Breaking the Silence — on Mental Health and the Postpartum Experience

Anxiety Manifested

Imagine you are a first-time mother. Your sweet baby is weeks old. She reclines in a bouncy chair at the base of your pantry shelves and coos contentedly. You decide that she is docile enough for you to prepare dinner for the evening, and you reach for the crock pot on the top pantry shelf.

As your fingers grasp the heavy appliance, you stop with a jolt. You realize that the crock pot is directly above your daughter’s head. Rather than moving on from that realization, you spend the next few minutes sinking into the horror of not just the idea, but the mental visualization of dropping the heavy crock pot on your infant’s head, the resulting blood and shattered skull, the call to paramedics, the harrowing ride to the emergency room, and the eventual death of your child by your own clumsiness.

This is the reality of my postpartum anxiety, and one of many mental challenges I went through as a new mother. At the time, I had no formally diagnosed mental issues, only suspicions.

Postpartum Woes and My Cry for Help

It was not until after my second child’s birth that I began to have issues severe enough for me to seek help. I had a toddler always vying for my attention, and a baby who cried often. I was trying to toilet train my daughter, which was one of the most frustrating experiences in my life. I scared myself sometimes when the baby was crying, my daughter was dawdling in the bathroom, and I got so mad I grabbed her arm with force.

When my second child was around five months old, the stress got to be too much for me. I was a stay-at-home parent and I had no interest in packing up the kids to go out. We lived in a very small town 30 minutes from the nearest city, and I felt the walls closing in on me.

The emotions I experienced ranged from a perpetual feeling of worry to anger. When I read checklists for postpartum depression, I didn’t exactly fit the description. Most talked about crying every day and feeling in the depths of despair. I felt this once in a while, but more often felt overly stressed, angry, enraged, and out of control. Postpartum depression checklists don’t usually highlight those attributes.

When I broke down and decided I needed help, I started by calling the “stressed-out parents telephone line.” I don’t remember what organization ran this, but it obviously was not for people with mental illness. The person on the other end tried to assure me that all parents have stress, and that I should reach out to the people around me and make sure I take time for myself. The advice was supposed to comfort me, but I hung up feeling emptier than before.

The second call I made was to my obstetrician’s group office. I talked to the nurse, and she informed me that five months postpartum was too far beyond the point for postpartum depression, and that they wouldn’t really be able to help me at their office. She suggested I call my general practitioner. Again, I hung up feeling dejected.

I felt very alone, and I went on like this for a few more months until the day my husband reached his own breaking point with my anger and negativity. As is common in relationships affected by mental illness, rather than asking my husband for help, I shut down. The tipping point happened when he ended one of our arguments by saying, “You need help!” He was saying it rhetorically, but it was the push I needed. I took him literally and the very next day I found a counselor.

Part of the initial evaluation was a battery of written tests. I took them home and worked on them for hours over a few days, then returned the completed tests to the therapist’s office and spent an hour or two describing to her my family history, my childhood, and my present issues.

A week later I sank into the sofa while my counselor revealed to me the patterns in my test results: depression, generalized anxiety, overall negativity. It was surprising because over the years I had attributed my feelings to moodiness, hormones, or my personality. I never considered that they might fall under a formal diagnosis.

Then she said, “And now we need to have a talk about ADD.” She told me that the results of the tests and my history strongly indicated that I did indeed have ADD. It wasn’t clear if I also had hyperactivity. I leaned more towards inattentiveness, but there were plenty of examples from my childhood that fit under hyperactivity.

I sat in the car after the appointment, breathing in the frigid January air with a smile on my face and peace in my heart. For years I had been overly hard on myself for my forgetfulness, my “spaciness,” my disorganization, and my intense emotional reactions. All of those qualities could be explained by ADD. In my mind I went through example after example of how the ADD had affected my life, relationships, and profession without my knowing.

ADD in the Female

Later I would read articles about women and ADD. Many women are not diagnosed until their 20s and 30s when they are having postpartum issues, specifically with the second child because of the overwhelming nature of having double stimuli. The birth of the second child is often the point of diagnosis for women because with anxiety and help from others, mothers with ADD are able to compensate and handle just the one child. However, in trying to juggle two children’s needs, the mother begins to go over the edge.

Girls in general are grossly under-diagnosed with ADD because their symptoms in school are not as evident as boys’. Instead of jumping out of my seat, I sat and daydreamed, stared out the window, doodled, or fell asleep on my desk. My mom was a teacher so I learned excellent study habits, and those combined with my co-morbid anxiety were enough to compensate for the challenges of ADD. However, it also meant that I would sometimes stay awake studying until 2am and set my alarm for 5am so I could wake up and study more. Anxiety is how I made it through high school and college with a 3.7 GPA, a fact that prevented me from believing I could have ADD.

The Merits of Medications

Once I had the ADD, anxiety, and depression diagnoses from a licensed counselor, I went to see my general practitioner. She prescribed the lowest possible dose of stimulant, which I soon realized was laughable. Either my doctor didn’t believe me or she had no clue how to prescribe ADD medication. So I made an appointment with a psychiatrist.

The psychiatrist started me on an appropriate dose of a stimulant, which was a turning point in my life. In taking it, for the first time my brain felt an internal calm. I was amazed at how I could sit with my children as usual while they played, and instead of feeling worried and unsettled, my brain was focusing on my love for them as it never had before. I watched them play and looked at them in a completely new light.

I wanted to try treating my depression with therapy rather than medicine, and got through six months of it before I decided therapy wasn’t enough. I still felt like something was “off,” and the stimulant had the dichotomous side effect of increasing my anxiety while also providing calm. It was hard for me to pinpoint the persistent melancholy. So I worked with the psychiatrist to find the correct mix of anxiety and depression medicines, and finally started to feel like the “me” that had been hiding away for my whole life.

