Postpartum Depression – The Overwhelming Emotions Nobody Told Me Came With the Baby

Postpartum Depression - The Overwhelming Emotions Nobody Told Me Came With the Baby

In my nursing school maternity rotation, I remember briefly talking about the “baby blues”. It sounded so benign and universal, like a shadowy cloud quickly drifting through the sky, crying a few tears as the hormones crash. In my mental health rotation, the idea of postpartum psychosis seemed like a rare anomaly on the opposite end of the spectrum.  

It never occurred to me there were a thousand different experiences in between.

From Birth to Postpartum Depression – And Everything In Between

The emotions I experienced after giving birth shocked me. I had never experienced anything of that intensity, or that out of control, in my life. I cried all of day three postpartum. My midwife was there to tell me it was normal and gradually I adjusted. I found a letter years later I had written my daughter when she was colicky, in it, I apologize for bringing her to earth where she had to feel so much pain. Reading it outside of the moment, I realized just how altered my mental state must have been.

With my second baby, the waters were smooth. Other than a few tears on day three that I knowingly embraced as a physical reaction to hormonal shifts, I felt tired but happy. She was born in the summer and the days were sunny.

Then baby number three. We had feeding issues from the beginning. I was in pain physically and mentally distressed at my perceived failure. I quickly spiraled into day three on repeat. I couldn’t stop crying. It was like a fog had settled. It took a solid support network to see me through.

Some Postpartum Truths

My experiences made me curious, as I’ve watched my friends experience postpartum depression and talked to the moms in the NICU where I work I began to see themes emerging.

No two experiences are alike.

Every woman who enters into childbearing comes with a unique genetic makeup. If there is a family history of depression her risk of experiencing it herself goes up. Each pregnancy is unique and depression may even begin in pregnancy. A loss in pregnancy or the delivery of a baby with complications increases the risk again. A traumatic delivery can result in symptoms of post traumatic stress for women, and for their partner, again increasing the chances that she will experience a form of postpartum depression.

Even the same person, as in my case, can have completely different experiences with each baby.

Having a baby is something you need to recover from both physically and mentally.

While having babies is commonplace, the immensity of this life shift is often downplayed. Media is saturated with women looking great after recently giving birth. Social media allows us to share the good moments, while withholding the bad, causing a skewed perspective. In many cultures around the world, women are honored after birth for a period of time. They are taken care of and encouraged to take the time to heal physically.

The recovery needs to fit the person.

Some women may find that staying home and having help with the baby care is what they need to recover. Other may need to get out, and themselves be supported in caring for their families. When we apply a prescribed solution to our stress because a nurse, our Mother in Law, or the internet told us we should, it can have the opposite effect. It can be difficult to advocate for our mental health needs when culture dictates something different.

For me, I had a lot of anxiety about others taking care of my existing children. The money and stress of putting them in care to help me when I was struggling would have had the opposite effect I wanted it to.

Birth and caring for a newborn sets you up for poor self-care.

Caring for a new baby is demanding. Even if delivery is ideal, and often it’s not, women and their partners are faced suddenly with broken sleep, learning how to take care of a baby, and remembering to eat. There can be unresolved feelings about the pregnancy and birth. If women are the first in their families and peer groups to have a baby it can be isolating. Many moms joke about never being able to shower or even go to the bathroom alone, but having to renegotiate these basic behaviors of self care can contribute negatively to mental health.

It’s something that isn’t talked about that much especially to new moms.

Recently, women have begun speaking out about the mental challenges that come along with a new baby. From celebrities, to friends over coffee, there has been a big shift towards realization, that while postpartum mood disorders are concerning and should be treated, they are common.

When the stigma is removed it gives women the confidence to admit they are struggling, which is often the first big step towards recovery. When shame stops women from speaking out, it also fosters denial. Instead of spending energy on finding treatment, it can be easy to put all that energy into convincing ourselves that these feeling aren’t real.

There are things to do to help prevent it.

There are many things we can do to buffer the stress of having a baby. Managing expectations is the biggest one. Having a realistic view of just how little sleep, or how hard breastfeeding will be, can go a long way in normalizing it when it happens. If women realize the challenges, they can be prepared with meals, knowing where to get support for feeding, and strategies for getting rest.

