I Was Her and She Was Me: Breaking Barriers in Prenatal and Postpartum Anxiety and Depression

This is a slightly edited version of what I wrote for FYI Magazine in NY about Prenatal/Postpartum Anxiety and Depression

I’m standing at the bottom of the three flights of stairs that lead up to my apartment gazing hesitantly upward. Every day it’s the same trip, but every day I hover over the first step a little longer. I grab a handful of grocery bags in my left hand, a slightly heavier handful in my right, and begin my slow, treacherous hike to the summit.

Nope. Not going to happen. I have to take a break on the first landing step. I text my husband to just, you know, let him know what I’m going through. I breathe in... Okay. Here we go.

I make it to the last step but I can’t get to the door. I collapse on the top landing and close my eyes for a minute. Maybe I can just order Chinese and eat it here.

Clutching the railing for balance, I stand myself up to unlock the apartment and a sense of accomplishment courses through me. I let the groceries crash onto the floor and collapse onto the couch. No one told me I'd feel like a mountain climber at eight months pregnant.   

The treacherous stairs, though, were the least of my problems. I had this paralyzing, yet jittery sensation in my chest that would sometimes flare up so unforgivingly I wouldn’t be able to get up from my chair. My mind was occupied with a million fears. Thoughts like, I’m going to disappoint everyone by wanting space and privacy after the baby; I should be glowing and excited, but instead I’m miserable to be around; If I can’t handle pregnancy, I have no chance at motherhood. When I didn’t know what do anymore, I registered for a prenatal yoga class as an attempt to decompress. There was something about being in a room full of other women who could barely touch their knees that comforted me. For the last ten minutes of every session, we would have a guided meditation and I would just lay there, very still, with my eyes fixed on the ceiling and tears rolling down my face.

The anxiety was like a demon inside of me. It wasn’t me, yet it was in me and taking over, and I was deeply ashamed that I wasn’t strong enough to control or stop it.

I became religious in college and believed that my anxiety in pregnancy stemmed from my spiritual shortcomings. If only I could learn to achieve more peace of mind, pray with more intention, plan a more productive day, I could overcome this burden. I would think about my holy great grandmothers and how they must have had more important things to deal with than to waste time on “anxiety”.  I would think about all the mothers I knew in my community who seemed to effortlessly manage a kindergarten’s worth of children, frequent guests and happy homes. It was only my first pregnancy and I could barely manage to make kosher ramen noodles for dinner.

It took me a while to realize that I was far from alone. After my own first experience, I began hearing from both non-religious and religious friends and acquaintances about their struggles with anxiety and depression – both prenatal and postpartum. I was always shocked. Everyone else looked so perfectly blissful to me. It turns out that no matter who you are or what you’ve accomplished, life can feel like it’s falling apart during this vulnerable time. You may have to quit your job because the anxiety has stolen your ability to concentrate. You may develop insomnia from racing thoughts at night or feel unable to care for your home during the day. Anxiety and depression can impact your marriage, as you and your spouse experience tension from the growing responsibilities, high expectations and unexpressed resentments. It can become a sort of paralysis, rendering you unable to leave the house or enjoy friends. As one mother shared with me, “I absolutely felt alone. Everyone expects you to be happy… I literally couldn’t keep it together. I couldn’t read, listen to music, had no interest in spending time with people, no love towards my toddler”.

Before I understood how many of us struggle, I thought I was the only one who felt high-maintenance and selfish during postpartum. Everyone wants to see the baby, and as mothers we often feel an obligation to allow everyone to visit, even when we desperately need time alone to recover from emotional and physical pain. I have talked to women of all different backgrounds who have had panic attacks while people sing to the baby in another room, who have cried uncontrollably while a phone rings in their hands nonstop, who have left a room in tears while guests whisper, “Do you think she’s depressed?”. It’s happened millions of times. Mothers sitting on their beds, in their nursing chairs, locked in their bathrooms, crying and panicking alone while the living room fills up with people who have come to play with the beautiful baby. As one young mother confessed, “When the guests left, I sat down on my parents' basement steps and started crying so hard I could barely breathe. My poor husband was like, ‘Huh? What’s wrong? You were fine one second ago’ and I couldn't even answer. I felt like speaking one more word would be too much effort for me.”  

