Credit Stuart Bradford
On a walk with my husband through Joshua Tree National Park in late January, I felt sad for no reason in particular. Or maybe for lots of really good reasons. I wasn’t sure which it was.
At the time, I was six months pregnant. My husband, Raj, asked me what was wrong. “Nothing,” I said, and kept walking, kept stewing, kept wiping away a few tears from under my sunglasses when he wasn’t looking.
“Are you depressed?”
The Times had recently published a story about updated guidelines calling for pregnant women to be screened for depression – both during the pregnancy and after giving birth. Raj must have read the article, too.
During my first pregnancy, when I was quite happy, Raj read all about postpartum depression. Soon after our baby arrived, the questioning began. Raj would get all serious, look me straight in the eye and say: “Do you have postpartum depression?”
Umm. No, hon, I am feeling pretty good.
But this time around, this pregnancy, things have felt different.
Did I have “pregnancy depression?” Would I pass the screening? What’s the difference between being pregnant – with a crazy amount of hormones flowing through your body – and being pregnant and depressed?
It can be so hard to tell. Like when there is a blizzard back home but you escaped just in time, and you are sitting by the pool at a beautiful hotel in Palm Springs, and the air feels just right, and your toddler has finally gone down for a nap, and yet, you are crying.
Or when you wanted to go pumpkin picking so your husband tried to cheer you up by returning from Home Depot with a large pumpkin and orange mums. You know he was just trying to help, but pumpkin picking at Home Depot? Pregnancy depression might be when you can’t see the pumpkin and mums on the front steps without bursting into tears.
Is that pregnancy depression, or just pregnancy?
Pregnancy depression could be when your toddler is playing on the balcony outside your hotel room and for a split second you think: If he falls, he falls; it would be an accident. And it doesn’t immediately occur to you just how disturbing that thought is.
That’s shocking, but is it depression?
I see doctors and nurses every four weeks for my pregnancy. But they haven’t once asked me how I’m doing emotionally. One time I arrived for an appointment visibly distraught. I hoped someone would ask, but nothing.
I don’t know why I haven’t raised the issue myself. Maybe it feels like they aren’t the right people to discuss this with. The nurses take my blood pressure. I trust my doctor to perform a C-section, if need be. What do they know about moodiness?
On the other hand, in recent years there has been a real increase in awareness about mood disorders during pregnancy. If the medical professionals seeing pregnant women and new mothers aren’t looking for these things, asking the right questions and identifying patients who need help, then who is?
When we returned from Palm Springs, I looked deeper into pregnancy depression and what it means. The episode with our toddler on the hotel balcony had scared me. My thought was fleeting, but I was horrified that I could even think such a thing.
The more I read about pregnancy depression, also called perinatal mood and anxiety disorder, the more I realized it might not just go away. I began to worry that I would struggle even more once I gave birth and was home with our baby – sleepless and overwhelmed with a newborn and toddler, especially when my husband was out of town on business.
I also wondered if our toddler could sense my mood. And what if when the baby came, my sadness affected my ability to bond with him?
Moodiness on its own I can manage. But depression that could affect my children and my relationship with them? That was something I wasn’t willing to tolerate.
It was time, I decided, to talk to my husband.
When I called Raj, who was traveling, he could hear something off in my voice. This time he asked, “Are you sad?”
Yes, I was sad.
I told him I was concerned that my sadness over the past few months was a real problem. That it wasn’t going away. That it might get worse.
It helped being so honest with him, and with myself. He didn’t judge me, which now I realize was my fear. He told me it wasn’t my fault. He said he’d watch our son, and I could see a therapist or support group available on the weekends. He said he was glad I had told him – and I was, too.
The next day I contacted Postpartum Support International, an organization that supports women facing mental health issues related to childbearing, and talked to a coordinator in New York City. She gave me a handful of therapists to call.
Something changed after I acknowledged that I was struggling, that I needed help: I started to feel better.
I found a therapist who was warm and understanding and let me go on and on about my concerns about taking care of two children while my husband was away, and my fears that I wouldn’t be able to manage.
The therapist didn’t have specific answers. (And unfortunately she didn’t offer to lend a hand with late-night feedings.) If anything, she told me what I already knew – that it can be really hard to tell the difference between a wave of pregnancy hormones and clinical depression. She said it seemed that I was suffering from the former.
But we also agreed that what I was experiencing was real. That hormone fluctuations can manifest in many different ways, and that it’s often not enough to just ignore them. In fact, sometimes, it’s the very act of addressing them head-on that makes all the difference.
Hanna Ingber is an assistant editor on the International desk at The New York Times.
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