It has taken me three kids to finally acknowledge that self-care is not an indulgence. It is a necessity that makes me a better mom. It’s also something that looks different at each stage of motherhood. When I had a newborn just having 20 minutes for an uninterrupted shower was amazing. As my kids get older I’m looking forward to a whole weekend away.

There are things to do to fix it.

All the things that help depression can be used to fight postpartum mood disorders with some creativity.

  • Walk

My easiest postpartum was in the summer where we walked every day out in the sun. It’s harder when the weather is cold and dreary, but getting out even if it’s just for a brisk walk in the mall before the stores open, can make a big difference.  

  • Connect

Some of my best friends still are coworkers who had babies at the same time. We would drag each other out for walks even when we didn’t feel like it and be reminded that it’s hard for everyone as we shared our joys and struggles with motherhood.

  • Recharge

Mindfulness and relaxation are important too. From baby and me yoga to listening to a relaxation meditation or mindfulness app while the baby is sleeping. I used instagram to take pictures everyday of the small things I was a grateful for.

  • Nourish

Then there is nourishment. It is so easy to forget to eat and drink when there are small people demanding our attention but our bodies need whole, healthy foods and plenty of water to recover from birth, to produce milk and to cope with caring for a baby. Sometimes good food need to be supplemented with iron, omega 3s and other vitamins to address specific deficiencies as well.

  • Medication

Then there is medication. There comes a time when the symptoms of depression and anxiety are so overwhelming that all of the above seems insurmountable. Medication can be the one thing that allows women to reclaim their life. It can be what it takes to bring them back to a place where they are capable of eating, drinking and sleeping.

It doesn’t make you a bad mom.

There is a lot of shame around perinatal mood disorders. There is shame for many of us who thought we could do it all and were sideswiped with realizing just how challenging motherhood can be. There is guilt over needing medication, and over not taking it, over stopping breastfeeding, and for powering through.

Shame and guilt has become the norm for so many parenting decisions. When moms are vulnerable with their stories of how hard it is, and the many factors that went into their decisions, it is harder to judge and easier to empathize. Managing expectations can only be done when other mothers share not just the joys, but the challenges.

When We Share our Story

When I share my struggles with motherhood it is met with an overwhelming response of “me too.” Knowing that other moms feel the same way makes it harder to believe there is something wrong with me. It’s normalizing.

All women find parts of motherhood challenging, as it should be. The task of raising human beings is one that comes with great honor, but also great expectations from society and ourselves. There is so much pressure to find the one right way that we’ve lost sight of the millions of good ways.

Knowing that anger and anxiety, sadness and numbness are all things that come with the positive emotions of having a baby, can leave us prepared for both. It’s normal to feel everything.

When the negative feelings take over and crowd out the joy and the happiness, when they steal the peace and the calm, knowing that it is ok to seek help can aid in creating a better balance.

When we suffer alone, we fight alone and it becomes a vicious circle of not realizing we need help, and not realizing that we are not alone.

If you, or someone you know is struggling with the emotions that come with pregnancy and postpartum, which left untreated can extend far into motherhood, Postpartum Progress is an excellent resource. It has everything from current research to personal stories.

Women shouldn’t suffer alone. As a society we need to care for our mothers who are raising the next generation. Then they can be empowered and equipped emotionally to do it well. It affects us all.


About the Author: Jenn Shehata

Jenn is a messy mom and ordinary nurse living a beautiful life. She writes to remember and to reimagine the story. You can find her at www.cryandnurseon.com writing about motherhood and nursing and all the thing that make her cry.

When she’s not chasing her three kids, watching Netflix with her husband, or working in the NICU, she is a voracious reader, always looking to understand the world better through people’s stories. Preferably with a latte in hand.

Find out more about Jenn on Facebook, Pinterest, and Twitter.

4 Comments

An

I too suffered postpartum depression that I was no way prepared for. All the prenatal magazines and books I read, this in 1985-86 during my first pregnancy, also talked about baby blues but not about postpartum depression. Depression for me manifested in increased anxiety. My son was almost 2 years old before I finally sought professional help. Thankfully by 1990, when my second son was born, I was prepared and recognized the symptoms and got help quickly. I think more obstetricians, doulas, midwifes, pediatricians, and perinatal healthcare nurses should be fully educated in postpartum mental health so they can in turn educate their moms-to-be before, during and after the birth…to ask perinent questions regarding exactly how they are doing, not just 6 weeks after birth, but during well baby checks as well.

