friend Susan describes her antenatal depression like this.  “I just remember feeling a crushing weight and numbness. I wanted to not be pregnant anymore and had thoughts of throwing myself down the stairs. That’s what sent me to a perinatal psychiatrist. All my joy left like I was in a vacuum – and I was suddenly convinced a new baby was the end of everything as I knew it.”

My experience of antenatal depression differed from Susan’s.  My depression manifested itself in extreme irritability, bordering on rage.  I had no patience for anything – traffic, my husband, my daughter, my parents and my sister, my friends, and my co-workers. One of the triggers for my rage was my daughter’s refusal to take naps on the weekends.  I could barely control my reaction.  I would yell and scream at my husband.  I would need to leave the house to give myself an adult timeout.  I still cringe when I remember an epic tantrum that occurred during my seventh month of pregnancy.  I was at a concert at an outdoor venue.  I cut in front of everyone waiting in line for the bathroom and for water, simply because I was pregnant.  I was rude to everyone that day. I took out my rage on anyone in my path.  This irritability and rage manifested itself in full-blown postpartum depression and postpartum anxiety after my youngest was born.  I wish I had recognized these signs sooner.  I could have treated this during my pregnancy when my initial struggle began.

Antenatal depression and antenatal anxiety are not as widely known as the other perinatal mood disorders.  We do moms a disservice when we fail to screen for depression and anxiety during pregnancy.  We need to focus on both the needs of the mother and the needs of the baby.  Mothers are vulnerable during both pregnancy and the postpartum period.  Ask the pregnant mom how she is doing and really listen.  I read this amazing piece that Andrew Solomon wrote regarding depression in pregnancy.  Thank you Andrew for speaking up for both the mothers and the babies.  If you are feeling fragile, do not read Andrew’s piece.

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Head Vs. Heart: Why Postpartum Feelings Matter

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frostMy (baby) cousin gave birth to a beautiful baby girl this week. The night before her delivery, I got a text from her:

“Is it normal not to be excited?”

My heart sank a little. Just a smidge. She was having a scheduled c-section for breech presentation and it wasn’t the birth she’d had in mind or the one for which she had planned. I knew what she was feeling because of my own experience with a c-section 5 years ago.

“Yes,” I replied. “You get to feel however you feel. No one can tell you to feel any differently.”

As I drove up to the hospital the following morning to be there for her, I thought of what I wanted to say here this week on Postpartum Progress. Then I realized I’d already said it.

You get to feel however you feel. No one can tell you to feel any differently.

I mean, they CAN tell you. They undoubtedly WILL tell you. You don’t have to listen to them.

When you’re in the thick of postpartum depression and anxiety and you open up about your feelings, you’re likely to hear any number of well-meaning (but usually completely off-base) responses.

“But you have this healthy baby! Why are you depressed!?”

“You had the exact delivery you wanted! What is there to be depressed about!?”

“Your baby sleeps all the time and never seems to cry! Why are you sad!?!”

If you’re like me, you’re probably able to see all of the reasons why you SHOULD feel differently than you do. Knowing that you should feel differently doesn’t mean you will. In fact, being able to see all the reasons why you should feel differently will likely make you feel worse because you don’t.

You may not be able to explain it. You don’t have to. It just is. The very fact that you’re acknowledging that something isn’t right, that your head and heart are colliding, is enough.

As Gustave Flaubert once wrote, “one can be the master of what one does, but never of what one feels.”

Because here’s the thing about feelings, especially postpartum feelings.

They’re rarely rational, frequently inconvenient, and almost always uncomfortable, for us and for those with whom we share them. But giving voice to them anyway is important for healing.

Take a look at this:

The most important things are the hardest things to say. They are the things you get ashamed of because words diminish your feelings – words shrink things that seem timeless when they are in your head to no more than living size when they are brought out.”–Stephen King

Read that again. Really read it.

Owning your feelings, speaking them, bringing them to life, that’s what makes them manageable, defeats them when they need to be defeated.

It’s okay to feel your feelings. They are yours. It’s okay to acknowledge them and process and then decide what you accept and what you toss out. That’s your starting point on your way through it and through it is the best way out of it.

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