When Your Postpartum Depression Doesn’t End

My baby got older, but my sadness didn’t go away

A few weeks after I gave birth, my husband showed me the photos of my C-section.

“You don’t want to see this one,” he said. It was taken early in the process; the doctor had called him behind the screen that shielded me, just before she pulled out my daughter. It was, my husband said, too early. The baby wasn’t even out of my uterus yet.

But I did want to see. I wanted to see the wound, the source, as if it might heal me. I’d go back and look at that picture again and again, a reddish blend of guts and blood and dark, matted hair. An alchemic mixture of the two of us at the moment before we were separated.

When the doctor told me that my daughter was breech, and I would need a C-section, I wasn’t that surprised. I knew that deep down I wasn’t the sort of person who would have survived giving birth on a dirt floor. I never planned a natural birth, didn’t have music picked out, hadn’t daydreamed about a birthing suite where I would squat rather than lie prone on a table. I was glad I didn’t subject myself to sitting on the floor of some birthing class, hyperventilating.

Instead, I put my faith in medicine. Part of this was because I knew that I had other medical conditions, ones that might later require patience in hospitals. This was, I suspected, to be my way through life. I simply didn’t have the constitution to be “natural.”

In the hospital after my C-section, the attending physicians marveled at my scar. How neat and tidy it was! I was up and peeing painfully the next morning as soon as they removed my catheter. How brave I was! My obstetrician said that I was a good candidate for a VBAC, a term I didn’t know at the time, but I did know that she was nodding at me approvingly. I was a model patient: standing and showered and trolling up and down the hallway of Labor & Delivery, still hunched over in pain. There was a window at one end where I would pause. Then I would drag myself to the other side where there was a concierge desk for the fancy private rooms. The nurses were impressed at my fortitude.

I’ve always known that I was a good patient. In fact, I saw it written on one of my medical charts when I broke my ankle in my 20s. “Pleasant patient,” it said at the top, and the memory itself is also pleasing. I like to think that I received this praise because I walked on a broken ankle to an X-ray machine, convinced that if the nurse thought I should be able to walk, I should.

A history of depression is different, though. There is no being brave, there is no fighting through it.

I’ve been suffering from some form of depression perhaps since college although it really only became more obvious when I started working in New York after graduating from law school. At that point, a friend told me that I was “difficult to be around,” and, therefore, she was respectfully distancing herself from me. It seemed like the sort of thing her psychiatrist husband might tell her to tell me, or advice she read in O Magazine.

I was perversely pleased. Finally, someone had confirmed what I had known about myself for some time: that I was unpleasant to be around. I didn’t even like being around myself.

I knew there was something wrong with me, and now I knew people could tell. The trouble with depression, however, was that I was unsure what the wound was. I couldn’t tell someone what hurt. I never actually felt depressed; I generally felt anxious, and I kept most of my stranger habits secret, which I could because I was single and lived alone.

I tried different antidepressants. I became a yoga teacher. I met my husband. And then I declared myself “cured” and stopped. Depression was, I decided, just a feeling, something temporary that would pass.

Now is the part of the story where you expect me to talk about postpartum depression, the way I cried at night while my daughter was not sleeping while I looked out the window of our ninth-floor apartment to see which people were also awake at 3 A.M. Or maybe the way I wept the day my husband returned to work. “You can’t leave me all day!” I exclaimed with multiple tissues crushed to my nose.

The postpartum depression story is a familiar one. Mothers feel depressed for a while, and then, one day, the curtain lifts. They can see in color; they delight in their little one’s toes.

It’s just time, they say. Everything is temporary.

I waited patiently for the depression to run its course. There were good days, of course. The summer turned to fall, and the leaves fell in pleasantly orange drifts, and my daughter slept heartily in the stroller as I pushed her around Central Park.

But I never felt quite right, and when I went in for a check-up of my physical wound and the same O.B. who did my C-section asked me “How are you doing?” I started to cry, as if out of nowhere.

“I’m fine, I’m fine,” I said. “Just tired.”

She asked if I was really fine and sent me away with pamphlets. “Not just the baby blues!” they screamed in my purse. “No shame in antidepressants!” they giggled, even as they promised that this was a temporary condition, a common one, and one that, like childbirth, you just have to get through.

Every nurse, every doctor, every women’s magazine talked about postpartum depression, it seemed. Most recommended antidepressants, just for a while — it was only temporary, after all. But I didn’t want to go backwards. I had finally proven to myself that I could move on, that I could tough it out. And I counted on the fact that it would fade, in time. I read those stories, too.

Here was the reality: There was a fountain of sadness, a great well, like a chasm had opened up, and I no longer knew how to keep it all inside.

After my daughter turned one, I went to see a new doctor for allergies and mentioned, as if it were a throwaway thing, that I might still be depressed. I saw his face as I listed my history of anti-depressants, like some string of chemical bad dates. I saw him squint and do a mental calculation, and I knew what it meant. He thought something was wrong with me, emotionally. A diagnosis formed in his head. He thought that he knew me.

“Have you tried therapy?” he asked. “Does your husband help with household chores?”

I wanted to protest, to say that isn’t who I am.

“I’m not depressed,” I said, as tears ran unbidden down my face.

I accepted the Lexapro prescription, telling the doctor that I was only taking it so that I could be a good parent and companion. It was, I emphasized, for other people.

And maybe it’s true, maybe I am depressed, but it hurt me to think that I could be so easily summed up. How do you explain to someone what the highs and lows are like? For me it had been the constant drill of medications, adjusting them up, adjusting them down, always measuring my feelings like a symptom, like checking my temperature, a sign that essential body chemistry was amiss rather than, simply, feeling.

When I gave birth, I was lying on the operating table pinned down by my arms and legs, vomiting into a kidney-shaped pink plastic tub. I cried. My OB made an incision in my abdomen and pulled out my uterus, spreading it open so that she could pull my child out into the world. My guts were somewhere on my thighs. The doctor held my daughter high so that I could see her over the screen.

“Here she is!” the doctor said. The baby was wrinkled and pink and messy.

She cried.

“It’s her! It’s her!” I said.

I had known her voice forever, it seemed, for my entire life. That was, I now know, just a feeling, but at the time it seemed like enough.

In meditation, I was told that feelings pass like waves over the shores of the self. When I’m depressed, the self feels less steady, as if it were always changing. But then again, maybe it is.