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The Many Faces of Postpartum Depression

By Amalah

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I heard a LOT about postpartum depression when I was pregnant for the first time. Women were finally opening up about their experiences, the media was talking about it, there were brochures and book chapters and checklists about the signs and symptoms. By the time I was discharged from the hospital, I was completely sick of the topic. Yes, yes. Depression, sleep problems, loss of appetite, fatigue, feelings of worthlessness, thoughts of suicide. Seek help. Speak up. Postpartum psychosis requires an immediate call to 911. Got it, check. As someone who had been through bouts of the regular old-fashioned kind of depression and YEARS of anxiety problems, I figured I would be more than capable of recognizing PPD if it were to happen to me.

And you know what? I didn’t have any of the symptoms the books and brochures talked about. I had the postpartum blues (or baby blues) for a week or so — lots of crying while I struggled to breastfeed, viewing everything that was “wrong” with Noah as some kind of colossal failure on my part — but once the hormones regulated all that went away and I was a confident, happy new mom who you would never, ever peg as having anything remotely close to PPD.

Except for, you know, the fact that I was terrified out of my gourd a good 75% of the time.

When Worry Becomes Something More

Sure, there’s always fear when you have a new baby — of course you’re going to fret about SIDS and milestones and sleep and worry about dropping the baby on the kitchen tile. That was actually the sort of stuff that rarely occurred to me to really worry about. Instead, I went out of my way to invent stuff to be afraid of.

I secretly, internally, obsessed about the future, imagining all kinds of awful worst-case scenarios. That Noah would get sick and die of cancer, or in a car accident. That he’d be kidnapped and hurt and molested and killed. Every sad news headline spawned an alternate reality where it was US, it was NOAH, it was my child, my loss, my tragedy. Now that I had a baby, I was acutely aware of just how much I had to lose, and it drove me a little crazy there, for awhile. I couldn’t think about how much I loved Noah without getting overwhelmed by how vulnerable my heart was now. I bit my nails and lost weight (“I’m just losing baby weight! That’s all!”) and read the newspaper to torture myself on purpose, thinking that I could force myself to grow a thicker skin. I only cried over superficial stuff like dropping Noah off at daycare or mean comments about me on the Internet, and never uttered a word to anyone about my intrusive dark thoughts and fears and fantasies. It got worse right around the end of my maternity leave and continued for a few months after that. At some point, and I really don’t remember when, it just…stopped.

Did I have a classic debilitating case of true PPD? No, I didn’t. More like a postpartum anxiety disorder — which, considering my long, storied history with anxiety and panic, I SHOULD HAVE RECOGNIZED. In fact, it never really occurred to me that something was ever wrong until after Ezra’s birth. Because I DIDN’T have any of those thoughts. I’ve had some anxiety issues related to Noah and his special needs, but it’s a concrete sort of worry. I don’t start shaking and gasping on the highway because I can’t stop visualizing a car smashing into the baby’s carseat, and THEN start worrying that I had somehow actually glimpsed the future or that my thoughts would actually will the accident into existence. Yeah. Nothing like last time.

Cough.

Postpartum Depression Doesn’t Always Look Like Depression

Perhaps I missed it, but I really didn’t know just how many flavors of postpartum depression there are, and how many of them don’t actually manifest in a classic sort of depression, where you can’t get out of bed and fantasize about swallowing pills. For some women, it’s anxiety. Panic. Others get something more like obsessive-compulsive disorder, fretting about hand-washing and germs and toxins in foods and the environment. Some women describe an irrationally short fuse — anger and rage, usually directed at themselves for “failing,” but sometimes they lash out at their partners or strangers. Basically, if there’s a mental condition out there, it can take a special hellish form in the postpartum months.

So. Yeah. I should have spoken up last time. Maybe I needed medication, maybe I needed to talk to someone, maybe I just needed to let Jason know what was going on in my head so he could help me redirect and talk through my anxious energy. But I just honestly didn’t know that what was happening wasn’t NORMAL rookie-mom worry, that it was excessive and not something I should have been internalizing and keeping to myself. I was *okay* in the end, obviously — it ran its course and evened out eventually — but I think if more people had stressed to me that hey, postpartum depression is not always just depression, that it actually can manifest in a number of mood and anxiety disorders, that it’s (GASP OMG CONCEPT) different for different women, I would have been a bit more self-aware that I didn’t have to live like that. Postpartum depression — in all its faces and forms — is completely treatable AND curable. And it happens to the best of us, and the BEST OF MOTHERS. No shame.

