The Postpartum Depression to Clinical Depression Pipeline

It’s hard to pinpoint exactly when my postpartum depression turned into regular old depression depression. The truth is, I didn’t know I had either type of depression until it was far too late.

As new moms, we take those obligatory surveys at the pediatrician’s office when we take our babies for checkups. You know the ones — just a few simple questions aimed to measure whether we’re too depressed to take care of our babies and ourselves. If we’re being honest, most of us know the “right” way to answer those questions, and we answer accordingly. In a system that is simultaneously too slow to take children out of truly dangerous homes, and too fast to take them away from parents who love them, we know better than to take any risks.

And so, we expertly sidestep the only resource that is supposed to help us.

Our spouses, our families, and our friends often fail to notice the signs of postpartum depression. They count our unshowered bodies and greasy hair as just part of the new mom motif. When we stay in our pajamas all day, they assume it’s because it’s just more comfortable. As we slowly disappear from our social lives, failing to reply to text messages or show up for friendly gatherings, they conclude we’re just preoccupied with the new baby.

No one bothers to ask if maybe these drastic changes in our behavior have a deeper, more urgent meaning.

I don’t know what parameters the psychiatric community puts around the length of postpartum depression, but I’ve read that it is most common in the first year after the new baby is born. If that’s true, then my postpartum depression must have turned into regular depression almost six years ago. At some point, the lack of personal hygiene, the chronic loneliness, the lack of sleep and the crushing weight of expectation the world puts on new moms just became routine. It was my new normal. So, I didn’t really notice that something was “wrong.” I concluded, like everyone else around me, that this was just what being a new mom was like.

Over time, depression just became a way of life. It became “high functioning” depression — the insidious kind that is skilled at hiding itself from the world. It began to look more and more like anxiety, which is quite common in people with high functioning depression. Rather than sequestering ourselves to our rooms, unable to get out of bed, we dive into neuroticism and over-activity. We overthink. We hyperfixate. We fret and catastrophize. Our lives become cloaked in busyness as a way to avoid feeling the things we don’t want to feel.

I became a master at it.

And as I made myself busy with worry and angst, the world around me assumed that it, too, was part of being a mom. Only now, my kids were bigger. I was busy because my kids kept me that way. The forgetfulness, the disorganization, the constant dropping the ball and letting people down, was all because of “mom brain.” I was just keeping up with the kids, like every other mom. Nothing to worry about.

And slowly, silently, I slipped into the spiral of depression and anxiety that left me barely able to take care of my kids, let alone myself. The worst part?

Nobody noticed.

For a culture that touts motherhood as “the most important job a woman can do,” we sure don’t seem to care too much about mothers. We are expected to martyr ourselves for the sake of our families. We are physical laborers, emotional laborers, domestic laborers. Our work is often invisible, unnoticed and unappreciated. And as this labor erodes our mental, emotional, and physical health, we find ourselves desperately alone. The world says, “I just don’t know how you do it all!” and never bothers to consider that maybe doing it all is killing us.

If we are going to survive the postpartum depression to chronic depression pipeline, we have to take it upon ourselves. Our society isn’t interested in taking care of us; it isn’t responsible enough to be entrusted with such an important task. So, we have to be our own advocates.

Here’s what we need to be advocating for:

We need real psychological support as we transition into new motherhood. I honestly think every new mom should be going to regular therapy to help them navigate the radical life changes a new baby brings.

We need access to affordable, accessible, evidence-based mental health care that focuses on the unique experience of motherhood.

We need paid maternity and paternity leave so that both parents can take time to rest, recover, and bond with the baby.

We need affordable and accessible childcare so that parents (and especially moms) can have opportunities to care for themselves.

We need family-friendly workplace policies so that parents can provide well for their children without the constant anxiety of losing their job if their child gets sick.

And finally, we need better support for single moms. For a country who is trying desperately to force every pregnant woman to become a mom, even if she doesn’t have the means to take care of a child, we certainly don’t do much to help those moms be successful.

It may be a very long time before we achieve these things. But as a mom myself, one who struggled, and continues to struggle, to overcome the crushing weight of the postpartum depression to clinical depression line, I won’t let us forget the work that needs to be done.

We deserve better.


Amber Wardell is a psychologist and author who writes about marriage, motherhood, and mental health. Subscribe to the newsletter to get free weekly content and digital downloads, and to never miss an article!

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