We Need to Stop Blaming Postpartum Depression on Hormones
Ten weeks after my second child was born in 2013, I checked myself into the hospital to be treated for postpartum depression and anxiety.
Shortly after my healthy, beautiful baby was born, I began to notice a vague sense of unease creeping in on my thoughts. Soon, this feeling latched on to me with a death-grip, leaching every bit of joy and meaning from my life. My children were clean, fed and cared for. I loved them. But I felt like an animated corpse.
I confessed my feelings to my OBGYN, who gave me a prescription for an antidepressant. Despite the medication, my condition continued to worsen until I was unable to function and wished for the rest I thought only death could bring. When I called my doctor again, distraught, she told me to go to the hospital immediately or she would call the police. I could either go “willingly,” or I would be forced to go.
So my husband and I dressed our newborn and toddler warmly and secured them in their carseats, then set off into the flurry-filled March morning as if we were going on a family outing.
When I arrived at the local ER, a brief physical examination revealed an elevated pulse and “moderate signs of distress.” Missing from the doctor’s notes was that, kept awake at night with a roaring, belligerent anxiety, I had not slept for 72 hours. Nor did it mention that, my throat constricted with constant, grinding terror, I had withered to 10 pounds below my pre-pregnancy weight.
After my husband left with our children, I was strip-searched. I undressed myself as the nurse directed and displayed my ravaged, depleted body to her, lifting each aching breast in turn to assure her that I hadn’t hidden contraband beneath them. Then I was given a hospital gown and socks to wear and led through the freezing corridors leading to the behavioral health unit.
I was deposited in a hard plastic chair in the common area and left there for a long time. The staff didn’t seem quite sure what to do with me (the hospital was in an area particularly hard-hit by the opioid epidemic, and I was the only patient there who was not detoxing). The only staff interaction I can recall from that first day of eight was when a nurse came up to be and said, “Don’t worry, hun. It’s just your hormones. Once they even out, everything will be fine.”
I think she meant to be encouraging, to place the blame on something outside of my control. There was nothing wrong with me, as a person, it was just that some pesky messenger chemicals were wreaking havoc on my thoughts. Still, her comment rankled me. And it still rankles me today.
The connection between hormone levels and postpartum depression is, at best, vague and poorly understood. The research, however, is much clearer when it comes to protective factors. Numerous studies have concluded that the risk of postpartum depression decreases when the mother has stable personal relationships and a robust social support network. Attributing a woman’s painful, isolating, life-threatening mental health crisis to a hormone crash absolves all of the people, systems and cultural beliefs that contributed to turning a vulnerable time in her life into a nightmare.
It was not my hormones that glorified having many children spaced closely together. That was the religious subculture I was embroiled in at the time. So I became pregnant with my second child when the first was still a baby, before my body or emotions had healed from my first pregnancy and delivery. And while this religious subculture required many babies from me, it did not have policies or systems in place to support me during that time.
It was not my hormones that demanded I breastfeed my baby at any cost. That was the insidious mommy culture I encountered both in my local community and online. So I worked round-the-clock shifts nursing the baby, then pumping, then cleaning pump parts, only to have to nurse the baby again.
It was not my hormones that did not offer my husband paid paternity leave. That was my husband’s employer. So I took every night shift with a colicky baby who only slept 45 minutes at a time, all so my husband could go to work every morning for an employer who didn’t value him or his family.
It was not my hormones that made it hard for me to ask my community for help. That was classic American individualism. I didn’t want to look weak or like a bad mom, so I downplayed the scale of my misery on the occasion that someone asked.
It wasn’t my hormones that said, “you got this, Mama!” or “This is just a rough patch, you’ll get through it!” when I did honestly disclose my struggles. That came from people close to me. I did not have this, and it was not a rough patch. I was in trouble, and I didn’t feel like anyone heard me.
It was not my hormones that made an overworked health system where it would have taken six weeks to be seen by a psychiatrist. With no other options, I went to my OB for help. She prescribed the wrong medication for me and offered no other support or resources.
There were many individual people who helped me during my postpartum period, but in the end it was not enough to counteract all the other negative elements influencing my postpartum period. It was not “just” my hormones. Postpartum depression and anxiety can be prevented, in many cases, by supporting and caring for women during this vulnerable and intense time.
Although traumatic, my hospitalization experience marked a period of personal growth for me. Still, I have asked myself if things could have been different.
What if there had been widespread, coordinated effort to ensure good sleep, good food, good healthcare and emotional support for me? What if instead of resorting to hospitalization, my doctor had connected me with a social worker or postpartum doula when I first reported difficulties? What if society had made me feel seen and valued as a woman and a mother? What if someone had listened to me before the situation became a crisis? And, most of all—what if we stop seeing postpartum depression as a biological failure of the mother, but instead as a failure of her culture?
Getty image by Rudzhan Nagiev