If you’re concerned about yourself or someone you know, check out Postpartum Support International’s website or call their helpline (800-944-4PDD). Your OB or midwife or primary care doctor should also be able to help you — it’s just important to CALL SOMEONE. If you’re having serious problems and thoughts of harming yourself or others, call Hopeline at 800-SUICIDE — they can help you find specialized postpartum resources in your area.

If you landed here but are still pregnant, visit Amalah’s Pregnancy Calendar. You won’t regret it.

Photo credit: Porcelaingirl°

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Amalah
About the Author

Amy Corbett Storch

Amalah

Amalah is a pseudonym of Amy Corbett Storch. She is the author of the Advice Smackdown and Bounce Back. You can follow Amy’s daily mothering adventures at Ama...

Amalah is a pseudonym of Amy Corbett Storch. She is the author of the Advice Smackdown and Bounce Back. You can follow Amy’s daily mothering adventures at Amalah. Also, it’s pronounced AIM-ah-lah.

If there is a question you would like answered on the Advice Smackdown, please submit it to [email protected].

Amy also documented her second pregnancy (with Ezra) in our wildly popular Weekly Pregnancy Calendar, Zero to Forty.

Amy is mother to rising first-grader Noah, preschooler Ezra, and toddler Ike.

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chiquita
Guest
chiquita

Amy, thanks for this. I was very anxious after the birth of my first baby and could. not. sleep when the baby slept. I hated my husband for going to work. I fortunately was in therapy throughout my pregnancy, so had some professional oversight, but it was a hard, hard couple of months. I think it is hard for many women to figure out what is going on b/c we expect it to be hard and to be anxious. So it is hard to tell when it crosses a line. I think telling someone else is key so they can… Read more »

Kari Weber
Guest
Kari Weber

With my first son, I didn’t feel any of the symptoms either. Just a need to do everything myself. I thought that if I asked for help, someone would just remind me that I was the wone that wanted the baby. And then I would… feel bad? I don’t know really what it was that kept me from asking for help. At the time, it seemed like a much bigger thing. I was breast feeding, so I just justified in my mind that it was just “easier” for me to do all the diaper changes since I was feeding him… Read more »

beanery
Guest
beanery

“I had somehow actually glimpsed the future or that my thoughts would actually will the accident into existence.”
Oh my god, yes! That was totally me. So glad you got through that (me too!). Thank you for writing this.

Kellie
Guest
Kellie

I got PPD with my son. It went undiagnosed until he was almost 2. He also was diagnosed around the time with Autistic Spectrum Disorder so my docs wondered if it really was PPD or actual depression from the insane and confusing life we had been living up until that point. When my daughter was born 21 months ago, I made sure I was aware of the old signs and symptoms. It had been a full 6 months that I was off everything before I got pregnant with her and I didn’t want to have to go back on meds.… Read more »

madison
Guest
madison

Wow. I don’t know where to start. My first son is 6 months old on Monday & I suffer from everything you all mentioned. I cry when I drive accross bridges, I haven’t let anyone, even my parents, babysit, I envision people breaking into my house and stealing him so much so that he has never slept a night alone in his crib.. I didn’t know it could be PPD because I’ve never thought of hurting him. I’m doing everything right. The breastfeeding, the organic baby food making, throwing stupid parties for Easter, his half birthday etc. I didn’t think… Read more »

madison
Guest
madison

Wow. I don’t know where to start. My first son is 6 months old on Monday & I suffer from everything you all mentioned. I cry when I drive accross bridges, I haven’t let anyone, even my parents, babysit, I envision people breaking into my house and stealing him so much so that he has never slept a night alone in his crib.. I didn’t know it could be PPD because I’ve never thought of hurting him. I’m doing everything right. The breastfeeding, the organic baby food making, throwing stupid parties for Easter, his half birthday etc. I didn’t think… Read more »

Jamie
Guest
Jamie

I had the same anxiety issues as you did with my second. Nothing with my first. With my second I would be terrified of things like driving the car because I just knew I was going to get in a horrible accident. I finally told my husband about it. I told him I didn’t think I needed medication yet, I wasn’t thinking of hurting myself or anyone else, but if the anxiety didn’t start getting better soon I was going to go see the Dr. It started clearing up a couple weeks later.

