Postpartum Mental Illness
I couldn’t wait to be a mom. I wanted it SO badly, that I couldn’t envision a reality where I wasn’t blissfully happy in the first years of my children’s lives. I spent years envisioning what it would be like when I had my first baby. I could see it clearly! I was convinced through my teenage years that I was going to have a daughter young, and we would be super close, almost like Lorelai and Rory Gilmore. She’d have Chris’ blonde hair, and maybe blue or green eyes, but my big eye shape, and my goofy and creative personality. We’d share clothes and shoes, and she’d like all the music I liked. We would do everything together. It would all be sunshine, daisies, and rainbows.
In 2010, I was standing next to my car scraping ice off my windshield in front of my boyfriend’s home, when I was struck by a passing vehicle going 35-40mph. As I was bouncing between my car and his, and then tumbling through the air before hitting the ground, I saw the future I was going to miss out on if I was about to die. Not a flash back of my whole life, as many near-death survivors talk about. I saw me and my boyfriend (now husband, Chris) getting married… and then having a baby shortly after. A baby boy who looked exactly like me. Brown hair. Brown eyes. My cheeks, my nose, my chin, my lips, my hairline, my forehead, my ears, my everything.
Since you’re reading this, I obviously survived the accident, and I also seemingly had a premonition, because my oldest child was the son I saw in my mind - the spitting image of the boy I envisioned in that near-death experience. (With a little less hair.) The little goofy and creative blonde haired, big green eyed girl came second. Our third is a carbon copy of my husband as a baby.
Left to Right: Allison (our youngest), Sam (our oldest), and Natalie (our second)
As a very social and outgoing person, I suppose I could have anticipated being lonely when I quit my full time tech job to stay at home with our son, and no longer being surrounded by dozens of coworkers 5 days a week. But I joined a variety of online groups for moms who had babies around the same time, and I spent many hours per day talking to those moms.
In the first weeks postpartum, the baby blues hit hard - but I was told they should go away on their own soon. Instead, it got so severe so quickly, that by the time I realized I needed to schedule my 6 week checkup, the thought of them asking me how I’m doing was terrifying because I knew I would break down sobbing. And what if I was too honest about how sad I was, and the daily intrusive thoughts about dying so they could have my life insurance policy, and they got scared that I might hurt my baby? What if they decided to put me in the mental hospital for a psychiatric hold if I was too honest about how often I thought about getting killed in a car accident? I never scheduled that 6 week checkup. By the time I knew I wasn’t doing well, it was already too late for me to take that step.
And I spent the first year of motherhood completely in denial about just how severely I was struggling with my mental health. Crying every time my baby cried for more than about a minute, and quickly spiraling into panic attacks. Things with my husband weren’t great, at the time, either. He was under a significant amount of stress with work, and when he came home, he immediately went upstairs to study, as he was trying extremely hard to obtain his CISSP, a cybersecurity industry certification, that is more or less the equivalent of a Bachelor’s degree. My son wouldn’t take bottles from anyone, and believe me, I spent a whole year trying to get him to take one, so I could leave him with a babysitter for more than an hour at a time. My son was extremely attached to me, and we co-slept for quite a long time, because I couldn’t sleep train without having panic attacks. I was overstimulated, over-tired, and didn’t have the kind of social support I’d envisioned having. I almost never saw my two best friends. I felt invisible to everyone. And yet, I felt this immense social pressure (thanks to the dysfunctional social media dynamics of 2014 where most people portrayed these picture perfect lives and were terrified of talking about mental health) to pretend like I was LOVING motherhood.
I spent an hour styling my hair and trying not to cry my makeup off, while my baby screamed at me and refused to take a nap. This is literally the biggest smile I could force. Most of my photos of me and my son were like this.
When I look back on the selfies I took of my son and I during that first year of his life, I can see the way my smile didn’t meet my eyes. I can see how hollow I felt. And I can’t explain to you the immense guilt I felt every time I talked to neighbors and church members my age who were dealing with infertility and miscarriages - here I was, being a mother, being the one thing they wanted to be more than anything else in this world, and I was having daily intrusive thoughts about wishing I’d be killed instantly in a car crash, so my husband could move on and find another wife to help him raise our kid. I told myself they’d be better off with our life insurance policy. I wasn’t good enough for them, and they deserved better. I remember one time I was having such a severe panic attack about this, that I even considered whether I was such a bad mom that the right thing to do for him might be to actually run away from my family and disappear forever.
Looking back on this time in my life makes me instantly break down crying. Because this was classic postpartum depression and anxiety - but I was in SEVERE denial about it. But since it wasn’t how I’d seen it portrayed in TV, like the episode of House M.D. where the young mom tries to drown herself and her baby, I didn’t think that’s what was happening to me.
