postpartum depression asian momsToday we’re so happy to welcome Cat, a Chinese-American Warrior Mom, who blogs at Postpartum Thoughts.  The story she has shared with us is fantastic and I’m so excited for you to read it …

When I was pregnant with my first child, I received all the standard prenatal care: frequent OB visits, lab tests, and ultrasounds.  I also received a large packet of materials on postpartum depression.  However, I wasn’t worried about the immediate postpartum period because my mother would be living with us for five weeks after I gave birth.  How bad could it be if I had help from someone who already raised two kids herself?

In the Chinese culture, it is common for the new mother’s mother-in-law or own mother to live with her for a month after giving birth to help with the baby and to cook for her.  According to traditional Chinese medicine, our bodies have a “hot” and “cold” nature, which must be balanced for good health.  Giving birth makes the body “cold,” so in the first postpartum month, new mothers are not supposed to drink cold water, go outside, or shower, all of which can make your body “cold.”  (That’s right – no shower for a month!)  Additionally, they are supposed to eat “hot” foods such as ginger.  My mom gave me a hot water thermos before I gave birth and adamantly told me not to drink any cold water during or after delivery.  When my husband and I came home from the hospital with our daughter, my mom and several pounds of ginger greeted us.

I experienced the normal mixture of gratefulness and stress to have my mom around.  I was grateful that I didn’t have to be alone with the baby, that I didn’t have to cook for myself, that she was always willing to rock the baby to sleep when I was too tired to do so anymore.  At the same time, I was stressed because my mom seemed to be watching my every move, not giving me space to learn to be a mother on my own.  I thought I was disappointing her when I caved in after two days and took a shower, and I felt anxious asking for her “permission” to leave my own house when I couldn’t stand being trapped indoors anymore.  However, the friction we experienced was not unusual for any typical mother-daughter relationship.  I was managing as well as any new mother would.

Then one day, my baby woke me from a nap with her crying, and a sinking feeling immediately washed over me.  I couldn’t open my eyes, let alone get up.  I felt as if I had lead weights on my arms and legs.  This feeling of dread upon waking became a regular occurrence.  I willed myself to get up each time, mostly because I knew my mother would come knocking if I kept my daughter crying.  By the time my mom left, panic attacks had replaced my depression.

To call them “attacks” isn’t accurate because I was in a state of panic throughout the entire day, every day.  From the minute I woke up until the minute I went to sleep, I couldn’t take a single deep breath.  My heart was constantly racing.  I felt scared and paranoid about someone kidnapping me or my daughter.  I also felt a great deal of anxiety about my in-laws moving to our neighborhood.

At the time, I thought my anxiety was due to character flaws.  I had never heard the term “intrusive thoughts” before, so I thought I just needed to “get over it.”  I pushed through and “got better” on my own over the course of about half a year, even though I still had semi-frequent panic attacks and nightmarish thoughts about someone harming me or my baby even two years after I gave birth.  It was not until I came across Postpartum Progress that I was able to “diagnose” myself with postpartum depression because I learned about intrusive thoughts and postpartum anxiety.

So how is postpartum depression or anxiety different or the same in an Asian context?  At least in the Chinese culture, there is such a large emphasis on physical recovery that a new mother may not feel comfortable admitting to mental or emotional struggles.  Some of the restrictions for the first month, such as not leaving the house, might aggravate postpartum depression.  On the other hand, having live-in help definitely alleviated some of my anxiety because I had someone to talk to.  My panic attacks flared up after my mom left and I was left alone with my baby for the first time.

Before I had my second child, my mom also told me “not to cry as much” because it was bad for my eyes (due to the tears affecting my hot/cold balance).  This may sound insensitive, but Asian cultures value emotional restraint rather than emotional expression, counter to Western cultural values, which may lead an Asian woman to believe she should just hide her depression or anxiety.  There is also definitely a stigma in the Asian culture against mental illness, often rooted in superstition (eg: a person suffering from mental illness has “bad luck”).  Finally, Asian cultures operate on the concept of “saving face,” which requires doing whatever you can to preserve your dignity and honor.  The emphasis on emotional restraint, the stigma against mental illness, and the desire to “save face” might prevent some Asian women from admitting they need help or from seeking help.

For me specifically, I never felt like I could openly talk to my mom about my depression and anxiety due to cultural stigma and restraints, even though she was my primary companion during the day. Thankfully, my husband, who is also Asian-American, was very supportive and always offered me patience and a listening ear. However, despite some cultural barriers in getting support from my mother, my primary hurdle in getting help had little to do with my cultural background but more with poor education.  I had access to educational material, but the material was not effective in helping me to identify postpartum anxiety.  I read all the pamphlets from the doctor about postpartum depression, and although they mentioned anxiety and “thoughts of hurting your baby,” they were not presented in a manner that made me realize the breadth of how postpartum mood disorders affect women.  My mind focused on the word “depression,” and therefore, when I experienced severe anxiety and intrusive thoughts, I didn’t recognize them as anything but personal struggles.

I hope that my story will enable other women, particularly Asian women who may feel a cultural stigma against mental illness, to recognize that their struggles are not just personal flaws that they should bury, and to find the courage to seek help.

Did cultural stigma against mental illness prevent you from seeking help for PPD?  For Asian women, did you participate in the one-month sitting period, and if so, how did that affect your postpartum recovery (both positively and negatively)?

-Cathy Q., Postpartum Thoughts