Why Don’t We Talk About Postpartum Depression?

I recently blogged a bit about my postpartum depression (PPD). It is the beginnings of an essay I plan to write, and possibly part of a future memoir. There are still a number of moving parts to my life right now, much of which I am not ready to make public, so the post is purposely ambiguous. But I hope it gives you an idea of how PPD feels, even if depression manifests in different ways in different people.

Your questions in the comments, however, are helping me understand what it is I have to address in subsequent revisions and essays on PPD, when I share my process. For the record, I’m scared shitless writing about my PPD. But I know it helps more than it hurts me to do so.

But mostly, I’m glad I’ve got people talking. The thing that mystified me most about having PPD was the total isolation and lack of rescue/help/resources/education. My friend S also survived PPD and interviewed me for a story she is writing on the subject. One of her questions was, “What can we do to change the landscape for mothers with PPD?”

We can do so much. Because right now, there is so little. Here are some of my thoughts on the taboo nature of PPD–of discussing PPD, of addressing PPD, etc. I welcome you to join in on the discussion…

1) Other women don’t want to relive their PPD experience:
When I started to suspect I had PPD, I reached out to other mothers who I knew had had a hard time with their babies–I knew at least one of them had had PPD. “I think I have postpartum depression,” I wrote via email. But the response was underwhelming–the responses ranged from complete silence to “I hope you get help.” The dearth of empathy was shocking. That I wasn’t invited to talk about it further, was debilitating.

One of my closest friends, after I got treatment and my PPD was behind me, told me, “I couldn’t relive it.” And it turned out she wasn’t the only one; women whose postpartum period was horrific don’t reach out, because it’s too uncomfortable. Because they never want to be reminded of that period in their life, ever again. I understand this. But it has to change.

And let’s face it–many of us hobble out of PPD, and don’t know how we did it. And many women are afraid it will happen again. Depression–and particularly the creature called PPD, is horrific.

2) Shame:
No one wants to admit having postpartum depression or even having baby blues, because there is a singular acceptable image of motherhood. We are supposed to be happy. We are supposed to adore our children. We are not supposed to regret anything.

I love my kid–I would die for her, but I  motherhood is so so hard it is impossible to love at times. There is a difference. I clawed my way back from postpartum depression, largely for my daughter. My daughter has made me a better person. And I hope I am the best mother to her. But this has come with great pain. I’m not ashamed to say that.

3) The details are horrific:
No one wants to discuss the details of postpartum depression, because they are so dark and ugly and socially unacceptable. The details include not only OCD and anger and wanting to die and believing you are dying, but in most cases wanting your beloved baby to die, even as you hold and cherish your baby in your arms, even as you are unwilling to let your baby go. It is horrific. I did not want my kid to die, and that’s why I got help.

4) Lack of education:
My husband explained to his boss that I had postpartum depression, and his boss had no idea what PPD was. He had to describe it as “clinical depression,” which honestly made me bristle. So many men don’t know what this is. So many women don’t know what this is. The ignorance prevent partners from truly helping out–from lack of community support so they can take time off to support partners to the fact that my husband didn’t even recognize the signs; he said he thought what I had become, would be forever. And that was a contributing factor to irreparable harm.

Nevermind the fact that when I finally called my OBGYN’s office, the receptionist literally responded, “PPD? What’s that?” Ugh.

5) Who can help:
The pamphlets on PPD say “Call your doctor.” WHICH doctor?! In my OCD-postpartum state, I literally obsessed about WHICH doctor to call. In the end, I called the person whom I trusted most, my old therapist. He isn’t a PPD specialist, so he told me to call the pediatrician, who told me to call my OBGYN. I made four calls that first day I decided to get help. The OBGYN’s office didn’t return my calls that first day. I called every 2 hours the next day, and finally got a Nurse Practitioner to call back. She sent me a prescription right away. Thank goodness. But man, I had to make a lot of calls, and persist. Not right.

In the end, because I’d waited 10 months for help, they told me that I would eventually have to ring my primary care physician. Jeebus. And ultimately, I ended up back with my old therapist.

6) Depression isn’t always obvious:
Depression manifests in many forms. And if people didn’t know you from before pregnancy or motherhood (as many healthcare professionals who see you in the postpartum haven’t), the onus is on you and your village to spot the signs. I’m a very energetic, positive person, and when I’m depressed, I’m subdued, but very much within normal range of behavior. I cried a lot, but my friends chalked it up to exhaustion.

My PPD made me restless. And angry. My energy was spikey. I was in bed, or I would get a burst of energy and do something, and then I’d collapse and crawl back into bed. Also, I’m good at faking it. And (read: shame above) wanted to fake it. My OBGYN asked about postpartum depression as part of regular postpartum screening, but who’s going to admit the above things (read: details above).

7) Isolation:
I was alone all day everyday for a few months. There were days I saw no one but my mother’s helper–and she didn’t know me from before motherhood (read: depression isn’t always obvious). No one saw how despondent I was.

8) Not knowing what to say:
The few people I told about my PPD suspicions (“Hey, I think I have postpartum depression”), tried to shift focus. “But your child is so beautiful and amazing!” they would say in response. “But I’m dying,” I would think. “I’m dying, and no one cares.” Yes, my child is beautiful and amazing, but that has nothing to do with postpartum depression. And it’s not cheering me up. Because I have postpartum depression.

Some of things I wanted people to do was to hug me. To say, “Hey, that is awful.” If you’ve had PPD, share your experience. And if someone suspected I had PPD, I’d have appreciated something  gentle and discussion-opening along the lines of, “Hey do you think this is baby blues, or more than baby blues? What do you think?”

9) Education:
It’s not only mothers who have to be educated about PPD. The entire village must know what this is. That mothers have the responsibility to self-diagnose is atrocious. That I had to self-diagnose was horrific and overwhelming. This is something about which the village should know and understand how to approach. Only one person in my social circle asked me if I had PPD, and she said it in such a condescending way (“i don’t know you very well, but I hope your doctors are helping you out”), that I retreated.

10) Waiting/Not realizing PPD is a Different Creature than “Regular Clinical Depression”:
PPD can lift, but even then, not really. It lingers. Waiting is a killer. Help must be as immediate as possible. PPD is chemical. It’s hormonal. For people who are anti-depressant averse, help takes much longer. Because we wait for the PPD to lift, before we concede to anti-depressants.

Don’t wait. PPD is a different creature than “regular clinical depression.” Be open to all the treatments. They can be life-changing. Save your life.

*************

UPDATE (Resources):
There are resources out there–here are a couple, which the Postpartum Resource Center of New York, provided me this morning:

You are not alone. You are not to blame. With help, you will be well.

Postpartum Support International (PSI) is dedicated to helping women suffering from perinatal mood and anxiety disorders, including postpartum depression, the most common complication of childbirth. They also work to educate family, friends and healthcare providers so that moms and moms-to-be can get the support they need and recover.
Helpline:  800-944-4PPD (4773) or email support@postpartum.net
www.postpartum.net

In New York:
Postpartum Resource Center of New York provides emotional support, educational information and healthcare and support group resources for New York State families.  Free and confidential support including Moms on Call and Family Telephone Support available
Helpline:  Toll-free and State-wide at (855) 631-0001 (Hablamos Espanol)
www.postpartumny.org