Post-Postpartum

My Own Case Study in Avoiding Avoidance

In early November of 2000, I received a call from the labor and delivery nurse at the hospital where my healthy, hefty son had been born only a few days earlier.

The bright and cheery voice greeted me: “How are you? Everything going alright?”

How are you is an inane question under any circumstance, but it seemed even more so to me at the time. I was most definitely NOT “alright.” I hadn’t stopped crying since I had been home, I hadn’t experienced anything that felt like bonding with my son, I was unable to sit or toilet without intense pain, and my once size-A breasts felt like two cantaloupes that had been filled with rocks and glued to my rib cage.

“Well, I’m crying a lot,” I offered, tentatively, not sure how pathetic I wanted to appear. Said son, still sturdy and strong, was sleeping in my lap, his pajamas wet with my tears.

“Of course! That’s to be expected! But just ordinary postpartum crying, right? It’s not like you’re crying all the time or anything, right?” she asked, her cheery voice now edged with hope and a bit of panic or fear, or both.

“Oh, no. No, of course! Not all the time! Not at all!” I laughed nervously, through my tears, and hung up.

Thus began what would be my long journey with intermittent bouts of depression, postpartum or otherwise. When I look back on those years, I know I did enjoyable, adult things. I have photographs of me on vacation, out to dinner with friends. I’m pretty sure I went to yoga. I ran marathons. I even qualified for the Boston marathon. But it was as though those experiences were happening to someone else, and I was left a bystander in my own life. I lacked even the slightest ability to experience joy in my extremely comfortable and privileged life. Everything always seemed too fast, too intense. I cried. I was angry. I blamed other people (including my children) for my unhappiness and was unable or unwilling to consider my own role in my deteriorating relationships (with friends, my husband). And through it all, the fatigue: my daily checklists required massive amounts of physical energy and massive mental contortions to avoid acknowledging how alone and unloved I felt.

In spite of living that life — that life of being always on the edge of something: happiness? a nervous breakdown? — it wasn’t until my fourth biological child was born that I understood what real depression looks like, up close and personal. Whatever else I had experienced as a result of being mostly alone with small children, I was unprepared for the dark intensity and severely diminished quality of life that came with full-blown postpartum depression. It pains me that I mostly consider my depression in relation to my becoming a mother; likely I had other depressive periods of my life, other times of feeling misunderstood and grieving for a loss I couldn’t name. Nevertheless, my postpartum experiences brought my depression into sharpest relief.

Depression seems both an overused term and a completely misunderstood one. It is used commonly as synonym for a wide range of emotions and experiences: dissatisfaction, loss, disappointment. But it can also mean terror, pain, and anger: the really ugly and scary emotions that no one wants to talk about. It can hit during the day and vanish again suddenly, or it can come and make itself at home for weeks, months, years: it can be a light misting of rain or a bar-the-windows hurricane. I had my second miscarriage before getting pregnant with our fourth baby. I required a DNC for this one (something that I did not require for my first miscarriage). My husband and I went out to dinner afterwards. I wore an enormous black sweater and was alternately repulsed by and fascinated by the red wine in my glass. That pregnancy, the one that required the DNC, had been an accident. Our family was comfortable, and I was finally finding some stability and routine in my life with three small children — our third infant, for me, had been the easiest one yet. And since “three was the new two,” my husband and I felt as though our family was complete. After the miscarriage, however, both of us changed our minds.

When our fourth biological child and third daughter was born, I thought,

“This is the one who will save me.”

“This is the one whose smells I will savor.”

“This is the one I will hold without wishing for someone else to hold her.”

I labored intensely for a short period of time. I cried. I cried some more. The pain was worse than I remembered, but the upside of an intense labor is that it is a fast labor. There was barely time for a brief nap, a quick checkup, and an attempt at a bath (both mama and baby) and we were all home, back in the same king-sized bed where my water had burst not 30 hours previously. Once we were home, she wanted to nurse all the time, but she didn’t gain weight. I had nursed three other children before she came along; I should have been an old pro. At a minimum, I knew to let her suck as long as she wants: eating again, thirty minutes later? No problem!

A week later, there was a trip to the emergency room. She had a fever. She hadn’t gained weight.

“Ma’am, do you know you’re supposed to feed her?”

They had to test her for meningitis. The long needle in her perfect, impossibly small back. I stood outside in the cold with the ambulances. I called a friend and cried. I cried because the friend was kind. Because the friend was concerned. But I cried also because I couldn’t explain the depths of my despair over a cell phone, with sirens in the background. Likely, even had those obstacles been removed, I don’t believe I could have put my feelings into words then. A tortuous new kind of pain overcame me — something new and different than anything else I had experienced in my seven years of motherhood. I understood a basic truth about myself: there are some things I won’t do for my children. I couldn’t watch that needle. I couldn’t hold her while she cried. I let my husband do that. It felt like I was abandoning her, but I knew some part of me would break and never recover if I had to stay in that room with her.

We drove home, later, after a consultation with the lactation specialist, a consultation with the doctors: make sure she stays awake while she nurses. Don’t let her sleep more than 90 minutes at a time. Be sure her diapers are very wet.

I sat in the middle of the backseat of our SUV with her asleep in her car seat beside me. I was uncomfortable and my head had no place to rest and as I watched familiar landscapes outside my window, my exhaustion crowded out any other knowledge, any other state of being. I wasn’t thinking of my baby and her current tenuous health. I wasn’t thinking of my older children, whom I had only just started to ignore, and I wasn’t thinking of my husband, the father of this baby with concerns and worries of his own who now had to shoulder my share of the burden of parenthood, as well. As he drove, my husband glanced back at us in the rearview mirror. “She’s going to be ok,” he said, misinterpreting the look on my face. And I agreed, of course. How could I admit to him that I wasn’t concerned about her being ok? How do you possibly admit to your child’s father, to your chosen life partner, that you just really aren’t up for the job after all?

