I was sitting at a coffee house in Cobble Hill across from one of the most influential women in New York in the field of maternal mental health advocacy. Inadvertently, the conversation became an intimate exchange of war stories that happened to us during our personal bouts of postpartum depression and how awful it was when we were attempting to access some form of adequate mental healthcare that would diagnose us correctly.  Though we are both mental health professionals, we had no clue to what the hell was going on. You simply can not be your own dentist. In other words, when you are in it, you are in it.


She was seeing a therapist during the initial waves of postpartum depression who was unable to help her. It was only when she almost threw her child and herself in front of a bus, that she turned around and checked herself into the emergency room. I was seeing a therapist and asked for a psychiatrist. She replied, “You can not afford one.” When I finally could afford an overpriced Manhattan psychiatrist, I went to one who simply stated it was dysthymia (low grade depression), and prescribed Sam-E which only triggered an intolerable level of anxiety.


So what really happens during a postpartum depression? Why is it so difficult to diagnose? And why is it so common? Some studies have found 10-15 per cent of mothers will experience postpartum depression. Some studies find approximately 1 out of every 7 mothers, and 1 out of every 10 fathers suffer Postpartum Depression.  So, ultimately, this article is an attempt to clear the foggy lens of postpartum depression. What does a postpartum depression truly look like?


Agitation, anxiety, over reaching.  For my new friend, she was obsessed with breastfeeding and lived in serious fear that she did not  have enough breastmilk for her baby. Once the anxiety settled down, the suicidal thoughts came storming in. For me, it was a feeling of overwhelm and joy. I would feel so content that I had this beautiful child and so very overwhelmed.  The overwhelm catapulted into exhaustion. The exhaustion was exacerbated by stress. The stress drove me to work more and then I simply burnt out and stopped sleeping; all under the mantle of guilt that I was not a good enough mother. That I was neglecting my child somehow. I was not feeding her enough vegetables.  The three days she was in daycare was too long.  My hours were too long at work.  Everything fell into the amorphous overwhelm of “I am not doing this right.”   Eventually, I was finally able to see a good psychiatrist who prescribed the correct medication and I am finally okay. But it took awhile.  Too long in my opinion.  I come from a legacy of postpartum depression. My mother had it and my grandmother.  Though ultimately, the question remains:  What happens?


Though human behavior can not be defined in a few standard patterns, there are some anthropological, biological, and sociological components that drive our modern mother towards postpartum depression. And there are ways we can influence these components to veer our mothers in the right direction.


Psychotherapy, the classic old fashioned your-parents-screwed-you-up psychotherapy, has truly driven an unmanageable wedge into being a human mother.  Human mother, what a great term. You mean, I am human? I can cry sometimes? Yes. Yell at your kids every now and then? Absolutely.  My theory is if you never lose your patience around your children, you are simply not around them enough. And then there is this pressure. Your parents did not screw you up (entirely). There are multiple systems in place that influence your formative years of psychological growth, and one of them is the family system. But there is the school system, the cultural system, the socioeconomic system, the religious system to name a few. They all play a role in your psychological health and growth.  That pressure though. That you are the be all end all for your child and if you make a mistake your child will hate you and cut you off, is very real and very scary for many people, because that is what a lot of awful therapy can do to a person. It can perpetuate a victim mentality and make you hate your parents for life’s inevitable challenges and disappointments and for existential crisis that are inherent in self actualization.


Then there is the isolation factor.  In other cultures around the world, there are family members and friends who come in and teach the new mothers how to take care of her child. There are rituals that celebrate the rites of passage for both parents.  Here, we are lacking a bit in that area. The famous saying, ‘It takes a village to raise a child,’ is true.  I believe it takes 12 people to raise one child.  Many of us do not have this and if you do, bless you.  One client of mine suffers severe anxiety and then noticed that when her annoying in laws came in to help her with her twins for a weekend the anxiety lifted.  These in-laws were not easy people to be around, but despite that, life was a lot easier because of their care and love and attention.  You can not outsource love.  A lot of mothers can afford to hire the nanny or the sitters, but they really can not replace the obnoxious mother in law who adores your kid or the snobby aunt who will do anything for your baby.  Family is family and outsourcing is outsourcing.  


So, how to do we shift this terrible tide?  By becoming more aware of the presentation of postpartum depression. That “neurotic” mother obsessed with her baby’s weight probably has postpartum depression. That hippie mother who still wears her child and refuses to use a stroller may have postpartum depression.  And though easier said than done, try to be more gentle with yourself and your extended family.  You are going to make mistakes. That is okay.  Your parents may have made mistakes, that is okay. We learn. We grow.  We heal. We forgive, and that is healing.  Recognize that the pressure is very real in regards to the responsibilities placed on a small parental unit (2 people, sometimes 1, or 1.5 depending on the hours the other partner works)  and be as gentle with yourself as you possibly can. When you recognize yourself judging yourself, do not judge the judging. You are only human.


The upside is that we are learning more and more about postpartum depression and other perinatal mood disorders.  With this knowledge, our mothers are empowered to voice their needs.
Written by Zoe Hicks, Licensed Marriage and Family Therapist and Founder of the Postpartum Project, an online directory of therapists who specialize in the treatment of  postpartum depression.