When my first son born, I definitely experienced the “baby blues.” I remember holding him on the couch when he was a few days old and sobbing uncontrollably, and for no discernible reason at all. All the baby books, along with my healthcare providers, assured me that this was normal, and if it passed, it was nothing to be concerned about.
As the first year of my son’s life progressed, I had other moments like that, of sudden and deep sadness. This was coupled with moments of intense panic. I’d wake up in the middle of the night, heart racing, to check to make sure my baby was breathing. Other times my heart would race in panic at odd times, like when it was time to drive home from somewhere, or when my son was taking too long to fall asleep.
When the feelings were there, they were very intense and almost unbearable. But each time, these moments would pass, and my general feeling as a new mom was one of contentment, so I didn’t think there was a problem.
Flash forward to when my son was a toddler, and I developed the most serious and debilitating case of depression and panic disorder that I’d ever experienced.
There were a number of factors that probably caused this: my son was rushed to the hospital after inexplicably fainting one afternoon (he was fine, but it was traumatic for me); I experienced an unexpected miscarriage after not even being aware that I’d been pregnant; and I was having fights with my father that were very triggering. And let’s not forget that raising a toddler in general can be extremely taxing — my son’s toddler tantrums were a million times more draining and demoralizing than his baby fussiness.
It only occurred to me years later that I may have been living with a case of postpartum depression or anxiety that had gone untreated – or that perhaps I was experiencing a postpartum mood disorder that had presented itself at a later date.
Well, it turns out there may be some truth to that, and that the “toddler blues” or late-onset PPD, is actually a thing that more folks in the mental health world are beginning to recognize.
Most of us don’t even realize this, but as it happens, PPD doesn’t just include the first few months after birth. The American College of Obstetricians and Gynecologists (AGOC) defines postpartum depression as occurring “up to 1 year after having a baby.”
But even that definition may be too restrictive, says Karen Kleiman, founder of the Postpartum Stress Center, in an interview with Blood + Milk.
“Most experts now agree that the term ‘postpartum depression’ is somewhat restrictive, and suggests that the condition is time-limited,” Klieman explains. “We used to say that women were most at risk for postpartum mood and anxiety symptoms between three weeks and three months postpartum. As more studies are carried out, we are learning that symptoms of depression and anxiety can surface anywhere along a spectrum experiences and emotions.”
Obviously, you probably can’t say that your symptoms of depression or anxiety are caused by PPD if your child is many years past the baby or toddler years. Yet giving PPD a hard deadline of one year postpartum may not most accurate either, says Kleiman.
“It’s difficult to say, with certainty, how common late-onset postpartum depression occurs,” Kleiman clarifies. “But what we do know is that the spectrum of postpartum distress stretches further than we previously understood, bringing attention to the fact that women are struggling longer and well beyond the first postpartum year.”
There is also the perspective that many cases of depression and anxiety that seem to manifest in the toddler or preschool years stemmed from those baby years – i.e., that many women live with untreated cases of PPD, which morph and evolve into enduring mental health issues.
This was certainly the case for me. I felt like my experience of PPD was that it built and built over several years, and reached a crescendo when my son was a toddler.
Kate Kripke, a licensed clinical social worker specializing in reproductive mental health, calls this manifestation of PPD “continued postpartum distress.”
“While I can’t make a blanket statement about each and every woman who calls me, more times than not these women—one, two, or three years past the birth of their little ones—are struggling with a form of maternal distress that dates back, in one way or another, to their pregnancy, postpartum, or even before,” Kripke writes in an article for Postpartum Progress.
“While these moms wouldn’t technically have postpartum depression any longer, they are often struggling with what I will call here continued postpartum distress that was never adequately supported when they first noticed symptoms,” Kripke continues.
The bottom line is that women need better care and support, in the immediate postpartum period, and beyond. There needs to be less stigma surrounding postpartum moods disorders in general. So many women soldier on through their difficult feelings, not wanting to put their needs before others’, or admit that there is a problem.
Of course, so many women simply do not have mental health services accessible, or do not have lifestyles that would allow them to take a few hours to tend to their mental health. This needs to change. Women’s mental health should be taken seriously: no one can be a good mom without taking care of themselves first. And we all need to understand that mental health coverage isn’t just a convenience; sometimes it’s a matter of life or death.
I can’t say for sure, but I believe that if I’d treated my initial symptoms earlier, things would not have gotten as horrible as they did later. Those few months of “toddler blues” were among the most difficult of my life. I ended up going back into therapy and getting the help I needed. But I wish I knew that there was a name for what I was experiencing, that it was real, and that I didn’t have to suffer for so long in silence.