“I’m ready to start a family,” I eagerly told my husband in the summer of 2014, as if it was just as easy as me being “ready.” I did have a feeling it wouldn’t be that easy for me. I had a few things working against me: an irregular period my entire life, I’m a type 1 diabetic, and I have a baseline level of anxiety that I knew would somehow get in the way.
Luckily, it only took one round of clomid for me to get pregnant. I was ecstatic and only anxious about keeping my blood sugars within normal range. Pregnancy wasn’t easy as a diabetic, but I took on the challenge and worked hard so that I could produce a healthy baby. And that I did. Little did I know, though, that I had many of the risk factors of developing a postpartum disorder.
I am a clinical psychologist. I knew the signs of postpartum depression and as a new mother, I would check in with myself frequently with the DSM (Diagnostic and Statistical Manual of Mental Disorders) checklist of depression. I denied most of the criteria. But something was still wrong. The raciness, the perseveration, the unbearable sleepless nights alone with my thoughts. If I stop breastfeeding I’ll be happier, I thought. I stopped. I wasn’t sleeping any better. When she has a schedule I will be happier. I sleep trained her and put her on a feeding schedule. It still wasn’t getting any better. I went back to work when my maternity leave ended. I was happy at work. I dreaded going home. Something was wrong. I finally went for an appointment with my primary care physician. I told him how I wasn’t sleeping. “Baby keeping you up?” he asked. “No, she sleeps through the night.” It was then that I realized I suffered from Postpartum Anxiety Disorder.
Emotionally, I loved my new baby endlessly and I rationally, I understood how lucky I was to have her. Yet, I was still mourning my old life – a time that I only needed to worry about myself. I felt an odd sense of relief once I finally recognized what was going on in my own mind. I knew I had a lot of work to do on myself, and for myself. Between more regular therapy appointments and making sure I utilized my own network of social support, I began to understand how challenging it was for me to accept my new role as a mother.
After working through my struggles and making self-care a priority, I began my training in Perinatal Mood Disorders. I became passionate about treating and supporting women going through the overwhelming adjustment to motherhood. Something I learned in my training is the importance of education. Knowing the risk factors of a postpartum disorder can help women prepare and have supports in place if/when they are struggling. Even just being able to recognize the effects of hormonal changes and the life changing experience of giving birth is valuable.
Risk factors for a Perinatal Mood Disorder include: history of another mental health disorder, mood reactions to hormonal changes (puberty, pms, birth control), endocrine dysfunction (diabetes, thyroid imbalance, infertility), inadequate support, interpersonal violence, and financial stress. Other contributing factors include: a difficult pregnancy, difficulty breastfeeding, and societal expectations of motherhood. At least 1 in 7 mothers experience serious depression/anxiety during pregnancy or postpartum. That number is too high and prevention is key to reduce the shame/guilt new mothers feel and normalize the need for support.