How Postpartum Depression Changed My Work + My Life
I spent decades telling myself that I still had time to have a baby;
I needed to focus on my career, get healthier, find a partner, etc.
All this led to me waking up at forty and realizing that it was now or never.
On October 6th, 2022, I found myself at 42 years old, struggling through a very difficult home birth.
I’d had a healthy pregnancy, thank goodness, but the delivery turned out to be much different than I’d expected.
I was already nervous about my impending postpartum experience,
Specifically postpartum depression. The last thing I wanted was to go to a dark place, especially as a new mom. In fact, I’d planned on having my placenta encapsulated, as I’d learned that the high level of hormones stored up in the placenta can lessen or even prevent the steep drop into depression that so many women experience postpartum.
[A quick note on placental encapsulation: the placenta is a filter, so I do not recommend that people who’ve been exposed to heavy metals, toxins, medications, or an unhealthy diet through pregnancy take their placenta after birth.]
For a few reasons the placenta encapsulation didn’t happen. So I was without the only thing I planned on getting me through my postpartum days.
So I entered motherhood depleted, mentally and physically.
But as I’ve always done I muscled through.
It wasn’t until months later, struggling with everything, that I looked around and realized that I was, in fact, depressed. Before that I just thought that the absolute lack of care, interest, inspiration, joy, or contentment I felt about anything was me being “tired.” But the absolute “not-caringness” that I felt was profound: for the first time in my life I lacked energy for my work, my career, my health, or doing anything more than showering and feeding myself and my baby.
Actually, it wasn’t even me who recognized my lack of self-interest or care as depression.
5 months after my daughter was born I went in for a visit with my new primary care provider, and the medical assistant happened to do a depression screening with a tool called a PHQ-9. She caught it, and alerted the doctor.
It can be hard for the driven woman to recognize depression - symptoms are too easily written off as exhaustion, stress, overwork, or completely ignored by drowning out the voices with Netflix and over-working. Especially when, all of the sudden, her focus is pulled entirely off of herself and onto her new baby.
I should know - I’m a doctor, but I needed another doctor to tell me I was depressed.
That’s the thing about postpartum depression, I realized: when a busy, driven woman who’s used to having a lot on her plate now has a baby, she’s dangerously at risk for developing postpartum depression and not even knowing it. That’s because a lot of depression symptoms can be written off as stress, overwork, lack of sleep, or just being a new mom.
Here’s another thing I learned: when it comes to our mood, our heart health matters.
While I was lucky to have avoided the many chronic cardiometabolic concerns that many women develop in pregnancy and postpartum, women who do develop cardiometabolic health issues are much more likely to suffer postpartum depression as well. The cardiometabolic health issues associated with postpartum depression include
gestational diabetes
hypertension
persistent weight gain
anemia
cardiac failure
When left untreated, these can all contribute to a woman’s developing postpartum depression.
And the cardiometabolic health issues that a woman develops in pregnancy and postpartum can become chronic, robbing her of precious years she could otherwise enjoy watching her child grow up.
Maternal health in America is a mess. Women are dying at alarming rates in pregnancy, labor and delivery, and postpartum, because they’re developing acute medical conditions during this time of life that are inadequately treated (unfortunately, this is too-often due to a woman’s not seeking medical support in pregnancy and postpartum).
When my postpartum depression was labeled, I dove into the research.
I made the decision to try natural therapies first, although I recognize and honor the place that antidepressant medications have in saving the lives of depressed postpartum women. We must use the tool most suited to her: for me, as a naturopathic doctor, I wanted to dig into my own toolbox before considering medication.
I learned the essential diet and lifestyle factors necessary to reduce a woman’s risk of developing, or worsening, postpartum depression. As it turns out, a healthy diet will do more than almost anything else to help a woman recover her heart health and her mental health postpartum. Specifically the research points to the Mediterranean diet as being the most effective diet for a woman’s cardiometabolic and mental health.
Along with diet, regular exercise is critical for her heart and her mental health, in equal measure. And of course, sleep is essential. Getting enough sleep may be the other most critical piece of helping a woman recover postpartum. But this is easier said than done, when someone has to wake up multiple times a night to feed (most often mom, especially when she’s the baby’s primary food source!). And yet, sleep remains a non-negotiable factor in a postpartum woman’s mental and emotional wellness.
So what can be done about that? This is a question I sought to answer in my book, POST: The Essential Guide to Creating Your Postpartum Self-Care Plan in Pregnancy.
I wanted to create a research-based, realistic plan for postpartum women to safeguard their cardiometabolic and mental health in pregnancy, postpartum, and for the rest of their lives.
Inside my book pregnant women are guided to create a Postpartum Self-Care Plan that they and their loved ones can reference as often as needed, to help safeguard their postpartum and long-term health.
And as far as sleep is concerned, it turns out that there’s no magic pill, powder, or bullet that can transform a postpartum woman into a well-rested super-mom. She’s got to rely on her people, on her village, to help her raise that baby postpartum. She and her partner, or family members, will have to co-create a sleeping plan, and know that it will probably change over time. But creating that sleeping plan is important anyway because it opens the door to letting other people help her, so she doesn’t have to be super-mom. Instead, she can be “super-me” by striking the balance between learning how to be a great mom to her baby, and taking care of herself too.
THIS is how we change the trajectory of women’s health — by addressing it where we’re weakest: with maternal health.
As far as my journey with postpartum depression: it didn’t get better right away, but slowly, over time.
As I focused again on maintaining a healthy diet, exercising every single day, prioritizing sleep, and stressing less, I started to feel better. Plus, I kept an eye out for red flags that would signal a need to call my doctor right away.
When I returned to my doctor’s office two months later, I was re-screened for depression and my score was much lower.
My first 12 months postpartum were a journey of learning how to be a mom, how to feed my baby, and how to take care of myself so I could do the first two things to the best of my ability. All this while doing all the other things that were still a part of who I am: working, being a daughter, sister, friend, partner, and writing a book so I can help other postpartum women. Because if I could feel as depressed, alone, alienated as I did, with all the knowledge and resources I had postpartum, then I know that other women are suffering at untold depths. And I want to help every single one of them.
Because I firmly believe that