New Challenges, Same Story

By the time I became pregnant with my third child, I had worked through many personal issues and also cured my cabin fever by getting a part-time job at a library. Finding a job was suggested by my therapist, and it fulfilled my need for mental stimulation and adult interaction. I still felt an undercurrent of anxiety though, especially when my children were at the babysitter’s. It was a small price to pay for the way I was able to focus on work and enjoy my children.

Unfortunately, I was not able to take the medicines while I was pregnant with my third child, nor for 14 months after while I was breastfeeding. My son Kyle was diagnosed with Down syndrome at birth, and my reaction to that diagnosis is an enigma to me. For someone with a history of depression, anxiety, and negativity, one would have expected me to sink deep into the depths with a child’s diagnosis of Trisomy 21. However, I didn’t cry about it once.

For months I wondered if I was in denial. Writing this, I know how impossible it sounds, but it is the absolute truth. Maybe I had perspective. I know what it is like to live with a neuro-diverse brain, and maybe that allowed me to believe my son would have challenges, but would also be an integral part of our family and live a full life. His diagnosis made me feel different and special. I also had gone through an intense grieving process just weeks before Kyle’s birth when my dear Granny died, which helped me see his birth as a blessing.

The postpartum anxiety did haunt me though, as it had with my other children. It manifested as negative thoughts during my third postpartum period. Sleep deprivation increased the negative thoughts. Mostly, I felt as if an outside source was whispering “you hate him” into my mind. I never told anyone about those words, not even my husband. I was ashamed by them, despite knowing they had no truth. Thankfully, I recognized my thoughts as anxiety and did not sink lower because of them. Each time the thought entered my mind, I would immediately and deliberately replace it with a positive one.

With Experience Comes Wisdom… sometimes

With the birth of my fourth child, I was well-accustomed to the effects of postpartum anxiety and unmedicated ADD, and was able to talk myself out of the negativity for a while. When I prayed for my children at night, I would pray for them to avoid specific ailments and harm. These thoughts would spiral into detailed imaginings of the harm, leaving me in a fit of worry. When I realized this, I was able to scale back the detail in my prayers and avoid the scary pictures. Knowing one’s problems and tendencies is key to finding the solution; however it’s not always enough.

I knew to expect that the fourth postpartum experience would be similar to the second, especially considering my third child’s extra needs. What I didn’t plan for was the way each experience manifests itself different from the last. Sadly, my parents were on the receiving end of my paranoia and negativity, to the extent that I projected my troubles and viewed them as coming from my parents. I closed myself off from them at a time when I desperately needed their help. In the midst of my postpartum mental haze, I saw them as threats and their help became a source of greater anxiety for me. I didn’t realize any of this until I weaned my fourth child at a year old and started taking antidepressants again. The fog lifted, and I realized how bad things had been.

Postpartum anxiety, depression, and ADD will always be a part of me. My challenge is in finding the help I need from professionals, my family and friends, medication, and literature. Cumulative changes I have made such as finding work to stimulate my brain, asking for help, and recognizing my behavior patterns have furthered the healing process. My comfort lies in knowing why my brain goes in the directions it does. I will always struggle with unwanted thoughts and mental images, but I have learned what tools I can use to avoid them taking over my life.

This essay was originally submitted for a book publication called Mothering Through the Darkness. My piece was not selected for the book, and I hope it will now reach many or more people through this blog. I hope what I have written will encourage struggling women to get help from professionals and be open about their experiences to break the walls of misunderstanding.

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About Katie

Katie Bee is the author of for Elysium blog: a site about family, Down syndrome, home, art, and writing.

14 thoughts on “Breaking the Silence — on Mental Health and the Postpartum Experience

  1. Liz

    I think this is beautifully honest. I’ve had an anxiety disorder since just after college, and it got worse after each birth. After I had my third I was diagnosed with PTSD with mild OCD. There is so much stigma surrounding mental illness, especially for mothers. I applaud you for putting this out there.

    1. Katie J.

      Thanks for your encouragement, Liz. As you know, it’s not easy to speak of mental illness, but the more we share our stories, the more we can help all women. I am glad you sought help for yourself too with all you have gone through.

  2. Kristin Nilsen

    Thank you so much for turning the rejection experience into something positive. I have no doubt that your offer to collect the rejected essays could start a movement of its own. And after reading your essay, I’m really wondering if I have ADD and if maybe I should do something about that. And that’s what this all about, isn’t it?

    1. Katie J.

      Thanks, Kristin! I hope people will respond to the offer–I will have to check back on facebook after Lent is over. 😉 I am so happy to hear that my essay was thought-provoking for your own situation… definitely what it’s all about! Good luck in your search for answers.

  3. tinap222

    Wow, I can relate to this on so many levels, but somehow I’ve escaped the anxiety with this 3rd baby, for now, so I’m going to just enjoy the ride. So interesting about the ADD though.

  4. Hannah @Supermommy!...Or Not

    Thank you for sharing this. I’ve had postpartum depression since the birth of my 2nd child, but it got a little better until my 4th child was born. The stress of having a very needy medically complex baby while taking care of 3 other young children overwhelmed me, and I finally talked to my doctor about it since I was having constant suicidal thoughts. She put me on an anti-anxiety medication and the change was huge. I now can finally enjoy my children and don’t feel my heart racing everytime someone cries. I tried weaning off of it last month and it was definitely a no-go. For now, I’m fine with being on it if it means that I don’t have to feel like that again.

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