Postpartum and Perinatal Depression and Anxiety, There is Hope and There is Help
For this blog post, I collaborated with Annika Papke, a licensed mental health therapist who specializes in perinatal and postpartum anxiety and depression. We share two client stories that take an in depth look at these challenges and provide resources and information. While we do not address the partner experience in this post, we recognize and honor that the postpartum time period can be especially challenging for partners, and many partners have and continue to be challenged with postpartum depression and anxiety. Partner resources are also available at Pospartum.net.
Overview
Perinatal and postpartum depression and anxiety–depression and anxiety during pregnancy and after childbirth–affect many women. Until recently, these topics were incredibly taboo to discuss, even in private conversations. Now, with more people sharing about their experiences with their postpartum and perinatal challenges, others are starting to talk about and learn more about the delicate time of pregnancy, after childbirth, and throughout the first year after birth.
For too long, many women have suffered in silence due to the stigma surrounding these treatable conditions, and many women struggle to understand what is going on for them after childbirth. Women may be faced with difficulty in silence not only because of stigma but also because they may not know what is happening to them, having never dealt with the conditions of perinatal and/or postpartum depression or anxiety before. Pregnancy through a baby’s first year is a difficult time that is often painted in society as something that is only filled with happiness. Of course, this time brings happiness to new mothers, and at the same time, if we do not start talking more widely about perinatal and postpartum concerns, too many women and families will continue to hurt alone.
The time after childbirth is met with long periods of interrupted sleep, judgment about feeding, and emotions ranging from sadness to self doubt to heightened confidence and a new found capacity for love. This time is complex, and the level of care and attention before and after childbirth is something that we need to be talking about for healing and hope.
In this blog post, we provide two different stories from clients (with approval) who have dealt with these issues firsthand. After, we include strategies and resources for those who may be dealing with these conditions as well for those who can help their friends and family members during pregnancy and after childbirth.
Perinatal anxiety and depression client story
I always knew I wanted to be a mom and looked forward to being pregnant. I envisioned being happy and excited. I couldn’t wait for the opportunity to get a nursery together, pick out baby names, shop for tiny onesies and socks, and take the weekly baby bump progression pictures. Everyone knew how badly I wanted this so almost no one could understand what happened when I finally found out I was pregnant.
Discovering I was pregnant wasn’t the dream I had envisioned. I was in the middle of a move and job change so things were already stressful. The thoughts and feelings of being overwhelmed and scared seemed connected to everything else going on in my life, so I chalked it up to that. It wasn’t until the thoughts shifted to a darker place and I began questioning if I could do this anymore. I’ve had times in my life when I felt depressed or anxious, but this was something so different. For the first time, I felt completely out of control of my thoughts and it was very scary. I knew I didn’t want to be dead, but it was so difficult to stop the thoughts around ending my life in order to escape what I was feeling.
I was extremely confused with what I was experiencing. I had heard of postpartum depression, but I was still pregnant, so why was this happening to me now? It was also early in my pregnancy, and I wasn’t sure how I was going to make it through feeling this way.
My partner had a very hard time understanding what was going on with me and again was confused because all I wanted was to be pregnant and have a family. This played out with me becoming easily agitated and in a constant state of irritability. I had moments where I wanted to pretend things were normal and would try and ask for a silly food craving, only to become so upset and inconsolable because it wasn’t the right thing and I still didn’t like how I felt. I was miserable.
Thankfully, I had a support system that knew I needed help and I was able to see a doctor who listened and believed my experiences. I was diagnosed with perinatal depression and prescribed an antidepressant. After the appointment, I felt a wave of relief that someone knew what I was going through, that I had a name to what I was experiencing, and there was hope that I could feel better. Within a week of starting the medication, I started to notice my thoughts quieting down and having more control over my emotional responses. I still had the stressful external factors in my life, but I no longer felt completely out of control.
