When I learned we were going to have a baby, I was BEYOND THRILLED! It had been a hard path for us, getting pregnant. I was “older,” had a high-stress job, and unfortunately had several miscarriages along the way. I wanted a baby so incredibly badly, the fear that I wouldn’t be able to have one seized at my heart, and I had to actively choose faith and positivity multiple times a day just to make it through. Having a healthy pregnancy was an incredible blessing. And despite some physical complications during my pregnancy, I felt radiantly joyful throughout. None of of the hard stuff registered as a negative. Every aspect was a privilege.
In the vein of most Type A people everywhere, I thoroughly researched every single aspect of pregnancy, infants, parenting, and baby gear. I scoured the internet, read books and articles, even medical journals. I did everything I could to have a healthy pregnancy and healthy baby.
When the time came, I had a beautiful, gloriously healthy baby with the biggest, fattest cheeks you’ve ever seen. While I had loved and nurtured him throughout my pregnancy, in the first moments of holding him, all that I had previously been was hollowed out and then re-filled with a primal love that consumed all of me. And then the fear set in.
I wasn’t scared of the responsibility. I was scared he would die.
As Elizabeth Stone said, having a child "is to decide forever to have your heart go walking around outside your body." I saw danger everywhere in a visceral way, in flashes of explicit visions that always ended in harm. If I picked him up, I saw him fall and his neck break or head smash. If I took him for a walk, I saw us getting hit by a car, his death in horrific detail. I was constantly vigilant, barely sleeping for listening for his breath. I anxiously waited for the year mark when I didn’t have to fear SIDS. I greeted each stranger who came to our door with suspicion, inexplicably certain he or she would be a crazy person coming to kidnap my child and kill me. When driving, I would have visions of driving into oncoming traffic or off bridges – not because I had a desire to harm us, but because I was somehow afraid it could somehow accidentally happen.
During this time, it felt like only I could anticipate the dangers everywhere, and only I understood how real and serious they were. And so I never left my baby’s side. Showers were quick and efficient, often with him safely situated in a bassinet in the bathroom with me. I handled every feeding and almost every diaper change. We didn’t have date nights. I didn’t leave him with my husband, much less with our visiting parents, other family members, friends, or a sitter. I took him with me everywhere, all the time – including during my “self-care” moments when I went for facials, massage, pedicures or on walks. Above all, I needed to protect my baby, and I knew without a doubt that only I was capable of doing so, because only I appreciated what could happen.
As we had no family in town and my husband was working nonstop, and because I was also gloriously happy, no one noticed how skewed my perspective on danger was. And despite all my preparations, all my research, and possibly because I didn’t feel depressed and I had no impulse to hurt my child, it did not register in my mind that perhaps this was not “normal.” But that doesn’t mean it was.
So how can you tell when your baby blues and newborn nerves are something more?
Baby Blues or PMAD?
Parents often experience some form of “baby blues” in the days after childbirth. In fact, up to 85% of new mothers experience the baby blues after giving birth. Baby blues, also called postpartum blues, are the result of hormonal changes and the stresses of being a new parent. This condition is transient; it comes on around 2-3 days after birth and lasts around 2 weeks. During this time, a new parent feels overwhelmed, tearful, exhausted, hypo-manic or irritable. With self care, support, rest and good nutrition, these blues resolve naturally.
If, however, depression or anxiety persists longer, is more severe, or interferes with family bonding, this may be a sign of a Perinatal Mood and Anxiety Disorder (PMAD). Unlike the baby blues, perinatal mood and anxiety disorders are not limited to the time immediately following birth. They can first appear during pregnancy, right after childbirth, or even months after the child is born. Further, PMADs are not limited to birth mothers. Mothers, fathers, and adoptive parents of every culture, age, income level and ethnicity can experience them. In fact, one in 10 new fathers experience PMAD. PMADs do not usually resolve without treatment.
Additionally, although the term “Postpartum Depression” (“PPD”) is often used, there is actually a spectrum of disorders that can affect new parents. Below are some identified by Postpartum Support International.
- Depression/Anxiety in Pregnancy. It is estimated that 15-21% of pregnant women experience moderate to severe symptoms of depression or anxiety.
- Postpartum Depression. Approximately 21% of women experience major or minor depression following childbirth. Low income parents and teen parents have rates up to 60%. PPD symptoms differ for everyone, but may include feelings of anger, fear and/or guilt, lack of interest in the baby, appetite and sleep disturbance, difficulty concentrating/ making decisions, and possible thoughts of harming the baby or oneself.
- Perinatal Panic Disorder. This is a form of anxiety that occurs in up to 11% of new parents. Symptoms include feeling very nervous, recurring panic attacks (shortness of breath, chest pain, heart palpitations), many worries or fears.
- Perinatal Obsessive-Compulsive Disorder. According to Postpartum Support International, this is the most misunderstood and misdiagnosed of the perinatal disorders. It is estimated that as many as 11% of new mothers will experience the following symptoms obsessions (persistent thoughts or intrusive mental images often related to the baby), compulsions (doing things over and over to reduce the fears and obsessions) or avoidance, and a sense of horror about the obsessions. These mothers know their thoughts are bizarre and are very unlikely to ever act on them.
- Postpartum Posttraumatic Stress Disorder. An estimated 9% of women experience PTSD following childbirth. Symptoms typically include traumatic childbirth experience with a re-experiencing of the trauma (dreams, thoughts, etc.), avoidance of stimuli associated with the event (thoughts, feelings, people, places, details of event, etc.), and persistent increased arousal (irritability, difficulty sleeping, hypervigilance, exaggerated startle response).
- Perinatal Bipolar Disorder. Over 70% of women with bipolar disorder who stop medication when pregnant become ill during the pregnancy. Twenty-two percent of depressed postpartum women are suffering from a bipolar depression.
- Postpartum Psychosis. This occurs in approximately 1 to 2 of every 1,000 deliveries. The onset is usually sudden, most within the first 4 weeks, with symptoms including: delusions (strange beliefs) and/or hallucinations, feeling very irritated, hyperactive, decreased need for sleep, and significant mood changes with poor decision-making. There is a 5% suicide rate and 4% infanticide rate associated with Psychosis and thus immediate treatment is imperative.
For additional information and more comprehensive list of symptoms, click here.
If you are experiencing any symptoms or house any concerns, please do not wait it out. Seek professional assistance. A great resource is Postpartum Support International, 1-800-944-4PPD (4773), www.postpartum.net.