Depression.
That one word stirs up an awful lot of negativity. If you have experienced it yourself you know the feelings associated with it. If you have not experienced it you likely respond to that word with a hushed embarrassment or naïve confusion over what it really means.
But did you know that as many as eighty percent of mothers who have given birth will experience the mildest form of Postpartum Depression called "The Baby Blues?" And, of those mothers, approximately ten percent will suffer a more serious form of Postpartum Depression (PPD)?
And did you know that more than 65% of adopting parents also
experience the same symptoms called Post Adoption Depression (PAD)?
With such a huge number of people (that's right, women AND men) experiencing depression after one of the most natural and common life experiences, you would think everyone would know what PPD and PAD are, right?
I didn't. And since
my own experience with PPD (which I have never discussed openly on this blog) I have observed a large number of people also experiencing PPD or PAD and just not knowing what to do.
So, what is it?
Well, for starters, its not as funny and lighthearted as movies or other media make it seem. When "baby blues" are depicted in most movies you see a post-delivery mom in her bathrobe sitting on the couch crying through a random commercial on TV. Or a mother swinging instantly from laughter to tears. Some movies have tried to touch on the idea of PPD by depicting new mom's who just seem stressed out or unhappy. But PPD and PAD are so much more.
PPD is usually set into motion by hormones in the mother's body. Pregnancy and delivery are both influenced by a flood of chemicals and hormones. The reason such a large percentage of mothers experience "baby blues" after the birth of their child is they are processing and coping with the abnormally high amount of those chemicals and hormones.
So why do husbands and adoptive parents experience the same symptoms if they are not going through pregnancy and delivery? Well, in short, they are. Every emotion you feel is created by a chemical or hormone in your brain: stress, joy, anticipation, disappointment, worry, love, etc. Both pregnancy and the adoptive process take months of preparation and include months of extreme emotions. The delivery process is mirrored by "gotcha day" in adoption in stress and emotion. Both mothers
and fathers are experiencing these extremes of emotion. Add to that the most common result of adding a child to a family (sleepless nights, and for some adoptive parents jetlag) and the human brain has a hard time coping.
What does PPD and PAD look like?
Here is the list of symptoms doctors look for:
Symptoms of Depression
Diagnostic Criteria From DSM-IV
Five or more symptoms in a two week period.
- Depressed mood most of the day, everyday (feeling sad, empty, or tearful) or feeling exceptionally irritable.
- Markedly diminished interest or pleasure in all or almost all activities.
- Significant weight loss or weight gain, increase or decrease in appetite.
- Insomnia or hypersomnia nearly every day.
- Psycho motor agitation or retardation nearly every day observable by others
(restlessness or being slowed down).
- Fatigue or loss of energy nearly every day.
- Feelings of worthlessness or excessive or inappropriate guilt nearly every day.
- Diminished ability to think or concentrate, or indecisiveness nearly every day.
- Suicidal thoughts or ideation.
I have not shared my experience with PPD in detail in a public way before because it was a very scary time for me and I was afraid of what 'people' might think. But guess what: PPD is not something to be ashamed of. It happens. It can be treated. And life goes on. I am not a bad mother because I experienced PPD. My ability to carry on and continue to grow each day as a mother was not taken away. I am proud of who I am and how far I have come. So, because I believe it may help others understand what PPD really looks like from the experience of one mom who lived it, here is what PPD looked like for me:
1. Daily crying- I am not a person who cries, ever. Around the 7th month of my pregnancy I contacted my doctor about random crying. It was so unlike me. I started feeling better after meeting once with the psychologist from my OBGYN's office and making some simple adjustments to my stress level and self-care that she recommended. After that I pretty much checked the crying off my list of concerns. I felt fine again. But just a few weeks after my son's birth, nothing helped the tears. They came everyday, sometimes for a reason and sometimes for no explicable reason at all. I just felt sad and overwhelmed.
2. Change in activity and personality- I am a very active person. I am usually engaged in cheerful conversation with those around me. And I very rarely just sit around doing nothing. During my struggles with PPD my personality was different. My Mom told me I looked different to her. My smile was missing. I was difficult to engage. I wasn't really interested in anything. Conversations just didn't develop. My words were gone. I stopped journaling. I stopped blogging. Sometimes I just felt lost.
3. Agitation- As my PPD progressed before treatment I became increasingly agitated. Anxiety is something I had never experience before. I became obsessive about certain things. Constantly worried and suddenly very protective of my baby. I did not like having him out of sight or out of my arms. But at the very same time I felt distanced and not connected to him. At one point I cried to Brad that my baby did not look cute to me (even though just 2 weeks earlier I had been completely smitten with his gorgeous features). Strange and irrational fears started to make their way into my mind. Thoughts that I could immediately follow with, "that doesn't make any sense." I would easily become overwhelmed by noise, touch, or environments outside of home.
