Thanks to Brooke Shields (and unfortunately Tom Cruise), there has been much discussion in the last few years about Postpartum Depression. I’m glad the issue has attracted a lot of attention! Not only are people talking about it, more and more mothers are becoming aware of the symptoms, addressing it promptly and seeking help. It isn’t such a taboo subject anymore. Brooke’s book, Down Came the Rain, is a terrific book for mothers experiencing postpartum depression, those who want to prevent it, and people who are supporting a loved one suffering from it. I highly recommend it as a resource that gives hope and shows the light at the end of the tunnel!
Fortunately, I don’t see too many patients with postpartum depression in my practice. What I am seeing with increasing frequency, is mothers who are completely overcome by anxiety. These are women from all walks of life, who are crippled by their fears and doubt their ability to care for their baby. They are exhausted and spend the majority of their time questioning every aspect when it comes to the care of their baby. They read anything they can get their hands on regarding childcare and inevitably find something that reinforces their insecurity that they are doing everything wrong. They are tormented by all the different opinions out there and feel completely incapable of deciding what is best for their family. Their minds are racing with all the things they should be doing and how they can do them better. The expectation that they be perfect mothers is an all-consuming goal that none of them will ever achieve.
My experience in this regard has also been that the more educated and successful a woman is before she has her baby, the more significant the anxiety after the baby is born. It is almost as if these women have life under control and are confident before the baby. But once the baby comes, they are no longer in control of their situation (who is with a new baby?). In an attempt to regain some semblance of control, they go overboard, hoping to do an even better job at motherhood than they did in their career. They throw themselves into the new job, but make themselves anxious in their pursuit of doing it right.
I realize that I am making a lot of generalizations with nothing but my experience to support it. But I do find this to be the most heartbreaking aspect of my job: trying to help an obviously smart, capable, loving and devoted mother see that she is doing a wonderful job! No matter how hard I try to point out all the things they are doing right, they can find me a contrary opinion that says they are doing it wrong-breast or bottle, family bed or Ferber, to vaccinate or not, Gerber baby food or homemade, cloth diapers or Pampers? It is nearly impossible for me to provide the reassurance they need and I frequently find myself at a loss when trying to make them feel better.
The other difficulty is that these women are usually able to function rather well, compared to a woman who is truly depressed. It is usually several months after giving birth that anyone notices these mothers struggling, as they are relentless in their pursuit of the appearance of perfection. Because they are running on overdrive, only the people who are closest to them realize they are having difficulty and often don’t know what to do to help them. And I am not sure what the best answer is.
I do know though that there are people far more qualified than I am to deal with these sort of mental health issues, and that should be the first place to start. Counseling and medication do help, and it is not forever. We have to remember that many phases of motherhood are just that, a phase that will pass. Sleep also makes a big difference, and that should be a priority of every new mother and those who can help her. And I am not talking about an 8 hour night. But a good nap each afternoon or in the early evening works wonders to help your body and mind rejuvenate. In addition, socialization with other mothers is strongly encouraged. Isolation makes anxiety much more intense. Having other mothers to share your experiences with and who can offer insight into how they have handled similar challenges can make all the difference!
When visiting the lactation offices at Women and Infants Hospital one day, I saw quotes on their wall that I wish every mother could remember:
You’re the only mother your baby has, and she thinks you’re wonderful!
The good news is that you don’t have to be perfect!
How I wish every new mother knew that and took it to heart!