Things were not going well that first year or so. Chris and I ended up in marriage counseling, and our marriage barely survived. Things finally rebounded after we both worked really hard to mend our relationship, and we decided to bring more children into our family. I started a fitness program called Couch to 5K that helped me learn to love running, and it was so good for my mental and physical health that I was able to stop taking antidepressants.
When we got pregnant with our second child, I had a talk with my husband about how we were going to plan for my postpartum mental healthcare. My provider explained that the type of medication I wanted could suppress our baby’s instincts to start breathing in the first minutes after birth, so I decided to plan on starting to take it immediately after birth, and I didn’t want to wait until my 6 week postpartum checkup. I said I needed that appointment scheduled immediately, and I told my husband that I might not be emotionally strong enough to be completely honest with them if I was struggling. So I needed him to be prepared to come to those appointments with me, and tell them what he was seeing. I explained that part of what exacerbated my mental illness was breastfeeding and not being able to get our son to take a bottle, so I wasn’t able to leave him with babysitters, and the thought of telling him that we needed to start spending a lot of money on formula every month scared me, because I worried he’d think I was being too selfish and not sacrificing enough for our children, and I worried that he would complain about making that switch. I needed to set the expectation that he was not allowed to complain about the cost of formula if I decided I needed to quit nursing, because the guilt would absolutely break me and I would continue breastfeeding until my mental health finally killed me. And I needed him to be prepared to make those calls for me if it seemed like I was in a mental health crisis, because when I’m struggling like that, I can’t make that call without inconsolably crying and being unable to speak. I did the same thing with our third baby.
And I decided that I was going to be very open and transparent about my mental health, hoping that it would allow my loved ones to know that I was not okay. I hoped it meant people would show up for me if I needed help.
I’d post images like these and resist the urge to slap on a fake smile. And I tried to be honest in the caption about what was going on for us. I remember this was about the point I realized that I was really struggling with seasonal affective disorder. I remember hoping for literally anyone to show up and visit me… or even comment on these posts and start talking to me about it, because I felt so alone.
I remember how I’d frequently reach out to people, asking them to come over and hang out. Or go do something with me. Come over for a movie night. Or a craft night. Wear your pajamas. Don’t even bother putting on makeup. I’ll make us treats. And we don’t even have to talk, we could just sit in silence. And of the probably 1-2 dozen times I asked people to come over, I think a friend showed up twice. I was so thankful for those moments when they offered to come help do dishes or fold laundry with me so I didn’t have to do it alone, because it was SO NICE to have someone show that they cared enough about me to actually get in the car and show up.
And when post after post with subtle mentions of struggling with my mental health weren’t effective to communicate how much I needed emotional support… I tried being more direct about it. This might have been the first time someone actually offered to come over, and I was extremely thankful for that. (Thanks a million, Liz.)
I think the original draft of this post where I talked about just how bad I was struggling actually exceeded the character limit on Instagram, so I had to try and condense it and leave out some of the things that had been pushing me to my limit. The frustrating part was that these things weren’t even objectively difficult things - but my emotional bandwidth to handle them without completely falling apart, was very limited.
I say all of this, because I want you to know that you can talk to me if you’re struggling. I want you to know that you can tell me how hard motherhood is, and how miserable you are, and that I’m not going to judge you or think you’re a bad mother.
If I check in with you to see how you’re doing, please do not feel pressured to lie and tell me that you’re doing great, when you’re actually not. One of the things I really don’t love about living in Utah is the way that literally every neighbor you meet will say “I’m just three houses that way if you ever need anything.” But when they say “anything,” what they really mean is an egg or a cup of sugar. They’re clearly not expecting to become someone you’d rely on enough that you could call them when you need someone to come hold a screaming colicky baby while you go have a panic attack in the shower.
I was about 8 months postpartum with my second child, who was suddenly a much more difficult child the moment she became mobile, deep in the trenches of postpartum depression and anxiety yet again and struggling to stay afloat, and questioning if I was cut out for 3-4 kids if my second was such a hard baby. I had spent about a month weighing the pros and cons of the various birth control options available, hesitating a little bit about which IUD I should try this time around. One Sunday night, I laid in bed talking to my husband about calling the doctor first thing in the morning to schedule the appointment to get the Mirena IUD, and I remembered that the previous times I’d scheduled an appointment to get on birth control, they asked “What was the date of your last menstrual period?” Huh, I couldn’t remember, but it was a few weeks prior… It would probably start any day now. I rolled over, opened my phone, and checked my cycle tracking app. 36 days ago??? SAY SIKE RIGHT NOW. I leaped out of bed to run and take a pregnancy test, and it was immediately positive. Our daughters were born just 17 months apart.
