Postpartum depression (PPD) strikes at a time when you least expect it, following the joyous anticipation of a new baby. PPD has always been among us — it affects roughly 15 percent of women— but when actress Brooke Shields described her personal struggle in Down Came the Rain, her memoir focused a national spotlight on a troubling issue, one that remains difficult for women to talk about, or sometimes even recognize in themselves.
Shields describes the confusion she felt after the birth of her first daughter, Rowan. Though she had desperately wanted a child, PPD brought a dark cloud of self-doubt. “Here I was, finally the mother of a beautiful baby girl I had worked so hard to have, and I felt like my life was over. Where was the bliss? Where was the happiness that I had expected to feel by becoming a mother? She was my baby; the baby I had wanted for so long. Why didn’t I feel remotely comforted by having or holding her?” she writes.
“I started feeling like I had made a terrible mistake in having this child. I would look at how little and vulnerable she was and didn’t feel at all capable of tending to her needs,” says Shields. “Her helplessness terrified me. Rather than wanting to care for her, I wanted to forget her and run away.”
"Everything I did was wrong"
Arlington mom Beth Carson knows those feelings all too well. She experienced PPD following the birth of two of her three children, and that period left her feeling anxious and unable to cope with her new responsibilities as a mother. “I was OCD about everything. I’d burn something on the stove and would feel like everything I did was wrong,” she says. “With my son, I would stay up every night crying over the smallest things. Even if nothing went wrong, I couldn’t handle small things, like losing a sock,” she remembers. “I’d see friends with a perfect baby and a clean house and feel horrible because I couldn’t do that.”
It was her mother who finally suggested that she see a doctor and when her diagnosis came back as PPD, Carson found herself surprised because, “I’d always been happy-go-lucky, and had never had depression issues.” OB-GYN Yvonne Moore says Carson’s inability to see her own mood shift is not that unusual. “Mom is so busy doing caregiving that she might not realize she’s not herself. We do a poor job educating people about PPD and how common it is.”
"Why do I feel this way?"
Doctors say postpartum depression is largely caused by hormonal changes brought on by pregnancy. Women who have a history of depression are at higher risk for PPD. But other issues can also factor in, such as stress caused by marital strife, returning to work too soon, financial worries, and job woes.
Let’s be clear: Nearly 80 percent of new mothers experience the baby blues, a brief period of sadness, crying, worrying, and mood swings that occurs one to two weeks after giving birth. Those feelings quickly subside. PPD is vastly different. Once the veil of depression descends, it is unrelenting, all day, every day, robbing you of the ability to find pleasure in life and bringing on feelings of sadness, worthlessness, and the inability to connect with your baby. Left untreated, PPD can last up to a year or longer.
Writes Shields, “I knew deep inside I must love Rowan. . .I just didn’t feel anything for her. In addition, I felt such hatred and sadness for myself. It was impossible to understand or grasp.”
The mother’s feelings of inadequacy are reflected in such statements as “ ‘I know the baby doesn’t like me.’ They project their feelings on the baby,” says Moore, who practices with OB-GYN Specialists. “They know it’s not rational but that’s how they feel.” Such feelings make it very difficult for moms to bond with their baby.
Moore, a board member of Postpartum Support International, the first national support network for women with PPD, says many women feel guilty about being sick during what should is supposed to be the happiest time of their lives. But the inability to nurture one’s child is an important reason for women to seek help. “It’s not just about getting help for yourself, but for your child as well,” she says.
"I need help"
Lesley Swan (a pseudonym to keep her identity private) was just 22 when she learned she was pregnant with her second child. The relationship with her then-boyfriend had become rocky, and the news of a new baby on the way, while already raising a 2-year-old, placed additional strain on their relationship. Once the baby came, Lisa found herself spiraling into depression. She characterizes caring for her newborn as “emotionally draining.” Even just feeding her child was a “monumental” task. Her state of mind prohibited her from getting close to her newborn.
“The baby and I just never bonded,” she says. “I couldn’t accept that I had another child that needed my care.” Her depression became so severe that she even attempted suicide. That wake-up call eventually led her to seek help and give over the care of her child to her boyfriend’s family. “I hate to say that letting the baby go was part of the catharsis but knowing the baby was in a better place was a relief.”
“People who are depressed are often the last to realize it because they are functioning at a low ebb,” notes therapist Robin Karr-Morse, author of Scared Sick, a book that examines the effect childhood trauma has on adult health. A healthy mother is able to engage with her baby, responding promptly to her needs and cues: to be fed, to be changed, to be soothed.
But children born to women with PPD experience a joylessness when interacting with their mother. Karr-Morse writes that some experts refer to this experience from the baby’s perspective as “the dead mother” and that the child ultimately regards himself as not important enough to enlist his mother’s attention and love. Babies of depressed mothers are often drowsier, more passive, or more temperamentally difficult. They also tend to be more anxious and less able to tolerate separation.
Do you understand?
PPD can also negatively impact spouses or family members who either don’t understand or fail to recognize what the mother is going through. Shields describes how her supportive husband went to a baby store where he encountered new mothers excited about their journey. “There were women in the [baby] store who were happy to have their babies! What’s wrong with you? Why aren’t you happy? You don’t look at our daughter or sing to her or talk to her. Why? What’s happening?” he implored.
That is why speaking with a counselor or sharing your concerns with your OB-GYN, a psychologist, or at least a best friend is critical to overcoming PPD. Do what you can to reach out. Moore has noticed in her practice that postpartum depression tends to be much lower among women from India and the Middle Eastern cultures. These typically have an auntie or mother who tends to the new mother, living in for several months to ease her caregiving duties and allow the new mom find her way with baby. Doulas can also provide a similar service. Don’t be shy about accepting care from friends or other family members who want to help you, particularly during the early months. Also, join a support group of new moms so you can share your journey with others.
“Brooke Shields helped to de-stigmatize PPD because she got help,” notes Moore. “We owe her a little debt because she was so frank, so courageous. When you talk to people, you realize how many women suffer in silence.”
Ways to Manage PPD
• Join a support group for new moms (go to Parent Support Groups @ memphisparent.com).
• Talk it out with a counselor, don’t suffer in silence.
• Get medication.
• Catch some zzzs when baby is napping.
• Get out in the sunshine, a natural mood elevator.
• Exercise, be it walking or biking, to improve your mood.
• Learn more at Postpartum Support International at postpartum.net or call Dr. Yvonne Moore at 881-9323