For nine months she cherished the flutterings in her womb, and she wondered about the contours of the hands that prodded her, the unique works awaiting them. As she prepared a nursery in pastels and assembled a library of board books, she imagined all the long years with her little one, and her joy coursed vast and deep. She thanked God for calling her to motherhood.
But two months after her baby was born, she could hardly drag herself from bed. She would drift throughout the day weepy and listless, scarcely mustering the energy to return a phone call. Her baby’s cry from the nursery elicited none of the tenderness she had envisioned, but only waves of dread. She would run her fingers over her baby’s delicate toes, the scalp she had yearned to kiss, and felt only emptiness.
“God seems so far away right now,” she admitted through tears when concerned friends visited. “I don’t know what’s wrong with me. I’ve always dreamed of a family, but it turns out I’m such a terrible mom.”
She wasn’t a terrible mom. She needed help. Postpartum depression had taken hold.
More Than the Baby Blues
The stress of caring for a newborn can unnerve and exhaust even the best-prepared of new mothers. The wild fluctuation of hormones in the bloodstream pitch emotions into turbulence, prompting us to gush with enthusiasm at one moment, only to devolve into tears the next. Sleep deprivation diminishes our reserve. Anxiety seizes us as we obsess over doing things right.
These “baby blues” occur commonly after pregnancy, unsettling and confusing up to 70 percent of new mothers. Thankfully, as our hormones level out, the exhaustion and volatile feelings subside. In most cases, the baby blues resolve within a couple weeks. As they pass, we feel better equipped to weather the long nights, and to reap the joy.
In some women, however, despair lingers and takes root. Up to 13 percent of mothers suffer from postpartum depression (PPD), which the American Psychiatric Association defines as an episode of major depression during pregnancy or within four weeks following delivery (although many clinicians make the diagnosis within a year postpartum). The effects of clinical depression, heavy on the heart under any circumstance, can prove especially shattering when heaped on top of the strains and expectations of motherhood.
During a time when we anticipate celebrating God’s gifts (Ps. 127:3) and bonding with a new baby, PPD can leave us disconnected, despondent, and struggling with guilt. In approximately 20 percent of women this darkness hovers long-term, for as long as a year after delivery. In 13 percent it persists for two years. In the most rare and harrowing cases, PPD may even drive mothers to suicide.
Such tragedies signal that PPD is neither a normal feature of motherhood, nor a sign of a weak mom. Rather, PPD is an illness with potentially devastating consequences for mothers and their babies. Those struggling with PPD need help from a professional and love poured out by the body of Christ.
Spotting the Signs
The symptoms of PPD mirror those of depression during other times in life (e.g., saddened mood, loss of pleasure from activities we love, thoughts of worthlessness and guilt, difficulty concentrating). Often after having a baby, however, we mistake signs of depression for normal stressors of motherhood. In particular, sleep disturbances, fatigue, and weight changes—all features of clinical depression—may also represent typical postpartum challenges.
Given the overlap of symptoms, attention to your mood and the content of your thoughts after the birth of a baby is crucial. Fluctuations in weight and poor sleep may be normal when caring for a newborn, but daily hopelessness and despair are not. Exhaustion from new motherhood should never so deplete you that for weeks you no longer find joy in your passions. If you feel anxious and irritable, tearful, worthless, guilty, or detached from your newborn every day for more than two weeks, you’re not experiencing normal motherhood, but potentially something more sinister. If thoughts of suicide or harming the baby haunt you, you need help immediately.
Although researchers can’t pinpoint a single cause, data are perfectly clear that PPD is not a woman’s fault. Studies suggest a history of prior mood and anxiety problems can predispose us to PPD. The storm of hormonal changes in pregnancy also contribute. Whatever the specific etiology, PPD does not reflect incompetence as a mother, or as a Christian. False guilt may dissuade us from seeking help, but the majesty of the gospel is that when we admit we are drowning, God draws us near (Ps. 34:18, Matt. 5:3).
Treatment for PPD is effective, and you need not suffer needlessly or indefinitely. If you struggle with symptoms of depression for more than two weeks postpartum, fill out the Edinburgh Postnatal Depression Scale, a screening instrument to help physicians detect PPD. Bring the results to a doctor you trust. Voice your need for help. Bring a friend or a loved one; hold his or her hand. If the darkness progresses to thoughts of suicide or infanticide, reach for help immediately. Call the National Suicide Prevention Lifeline at 1-800-273-TALK or use their webchat.
Role of the Church
The body of Christ is uniquely poised to shepherd mothers through dark pastures. Churches often gather around expectant mothers in jubilation, showering them with gifts and warm embraces. After a baby’s birth, the continued compassionate presence of a church family can dissolve barriers to asking for help.
If a new mother reveals she is struggling, don’t dismiss her concerns as typical motherhood stress. Ask questions. Inquire more about how she feels, what overwhelms her, and for how long she’s endured sadness, joylessness, or hopelessness. If you suspect PPD, encourage her to see her physician, or better yet, offer to go with her. Partner with her. Pray with her. Offer concrete help, before she asks. Seek out others in the church whom she knows and trusts, and surround her with loving support. Rather than discount her struggle as a lack of faith, which will only deepen her feelings of guilt and worsen her depression, help her to cling to God’s promises while she walks in darkness.
Author Dana Bowman, who suffered through PPD, poignantly writes of the power of Christian love in an article for Today’s Christian Woman:
The church brought me food: cherry Jell-O and chicken burritos and green bean casseroles. And blankets for the baby. And a soft, fawn-colored blanket for me. The church sat and held my hand on my front porch as I sobbed so loudly the lawn guy across the street looked over, concerned. And we sat and rocked on the porch swing, my sweet church and I, and she listened. Just listened.
Listen to the mothers in your midst. Love them, as Christ loved you (John 13:34). When a shadow dulls the blues and pinks, recognize the signs, and draw near. Hold on to the suffering as she sobs, and walk with her toward recovery.