She Likes Purple
Guest

Although I had a smattering of symptoms, the worst was my insomnia. There were days I wouldn’t sleep at all and not because Kyle wasn’t sleeping but because I could never unwind long enough to sleep. I saw 6 a.m. without ever going to sleep more times than I can count. When I finally started sleeping and gave up breastfeeding, I regained my sanity and exhaled for the first time since he was born (two months in).

She Likes Purple
Guest

Although I had a smattering of symptoms, the worst was my insomnia. There were days I wouldn’t sleep at all and not because Kyle wasn’t sleeping but because I could never unwind long enough to sleep. I saw 6 a.m. without ever going to sleep more times than I can count. When I finally started sleeping and gave up breastfeeding, I regained my sanity and exhaled for the first time since he was born (two months in).

Di
Guest

Thank you, thank you, thank you.
You’ve summed it up so perfectly. Right now I’m wrestling with the aftermath of PPD with Claire (who turned two a week ago) so that the anxiety I’m feeling now doesn’t turn into PPD when The Tadpole is born in September.

shriek house
Guest

You make a great point, that PPD can present in a variety of ways. I always thought the development of PPD had a lot to do with whether the woman was prone to melancholy or anxiety already (raising hand), but the fact that you didn’t have it with your second child seems to indicate otherwise.
It’s funny though, I just wrote a rambling post about learning to let go of fear & anxiety, and as soon as I hit “publish” was overwhelmed with the thought that I’d just jinxed something somewhere badly. Sigh.

Shylo
Guest

Last week I was given the option to go to the emergency room or get in to see a therapist for PPD ASAP. Luckily, I did not need to head to the emergency room that day. But there had been some days when things were more acute — and when I could not have even found shoes, much less my car keys. I had an idyllic delivery, but the breastfeeding — oh my God has that been tough. It’s hard to bond with something that causes you pain, and it’s hard to relax enough to sleep when you know you’re… Read more »

Amalah
Guest

shriek house: Actually, women who have a history of depression/anxiety ARE more likely to struggle with PPD. Women who are bipolar are more likely to suffer from postpartum psychosis. But that doesn’t preclude someone withOUT a history of mood disorder suffering from a form of PPD. So there is a connection, but statistics and “more likely” are never the full story. Every woman and every pregnancy is different. With my second baby, breastfeeding went perfectly, there was no trauma or danger at delivery (scheduled c vs. emergency c w/ fetal distress, meconium & macrosomia), I asked for help when I… Read more »

Catherine S
Guest
Catherine S

Oh man, this one really hits close to home. Like, sobby, weepy mess by the end of reading your post close to home. My son is 9 months old on Thursday and I would not repeat the first 5 months of his life if someone told me that I would inherit 30 bazillion dollars and have sex with Brad Pitt for the rest of my life. The PPD, well, it was just bad. The insomnia started the day he was born and is just now getting better. I would not let anyone put ribbons or bows on our mailbox because… Read more »

kelly
Guest
kelly

Thanks, Amalah. I’ve been having problems with those fears you describe, and hadn’t really realized that that’s an expression of PPD. However, on Monday, I spent most of my day at work reading the blogs of parents who’ve had children die, trying to inoculate myself to the possibility. Near the end of my day, seeing the whole pile of work that I didn’t get done, feeling totally sad and depressed by all my reading, I realized, um, yeah, I need to talk to somebody, and made an appointment to see a therapist. So, this was a very timely post for… Read more »