My pregnancy continued to be a difficult journey, but after identifying what was going on, my care team was able to come up with a plan that supported me physically and emotionally. I was educated around the impact hormones can have on mental health and was better prepared for the changes that occurred after giving birth. After my child was born, I didn’t have the euphoric feeling that some people experience, it was more of an out of body experience where I was watching myself with my child. Breastfeeding was hard at first and thoughts of not being good enough or strong enough started to creep back in. Sleep deprivation was a huge trigger for me, and I quickly saw that without sleep I would revert back to the super scary time.
I reached out to my care team and explained what was going on. I am again so grateful that I was listened to and understood. My provider increased the dosage of my medication and helped connect me with additional resources and support so I could take care of myself in order to care for my child.
My journey continued to be filled with ups and downs. It wasn’t until I stopped breastfeeding that things started to level off and I felt ‘good’ again. There were lots of adjustments along the way, and I am so thankful for the support I received during this time that helped me through.
Since my experience, I have learned how common perinatal and postpartum anxiety and depression are, and I share my story in hopes that other people do not have to suffer alone. I know that every situation is unique and I was lucky to find a doctor that was able to help. I have heard countless stories of women that didn’t know who to turn to, how to ask for help, or even what to say to explain what they were experiencing. We are often afraid that if we speak our thoughts aloud this will make them true or people will think we are crazy. I can say that just because we have the thoughts it does not mean they are true or that they will happen. You are not crazy and you are not alone. There is help available and you can feel well again.
Postpartum depression and loss of baby client story
I was genuinely happy to welcome my son into the world. He was such a bright light–filled with love and contentment. He was a baby that I wanted and that I wished for. I remember a few days before he died, I was in the shower, and I just started to cry and feel so alone. I said to myself, “I wish someone would just take care of me.” I was drowning in my responsibilities between work and being a new mother, and I did not know that I was suffering so much. Other than this singular experience, I never really felt too overwhelmed and I operated on a very strict schedule with nap time, bed time, and feeding time, all of which revolved around a strict adherence to the clock.
Within the first two weeks of delivering a baby, a nurse comes to the home to check on the baby and the mom to see how they are doing. When the nurse arrived at my home, I answered the questionnaire she gave me with full honesty–no, I had not been crying constantly, or feeling anxious, or feeling overwhelmed. I had spent one day, about a week after delivery, with the tears flowing and me having no idea why except that instinctually I knew they needed to leave my body. This lasted between 24-48 hours, and just as quickly as they came, they went, which I learned was “normal” and was actually something to be expected. No one had mentioned that it is to be expected to have this sort of tearful release after childbirth. Breastfeeding went smoothly, and I enjoyed my time with my son in the early morning hours breastfeeding before work.
Everything seemed fine; however, when I think back to that day in the shower, I now realize how alone I felt as a new mother. Despite this feeling, I would trade feeling like that everyday to have my son back. A couple days after, he died, I was dumbfounded, in shock, in a new universe, and in a new world that I had no idea how to navigate, no idea how to let the pain go and no idea how to get unstuck.
Untangling the postpartum experience from the death of my son is a very tricky one. Was I dealing with postpartum depression prior to his death, or did his death trigger depression that happened to also fall within the postpartum time period where my hormones were all over the place, dealing with grief and loss, postpartum challenges, and a whole part of me cut off as I quit breastfeeding suddenly? It is likely that I was not depressed prior to the loss of my son and experiencing feelings that many new moms have after childbirth.
With the loss of my son, my whole world had fallen apart in such a quick timespan, and I did not know how to function–and for once, I didn’t know what to do. What should I do? Should I cry all day, or should I go back to work? Should I get a therapist right away, or should I go on a soul searching journey, traveling to new places? Should I die, or should I live? Should I stay, or should I move? All of these questions unanswered as I navigated the world of postpartum hormones and despair. How could I move forward when all I wanted to do was to move backward?
With the help of many, I am living a good life, and I can look back on my experiences with understanding and realize how far I have come. There is help and there is hope, and no woman has to deal with these challenges alone. Pregnancy and postpartum can be such isolating times and difficult to know how to find and connect to resources. There are many free resources to help.