4. Guilt- Oh, the guilt. Constant feelings of inadequacy. Constant thoughts of having "ruined" everything. Fear that the weeks after my son's birth would forever be remembered by my daughters as when mom 'changed'. It seemed as though my life had been perfect up to that point and "I" had changed everything.
5. Insecurity- I consider myself a pretty strong and confident person, but during the worst of my PPD I felt helpless. Like I suddenly didn't know how to do anything 'right' anymore. Nothing was good enough anymore. I couldn't make decisions on my own. I was overwhelmed by tasks that were not a big deal before. I constantly felt agitated and irritated but didn't know why or what to do.
6. Loss of control- My emotions became exaggerated. Fear would disturb me. Anger easily slipped into rage. Guilt became crushing. And any amount of joy, love, or excitement made me feel like I may just burst. Higher than a kite and lower than a skunk were the only two extremes I seemed to have.
That is a pretty concerning list. Looking back I see my experience with PPD (described to me as moderate to severe) as a very strange time for me. I simply was not myself. I had never before and not once since felt the way I did then. All together, the worst of my PPD lasted about a month (2 weeks before I realized I absolutely needed help and another 2-3 weeks after before I started to feel like myself again). Looking back, it was actually a brief time. But it felt like an eternity. I continued my treatment and support through my son's first birthday at the suggestion of my doctor to be sure I did not relapse.
Before my own experience with PPD I had always thought of depression as "stinkin' thinkin'." People who were depressed needed to just change the way they thought about things. Get outside and be active. Buck up and get over it. Right.
Depression is not something you choose. Depression is not something that goes away by itself. Depression is not something to hide. Depression is not something to be ashamed of or afraid of.
If someone you knew found out they were a diabetic today, what would you say to them? Would you discourage them from seeing their doctor? Would you judge them for taking medication? Would you not be supportive of lifestyle changes they needed to make?
Depression is a medical condition just like any other. It is treatable. It can be managed and conquered.
So what do you do if you think you might be experiencing PPD or PAD?
1. TALK to someone. The most common thing I have observed in myself and friends dealing with PPD/PAD is the need to keep it a secret. We don't want anyone to know. It is so important to realize that telling the right people does not include an announcement to the world. Not everyone needs to know, but someone does. Tell your spouse, you doctor, a trusted family member or friend, even your bishop or pastor. Tell someone. And you don't have to tell them everything. Just tell someone something.
2. If you are experiencing PPD or PAD ask your doctor if there is a support group in your area and think about going just one time. No one there will recognize you. You will be surprised how many other people are thinking and feeling the same things you are. You need to hear what they have to say.
3. If you are experiencing PAD ask your social worker if there is a support group in your area. Remember that it is your social worker's job to connect you with resources. She doesn't need details. She will not judge you. And she has heard it all before, for real.
4. Start taking care of you. Every mom has heard this one. But if you are struggling with PPD/PAD now is the time to do it. Your sleep is priority #1. Self care and recreation are important. Take a little time each day to do something for you.
5. Accept help. We all respond the same way to the offers for help: a smile and nod or "sure I'll let you know" because, surely our friends don't really want to follow up on their offer. Trust me, if they were bluffing they won't offer again and then you wont have to politely smile and lie about letting them know if there is something they can do. If someone offers to help, let them help! Make a list of things you would feel comfortable letting someone else help with (picking up a few things at the store, watching your other kids or even the baby, bringing dinner, carpooling) and when they offer, show them the list. Now is not the time to turn away willing hands.
6. Remember that nothing stays the same forever. Absolutes are the neon sign blinking "depression." Thinking that
nothing will
ever be the same or that you will
never get over this or you have ruined
everything or your circumstances will
always be the same is not realistic. Children grow, seasons change and things will get better.
And for those of you out there who have never experienced PPD or PAD who have read to this point, your friend/spouse/child needs you. If you offer to help but they never ask, get more specific. Instead of saying, "let me know what I can do" think of things you can offer like, "I'm planning to go to the store tomorrow, can I take your list and drop your groceries off to you?" Or simply drop a dinner off that can be frozen or refrigerated for another night. Mostly, make it okay to talk to you without judging, trying to fix it for them, or digging for details. Your friend does not need you to know details, or respond to the details if they slip out, they just need you to support them. And remember: nothing stays the same forever. Your friend, spouse, or child can make it through PPD or PAD and be "themselves" again. Don't give up. Stick around, and be sure they know you will.