Mental health has a terrible stigma in this country. In general, people scorn others whom they perceive as not having it all together, being different or struggling to navigate stressful times and situations. Some people have lifelong mental illness while many others encounter bouts of it at some point in their lives. In fact, Johns Hopkins estimates 26 percent of American adults will have a diagnosable mental health disorder each year and the CDC indicates more than half will have a diagnosable mental illness at some point in their lives.

Our job isn’t to judge those individuals. The saying, “Be kind, for everyone is fighting a battle you know nothing about,” comes to mind.

I have family members with profound mental illness. I know many people who struggle with mental health but function through it. I’m sure the number of people who are struggling with it and I don’t even know it is even higher.

But for just a moment, I’d like to focus on a subset: perinatal and postpartum depression and anxiety. The American Psychological Association estimates one in seven women experience PPD. I believe that figure is higher since many women try to hide their feelings from their doctors and even from themselves. Nevertheless, it’s a very real problem, yet not talked about enough and often comes with plenty of internal and external shaming.

My History

Landon’s traumatic birth story is well-documented on this blog. It shouldn’t come as a surprise that in hindsight I realized I had postpartum depression and anxiety for nearly the entire first year of his life. My OB and even Landon’s pediatrician screened me for it at most appointments. I usually indicated on the questionairre that I felt better than I truly did. Nonetheless, my score was borderline most times, but never definitively indicated depression or anxiety. I declined going on anti-depressants and, although I did schedule one appointment with a therapist, she was a very poor fit and communicator for my needs. I didn’t go back and I didn’t look for a different provider.

“I have a great support network,” I’d tell myself, even as I held my feelings close to my chest and shamed myself for feeling anything other than grateful Landon and I were healthy. The only feeling I should have had, I told myself, was ecstasy and joy over my newborn son.

The world told me this, too. When I finally opened to one friend that I was having “sort of a hard time,” the person suggested I talk to a professional, switched the subject and never asked me about it again. Another person asked me how I was, to which I responded, “I’m okay.” That person said, “You just had a baby! You better be a lot better than just okay!” Yet others questioned my ability to love and care for my own child.

Those instances cemented in my mind that I had no right to feel and express anything other than joy and affirmed my fear that if I opened up, I’d be met with judgment and criticism.

Through time, Brian’s support and finding a better balance between motherhood, my career and maintaining a bit of individuality, I got through.

My Present

Fast forward four years and I was pregnant with Bryce, which unearthed long-buried anxieties around pregnancy and childbirth.

The anxiety mounted the closer I got to my due date. I was braced for near disaster. In quite the opposite experience of Landon’s birth, I had a successful VBAC with Bryce after a wickedly fast labor that barely left time to get the epidural in, let alone have it take effect. It was a painful few hours (yes, just a few hours of labor), but we got our sweet Bryce at the end of it.

Meanwhile, postpartum depression often starts as a perinatal depression, which is even less screened for and understood than PPD. If a mother has had PPD once, she’s likely to have it in subsequent pregnancies and it’s likely to be progressively worse.

The depression in this pregnancy started the day after Martin Luther King Day when I received some news that sent me spiraling into an intense grief cycle I’m still working through. The few people I confided in regarding my grief didn’t understand it and I realized this will be a silent, heavy grief I’ll likely carry with me to the grave. Some pain is too deep to ever fully go away; rather, I need to learn how to live with it. It’s a terrible burden to carry alone.

I confided in my OB about my mental health struggles and also started working with a therapist through regular tele-health appointments. Although my grief hasn’t disappeared, she has helped me eradicate guilt I had early on by reminding me two opposite feelings can live in the same body. She has agreed with my sentiment that my grief may never go away, but she is confident I can get to a place where although that grief lives in me, it doesn’t rule me. I hope to even be at peace with it one day.

A successful delivery and comparatively smooth time caring for an infant alleviated my anxiety. But depression still lingers. I haven’t pulled myself out of that hole and still don’t know if I can, but I have learned to live and function in it and find moments of joy.

By no means am I an expert on mental health, but I have learned a few things throughout the years about what it’s like to live with PPA/PPD, what has helped me and what hasn’t.

You Are Worthy of Support

If you have PPD or PPA, here’s what you need to know:

• You are not alone. I know it feels lonely and isolating. But you. are. not. alone. I see you. An entire community sees you and wants to help. I turned to Facebook and sought out several support groups. Some of them I left quickly. Two of them, however, have been marvelous. A group of internet strangers have turned into some of my biggest cheerleaders and support people, and in turn have allowed me to be part of their support network, which is also healing.
• If people aren’t good supports, it is not your fault. I’m still working to accept and realize this. A number of people have disappointed me in their lack of support. On the flip side, others have been a true friend and listener. What I’ve realized, though, is that when people say insensitive, rude things to you, it is rarely about you. It’s about them and how uncomfortable they are hearing about something of which they have no understanding. Their comments are likely an effort to make themselves feel more at ease.
• Keep reaching out. Find that person you can talk to. Better yet, find multiple people. I believe it’s important to have your spouse, a close friend or family member in your inner circle. But it’s also important to have a professional who can provide critical help to gain coping skills and try to ameliorate anxiety and depression.
• You are a good parent. Having anxiety and/or depression doesn’t make you a bad parent. As a new mom in 2018 who had PPA/PPD, one of the most frequent mantras running through my head was, “I am a failure as a parent.” That was simply not true about me, and it isn’t true about you either. You are still a wonderful mother who loves your child(ren) AND has anxiety or depression.

What You Need to Know About Your Loved One

If your loved one has PPD or PPA, here’s what you need to know:

• They are doing the best they can. No one wakes up every day and thinks, “It’s a great day to feel anxious and depressed.” No one. They probably tell themselves to “snap out of it” or “get over it” or any combination thereof every day. If it was that easy, they would. Please don’t tell them that, too; it will only beat them down further. They are doing the best they can already.
• It’s hormones … and it’s not. Pregnancy and postpartum hormones are a bear. They make every emotion feel bigger and stronger than it is. BUT, pregnancy hormones do not fabricate emotions or thoughts or mean that what your loved one is feeling is “just the hormones talking.” It’s insulting and wrong to insinuate or say that. I once compared pregnancy hormones to drinking too much wine. Both simply allow you to fully feel an already-existing emotion and release all your filters so you just say and express what’s on your mind. Hormones or not, their feelings are real and worthy of respect.
• Love them, affirm them and listen to them. Whether or not they are, they feel alone. Respect what they might need to feel better, whether it be the need for space, the need for a fun afternoon out, the need to talk about it or the need to not. Tell them you may not understand what they’re feeling, but you support them and are an available, non-judgmental listening ear. Affirm them as a parent and as an individual.