Resources and information
Even though Perinatal Mood and Anxiety Disorders (better known as Postpartum Depression or Anxiety) are the #1 complication of pregnancy, the terms, verbiage and even diagnosis are relatively new and didn’t have an official name until the 2000’s. Throughout history, women have experienced symptoms of anxiety and depression during pregnancy and postpartum; however, it has not been until recently with celebrities coming out to share their stories that postpartum has become more of a recognized symptom of pregnancy. In a recent study it was found that 1 in 7 women meet criteria for a perinatal or postpartum diagnosis, so it is far more common than most people think.
In general, many women struggle to reach out for and accept help and there is an unspoken belief that it is a woman’s job to have children, so it should be easy. When pregnancy, childbirth and parenthood don’t go as planned, women often believe they are to blame and it must be their fault. These distorted thoughts are usually what get in the way of women reaching out for support. For some women it is hard to put their experience into words, so there is a fear of being misunderstood, looked at as crazy, or even feeling afraid that if they speak up their baby might be taken away from them.
It is so important that women know that these thoughts are not true and that they are not alone. There are several resources available for support and can be accessed by phone, video and in-person.
One of the best resources available is Pospartum.net. Postpartum Support International (PSI) provides education, resources, and support for a wide variety of parenting and birthing people. On their website, they connect people with local resources and they have a crisis line available 24/7. Having the knowledge of what is going on can be extremely helpful and this resource helps put people on the right path to finding support.
Other resources available are mental health counseling, grief and loss coaching, and support groups. PSI has a directory on their website to connect people specifically trained in Perinatal and Postpartum Anxiety and Depression, and they also have support groups available in-person and online.
If anyone is having a mental health emergency or thoughts of harming themselves, it is highly recommended to call 911 or go to your nearest emergency room.
From Annika
When people ask me how they can help someone who might be struggling, I encourage them to just talk to the person about it. Ask the real questions, not just “How are you doing?” When someone is struggling it can be really hard to verbalize what is going on, and so the answer might be a version of “I’m doing okay,” when inside the person is actually struggling. The goal is to create a safe space for open dialogue.
Here are some areas to explore with example questions to ask and solutions to offer:
Feeling overwhelmed with household tasks
How are you managing stuff around the house? I know laundry can pile up quickly and sometimes making food is the last thing we want to do. I’d love to be able to help.
Instead of saying “Let me know if you need help,” try, “I want to bring over some frozen meals, does your family have any food sensitivities?”
Getting enough sleep
How’s your sleep?
“I’d love to come sit with the baby so you can take a nap.”
Self-doubt
Being a new parent can be tricky, how are you feeling about it?
Normalize the experience of not knowing what to do. “You are doing a great job. This seems really hard.”
Isolation
Do you want some company?
Make sure to check in and see that it is okay to come by for a visit, and then offer reassurance that it’s okay if the house is a mess and mom is still in pj’s.
It’s important to note that being the supportive person does not mean that you need to have the answers or make things better. Just being present and open can offer a huge amount of relief for someone struggling. Passing on resources for them to look at later might make all of the difference.
In conclusion
While it often doesn’t feel like it when you are in the depths of your experience, there are hopeful options, support, and help. When you are experiencing perinatal or postpartum depression and/or anxiety, others may let you know that help is available and it may be helpful to seek support, and yet sometimes, you may have to be the person to seek your own support. Whenever you feel stuck, ask, “What is one thing I can do to get help that does not only rely on myself as the only resource?” We look forward to a world where no person has to suffer in silence regarding mental health challenges, pregnancy, and childbirth.
Do you have experience with perinatal and postpartum depression as a survivor or as a friend or family member? What has been most helpful for you in these situations? Please share forward your thoughts and strategies, and I will connect with you about opportunities to include them in a future post.
About the authors
Annika Papke is a licensed mental health therapist who specializes in perinatal and postpartum anxiety and depression. She is passionate about providing education and resources so that no woman has to suffer alone in silence. She is the owner of Hope for Tomorrow Counseling, LLC located in Broomfield, CO, and she also provides virtual counseling services to anyone in the state of Colorado.
Learn more about Eryn Elder. I offer services virtually to anyone in the United States, and I have both personal and professional experience with child loss and postpartum challenges. I believe you have the capacity for healing and hope, that you are not alone, and you can live a good life.