We live in a society where perfectionism and independence in motherhood is celebrated. The United States is the only industrialized country where working mothers and fathers have no guarantee of paid leave after the birth of a baby. Mothers are often left home alone to care for their newborn and any other children, to make multiple trips to medical appointments, and to return to work and normal life as soon as possible. On top of that, there is constant pressure to do everything right - to have the right birth plan, to be overjoyed the moment the baby is born, to invite family as soon as possible afterwards, and to commit to full-time breastfeeding even if it brings tremendous anxiety and pain.  Ruchi Kuval, the inspiring writer behind the blog, Out of The Ortho Box, put it best when she said to me, “Everyone giving free advice postpartum was very upsetting to me. It made me feel dis-empowered as a woman. I would have liked someone to tell me, ‘Inside of every woman is a wise, intuitive person who has a lot of the answers. Most of this is just what feels right to you… Listen to your gut.’” It’s very hard to stay attentive to ourselves and our needs when everyone expects something else from us. One mother wrote to me about falling apart from all of the advice and expectations:

Right before I was having my in-laws sleep over for [that weekend], I had an appointment with a lactation consultant. She told me I had to nurse, feed pumped milk, feed formula, and pump at every feeding! It was not at all ­­sustainable… That night, with everyone in my apartment, I broke down. My baby was being held by someone else and I went to the armchair in her room and just cried. The tears flowed down my cheeks. All my anxiety and worry came to the forefront, and I just couldn’t stop crying. I was still physically recovering, nursing, there were way too many people in my apartment... I just couldn’t cope. There's a certain sense in society that everyone has babies and is immediately smitten. That was not the case with me. I think I was too overwhelmed and exhausted to feel love.

The pressure we feel to sacrifice ourselves often takes precedence over any instinct to rest, say “no”, or ask for space (or for company). When a mother of two told me that her and her husband worked together after their second baby to keep guests at bay and put away her cellphone for two weeks, only checking for urgent messages, I was blown away. Seldom do we hear about these kinds of boundaries. Instead we assume that the strongest women among us have no need to relax, ask for help, request privacy, or take a break from the constant caring of others. We think that some women have such a pure ability to give that they simply have no room for anger or sadness or anxiety.

But I wonder… Are we missing something? Are we simply imposing on these “perfect” women our own desire for perfection and imperviousness ? I asked my good friend Dr. Danielle Dragon, a therapist in Chicago, for her thoughts on this idea of simplifying the experiences and lives of other women to the detriment of our own well-being. She explained to me:

As a society we frequently think in a polarized view of ourselves and the world. Meaning, we believe our ancestors must have been complete martyrs; our neighbor who's expecting has it totally together. During times of stress, and certainly within an experience of postpartum anxiety and depression, this polarized view of life intensifies. We use language like, "How is it my friend can have a perfectly prepared meal and look immaculate, and I behave like a total mess?" It only increases our feelings of inadequacy and difference from our peers, mentors and foremothers. It only serves to expand an irrational system of isolating and shame-based beliefs that can deepen an experience of postpartum anxiety and depression. Additionally, for many women, therapy and/or medication may be necessary to navigate this scary and confusing journey. And that's okay too.

After my second daughter was born, I desperately struggled to manage life as a mother of two. I worked up the courage to talk to a very strong, well-respected woman in my community about the helplessness I had felt in both pregnancy and in motherhood, even though I knew she wouldn’t be able to relate. But instead of just nodding politely, she told me how much she had experienced those same feelings while raising her babies. She told me how much help she regularly needed from others, even though it made her feel guilty. She offered stories of when she felt­ angry or alone, or when everything felt like it was falling apart. I was her and she was me. We were both young mothers in that conversation, talking about our experiences that fell short of an unrealistic fantasy of motherhood. 

We have to redefine courage. It's not self-destruction and infinite sacrifice. It's seeking help when you need it. It's sharing your story with others when they need it. We can strive to become who we want to be while encouraging one another to be okay with where we are. But ignoring our pain is a recipe for isolation. We all have a role in creating a more compassionate society. We’re in this together.