Reply
Jenn

yes, yes, yes. I agree so much. Health care professionals need to be much better as assessing and straight up discussing mental health with women and know the resources to offer them.

Reply
Jana

Great article. I think those in a ‘compatible’ profession with raising children (I’m a teacher and ex-nanny) end up with greater perceived pressures to ‘excel’ at motherhood, which is totally unachievable – we all find our own way and have different strengths and weaknesses. I followed all your bulletpoints in my own journey to recovery, and now I speak freely to people about my own experiences in the hope it will encourage them to not feel the pressure (self-imposed I hasten to add) that I felt to be a self-sufficient, perfect mum. They don’t exist – we all need others and no-one is perfect!

Reply
Jenn

I agree. I think when we take care of children professionally we give ourselves less room for struggle and have skewed expectations.

I love this. “They don’t exist – we all need others and no-one is perfect!”

I’m slowly learning this.

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Behaviour is never from ‘bad’. It’s from ‘big’. Big hungry, big tired, big disconnection, big missing, big ‘too much right now’. The reason our responses might not work can often be because we’ve misread the story, or we’ve missed an important piece of it. Their story might be about now, today, yesterday, or any of the yesterdays before now. 

Our job isn’t to fix them. They aren’t broken. Our job is to understand them. Only then can we steer our response in the right direction. Otherwise we’re throwing darts at the wrong target - behaviour, instead of the need behind the behaviour. 

Watch, listen, breathe and be with. Feel what they feel. This will help them feel you with them. We all feel safer and calmer when we feel our people beside us - not judging or hurrying or questioning. What don’t you know, that they need you to know?♥️
We all have first up needs. The difference between adults and children is that we can delay the meeting of these needs for a bit longer than children - but we still need them met. 

The first most important question the brain needs answered is, ‘Is my body safe?’ - Am I free from threat, hunger, exhaustion, pain? This is usually an easier one to take care of or to recognise when it might need some attention. 

The next most important question is, ‘Is my heart safe?’ - Am I loved, noticed, valued, claimed, wanted, welcome? This can be an easy one to overlook, especially in the chaos of the morning. Of course we love them and want them - and sometimes we’ll get distracted, annoyed, frustrated, irritated. None of this changes how much we love and want them - not even for a second. We can feel two things at once - madly in love with them and annoyed/ distracted/ frustrated. Sometimes though, this can leave their ‘Is my heart safe?’ needs a little hungry. They have less capacity than us to delay the meeting of these needs. When these needs are hungry, we’ll be more likely to see big feelings or big behaviour. 

The more you can fill their love tanks at the start of the day, the more they’ll be able to handle the bumps. This doesn’t have to be big. It just has to be enough. It might look like having a cuddle, reading a story, having a chat, sitting with them while they have breakfast or while they pat the dog, touching their back when they walk past, telling them you love them.

All brains need to feel loved and wanted, and as though they aren’t a nuisance, but sometimes they’ll need to feel it more. The more their felt sense of relational safety is met, the more they’ll be able to then focus on ‘thinking brain’ things, such as planning, making good decisions, co-operating, behaving. 

(And if this today was a bumpy one, that’s okay. Those days are going to happen. If most of the time their love tanks are full, they’ll handle when it drops a little. Just top it up when you can. And don’t forget to top yours up too. Be kind to yourself. You deserve it as much as they do.)♥️
Things will always go wrong - a bad decision, a good decision with a bad outcome, a dilemma, wanting something that comes with risk. 

Often, the ‘right thing’ lives somewhere in the very blurry bounds of the grey. Sometimes it will be about what’s right for them. Sometimes what’s right for others. Sometimes it will be about taking a risk, and sometimes the ‘right’ thing just feels wrong right now, or wrong for them. Even as adults, we will often get things wrong. This isn’t because we’re bad, or because we don’t know the right thing from the wrong thing, but because few things are black and white. 

The problem with punishment and harsh consequences is that we remove ourselves as an option for them to turn to next time things end messy, or as a guide before the mess happens. 