That entire pregnancy, start to finish, was one long panic attack. Neighbors and members of the Church would stop by to visit on occasion, and say “Hey, how’s your pregnancy going? Are you just so excited?” I couldn’t lie to save my life. I’d respond, “It’s going horrible, actually.” Or, “I’m awful. How are you?” The looks on their faces were pure shock. We’re not supposed to be honest about that, I guess. I spent most of that year in trauma therapy for some trauma from my teenage years, but that last appointment before I delivered our third baby was spent sobbing to her about how terrified I was that I’d be so anxious and depressed that I’d mess up our kids. I’d be bedridden like my mom was. Unable to make myself get up and join my family for a trip to the grocery store, and missing out on family gatherings. Too sad to go make memories with them. I was so terrified of not being good enough for them.
I want you to know that it’s okay to struggle. It’s more than okay to not think motherhood is the greatest thing that’s ever happened to you. It’s not a sign that you’re a bad person. Or that you don’t deserve your children. Or that your kids are going to have an awful childhood because you’re spending every waking moment of your day feeling like you’re drowning in plain sight, and people are just smiling and waving at you and can’t even see that you’re barely hanging on.
There is hope. This does not have to last forever. And no, it doesn’t necessarily go away on its own if you’re just patient and have good diet and exercise habits. I waited way too long after my oldest was born for things to get better before I finally got on antidepressants. And it wasn’t until I listened to a podcast about HRT for postpartum depression and anxiety, in the middle of a global pandemic and a severe mental health crisis that nearly put me in the hospital, that I finally talked to my psychiatrist about how it felt like antidepressants weren’t as effective for me as I’d hoped they would be. I got my hormones checked in 2020, and found that a bunch of my hormones were critically low. My GP, bless her heart, was unconvinced that I needed to try HRT, and the lack of support meant I waited several more months (and another winter season with Seasonal Affective Disorder) before I went to see a hormone specialist.
A trendline graph of my progesterone levels in 2021. The level increases after multiple treatments with a hormone specialist, and directly correlates to an improvement in my general wellbeing.
Out of all the things I’ve tried over the last 4 years of doing HRT, by far the thing that has helped me the most has been Progesterone. I tried doing subcutaneous hormone pellets, vaginal troches, vaginal cream, sublingual troches, and right now I’m taking it as an oral supplement. I won’t go into the complicated details here about medication dosage and pros/cons associated with various delivery methods, but please don’t hesitate to ask me about it if you want to talk 1-on-1 about my experience - I’ll gladly answer your questions.
When my progesterone is low, I experience a number of symptoms that indicate to me that it’s time to address my hormones again. The first symptoms to return are insomnia and frequent headaches and ocular/aura migraines. Shortly afterward, my anxiety returns, and I find myself having a very short temper with my children, getting frustrated over extremely minor things and snapping at them over things that in my opinion aren’t justifiable. My sex drive plummets. My ability to motivate myself to do housework becomes nonexistent, and I find myself easily overwhelmed by completely manageable tasks, like dishes that should only take me 10-20 minutes, or making dinner. I withdraw socially, and don’t notice that I haven’t reached out to a friend for an extended period of time - and by the time I do, I can’t bring myself to send a simple text message, because my brain tells me that they don’t care about me anyway, because they haven’t reached out either, and I’m probably annoying. I cry a lot more easily when I’m frustrated, tired, or overwhelmed. I find myself going to lay in bed for a few hours every afternoon, and taking long naps because I’m too drained to even sit upright. I lose interest in my hobbies, like knitting, drawing, and landscape photography. I refuse to commit to trying to schedule play dates with my kids, or tell them I don’t think I’m up to taking them to a birthday party or family activity. I tend to emotionally over-eat to self soothe my anxiety, and gain weight really quickly, especially if I don’t have the self discipline to cook my own meals and instead resort to DoorDashing food. And more than anything, I want everyone to leave me alone. I don’t want to talk to anyone. I want to lay in bed and doom scroll for hours, and let life pass me by entirely.
If you have a history of mental illness disorders, and especially if you’ve experienced trauma (whether you feel it’s been appropriately resolved and addressed through therapy or not), you should know that you are at an elevated risk for experiencing mental illness again in the first 2 years of postpartum.
If you have experienced mental illness disorders before and have had success treating it with certain medications in the past, please address this with your doctor, and if you’re like me and struggle to proactively take steps to address it before you’re in a severe emotional crisis, I highly encourage you to make a plan with your partner and your providers to resume taking that medication, schedule check-ups ahead of time and earlier than the standard 6 weeks postpartum, and schedule follow-ups every 1-3 months as needed depending on medication adjustments. Discuss what mental illness might look like with your partner, and how it has looked for you in the past if you’ve struggled with it before. And if you’re in a dark enough place where you can’t love yourself enough to prioritize your mental health for your own quality of life… do it for your children, so you can set an example for your them of what you hope they will do if they ever experience a mental health crisis, and so they’ll know they can talk to you about it, because it could save their lives.
You matter. You are good enough. You can do this. And you don’t have to do it alone.
