Postpartum Depression: When having a baby
gives you more than the blues
by Karen Kleiman, MSW

Part One

When a baby is born, everyone expects that this will be the best time in their life. No one expects this time to be complicated by tears, frustrations, feelings of inadequacy, anxiety attacks and/or depression. It doesn’t always make sense and it certainly isn’t fair.

Julie couldn’t figure out why she felt so badly. Her baby was born three months ago, beautiful and healthy. Her delivery was uneventful and she and her husband, David had been looking forward to this time for months. Everything seemed to be going perfectly.

But something was wrong. Julie wasn’t able to put her finger on it, but she just didn’t feel right. She felt uneasy, nervous and just not like her self. She noticed that she cried often and easily, at the silliest things. David told her that he was getting tired of her being so irritable and negative all the time. “Great,” she said sarcastically, “Thanks for your support.”

As the tension between the two of them increased, Julie continued to feel more out of control. She was troubled by constant worries about her baby and didn’t seem able to get these thoughts out of her mind. She started waking in the middle of the night and not being able to go back to sleep. “This isn’t like me at all,” she said to her friend, “I feel like I’m going crazy.”

Many women have heard of postpartum depression (PPD). Studies show that up to 30 percent of all new mothers experience clinical depression and/or anxiety after childbirth. Like Julie, some think it is a state of craziness that they see exaggerated and sensationalized by the media. Others think it is a condition that only affects women who did not want their babies, or women who are not good mothers, or women who are weak. Still others, indeed most women, believe it is something that only happens to somebody else.

Studies show that up to 30 percent of all new mothers experience clinical depression and/or anxiety after childbirth.

We now know that these presumptions are not true. PPD can affect women who are happily married or women who are in constant conflict with their partners. It can affect women who are eager to get pregnant, and women who are totally unprepared for pregnancy. It can affect women who come from stable, supportive families with no history of mental illness or women from dysfunctional families of origin, who had previous episodes of depression. It can strike any woman, immediately after the birth of her baby, or it can surface many months later.

Unfortunately, PPD has been misunderstood and misdiagnosed for some time, by mothers and the medical community at large. There are many reasons for this:

1. Medical professionals have been taught to expect a certain degree of emotional upheaval during the postpartum period, so there is a tendency to normalize such responses and perhaps not take the woman’s concerns seriously.
   
   
2. We live in a society that does not tolerate a mother’s feelings of fear, ambivalence, rage. Often the expression of these feelings is interpreted as inappropriate and out of control.
   
   
3. Women strive to keep up with their own high expectations of motherhood and when they fall short, they are besieged with feelings of inadequacy, guilt and enormous grief. They hesitate to reach out for help for fear of being labeled a “bad mother.”
   
   
4. Symptoms of depression and anxiety after childbirth often fall through the cracks of the medical community -- with women bouncing back and forth for support among psychiatric, obstetric, pediatric, and general family practice disciplines.
   
   

Next Part
Part One	Part Two
Part Three	Part Four

About the Author: Karen Kleiman, MSW, is a clinical social worker and mother of two who writes and lectures on the subject of postpartum depression. She is the author of This isn’t What I Expected: Overcoming Postpartum Depression (Bantam Books, 1994). Ms. Kleiman is founder and director of The Postpartum Stress Center which provides educational consultation, diagnostic assessment, and group & individual therapy for women and their families who experience difficulties related to pregnancy, pregnancy loss and the postpartum period.