When you get pregnant, one of the first things you do is start skimming through pregnancy books, blogs, and websites for tips and advice. What kind of labor should you have? Is it worth it to hire a doula? Do any of those “miracle” anti-stretch mark creams on the market actually work?
In your endless quest for knowledge, you inevitably come across some information about postpartum mood disorders. You read the signs and symptoms of depression: fatigue, loss of appetite, crying or irritability, mood swings, and difficulty bonding with your baby. These descriptions make you picture a sad woman wearing sweat pants in a commercial for a new anti-depressant. Or, maybe you conjure memories of a news story you read once about a zoo animal abandoning her young. Whatever the case, you don’t imagine yourself with a postpartum mood disorder—because it’s a serious issue, sure, but it’s also something that only happens to other people.
That’s what I thought, too.
I was diagnosed with postpartum anxiety about seven months after I had my first child.
If you’re thinking that seven months sounds like a really long time to go undiagnosed, you’re absolutely right. I got my diagnosis way late in the game, and part of the reason that happened was because I didn’t know what real postpartum mood disorders looked like. My symptoms weighed much more heavily towards severe postpartum anxiety, but until my diagnosis, I didn’t even know that was a real illness.
The problems started almost immediately after I gave birth.
I felt panicky about putting my baby to sleep, so much so that I couldn’t fall asleep at night unless I had one hand resting on her chest to make sure she was breathing. I felt a sense of dread every time my baby needed to be fed—a fear rooted in my anxiety about breastfeeding and whether or not I could keep a baby healthy. I panicked whenever I was left alone with my baby. I chalked these things up to “new mom jitters” because, after all, this was my first kid. Of course I was scared.
Over time, my anxiety got worse. I developed coping mechanisms to try to deal with the constant fear and stress. Each night, I checked to make sure the stove was turned off, and that the the front and back doors were locked. That sounds like a normal thing people do before going to sleep, but it really wasn’t because my routine had strange caveats. I had to check the stove and doors in a precise order, and I had to do it twice, otherwise I couldn’t sleep. If I checked the doors in the wrong order, something bad would happen to my baby—at least, that’s what my brain told me.
For seven months, I lived like this, slowly becoming a prisoner inside my head.
But, when I saw my doctor, he only asked if I was bonding with my baby, or if I felt sad. I felt totally attached to my baby, and it didn’t occur to me that my anxiety or weird ticks could be attributed to post-pregnancy issues. I assumed whatever I was going through was something separate, something that didn’t place on the postpartum depression spectrum. I’m not alone in that mischaracterization of postpartum disorders.
According to the American Journal of Clinical Medicine, around 10 to 15 percent of women suffer from postpartum mood disorders, but only about half of them actually get diagnosed.
The reasons for this vary. Some women are afraid of the stigma of mental illness. Others don’t have access to treatment. And, many women like me don’t actually realize they’re suffering from a postpartum mood disorder.
Postpartum mood disorders encompass more than just depression. You can also have postpartum anxiety, postpartum obsessive-compulsive disorder (OCD), and postpartum psychosis. A 2013 study in the Journal Pediatrics actually found that postpartum anxiety is twice as common as postpartum depression, even though depression is the only ailment we ever really talk about. As many as one in ten new moms may get postpartum OCD, notes a study in the Journal of Reproductive Medicine. Most pregnant women don’t even know that’s a possibility. I certainly didn’t.
It wasn’t until one day when I had a full blown panic attack over my husband leaving for work that I realized I had to ask for help.
I saw a psychiatrist who diagnosed me with postpartum anxiety and depression. She stopped short of an OCD diagnosis, but said my anxieties and compulsions were similar to what many OCD sufferers experience, just not as severe. She started me on a combination of Zoloft and Wellbutrin to manage my panic and my intrusive thoughts, and we also started talk therapy to help me develop coping mechanisms to control my anxiety.
For the first time since my baby was born, I started to feel like myself again. But, if I’d never gone to see this psychiatrist, I never would’ve gained a real understand of what my problems were or how many women they actually affect. We know so much more about postpartum mood disorders than we did just a few decades ago, but that hasn’t kept women like me from missing the signs and symptoms.
It’s not enough to tell women it’s OK to ask for help.
The way we talk about these disorders is too simplistic. Not everyone with a postpartum mood disorder feels sad or loses their appetite. Not everyone gets the stereotypical symptoms of postpartum depression, because depression isn’t the only mental illness a new mom can experience.
We love to say that, when it comes to mental illness, there’s no shame in asking for help. But you can’t ask for help until you know there’s a problem. And when it comes to women learning the signs of a mood disorder so they’re able to recognize one in the first place, we clearly have quite a way to go.
Related-ish: How Exercising Helped Me Get Over My Anxiety