Postpartum Depression: It’s Not Just About Feeling Sad

Have you recently been experiencing difficulty after having a baby but question whether you fit a postpartum diagnosis? Maybe you aren’t necessarily sad. Or maybe the four- to six-week period you read about online has passed.

As both a therapist and mom of a 6-month-old, I’d like to share my experience with postpartum depression and provide an overview of some different ways it can manifest.

After each of my babies was born, I was over the moon and, unlike many new parents, I did not struggle with adjusting to a growing family the first few weeks. I didn’t mind the lack of sleep, breastfeeding was a breeze, and I couldn’t get enough of holding my sweet babies.

I was given the Edinburgh Postnatal Depression Scale at my son’s newborn and two-weeks pediatric appointments, and took it again at my six-week postpartum appointment with my obstetrician-gynecologist. My scores probably showed I was doing great. However, my issue with that scale, and with the name postpartum depression, is that they don’t really encompass or screen for the symptoms I began experiencing.

My symptoms started around week seven postpartum, at which point you aren’t visiting doctors or being monitored as regularly. Rather than experiencing some of the classic symptoms of depression, such as sadness, decreased energy, and loss of interest in activities I previously enjoyed, I instead felt extremely anxious, frustrated, and irritable. While I know these can be a part of depression in some people, I initially ignored them, 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 alphabetical order. My mind often felt like it was racing, and I felt an 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. I snacked even when I wasn’t at all hungry. I remembered weeks six to 10 being the hardest with my first baby, so I found myself justifying what I was going through, saying this will likely pass and it was 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. I attributed it to being exceptionally tired. 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.

My breaking point finally came one night when both of my kids were crying and I just couldn’t take it. I went downstairs and cried, too, wondering whether throwing my baby down the staircase might make me feel better. Although I had tried to dismiss or justify other symptoms, I knew that thoughts of harm were definite indicators of postpartum depression.

Thankfully, the therapist in me started recognizing this voice as similar to the voices I’m often told about by the people I help. I started to tell myself, “If you heard someone saying these things in your office, a red flag for depression and anxiety would definitely be raised.” I went back and forth in my mind, arguing between thoughts of, “I don’t need medication. I teach coping skills!” and, “You tell people all the time that depression is not a weakness or something to be ashamed of. It’s an involuntary condition that deserves attention!”

My breaking point finally came one night when both of my kids were crying and I just couldn’t take it. I went downstairs and cried, too, wondering whether throwing my baby down the staircase might make me feel better. Although I had tried to dismiss or justify other symptoms, I knew that thoughts of harm were definite indicators of postpartum depression.

I called my ob-gyn 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 antidepressant that day with a plan to talk to one of my colleagues and eventually taper off the medication.

I typically tell people to expect it to take at least a few weeks before they truly begin experiencing the effects of new antidepressant 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 have all gone away, and I’m more available to focus on my kids, knowing I’m doing a pretty decent job.

After experiencing this 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 you find yourself feeling scattered, anxious, irritable, or like a failure, please recognize that these experiences are associated with postpartum depression.

Additionally, know that there is much controversy in the medical and mental health worlds regarding the specific causes and criteria for postpartum depression, especially regarding the time frame in which it can occur. Regardless of when post-baby you feel a struggle, I encourage you to talk with a therapist and your doctor so you can feel better and enjoy those precious moments with your family.

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