I was so tired. And, yet, as chronically sleep deprived as I had been for the last seven years, I was told I couldn’t sleep. And what kind of a monster did that make me, that I couldn’t always wake up? That I hit the snooze button time and time again with her beside me, both of us determined to sleep uninterrupted. She was a constant reminder to me that I needed to do something more than I could manage: wake up, check a woefully inadequate wet diaper, turn on a light, make her eat. And since I forced myself, eventually, to wake up but still couldn’t make her eat, I cried. I cried when she wouldn’t nurse. I cried that she couldn’t nurse. I cried for taking her for granted. I cried for taking my other children for granted. I cried out of anger at her for making me so miserable. I cried for being so tired that all I could do was cry. On the rare occasions when I found myself alone, usually in the car after completing a carpool run with other children, in an inadequate and unwelcomed attempt at spending some time with them, I screamed and cried and pleaded for the universe to right itself. I made bargains with ghosts, pleaded with a god I no longer prayed to nor believed in.

It was during those months that I described what I was feeling to a friend: “It feels as though I am wearing an iron cloak. No matter how desperately I want to remove it, I simply cannot.” She just looked at me with her big blue eyes, and I saw the extent of her fear. Fear that she might “catch it,” fear that she couldn’t “fix me.” If the people in our lives are not who we assumed them to be, can it be that we ourselves are also not who we assumed we were?

It took six months for my daughter to begin to nurse properly and get back on an acceptable growth track. Six months of me sleeping on the sofa with her. Six months of me pumping and using supplemental nursing systems and taking herbs and getting massages and acupuncture. We went to chiropractors and cranial sacral specialists. My friends brought me tea. They sat with me while I cried. Reinforcements had to be called in from Chicago, my hometown. My sister took time off from work and my mother offered everything she knew to offer. People needed to feed me, console me. The irony of other people having to feed me, while I couldn’t feed my daughter, was lost on me then. I still don’t know what was more devastating to me: the extent of their love or the extent of my inability to be grateful for it.

My youngest child will turn ten this year. She has four older siblings who adore her, an involved and loving network of extended family and friends, and yet I have spent a decade of my life recovering from the trauma of not being able to give her what I thought she needed. Perhaps the lesson I needed to learn I am still learning: that life is random, that there are no guarantees. And I don’t mean that in a fatalistic sense of “life sucks and then you die.” But I am coming, with age, reflection, and lots and lots of love and support, and, recently, therapy, to see that what we think of as “normal” is only an illusion. Trying to fit ourselves into some rigid expectation that we have of ourselves — often without even being aware we have it — is nothing but an attempt to ignore the infinite number of possibilities open to us to love and be loved. Our world is full of hatred and shame and betrayal and intentional harm. Bad things do, in fact, happen to good people all the time. Instead of closing our eyes to that, instead of assuming and pretending that our lives can be perfect, painless, and sterile, it is our job as humans to embrace goodness wherever and whenever we can find it, even amidst the harm and misery.

My depression, which once seemed to be happening TO me, I now realize was simply my path. My struggle to avoid the pain, to live a life void of agony and discomfort, now teaches me that to be alive means to experience all emotions — not just the ones recorded for prosperity on greeting cards. As a wise friend recently told me, “depression does serve a purpose. It can help us focus on that in our life that most needs our time and energy.” The problem, of course, is that we are not told that. We are told it is something to avoid, to fix, to ignore. And avoiding discomfort is, above all, what I have come to see as one of the biggest problems with our culture. Until we can acknowledge the spectrum of human emotions and experiences as not just unavoidable but necessary, even illustrative, then we will continue to fool ourselves into believing that we have some control over the outcome. And as long as we think we have control over the outcome, we will continue to take things for granted, thereby missing out on gratitude, and true joy, and wonder, and love.

When I was experiencing postpartum depression, I likely would not have been able to hear the message of this essay. And likely my inability to hear it would have simply added to my guilt. In much the same way, I was unable to heed, or even listen to, the well-intentioned advice that bombarded me during those months. But the truth is, I don’t think new mothers should have to hear this message. I think this message is for friends and family members. For policy makers, doctors, counselors. Depression is simply a part of life — postpartum or otherwise. But its commonality doesn’t diminish its size. It can be life threatening and debilitating, and we need to treat it as such. We need to acknowledge it. Remove the stigma. Create a conversation. I’m not a physician or a scientist and I won’t pretend to understand the complex confluence of brain chemistry, hormones, and feelings of isolation and (lack of) attachment that cause some women to experience episodes like mine. But I do know that continuing to ignore a problem, as we see time and time again in our culture, will not make it go away, no matter how many times we try to convince ourselves otherwise. We must greet it head on, without shame or judgment or preconceived notions of how to “fix” the “broken” people. We must see people experiencing depression for what they are: complex humans with a wide spectrum of emotions and a great need for love and support. We must develop a more highly evolved language to discuss what is happening to women and babies at the time of the experience. If we all continue to expect and demand that women get back to work, back to the gym, back to their old jeans and their old bodies, we instantly shut down the opportunity to acknowledge that there is no going back — for any of us. There is only forward. There is only our quest. We need to acknowledge, honor, and encourage that path, whether it is full of laughter or full of tears. Likely it is full of both.