Just before I gave birth to my first child, a friend gave me a mug emblazoned with the words Mom Life is the Best Life. I couldn’t wait. At 37, I was finally going to be a mother, a role I’d dreamed of my entire life. The emotions that rushed through me when I first saw my new baby boy eclipsed any other love I’d ever had. I was in awe that I was now responsible for something so precious and fragile. Instantly, he became my entire world.
But what happened next is something that I have never shared before.
A big life adjustment
Within a few days, we were at home getting accustomed to a newborn’s routine and our new normal. I hadn’t had extended time off work in my entire life, and the shift from the frantic pace of my workdays felt restorative and helped me focus on my new role as a mom. Simple activities like rocking the baby and short, easy walks with the stroller and the dog were leisurely and took up the bulk of our time. And time passed quickly – the baby grew and seemed to change noticeably almost every day.
As the days slipped into weeks, I began to feel an odd sense of heaviness enshrouding me, a thick monotony I didn’t know how to shake. Being home alone all day with a colicky infant who seemed to cry every time I put him down compounded those feelings. I remember feeling like I never had free hands to do anything.
The baby’s infrequent, unpredictable naps were the only time I could get anything done around the house. Sometimes his crying overwhelmed me to the point that I would leave the room and scream into an empty hallway just to release my frustration. I loved my baby more than anything, yet I found myself, at peak times of frustration, feeling resentful toward him for taking away the freedom I used to have. I was appalled at myself and ashamed for thinking that way, which only made things worse.
Externally, including on social media, I declared my elation over being a new mom because it seemed like that’s what I was supposed to do. But internally, I was desperately grappling with feelings of failure. I didn’t tell anyone, even my husband.
I knew that postpartum women sometimes feel sad, and I thought my feelings could be related to that. But as a Type A person always driven to exceed expectations and be successful, my nature was to quickly bury any signs of defeat. Deep down, I feared that revealing I was struggling with a new baby meant that I was unable to carry through on one of life’s greatest journeys. I fretted people would think I wasn’t meant to be a mom. That Mom Life is the Best Life mug stayed in my cabinet, shoved to the back, untouched.
My experience wasn’t unusual
According to Connie Barker, a nurse practitioner with Novant Health Psychiatry - SouthPark, experiencing sadness or mood swings after having a baby is extremely normal. Postpartum depression (PPD) is a catchall description that encompasses many different feelings of sadness and worry after birth.
Symptoms can range from mild and lasting only a few weeks, or the “baby blues,” to more severe and lingering. Feelings of despondency and anxiousness are usually the result of natural postpartum hormonal changes directly related to the depletion of progesterone, increased prolactin production and decreased dopamine, which occur after a woman gives birth. Coupled with a significant life change like caring for a newborn, they can quickly escalate into something more serious.
Barker said studies have shown that postpartum mothers have anywhere from a 10 to 30 percent chance to experience some type of PPD in the first six months to a year after birth. The onset can be immediate, or symptoms can show up weeks or even months after the baby is born. Women most at risk for PPD include those who have a history of depression or mental illness, have had a high risk or complicated pregnancy, have multiple children, lack support at home, are single parents, have an infant in the NICU or have perfectionistic tendencies. But, she stressed, it can happen to any mom. (Novant Health pediatricians screen moms for postpartum depression at well child checks for the first six months. If they identify symptoms, moms are referred to the ob-gyn.)
Despite efforts to destigmatize mental health struggles, large numbers of women who experience postpartum symptoms still don’t share what they are going through, even with a partner. I was one of those people. I kept my feelings bottled inside.
There were times in the weeks after my first baby’s birth that I had complete breakdowns alone, sitting in a ball on my floor and sobbing uncontrollably. Yet I managed to mostly hide what I felt from everyone around me. As far as they knew, I was living proof of new baby bliss and intuitive motherhood.
After a couple of months, as my son got on a more regular, predictable schedule, my PPD symptoms began to subside. I started to feel more like myself again. After 12 weeks, I returned to work, which also helped restore feelings of normalcy. Life fell into a more comfortable routine, laughter came more naturally and eventually my baby grew into a toddler. Those months right after his birth — that at one point felt like they were completely engulfing me in a solitary cloak of sadness — now seemed like a long-ago memory.
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A new baby and a new challenge
Two years later, my second baby was born just weeks after I turned 40. In my eyes, she was perfect. I loved both of my children fiercely and wanted nothing more than to protect them and be the best mom I could be. Because of my experience with postpartum depression symptoms, I was on alert for feelings that might return with my second baby.
I was surprised and relieved that, at first, I didn’t feel the same empty sadness I had previously experienced. But what came next was even worse.
Everything that had to do with the new baby’s schedule, especially sleeping, caused me intense anxiety. I would wake up in the middle of the night with my heart pounding and immediately check her bassinet. There were nights that I was waking 10 times or more to make sure she was on her back and breathing.
