I am honored to write a blog series I’m entitling “Wisdom of the Hive Mind”, which will be addressing various issues related to postpartum and perinatal issues. For this series, I have the pleasure of interviewing mothers about their challenges, struggles, surprises and joys related to pregnancy and the months following birth. None of these women are clients of mine, but all are courageous and beautiful mothers with their own unique stories to tell. Some information has been edited or redacted to protect the women’s identity. Thanks to you all who have taken the time to open up about your own journeys through motherhood. It truly is an honor.
I’d like to begin this series with an antecdote by a woman I’ll call Laura (an alias). Laura had quite a rich and textured story to share, but one aspect I’d like to focus upon is her experience of postpartum anxiety. Here is part of her story:
“[During the postpartum phase of my first pregnancy,] I felt at the time that I was adjusting well, I look back now and I don’t think I adjusted as well as I thought. I spent almost the first 6 weeks in bed watching TV. My family and my husband’s family all live close by, so I had a strong support group. I started working out maybe 3 months after having my baby, and I went back to work after 3 months, 6 weeks with my disability leave and had to use vacation hours. I was not ready to go back to work. I missed my baby a lot, and I was emotionally up and down, getting angry at every little thing. I had anxiety and would constantly cancel plans with friends, I avoid parks if other people where there because I didn’t want to interact with others. I felt like I lost who I was in the past and I was only a mother and an employee at my job now and felt empty and felt like I was not contributing to the family. I did not like creating activities for my son and felt guilty about it. I felt I needed to be a Pinterest mom and do super insane creative things every day. Especially, since I hate to cook, found out I don’t want to just stay at home but I do want to work part time, because I want both worlds. After a year, I was able to figure out a routine that worked where I was working part time, could do workout classes with my baby, and was able to exercise but also get “me time.” I still had high anxiety, which was not diagnosed until later. I began to run, which helped a lot with my anxiety. I also, started a secret blog about one of my creative passions and that helped with my loss of identity issues. I started seeing a therapist, which in the end I did not use to full potential, as I was not fully honest with her. I will say the therapy with her did help with my confidence.
In the end, I look back now and realize that I was depressed and anxious. I knew I had a rough pregnancy. I thought I had a good recovery but now I know it was not and I was depressed. I also hated being pregnant and felt guilty about it. I hated the baby moving in me, every hic-up, everything. There was nothing I liked about being pregnant. And I felt guilty. Everyone told me that I would look back and miss the movement and feeling. And I didn’t and I still don’t. The only thing I miss, and this is terrible, was the attention. I do think having a child helped my relationship with my husband. We have been together right now as of today, 18 years and married 10 years. So it did help us learn how to communicate and love each other and learn how to be honest and take time for us. It also brought back youth and we learn new things about each other. We did have rough patches like everyone and saw a therapist once, but that is nothing unusual for 18 years together.”
Postpartum anxiety (PPA) is often referred to as the “hidden” postpartum diagnosis, as Postpartum Depression (PPD) gets so much recognition (as it should). PPA is, however, more common than PPD. PPD and PPA can both make women feel tired all the time, and postpartum (PPA) can involve physical symptoms, also. Changes in eating and sleeping, dizziness, hot flashes, rapid heartbeat, and nausea can all be signs of PPA, as well as the inability to sit still or focus on a particular task at hand. The onset of these symptoms for the majority of women is between birth and baby’s first birthday, but in some cases, they begin during pregnancy (25-30% of PPA cases develop during the perinatal phase). It is not uncommon for women to start feeling on edge shortly after giving birth. However, other particularly stressful life events, or even issues related to breastfeeding, can trigger PPA months later.
All new parents feel anxious to a certain degree, but they can usually talk themselves down from it. When the anxiety feels constant, impossible to ignore and very difficult to manage, those are some signs that it might be beyond the normal range of every day parenting anxieties.
Several contributing factors are the hormonal shifts that come after birth, the major responsibility and constant care of a newborn, and sleep deprivation, universal for all new parents. There’s also a myriad of changes that accompany having an infant in the household, which inevitably impacts the relationship dynamic with everyone else in the family. Several factors that may create greater vulnerability to PPA is pre-existing OCD and/or an eating disorder, perfectionistic tendencies, a Type A personality prone to worry, extreme PMS and prior miscarriage or stillbirths. A lack of social support and marital stressors can also contribute to this condition.
There is hope. Postpartum anxiety is very treatable by a licensed professional with postpartum and perinatal mood disorder expertise. Psychotropic medication prescribed by an experienced psychiatrist or psychologically minded OB/GYN can also be of use. Research indicates that Cognitive Behavioral Therapy and mindfulness based meditation are also effective in alleviating symptoms.
If you suspect you might be experiencing Postpartum Anxiety, know that you are not alone. It takes courage to ask for help. Talk to your OB/GYN about your symptoms and concerns, which will open the door to obtaining resources to start your journey to healing, and to becoming the best mother, woman and partner that you know you are capable of being.
Of noteworthy mention is Laura’s description of self care (“me time”) and finding her own identity after birth. It is so common for new mothers, or second/third/fourth time mothers, to question who they are beyond being a mother (or who they are beyond being a walking dairy for their infant). Motherhood is wonderful, but very demanding and can feel like there is little room for the old person you once knew who had interests, hobbies and passions beyond her own children. Know that this questioning of identity is very normal and it will take months to feel as though you’re gradually returning to yourself. There’s no need to pressure yourself to get immediately back into your old passions or interests, especially as it feel like there’s little time for that during the postpartum period. This is OK. Returning to your old self (or rather, a new version of you with the same old interests and passions) is a gradual process. If you feel like you have lost all interest or passion for things that once interested you, you might be experiencing anhedonia, which is a common symptom of depression. Again, please know that help is available and you can process these issues in a safe and nonjudgmental atmosphere with a licensed professional.