Today’s post comes from Dr. Aparna Iyer, a board-certified psychiatrist and assistant professor at UT Southwestern in Dallas, Texas. She also has a private practice in Frisco, Texas.
By Aparna Iyer
I am a psychiatrist who treats mental health issues during pregnancy and the postpartum period. I had thought that this would somehow make me immune to postpartum depression, as though I could have seen it coming from a mile away and warded it off. But I was wrong. Quite frankly, I never thought it would happen to me.
After nine months of a blissful, uneventful pregnancy, I had an emergency c-section when the baby’s heart rate dropped. Although I imagine I could have been thrilled with the prospect of simply having a healthy baby, I instead found myself in a fog afterwards. People kept gushing over the baby, saying how beautiful he was, but the reality is that I couldn’t see anything past that fog.
My family and friends started to notice as I became progressively more detached and dysphoric. Many friends wondered why I kept dodging their calls or avoiding their requests to come over to see the baby. It just seemed like such a unsurmountable chore to even get dressed in the morning and to put on a smile to meet people, to give off the semblance of the romanticized mother-baby experience that we are all so convinced we will have.
A rock amidst the choppy waters — it’s what we psychiatrists aim to be. We strive to be the calm that our patients need during their darkest times. But in those moments, I found myself immersed in the deepest of those water, grasping for anything that would give me a moment of relief. I was shocked that I, someone who works to give her patients relief from such struggles, could be experiencing it myself.
The reality is that postpartum depression does not discriminate. Although it can impact certain groups of people more than others, it really can happen to anyone. It doesn’t care whether you’re younger or older, rich or poor, healthy or medically complicated. Frankly, it didn’t give a hoot that I was a psychiatrist either. It arrives, often unannounced, angry and ready to plunge us into a vortex of sadness and irrationality. It drives a wedge between us and our friends, family, partners. It leads some of us to act dangerously, towards ourselves and our newborns. In fact, around 80 percent of women report mood changes in the postpartum period, and about 15 percent go on to experience postpartum depression.
And yet, we cannot talk about it. The reality is that we’ve spent the better part of the last nine months preparing for this beautiful experience. We’ve had the baby showers, sifting through countless names to find the perfect one, reading numerous books on parenting philosophies to find the one that fits you best, wondering how you’re going to do anything productive on your maternity leave when all you want to do is stare into those gorgeous little eyes. And now this — is this the ultimate failure, many of us wonder? It’s hard not to believe that it is, although thankfully the world and the medical community have slowly started to truly understand postpartum depression for what it is: an unfortunate but common medical phenomena, one of the most common side effects of pregnancy.
Oftentimes women come into my office seeking help for postpartum depression and various other postpartum ailments. Many describe the struggle to keep their symptoms a secret, trying so desperately to maintain the image of that idyllic beginning of motherhood. Those of us who have experienced postpartum depression know that can be a strong sense of shame and stigma surrounding postpartum mental illness; likely some of this stigma is perpetuated by the pressure placed on mothers to do it all in a seemingly effortless, fashionable way in a society that sneers at the very concept of depression.
Depression and anxiety during the postpartum period need to be taken seriously, by the postpartum mother, her partner, her family and her physician. It is everybody’s job to compassionately support the mental health and wellbeing of the mother and her baby. Untreated postpartum depression can have terrible consequences. These mothers are less likely to get postnatal care, more likely to self medicate with drugs and alcohol, and ultimately this may all result in their babies experiencing worsening outcomes.
Luckily, postpartum depression is very treatable. In many cases, these women can opt for talk therapy, which is often sufficient and a great source of relief and support. In some cases, we might have to also add an antidepressant. While this can make a patient nervous, especially if that patient is breastfeeding, many of my patients feel more confident with this decision once I present the data regarding the risk profile of antidepressants versus the risks of uncontrolled depression or anxiety.
Depression at any stage of life can be a debilitating experience, and I am not glad to have had it, especially during a time I would have wished to have enjoyed bonding with my baby. However, I suppose that this could be viewed as an extension of my training, an opportunity to have experienced what many of my patients experience. Sometimes when my patients are in their darkest times, I express to them that I can see the light, the relief, at the end of this tunnel, and that they have to trust me that we can get there. As I write this and pause frequently due to my now three-year-old rambunctious toddler smiling up at me and vying for my attention, I smile back and am grateful that I reached the light at the end of my mine.