Friends and neighbours would comment and compliment me. “You look great for someone who just had a baby!” or, “Wow, I love your new hair!” Little did they know my new, shorter haircut was a product of hating what I looked like so much, I needed a drastic change. I was also pulling my hair out. I needed it short enough to make it harder for me to sit there and go through the strands, picking out hairs that ‘didn’t belong’ and yanking them out. I camouflaged that by donating 15 inches to a charity. That was why I cut my hair off. Not because I was trying to look chic.
To look at me would mean you’d never know how much I was suffering. How badly I felt about myself and my abilities as a mother. You’d never even for one second think that the most horrible, intrusive scary images and thoughts daily invaded my head, making me feel as if I were the lowest of the low. How could a good mother think those things, anyhow? For me, the answer was simple. A good mother would and could not and therefore, I was not a good mother. That was my secret.
You would never know by looking at me or talking to me that I was suffering from horrible PND and OCD. You would never know how hard it was for me to leave my own house, to walk out that front door was positively terrifying. You would never know to look at me that I would just sit there and cry. You would never know the horrible things I thought. You’d never know I felt sad, alone and horribly depressed. You’d never know how irritable I felt, the rage that boiled or that I screamed into my pillow to relieve the stress until I was hoarse. You’d never know the crushing anxiety or the extreme numbness I could feel.
So what does postpartum anxiety look like? It looks like your friends, your neighbors, the perfectly put together mum at play group and the mums that runs into the dentist office 15 minutes late with a baby on her hip and a toddler in her grip. It looks like my friend who could not leave her house and it looks like the lady who whispered to me once that she knew how I felt. It looks like me, right there in the mirror, on my best days and my worst days. It looks like the new mum who quit her job to be home alone with her baby and it looks like the mum who just handed her 6 week old infant to strangers while she goes to work. We have a misnomer that a postnatal mother doesn’t dress well, doesn’t put on any make up, forgot how to do her hair and sits in a dark room and cries. Postnatal depression can look like just about anyone. That’s what makes it so dangerous and that’s why it goes untreated and undiagnosed too often.
I had the misunderstanding that admitting I had an illness was to admit I was weak. That I had failed at taking care of myself and therefore, my baby. By admitting my secret, by getting out how horrible I felt, that was when I opened the door to getting well.
Posted with permission (adapted for Australian readers). Originally posted by Claire Petrillo, Postpartum Stress Center.
Historically, anxiety is understood to be an ally; it is an internal signal that can serve to protect us, motivate us and alert us to danger. In these ways, anxiety reactions are understood to be adaptive and to a large extent, primal and instinctive. When people experience a dangerous or threatening situation, the fight-or-flight response kicks in. This survival response pumps adrenaline throughout the body, setting off a surge of physical changes such as rapid heart rate, palpitations or increased blood pressure. The purpose of this response is to prepare us for action. Most of us can recall a time in our lives when we responded this way, either to a very real threat or to a situation that we perceived as threatening to our well-being.
When we take a closer look into the restless mind of a new mother, we find an array of anxious responses that generally fall into three categories. First, there is the “all new mothers feel that way”, e.g. I wonder if she’s getting enough milk. These are anxieties that fit comfortably within a socially acceptable definition of “new mother anxiety.” Secondly, there is the “something must be wrong with me” axiom perhaps expressed as, I cannot leave the house until the baby is 6 months old. I heard that before they are 6 months old they are susceptible to mega-germs that can cause fatal diseases. I’ve tried to leave but I can’t breathe when I go outside, my chest starts pounding and tears pour out of my eyes. It’s just not worth it. These represent anxieties that interfere with functioning and require professional attention.
And third, by far the most common scenario, “Is this normal for me to feel this way?” are those anxieties that teeter between the two ends of the continuum.
The majority of women who seek professional support for symptoms of postpartum anxiety and depression are ones who find themselves wavering between the two extremes: Is what I am thinking normal or could I be going crazy? They know they are far more anxious than they’ve ever been before and wonder how much is too much anxiety. They worry that they are way too nervous, hypervigilant or obsessive, so much some days that they fear they might really be going mad. Thus, if we view this on a continuum, with “normal” anxiety at one end and severe, incapacitating anxiety at the other end, the preponderance of postpartum women who struggle with symptoms of anxiety fall somewhere between the two points, leaving a great deal of room for doubt and uncertainty.
It stands to reason that motherhood and anxiety would go hand in hand. The awesome responsibility and unpredictable nature of the role can combine in combustible fashion, leaving many women feeling vulnerable and unprepared. Nearly everyone, including the new mother and her surrounding loved ones and healthcare providers, expects some degree of anxiety to go with this territory. But this is a crucial part of the problem. It is often difficult to distinguish “normal” anxiety from that which may be a symptom of an anxiety disorder or an expression of postpartum depression. Most are not surprised or terribly concerned when the mother of a one week old infant reports that she is nervous about her baby’s well-being, or worried that he’s not eating enough, or wondering if he’s going to die from SIDS if she doesn’t go check on him throughout the night.
Another part of the problem is that healthcare providers more often than not dismiss early expressions of anxiety as par for the course. In addition, in spite of the current focus on postpartum mood disorders, the emphasis primarily remains on depressive symptoms. Women remain reluctant to express anxiety in general partly because it can feel so “whiny” or irrelevant. A woman’s urgent desire for relief is too often construed as neediness, a label that serves no purpose to a weakening spirit. Regrettably, many doctors reinforce this by referring to anxiety as merely a nuisance for the postpartum woman; something she just needs to get used to.
But make no mistake about it, at its worst, anxiety can be crippling, and within this context of postpartum women, it can be an crucial signal that requires further attention.Women should not be afraid to talk about it and seek help. Family members and healthcare providers must take the expression of anxiety seriously, they must stop responding with dismissive comments and they should feel obliged to help the mother find symptom relief either through self-help measures or professional support.
Posted with permission. Adapted by Karen Kleiman, MSW, LCSW, from "Dropping the Baby and Other Scary Thoughts" (Routledge, 2010) by Karen Kleiman and Amy Wenzel
Posted by Dr Renée Miller