Motherhood…
Not What I Expected
Motherhood can certainly be an exciting and joy-filled time for many women and their families; however, it can also be a time when many women are at risk for emotional illness. Expectant and new moms often expect what everyone else expected –that this would be the happiest time in their life, yet it can be painful beyond belief when maternal bliss is not your experience and you have been blindsided by an illness.
When a mother declares her ambivalence about being a mother, it is often frowned upon as failing. There is a universal expectation that mothers want to be mothers. It is expected that the maternal instinct will surface on cue and everything will fall into place; however, the stress of becoming a new mom can sometimes bring weepiness, irritability, and anxiousness. In the first couple of postpartum weeks this is to be expected, although when these feelings linger beyond the 2-3 week time frame then symptoms of depression should be suspected.
The voice of depression is often inconsistent with the expectations and reality of motherhood and often expressed as helplessness, dependency, fear and anxiety. Although these symptoms are part of the illness of depression, they are often experienced as the essence of the core self. Such as, I am a bad mother, everything is out of my control, I am powerless over how I am feeling, my loved ones will abandon me, my environment is not safe and lacks meaning, I am weak and dependent on others, and I will always feel this way. It is essential for a woman to know that when the illness is treated, the symptoms will go away and they will feel better.
Women who have never suffered from postpartum depression or any other form of depression or mood disorder may be wondering how they will know if they are experiencing a perinatal mood disorder. The single best way for you to know is to trust your instincts. If you feel that something is terribly wrong, chances are very good that you are right. Don’t let others dismiss or minimize your situation, you know best if there has been a change in your mood, personality, functioning, or ability to cope.
Perinatal Mood Disorders
Perinatal mood disorders pose unique challenges for a woman’s immediate and extended family and friends. When left untreated these disorders can have severe consequences, not only for the mother, but also for her child and the entire family. Knowing when to seek help is essential and the decision to seek support is a strength not, a weakness. The term perinatal mood disorders encompasses a wide range of syndromes that can affect a woman during pregnancy and after the birth of her child. It often includes prenatal depression, the “baby blues”, postpartum depression and postpartum psychosis.
It is common for women to experience some form of pregnancy related depression or anxiety. Prenatal (during pregnancy) depression affects between 10 and 20 percent of women. Adjusting to this significant life transition may simply call for additional support. The baby blues (which occurs after the baby is born) affects as many as 85 percent of new mothers. Symptoms of the “baby blues”, such as tearfulness and sadness, mood changes and reactivity, peak 3-5 days after delivery and are usually resolved within two weeks without treatment.
Postpartum depression (PPD) affects 15 to 20 percent of new mothers and usually peaks 3-6 months after delivery, but can emerge anytime within the first postpartum year. At least 33 percent of women who have had PPD have a recurrence of symptoms after a subsequent delivery. Symptoms may include feelings of hopelessness, worthlessness, and lack of motivation. Symptoms can interfere with the mother caring for herself and her infant with the potential to lead to suicidal ideation if left untreated. PPD is not the “baby blues” and depending on the level of impairment can be mild, moderate, or severe. Early intervention and proper treatment will augment recovery.
Postpartum psychosis is a rare condition that affects only one or two women per thousand and is often misrepresented in the media as postpartum depression creating panic and misunderstanding in women with much less severe disorders. Approximately 75 percent of women with postpartum psychosis have an onset within two weeks of delivery. This condition often puts the woman at significant risk for infanticide and suicide, which is considered to be a postpartum emergency.
Perinatal mood disorders are a complex combination of biological, emotional, and behavioral changes with the exact cause of condition unknown. A woman who recognizes that she has symptoms of depression and anxiety may be inhibited by denial, shame, fear, and/or lack of energy from discussing her symptoms with her healthcare provider. Women should be encouraged to be open about their feelings, to seek help, and to feel that her symptoms are not shameful and do not make her a bad mother.
The two most common forms of treatment for perinatal mood disorders are psychotherapy and medication. The type of treatment will depend on the severity of the symptoms. Treatment has an 80 to 90 percent success rate in patients. The earlier treatment is initiated, the better the prognosis.
Recognition, Healing & Recovery
Women need to be supported with the right information and education that provides clarification of a proper diagnosis and treatment plan. Healthcare professionals trained in treating perinatal mood disorders can provide reassurance and understanding regarding what a woman what is feeling. They can also provide validation for what a woman is experiencing and offer unconditional support and non-judgmental listening. There are well-trained healthcare professionals who know exactly what to do to help a woman feel like herself again.
The initiation of therapeutic healing provides a hint of relief and a splash of hope in what can be experienced as drowning in despair. Women should not have to suffer by themselves. The decision to get help is a strength not, a weakness. Seeking the right support can provide a plan to get you back on track to feeling like yourself again.