Too often lately, I have had moms calling my office in desperate need of postpartum depression support ten or 12 months after giving birth to their little ones. This is not at all uncommon, but I have been introduced to an increasing number of these women in the last few weeks, and so I am drawn to tell you about them today.
These are not the moms who felt good for the first seven or eight months only to be hit full force with symptoms of postpartum depression or anxiety upon weaning or when menstruating for the first time. These are the moms who have been struggling on and off for months and who have waited until a breaking point to reach out. What all these moms tell me is this: “I am so ashamed to be needing help like this, but I just can’t take it any more.”
These are the moms who, to the outside world, seem to be doing just fine. They pull themselves out of bed in the morning, have their showers, and pull on a clean set of clothes in order to impress others in their lives while, inside, they feel like complete impostors. They feel good enough to hold conversations, smile at the check-out clerk, and return emails, but find themselves in the fetal position when no one is looking. These are the moms who feel terrible for several days and then feel better the next, and so they tell themselves that they must be fine until they are hit, again, by several days of near intolerable suffering (once again, behind closed doors). These are the moms who are afraid to let their partners know the depths of their despair for fear of judgment by the people who are supposed to know them the best.
Yes. I worry about these moms. A lot.
What we know is that women who struggle postpartum anywhere along the spectrum from very mild postpartum adjustment to very severe postpartum psychosis, who reach out for support from an appropriately trained mental health provider, and who follow treatment recommendations get well. Thankfully, many of the moms who are in severe crises will get help sooner rather than later because friends, family members, or their health providers will be able to tell from the outside that something is drastically wrong. So, while I don’t at all like the fact that women who fall into the more extreme end of the spectrum suffer, I do know that the impetus for reaching out is often shared by others around them because there is simply no hiding their illness. The responsibility does not lie solely on them.
And the women on the other far end of the spectrum—those who feel ill-at-ease in their new roles, whose biochemistry is off enough to increase their feelings of vulnerability but resilient enough to balance itself out on its own over a fairly short period of time—these moms with mild symptoms I don’t worry so much about either because they are usually the moms who will find a community, pick up mom-baby yoga, or openly discuss their challenges with others.
It’s the moms in the middle—the ones who seem to get lost in the crowd of postpartum women—these moms have me in a real fluster.
It’s not that I can’t help them to recover, because I can. Those of us who work in the field of Perinatal Mood and Anxiety Disorders like postpartum depression know what to do to help these postpartum depression moms feel better. We know what questions to ask in taking a full history and inventory of symptoms, risk factors, and internal and external conflicts that may be interfering in their ability to feel the way that they want to. We know how to partner with these moms and how to advise them toward recovery.
But what we can’t do is take away the months of suffering that took place before they decided to pick up the phone. We can certainly help to strengthen attachments between these moms and their babies and support the relationships that have been troubled by the months before their desperate calls, but we can’t take away the lost moments. And this can be heartbreaking.
So, this post today goes out to all of you who may be, right at this moment, in that middle zone. To those of you who are reading this blog in secret when the lights are out because you don’t want anyone else to know that you might not be feeling so well. To those of you who have worked so hard over the last number of months to will this depression or anxiety away only to find it still cuddling up with you at night. To those of you who are so ashamed by how you feel that you would sacrifice your own well-being for secrecy. To those of you who are fantasizing of running away, who are having scary thoughts, or who have thought quietly about how much easier it would be if you simply weren’t here but who have not told a soul about any of this.
If this is you, please reach out. For you, for your babies, for your partners, for your family and friends, and for those of us on the receiving end of the phone line who are here to help you to feel better. You matter.
~ Kate Kripke, LCSW