Eventually, when we moved her to her own room, I couldn’t shake a constant fear that something bad was going to happen to her. I was waking up even more frequently to check on her. I’d often find myself unintentionally holding my breath in a panic until I got to her room to make sure she was okay. I was chronically sleep-deprived.
My anxiety didn’t bubble up only at night. Learning to be the mother of both a toddler and a newborn was a new challenge for me. While I loved both of my children more than anything, there were times that I felt so overwhelmed by their needs that my breathing would become shallow and my mind would start racing. I just wanted to be anywhere but where I was. At times, I even broke out in red, itchy hives all over my body, a symptom that I still experience to this day — even though my kids are now 3 and 1.
I was more than likely experiencing symptoms of postpartum anxiety (PPA), which is similar to PPD and also results from hormonal shifts after birth. It can be triggered by stressful situations, such as learning to parent, navigating parenting multiple children, managing relationships with a spouse or partner, weaning from nursing or managing finances related to a new baby. Women who have a history of anxiety or biochemical imbalances are generally more susceptible to PPA.
Barker, who has seen patients with all levels of anxiety, said that PPA can include panic attacks, symptoms of obsessive-compulsive disorder (OCD) or scary thoughts about things happening to the baby. These unwanted, invasive thoughts usually disappear with time. When those thoughts become repetitive or all-consuming, you need to seek professional help.
Determining a diagnosis
The distinction between PPD and PPA can be blurry, according to Barker, and women may experience symptoms of both. PPD is very similar to a major depression and is diagnosed within the postpartum period — considered a few weeks before birth to up to one year post-birth.
“The anxiety is overwhelming and so frustrating to someone who has never experienced their life to feel so out of control,” said Barker, who battled postpartum depression herself. “The good thing, however, is that the depression and anxiety are 100% treatable.”
Anxiety can be a component of PPD, she said, or it can show up on its own without depression symptoms. While depression screening tools are widely available, postpartum anxiety is a newer area of focus, and more studies are needed to develop screening mechanisms, Barker said.
For most women, PPD and PPA feelings go away with time. Others require treatment that can consist of medication, therapy with a provider or a combination.
Consulting with pregnant patients already experiencing PPD or PPA symptoms allows Barker to review what support they will have when the baby comes. An exact care plan depends on the individual, where they are pre- or post-pregnancy and their severity of symptoms.
As for my own diagnosis? Because I felt so ashamed of what I was feeling, I never actually saw a provider for diagnosis or treatment. This post is the first time I’ve ever shared what exactly I experienced, even with those closest to me. Based on my experiences alone, I can only assume that my two cases fell somewhere between PPD and PPA. I’m mostly fine today and my symptoms are, for the most part, gone.
What you can do
While PPD and PPA are not entirely preventable, there are steps you can take to lessen the severity. If you begin feeling what you think could be symptoms of depression or anxiety during pregnancy or after the baby arrives, the single most important thing you can do is to talk with your doctor. Barker said other steps you can take include:
- Postpone major life decisions in the immediate period after baby’s birth, which can add strain to an already stressful time.
- If possible, have someone help with household chores like cooking, dishes and laundry in the first weeks home.
- Carve out time for yourself whenever possible. Let someone else take the baby while you shower, take a walk or do something that makes you feel good.
- Exercise! Even a 20-minute walk with the baby in a stroller can do wonders for your mood.
- If you’re breastfeeding, especially for the first time, make sure you have a support system. This can include a partner, close friend or a lactation consultant.
If you’re the partner or close family member or friend of a new mother, be open and encouraging, and ask the new mom what would be helpful rather than guessing. Communication is key. Attempt to normalize her feelings as much as possible.
It’s okay to not feel okay
Not to get all coffee cup on you, but yes, becoming a mother can be one of the greatest joys of life. But that doesn’t mean it’s easy.
No one’s a perfect parent. And it’s healthy to acknowledge that parenting is also one of life’s toughest jobs. As someone who stayed silent about my experience with PPD and PPA symptoms out of embarrassment and fear, I urge you to be open about talking to your providers, partners and friends about how you feel as soon as possible so that you can get the support you need.
Recently I gave away almost all my coffee mugs. I kept the one that says Mom Life is the Best Life. I use it all the time. One day I’m going to pass it on to another new mom who’s just starting her motherhood journey. But I’ll tell her there’s an invisible tagline: It’s the hardest, most wonderful experience you’ll ever have. And you’re doing great.
Support group for moms: Novant Health offers a virtual postpartum support group ever other Monday from 7 to 8:30 p.m. and every other Tuesday from 10 to 11:30 a.m. Questions and registration: firstname.lastname@example.org.
Logan Stewart Kureczka is a 41-year-old mom of two, freelance writer and Novant Health patient. Dr. Stephanie Barbaradora-Froelich and Dr. Elizabeth Montague-Farwell with Novant Health NoDa OB/GYN each delivered one of her children. You can find Logan on Twitter at @LoganinCLT.