It is unfair.
Going through an entire pregnancy, delivering a human being, and still not being ‘done’ with your fluctuating being. As if you don’t have enough on your plate, you now have to be on the lookout for a mood disorder affecting 1-in-5 women in the postpartum period.
Postpartum Mood Disorders (PMADS) is an umbrella term for the specific spectrum of FML, eff-my-life, the rollercoaster of emotional states that can appear in the perinatal period. They are the most common perinatal complication.
Yes, PMADS are a medical complication, and not a moral failure. However, PMADS are treatable. Every. Single. One. Of. Them.
Depression has a reputation for being the not-so-subtle elephant on your chest, and it is portrayed in the media as a state of utter sadness, hopelessness and despair. While this may be the case, there are earlier signs depression may be making its grand entrance, and it is much better to pay attention to those, than to have to deal with the weight of a full blown depressive episode.
Due to the hectic day-to-day of infant care, these subtle signs can be overlooked.
Ask yourself the questions below. If any of them resonate, don't wait. Get care.
1. Poor Hygiene
Is it because you are too exhausted - or is it because you are too exhausted and don’t feel like it matters?
2. Shifts in Appetite
This can be a challenge to pinpoint because the hormonal changes have such an impact on appetite and satiety and time is not a real concept in those first months postpartum. Are you noticing that you haven’t felt hunger all day and it’s suddenly almost bedtime? Are you trying to self soothe by eating till the point of discomfort? If you are noticing a pattern of consecutive days of this, this deserves your attention. Feeding yourself can feel tricky when you are caring for literally everyone else, but you need well balanced nourishment in order for your mood to be stable.
3. Changes in sleep
Sleep is going to be hard to come by. However, a place to start assessing is to see if you are unable to sleep even when you are exhausted, and have the opportunity to actually get some rest. What are your feelings and thoughts in those moments?
4. Somatic symptoms
Are you noticing gut issues? Headaches? If you check in with yourself, do these sensations come up when you are feeling a certain way? The body tends to shriek out for attention, when in physical ways when we are having mental or emotional needs that are going unmet or noticed.
But how is it considered isolation when you are never by yourself? Isolation is an internal experience. You can be surrounded by all the well meaning people in your life and still feel completely alone in your experience. This happens when one has feelings society has taught us ‘good’ moms shouldn’t feel - like anger, resentment, aggravation and disappointment. These unphotogenic feelings are very normal and do not need to be hidden. Your mothering is not on trial.
6. Losing interest in things which used to bring you joy
Is it harder for you to laugh at things you once found hilarious? Do activities you once loved feel dull? Does nothing seem to make you feel good? This symptom is called Anhedonia, a telltale sign of depression.
7. Faking happiness
“Good mothers are content with their baby and feel fulfilled by the mere act of being a mom,” I repeatedly said to myself, while feeling like the epitome of a failure. The world has told us the emotional spectrum is supposed to go out the window when you become a mom. If you should dare feel darkness, then something is wrong... This is not true. Moms feel all the feelings, dark ones included, because they are still human. Easy to forget this, but good mothers are human.
8. Baby blues aren't getting better
The Baby Blues are the loud younger sibling of Postpartum Depression. 70-80% of women will experience these intense mood swings in the first weeks after labor.
Anxiety about your baby’s well being, uninvited thoughts about things that might go wrong, the feeling that you want to throw something or shout at a well meaning family member whose advice or presence is not calming - all of these pretty universal experiences in the first weeks.
These highs and lows l normally resolve on their own in about two weeks. If it does not get better, or is getting worse, you are more likely experiencing a PMAD.
9. Extreme guilt and sadness
Have you been harder on yourself, judging everything you are doing and feeling? Are you feeling guilty for not loving every moment? Guilt can be one of the most harrowing feelings that can take over in the postpartum period. Guilt insinuates you did something wrong which can lead you into a cycle of fear to do anything. Guilt sucks, but can be worked through.
10. Difficulty focusing and making decisions
This is when you might have difficulty making decisions and feeling anxiously scattered. Baby brain does slip into the postpartum period, this time with added exhaustion. This symptom looks like not trusting your ability to make good choices.
Where to go from here
These signs are guidelines but ultimately, you know you better than anyone… in normal times. This is not a normal time.
This new you could feel extremely foreign. You may have absolutely no idea who the washed out person in the mirror is, and why she keeps following you around. This is uncharted territory for first time moms. This new you is dealing with new situations and feelings she may not have known prior.
Overwhelm is often part of the deal, but there is a threshold, which when passed becomes paralyzing or hyper-functioning. Having a baby is all consuming. Those postpartum months have the subtlety of swallowing a giant ice cube; you can’t see it on the outside but something major is going on.
This is why it is important to be aware of the more subtle ways your body and mind may be asking for help.
Remember, all of this is treatable.
Statistics Citation: PSI PMAD Fact Sheet. Postpartum Support International, https://www.postpartum.net/wp-content/uploads/2014/11/PSI-PMD-FACT-SHEET-2015.pdf