Q: I am currently pregnant and all I am hearing a lot about postpartum depression and I am so worried that I will have it too. Do you have any advice for avoiding depression after the baby is born?
A: This is an important and scary question and one that deserves so much time and discussion! First let’s start with some definitions and break down the two most commonly talked about emotional states in the postpartum time for new parents.
Baby Blues
Baby blues effects 80-90% of new mothers and it causes them to be increasing emotionally sensitive and tender. The saying goes “When the milk comes in the tears starts to flow.” There is a tremendous hormonal shifting in the first two weeks after the birth of a baby. A new parent might find themselves not reacting normally to situations, their mood is louder and more intense and overall they might find themselves having a thinner skin emotionally. This might look like a new mom crying because they are so in love with their baby, grateful that you brought them a meal all the way to feeling waves of grief and sadness as they look back and process their pregnancy and birth. This emotional phase lasts for approximately the first two weeks after the birth.
Postpartum Depression and Anxiety Disorders
Postpartum Depression and Anxiety Disorders (otherwise known as PMADs) are treatable mental illnesses but serious diseases. Symptoms go beyond the first two weeks of baby blues and can have a later onset beginning 4-6 weeks after the birth. It is a medical condition of feeling hopeless and the inability to experience pleasure. A person’s favorite food, activity (such as yoga or dance) or tv show no longer brings a them joy. The new mom might have trouble eating or opposite of that, finding themselves eating way too much and it can also be triggered and exasperated by consistent sleep deprivation.
Postpartum depression and anxiety and cousins. With postpartum anxiety comes worries that are not able to be reassured and ruminating thoughts that circle round and round inside of a new parent. Both, postpartum depression and postpartum anxiety are mental illnesses and are highly treatable. If a person experiences two weeks or more of these symptoms and they are experiencing them more often than not and they are not going away, it is time to call someone, anyone. It can be the parent’s best friend, a family member, a therapist, their primary clinical care provider. Mental health is a highly stigmatized in our culture and there is a fear that if a new parent says they are not coping well, that they will be shamed for not being a good parent or cannot parent their baby. Our strength as new parents comes from being vulnerable and asking for help. The shame of depression and anxiety cannot survive when we tell our story and it is met with an empathetic response and support.
However, there is a large percentage of the new parent population that does not have postpartum depression or anxiety but still does not feel emotionally “good”. What is happening is a human developmental transition called Matrescence. There has been a growing problem of new parents misdiagnosing their postpartum emotional ups and downs and calling it depression because this transformational process is not something that has been talked about.
Matrescence
Matrescence is a term that was coined by anthropologist, Dana Rafael. Matrescence means the process of becoming a mother. It is one of the most substantial physical, mental, and emotional changes that a woman may experience in her lifetime.
Matresence is a developmental process just like adolescence. Do you remember your teenage years full of angst and tugging emotions? Were you mean to your parents for no substantial reason and then crying in your room for long periods of time? During our adolescence, we have hormones moving through us and pulling our emotions every which way, and our body is changing at a faster rate than we can process. The transition from pregnancy to parenthood is a similar transition. We know it is normal for teenagers to be all over the place emotionally, but we do not talk about the transition into motherhood the same way. There are whole books describing and supporting the arc of adolescence but there is not much out there on the transition of a pregnant person into parenthood.
The emotional transformation of matrescence begins during pregnancy and women don’t quite know what to do, Their bodies are changing at an alarming rate, the sense of autonomy has begun to shift, no longer can she do what she wants, when she wants it and her cycle is starting to be dictated by the baby growing inside of her. In my childbirth classes, pregnant women cry when they share how they are feeling and partners seem a little confused on who this new person is sitting next to them.
Matrescence is not an illness, it is a phase of life. It does not require treatment. there are waves of emotion that come and go and the best treatment for this developmental phase is not medication, but peer to peer support. It is important as new parents that they have have permission to talk about the complex aspects of this transition including the ups and the downs.The ability to put our feelings into words is healing. Sharing our story is healing.
A new mother may not be happy most of the time. However, worries are able to be soothed when she gets advice, she can find joy in her day to day. She has one or two nights when she cannot sleep but it is mixed into life, into moments when she feels like she’s got this. A new mother might have moments where she kind of feels like her own self again. She can sit and have a moment of peace when someone else has the baby. She can find wellness and relaxation within these periods of intense emotions.
If a new parent has no access to pleasure at anytime whether someone is watching the baby or not, that is a crucial aspect of diagnosing postpartum depression and or anxiety.
Just like teenagers have ups and downs, new mothers have ups and downs. Ups and downs do not mean you have postpartum depression. Ups and downs are a normal part of transformational growth. Befriending difficult emotions is key for healing and peer support groups are a place for new moms to connect and explore tears, anger, confusion fear and laughter, joy and hope. Peer support helps new mothers feel less alone, feel less stigmatized, normalizes this new developmental and transformational process in their lives. Peer support in and of itself can reduce postpartum depression.
No one is going back to their previous life after having a child and I think so much of the struggle of new parents is the vision and narrative that has been created even before pregnancy. The vision that they will have a baby, be fulfilled and then get back to whatever they were doing before, back to work, back to their regular life.
There is no going back to life before a baby. Life as a new mother and parent is inherently messy, complicated and difficult after having a baby and parenting is a profound and complicated road with no I’ve arrived moment. Yes, there is support, yes there are proven mental health practices to treat postpartum depression and anxiety, however there is no taking away the transformational process of matrescene just like there is no way to take away the transformational process of adolescence.
What we need is to have safe places to share our stories and receive the gift of listening. Listening to someone while they process their difficulties is a healing balm and through peer support we can lessen the hardships and suffering of feeling alone through our transformations.
What we need on these transformational human journeys is companioning, people to walk with us through the foggy woods. When we have someone by our sides and are able to tell our stories and we feel listened to an empathetic connection arises and shame cannot survive. By talking about matrescence and normalizing these parental transformational moments in our lives we will ultimately make it though and be better parents on the other side.
Do you have a burning question that you haven’t had a chance to ask a care provider or are maybe too embarrassed to ask? We’ve got your back! The 411 is like a “dear doula” column where you get to (anonymously) ask about all those things you think you’re alone in wondering, or that you might be struggling with. We’re here to affirm that no, you are not alone. With evidence-based answers from not only birth doulas, but childbirth educators, experienced moms, lactation educators and more, we’ll help save you from falling down the Google rabbit hole. We wanna know what’s on your mind! Submit your question online.