SUPAHMAMA!
Guest

now see, after my first was born i just thought my husband had turned into an idiot and it was normal to make him sleep in the other room as far away from me as possible. i also thought it was completely normal to rage at him in my head and then get pissy with him when he had NO IDEA WHY I WAS THROWING “LASER BEAM EYES!!!” at him every time he came into the room. let me just tell you, the drugs are the best thing that happened to me. i was even able to be convinced into… Read more »

Photomom
Guest
Photomom

I had the ppd- anxiety version, too. There were lots of stressful things going on not related to the baby, but it adds up. I just kept imagining I heard her cry at night, and got up to check her 3-4 times when she was snoozing away. I had zoloft for about 9 months, and while I wasn’t suddenly Woohoo rainbows and flowers, I could sleep better, didn’t imagine disaster scenarios from every day things, and stopped being so aggravated with my husband. (My girlfriend mentioned that she was more bitchy postpartum, and I told her , no , my… Read more »

Ysha Oakes
Guest

Hi Amalah and All Dear Mamas! My problem is after 17 years carrying the great positive effects of Ayurvedic postpartum care for preventing ppmds and reversing early or non-medicated later stages of anxiety, depression, and many other symptoms – I”m still swampt by how to use the media to get the good news out there. you can see some deceptively simple tips at my website, and links for more. I’m starting to blog, twitter and facebook too, tho the reason there are so many forms of this so called disease is each person has individual needs to balance. AND each… Read more »

Angela
Guest
Angela

Like everyone else, just want to thank you for running this. But with as much as PPD has been publicized in the last couple years, it seems like a lot of medical professionals still aren’t getting the point. I’m not quite 3 weeks pp, and at my 2 week incision check I mentioned to my OB that I was suffering, and had after the birth of my three year old as well. He told me to make time for myself. Heh. Called my PCM and was given an appointment for next week, that was the earliest possible. THEN I called… Read more »

sarah
Guest
sarah

hi, as i read this i couldnt help but think about my postpartum depression and imagining taking pills and everything. i finally do not feel alone, my daughter is now almost a year and half and i cant imagine going back to that. i fear that having another child will bring back my negative state of mind. i hope theres hope for me. i felt so alone and still do, somedays. i was depressed my whole pregnancy and i ended up with an emergency c-section. my boyfriend broke up with me 2 days after i had my daughter and i… Read more »

Becca
Guest

I was fine with my first born….just the typical hormonal things all new moms go through. Worry, fatigue, blues. With my second daughter I was full-on PPD. I wound up with a prescription for Zoloft (approved for breastfeeding, I heard) and must say it did me a world of good! I still suffered from horrible insomnia (that I still have remnants of now….3.5 years later). The insomnia really is the worst because it makes all the other symptoms so much more exaggerated. But with #2 I had as close to an actual breakdown as you can get….I lost all confidence… Read more »

paranoid
Guest
paranoid

I’m sitting here crying with recognition right now. My second daughter is four months old right now, and it took 18 months, two losses and IVF to get her. I look at her and my life and know that I should be happy (and many days, I am happy, really!), but still, there’s this hair-trigger temper. And rage. And the feeling that I just want to sit on the sofa and not talk to anybody or do anything but stare at the television but oh my god the three-year-old wants to play pretend ponies AGAIN. Even my husband thinks, at… Read more »

Landie
Guest
Landie

Reading these statements from mothers has been so amazing. I have PPD, but it wasn’t diagnosed until my son was almost a year old. I had a horrible birth experience (11 days overdue), ended up with a C section and was in the hospital for 6 days because my enormous son (10lbs, 8oz – and I didn’t have gestational diabetes and only gained 30lbs) was dropping weight like crazy. I had a horrible feeling from the very beginning that something was wrong and I had a very difficult time bonding with him. Turns out that there WAS something terribly wrong,… Read more »

Tamara
Guest
Tamara

I’m reading this and realize its a long time past the original post date – but I’m going to comment anyway. I didn’t ‘discover’ for lack of a better term that I had had PPD until recently. My daughter is a month shy of being 3 years old. My PPD was like all of you have said unique to me. I couldn’t say no to people, yet hated them for being in my house and taking my baby. I was paranoid about the most crazy things and some actual real things that had to be hashed out with the In… Read more »