Postpartum: It’s an Experience, Not a Disorder

So often when people learn about the work I do, I hear the phrase, “I think I had postpartum.” 

I want to clarify a few things:

First, if you gave birth, you’ve experienced postpartum. 

Postpartum is a period of time after childbirth and there’s often discrepancies regarding how long postpartum lasts. Some sources will reference a year after the baby is born. Others refer to the “4th trimester” – 12 weeks following birth. 

As my pelvic floor PT friend and I like to say, “Once postpartum, always postpartum.” It’s never too late to see either of us for support after having a baby. 

Second, postpartum in and of itself is not a disorder; however, so often we hear it referred to in this way. 

If you struggle emotionally after having a baby, you may question whether you qualify for a postpartum mental health diagnosis. Maybe you’ve heard of postpartum depression but aren’t necessarily feeling sad. Or maybe it’s beyond the four-to-six week period you may have read about online. 

Here’s the thing – Our society on the whole tends to lack an accurate understanding of what we now refer to as “Perinatal Mood & Anxiety Disorders”--or PMADs. 

When I went through my own experience of what I now know was postpartum anxiety, I’d never even heard the term. And I was a licensed therapist!

My Experience: 

After each of my babies were born, I was over the moon and, unlike many new parents, I did not struggle with adjusting to a growing family during the first few weeks. 

I didn’t mind the lack of sleep, breastfeeding was going well (minus a few bumps in the road), and I couldn’t get enough of holding my sweet babies.  

I was given the Edinburgh Postnatal Depression Scale (one of the standard screening tools currently being used) at my son’s newborn and two-weeks pediatric appointments, and took it again at my six-week postpartum appointment with my OBGYN.  No red flags were raised. 

This is the experience of so many women who, turns out, do have a PMAD but fall through the cracks. Either their symptoms are not inline with what’s typically screened for and known as “postpartum depression” (i.e. sadness, decreased energy, and loss of interest in activities previously enjoyed), or their symptoms may begin at a stage when they are not being regularly monitored by their doctor. 

For me it was week seven after the birth of my second baby when I began feeling extremely anxious, frustrated, and irritable.  I initially ignored these symptoms, assuming I was just facing the stress of parenting two little kids.  

Despite the lack of sleep that comes with a new baby, I had an incredible amount of energy and focus for certain tasks. For example, I felt an almost manic need to organize my spices one night, ignoring my crying baby so I could finish putting spice jars in ABC order. 

My mind often felt like it was racing and I felt this overwhelming need to constantly be doing something productive, other than just caring for a little one. 

At the same time, I had an incredibly hard time focusing and concentrating on simple things. Making logistical plans and decisions, like what time to meet for dinner or when to leave for an appointment, seemed confusing. I felt scattered and like I was living in a whirlwind and a fog.  

The racing thoughts made it hard to take advantage of those precious hours of sleep and the anxiety and the need to constantly be doing something caused me to start overeating, snacking even when I wasn’t at all hungry.  

I remembered week six to ten being the hardest for  me personally with my first baby, so I found myself justifying what I was going through, saying this will likely pass and was just harder this time around because two kids are more challenging than one.   

But the sound of my baby crying became like nails on a chalkboard. This was surprising to me, as I’ve always loved and wanted to care for little babies, but I attributed it to being overtired.  

Soon I started to feel symptoms of guilt, feeling badly about not bonding with my second baby the same way I had with my first. I worried I wasn’t giving him enough attention, then began hearing a pesky voice in the back of my head telling me I was a terrible mother.   

Thankfully, the therapist in me started recognizing this voice as similar to ones I often hear in clients, and I started to tell myself, “If you heard a client saying these things in your office, a red flag for depression or anxiety would definitely be raised.” 

I went back and forth in my mind, arguing between thoughts of, “I don’t need help. I teach coping skills!” and “You tell clients all the time that depression is not a weakness or something to be ashamed of. It’s an involuntary disorder that deserves attention!” 

My breaking point finally came one night when both my kids were crying and I just couldn’t take it. I went downstairs and cried myself, wondering whether it would be more satisfying to throw my baby down the staircase or slit my own wrists. That raised a serious red flag in my mind!

Although I had tried to dismiss or justify other symptoms, I knew that thoughts of harm were definite indicators that something was amiss. 

I called my OBGYN the next day and went in to discuss medication.  After listening to my symptoms, she nodded and said, “For me it was questioning whether I should throw my baby in the pot of chili.”  

I felt so much validation and relief from her comment, knowing I wasn’t alone, crazy, or a bad mom. I started an SSRI that day with a plan to talk to one of my colleagues.  

I typically tell clients to expect it to take at least a few weeks before they truly begin experiencing the effects of a new psychotropic medication, but within a few days I was feeling much better and found myself thinking, “Oh yeah!  This is what normal feels like!”  

The anxiety, irritability, and confusion faded away and I became more available to focus on my kids, knowing I was doing a pretty decent job of mothering. 

PMADS

After experiencing relief, I found myself worried about all the new moms out there who may not have the clinical experience I do, nor the ability to step outside themselves and rationally view what they are going through.  

If I, as a therapist, was dismissive of my symptoms, surely other moms were doing the same thing and failing to get the support they deserve.  

I began wondering why the symptoms of what I experienced didn’t seem to align with what I knew postpartum depression to be. I realized I had received zero training on postpartum mental health, and sadly, this is the case for so many therapists, psychiatrists, OBGYNs, and pediatricians. 

I did what most of us would do and turned to Google. In my research, I found Postpartum Support International and became eager to enroll in their training on PMADs. 

I learned that there is a range of mental health disorders that can occur during and following pregnancy. While I’d heard of postpartum depression and postpartum psychosis, I realized other diagnoses also exist, including perinatal anxiety, bipolar, and PTSD. (Perinatal = during pregnancy + postpartum, and all of these disorders can occur during either period). 

It was only in hindsight that I realized what I’d experienced was postpartum anxiety. 

Since becoming trained and certified, I’ve now encountered many other amazing providers who are well versed in these disorders and am finding that the world is starting to better understand maternal mental health topics.

Still, there is an appalling lack of awareness in both the medical field and among the general public. 

If you find yourself feeling scattered, anxious, irritable, guilt-ridden, or like a failure as a mother, please recognize that these experiences can be aspects of a perinatal mental health disorder. 

These disorders are very common and they are very treatable! 

Regardless of what specific week post-baby you experience a struggle, I encourage you to talk with your doctor or a therapist trained in perinatal mental health (PMH-C) so you can feel better and enjoy those precious moments with your family.

If you need support, get in touch here. I’d be happy to help get you support or point you in the right direction to feeling like yourself again. 🩵