Feeling safe in our important relationships is a primary need for all of us humans. That means making sure our relationships are free from judgement, humiliation, shame, separation. If our response to their ‘wrong things’ is to bring all of these things to the table we share with them with them, of course they’ll do anything to avoid it. This isn’t about lying or secrecy. It’s about maintaining relational ‘safety’, or closeness.

Kids want to do the right thing. They want us to love and accept them. But they’re going to get things wrong sometimes. When they do, our response will teach them either that we are safe for them to come to no matter what, or that we aren’t. 

So what do we do when things go wrong? Embrace them, reject the behaviour:

‘I love that you’ve been honest with me. That means everything to me. I know you didn’t expect things to end up like this, but here we are. Let’s talk about what’s happened and what can be different next time.’

Or, ‘Something must have made this (wrong thing) feel like the right thing to do, otherwise you wouldn’t have done it. We all do that sometimes. What do you think it was that was for you?’

Or, ‘I know you know lying isn’t okay. What made you feel like you couldn’t tell me the truth? How can we build the trust again. Let’s talk about how to do that.’

You will always be their greatest guide, but you can only be that if they let you.♥️
Whenever there is a call to courage, there will be anxiety - every time. That’s what makes it brave. This is why challenging things, brave things, important things will often drive anxiety. 

At these times - when they are safe, but doing something hard - the feelings that come with anxiety will be enough to drive avoidance. When it is avoidance of a threat, that’s important. That’s anxiety doing it’s job. But when the avoidance is in response to things that are important, brave, meaningful, that avoidance only serves to confirm the deficiency story. This is when we want to support them to take tiny steps towards that brave thing. It doesn’t have to happen all at once.l and it doesn’t matter how long it takes. Brave is about being able to handle the discomfort of anxiety enough to do the important, challenging thing. It’s built in tiny steps, one after the other. 

We don’t have to get rid of their anxiety and neither do they. They can feel anxious, and do brave. At these times (safe, but scary) they need us to take a posture of validation and confidence. ‘I believe you, and I believe in you.’ ‘I know this feels big, and I know you can handle it.’ 

What we’re saying is we know they can handle the discomfort of anxiety. They don’t have to handle it well, and they don’t have to handle it for too long. Handling it is handling it, and that’s the substance of ‘brave’. 

Being brave isn’t about doing the brave thing, but about being able to handle the discomfort of the anxiety that comes with that. And if they’ve done that today, at all, or for a moment longer than yesterday, then they’ve been brave today. It doesn’t matter how messy it was or how small it was. Let them see their brave through your eyes.‘That was big for you wasn’t it. And you did it. You felt anxious, and you stayed with it. That’s what being brave is all about.’♥️
A relationally unsafe (emotionally unsafe) environment can cause as much breakage as as a physically unsafe one. 

The brain’s priority will always be safety, so if a person or environment doesn’t feel emotionally safe, we might see big behaviour, avoidance, or reduced learning. In this case, it isn’t the child that’s broken. It’s the environment.

But here’s the thing, just because a child doesn’t feel safe, doesn’t mean the person or environment isn’t safe. What it means is that there aren’t enough signals of safety - yet, and there’s a little more work to do to build this. ‘Safety’ isn’t about what is actually safe or not, it’s about what the brain perceives. Children might have the safest, warmest, most loving adult in front of them, but that doesn’t mean they’ll feel safe. This is when we have to look at how we might extend bigger cues of warmth, welcome, inclusiveness, and what we can do (or what roles or responsibilities can we give them) to help them feel valued and needed. This might take time, and that’s okay. Children aren’t meant to feel safe with every adult in front of them, so sometimes what they need most is our patience and understanding as we continue to build this. 

This is the way it works for all of us, everywhere. None of us will be able to give our best or do our best if we don’t feel welcome, liked, valued, and free from hostility, humiliation or judgement. 

This is especially important for our schools. A brain that doesn’t feel safe can’t learn. For schools to be places of learning, they first have to be places of relationship. Before we focus too sharply on learning support and behaviour management, we first have to focus on felt sense of safety support. The most powerful way to do this is through relationship. Teachers who do this are magic-makers. They show a phenomenal capacity to expand a child’s capacity to learn, calm big behaviour, and open up a child’s world. But relationships take time, and felt safety takes time. The time it takes for this to happen is all part of the process. It’s not a waste of time, it’s the most important use of it.♥️

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