I wasn’t surprised when my phone rang as soon as I pulled out of the pediatrician’s parking lot. During my son’s checkup, I had brought up how I was feeling. They asked me to fill out the questionnaire they use to determine how you are coping postpartum, but I didn’t need it to tell me I wasn’t coping well.
The nurse who called me didn’t have to tell me that I scored poorly on my postpartum depression screening, because I knew. I knew I was spending my days overwhelmed and anxious. I knew most days I felt like I couldn’t get my head above water.
I scored an 18 on my postpartum depression screening. Whatever that means, it meant the nurse sounded a little panicked when she called. She asked if I could see a doctor today or tomorrow, she didn’t want me going into the weekend feeling this way. Did I have support, someone who could help me out until I was able to see someone and start treatment?
Did I feel safe?
This is what is like being diagnosed with postpartum depression. Everyone seems a little nervous around you. You feel obligated to say things like, “I’m safe. My kids are safe.”
I’ve had postpartum depression before. Not quite so severe, but I dealt with it after the birth of my first two children. And, when I was pregnant with my third and last baby, I was diagnosed with prenatal depression. I started a low dose of medication and then I started to feel normal again. I gave birth 5 months later, continued my anti-depressant for a few months and then slowly started to wean off of it. I was doing so well and the medication was making it difficult for me to sleep, so it felt like the right time to stop taking it.
I did well for awhile but after the new year I started to struggle again. I was having severe anxiety in the afternoons, making it difficult for me to function. Normal, everyday tasks that come with taking care of three kids and working from home felt like too much. Getting dinner on the table felt like a mountain of work, any time my baby cried I couldn’t think straight. On Sunday evenings, I would feel panicked. I didn’t want me husband to go to work the next morning. I didn’t want to be at home alone with my children.
And that was just the anxiety. There was depression too, which is harder to write about. I didn’t feel like myself and some days, nothing in my life seemed good. It’s hard to explain, there was just so much anxiousness and sadness during my days at home. I felt so incapable as a mother.
Even though I wasn’t surprised when I diagnosed with postpartum depression, again, I was surprised how hard I had to work to get my care. My pediatrician’s office wanted me to see someone within a day or two but in reality it was nearly three weeks before I saw a doctor. My situation was unique, there was an insurance snafu that was completely out of my control. We had been paying for insurance that never got set up by our broker at the beginning of the year, so my doctor’s office turned me away.
What was so surprising was that I couldn’t find help until I fixed my insurance situation. No one at my doctor’s office recommended resources or referred me to a self pay clinic. So, I just went home and struggled through another few weeks with depression and anxiety and three kids under five until I was insured again.
I don’t know a lot about what maternal mental health care is like in the states, but this is what mine was like. I can’t help but wonder what it is like for mothers who are worse off than I am. Who is watching out for moms that are too depressed to struggle through the system until they get an appointment, until they get a prescription or find a counselor that accepts their insurance? Who is checking in on moms who feel too ashamed of what they are feeling or thinking to insist that they be seen, to be honest about how much help they need?
When I talk to my mom about it, it is obvious we’ve come a long way. When she gave birth, there were no screenings at pediatric well visits for new moms. No one was checking in to make sure that it wasn’t something more than the baby blues. But it isn’t far enough. We need more options. For me, the only choice was to wait it out until I could an appointment or try for an inpatient stay (which I knew I wasn’t a candidate for). There needs to be another choice, there needs to be a level of urgency for helping out the moms who may not be a danger to themselves or their babies but they still need some help as soon as possible.
When I think about my own daughters becoming mothers, I hope they never have to deal with postpartum depression but I know that there is certainly a chance it may be a part of their story. If it is, more than anything, I hope for change. I hope that sharing my story might play the tiniest role in improving maternal mental health care for our next generation of mothers.