For the first 18 months of my son’s life, I took an online, anonymous postpartum depression (PPD) screening every two weeks. I remember clicking through the ten questions surreptitiously from bed, my body frozen yet thrumming while my son slept in the bassinet beside me. Whether I’d had a “good week” and enjoyed parenting, or a “bad week” where my son felt like a leech, the results never changed: “You may be experiencing severe depression,” the final page always indicated, before advising me to seek help. But like 75% of women, I never got it.
I once asked my husband if he thought I had postpartum depression. “I don’t know,” he said. Despite both of us being aware that postpartum depression was a very real risk, and despite him once describing me as a “walking zombie” in our son’s early years, his own unknowing sucked the energy from my body.
A few months later, I revisited the therapist I’d seen while struggling to adjust to the pregnancy. “I think I might have had some postpartum depression,” I said, as if I was speaking about the past, rather than the present. She nodded with empathy, but since I now seemed fine, she didn’t offer another appointment, and I was too timid to ask.
In “privacy” mode on my phone, I searched for PPD specialists in my area. The fact that I was doing this, and continuing to take screening questionnaires, should have told me something—to simply make that appointment—but it was so hard to know if my situation warranted it. I was trying hard to be a “good mother,” keeping myself healthy: drinking water, taking walks, returning to yoga, eating nutritious meals. I held my son and forced smiles. Shouldn’t that be enough?
Those moments—sometimes hours or days— when my thoughts dipped into something darker (I am not a good mother; I have failed my children; I am a failure) felt like an aberration, or perhaps harsh reality, or a disorienting house of mirrors I couldn’t describe. Making an appointment would have meant admitting to those voices—to my perceived failure as a mother. I couldn’t take a step that seemingly confirmed my inadequacy, that implied I was the problem, that there was something wrong with me.
It took me a long time to fully recover from the difficulty of my son’s early years. As I’ve studied, written about and explored evolutionary biology as it relates to motherhood, I’ve realized much of my self-blame was unwarranted. We are social creatures, evolved to raise young communally. Rearing children in isolated environments—and in a culture that asks women to bear others’ burdens to the detriment of their own health—is not natural. Indeed, it is becoming increasingly clear that the kind of maternal distress I experienced is symptomatic of a cultural pathology, rather than a personal pathology. Women parenting in stressful environments where they don’t receive adequate support are, quite frankly, going to show stress—which will often manifest as prenatal or postpartum anxiety and depression. Today, I understand this, as well as all of the barriers that stopped me from seeking help, but I also wish someone had seen my struggle during that time and gently pushed me to see a therapist. I would have benefited from professional support, and my son would have benefited from it, too.
Finding quality support, however, isn’t easy. The Policy Center for Maternal Mental Health recently gave the US a D+ for maternal mental healthcare (my own state received an F.). Many women do not have adequate mental health coverage, or access to sufficient practitioners. Insurance reimbursement policies and time-limited care also create barriers.
When I reached out to a cognitive behavior therapist for panic attacks when my son was two, she concluded our work together twenty minutes into the second session simply because I hadn’t had a panic attack the previous week. If you aren’t crying and acutely injured—if you are instead withdrawn and slow to trust—it can be easy to be overlooked. I’d like to think a postpartum specialist would have seen through my demeanor in those early postpartum years, but I can’t be sure.
Nonetheless, when I now bring to mind that version of myself—secretly taking screenings from bed every two weeks—I long to gently meet her gaze. I would tell her, as I would any new mother struggling silently: It’s not your fault. You are parenting in a situation that fails to provide you and your infant adequate support. That’s all. You’re not flawed. You’re not a failure.
But yes, help is available. There are people who can help you navigate this challenging time. You deserve that help, and you don’t need to prove your worthiness. Even if you’re only half-certain, let’s make that call.
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