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I Can’t Take Care of You, If I Don’t Take Care of Me

Photograph by Twenty20

“I thought PPD meant I had to hate my baby. But I never blamed her for my misery.”

“I thought I had to sit around the house and cry all day. But I was insanely productive.”

“I didn’t know that my rage was a symptom.”

When people asked how I was doing, I lied. The drive to appear like a strong mother outweighed my desire for help.”

“I didn’t even realize I had been depressed until almost a year after my baby was born and that fog of depression lifted.”

These are the voices of some of the thousands of women who suffered with postpartum depression and didn’t know they had it. They were told what they were feeling was normal. They were afraid to admit they were in pain. They kept silent because of shame and stigma. And most commonly, their symptoms didn’t look like the image of PPD they had been warned about. They were not listless or weeping all day. They didn’t hate their babies. They knew something was wrong, but they assumed it was just motherhood.

RELATED: What Postpartum Depression is Really Like

They are not alone. The National Institute of Health estimates that more than half of women with PPD go undetected and undiagnosed every year. That is hundreds of thousands of women whose voices are never heard. I’m going to add my own.

My daughter’s first year contained some of the darkest times of my life. But despite a lifelong history of depression and despite being very aware of PPD, I didn’t know I had it. I thought being miserable and overwhelmed most of the time was normal. I thought hating my husband was normal. I thought being convinced that my baby didn’t love me was normal. I thought panic attacks and digging my nails into my palms was normal.

But I wish I saved myself and my husband those months of pain. I wish I had found the strength to say, “I’m not okay.”

I know. It sounds absurd. And looking back on it months later, I’m stunned that I allowed such a terrible situation to continue. I brushed off the people closest to me who noticed something was wrong. I gritted my teeth and stuck it out and eventually found ways to ease my misery and guilt. And one day my depression began to lift. Things became less impossible. I began to blame myself less and enjoy my family more. But I wish I saved myself and my husband those months of pain. I wish I had found the strength to say, “I’m not okay.” How much joy and beauty did I miss? Why didn’t I realize that this suffering was real and it has a name?

Dr. Vivien Burt, Founder and Director of the Women's Life Center at UCLA, who specializes in reproductive psychiatry, has a rule of thumb for women who may be experiencing postpartum depression:

“It's normal for women after delivery to have mood changes here and there, even to go from being giddy to being fearful from moment to moment, day to day,” says Dr. Burt. “But if it lasts more than 12 days or if it's so severe, even if it lasts less than 12 days, to impair one’s function, to make it difficult or impossible to actually function normally, that’s no longer the [baby] blues. It is something else. And that needs to be evaluated.”

Dr. Burt believes that not recognizing the symptoms of postpartum depression can be major barrier for moms who desperately need treatment. It is often extremely difficult to see past the huge hormonal changes, the completely new patterns of sleeping and eating, and the intense emotional experience of new motherhood, and notice real depression. Women may be so disabled that they can’t ask for help. They may be hiding their feelings from family, friends, and doctors. They may be denying their suffering even to themselves, because admitting it sounds like weakness or failure.

RELATED: Do You Have 10 Minutes to Help Cure Postpartum Depression?

So, what can you do if you suspect that someone you love has PPD? Dr. Burt suggests that empathy and hope are part of the answer.

“Empathy goes a long way in gaining someone’s trust,” says Dr. Burt. “So, rather than put yourself in the position of accusing the woman of being psychiatrically unstable, the first step is to empathically resonate with the woman, and then to say, ‘But there is help available. I’d like to help you get that help. And I’ll do my part to support this in any way possible.’”

Dr. Burt also urges moms who are feeling trapped and miserable to think about the impact their depression can have on their children.

“A depressed mother is really an absent mother in many ways,” she says. “Not because she wants to be depressed, not because she wants to be absent, but because she can’t function properly. So, getting the help you need is not just for yourself, but it’s also for your baby and for the rest of the family.”

When you're feeling imprisoned by the myths of motherhood—the drive to be selfless, the need to do and be everything for everyone—the idea that “I’m doing this for my baby” might just be a path toward getting help. Eventually, I began to say out loud to my daughter, “I can’t take care of you, if I don’t take care of me.” It didn’t make the journey easier, but it was a beginning.

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