As Mother’s Day approaches, my reflections are incomplete without thinking of my lonely and dark postpartum times.
For a long time, I viewed my postpartum depression (PPD) as an “ungrateful” and “shameful” experience. A testament to my maternal inadequacy.
I have rarely shared out loud how tumultuous a time I endured in those early weeks after entering motherhood. Today, I share it with all my colleagues in writing because sharing is a way to absolve myself of shame. And maybe there is another young physician mom out there, just now in the throes of postpartum anxiety and depression, who society is telling to enjoy Mother’s Day, but she is having a very hard time.
I also share because May is Mental Health Awareness Month. For me, it is time to break the silence.
My first daughter was born while I was a second-year resident after a complicated pregnancy and resulting c-section.
Thankfully we were both OK.
I struggled with breastfeeding.
I was also terrified of “not graduating with my class” and the “good girl” in me felt like she was making her colleagues unduly work in her place while she was on “vacation”.
No one directly verbalized this to me. This was the byproduct of internalized social messages.
In those first few postpartum weeks, there were a lot of tears, overwhelm, and loneliness. I did not know what to label it.
You would think all my medical education had taught me how to identify PPD! As we know knowledge does not always equate to understanding.
Part of me did not want to acknowledge this reality. So I did what I know how to do best, throw myself into my work and work hard to numb out all the other feelings. Thankfully that episode of PPD did not only the initial three to four months.
“In those first few postpartum weeks, there were a lot of tears, overwhelm, and loneliness. I did not know what to label it.”
My second daughter was born while I was an early career primary care physician.
By now I was “ready”. I was going to get a “whopping” 3 months of maternity leave.
I was determined to breastfeed against all odds and I was not going to “let” any “blues or sadness” stand in my way. This girl was on fire! And guess what, the fire did get fizzled, unfortunately.
My breastfeeding plans went awry, I had another c-section and yes, I felt more inadequate, sadder, and worse than ever.
Maternity leave flew by and I returned to practice full time.
The baby wouldn’t sleep at night and I had full days of clinical responsibilities. Postpartum depression melted into work exhaustion and there was no relief in sight. Charting at home, mychart messages, diapers, and sleeplessness.
At work, my physician practice medical director dolled out unsolicited advice like “hire more help” and work on “your resiliency skills”.
Research shows higher rates of PPD recurrence with subsequent pregnancies after the first episode.
While limited data is available specific to PPD in physicians, physicians may be at a higher risk of experiencing PPD compared to the general population.
“At work, my physician practice medical director dolled out unsolicited advice like “hire more help” and work on “your resiliency skills”. “
The demanding nature of our profession, long working hours, and high levels of stress can contribute to the increased risk.
Furthermore, the stigma associated with mental health issues in the medical field deters physicians from seeking help, leading to underdiagnosis and undertreatment of PPD.
The demanding nature of our profession, long working hours, and high levels of stress can contribute to the increased risk of PPD (Post-Partum Depression) Click To Tweet
So what did I ultimately do?
I realized no one was coming to save me.
I finally sought help from my primary care physician and started medication, counseling, and coaching. I felt defeated, ashamed, and stigmatized. I felt the weight of my profession, motherhood, and my culture – all on my solo shoulders.
I kept my diagnosis under wraps, few knew. Despite all of that baggage, seeking help, was one of the best decisions of my life. My only regret, I should have reached out sooner.
On the surface, my life continued to look perfect.
I tapered off my medicine in 3-4 months, ASAP, the moment I felt better because I did not want to share, document, or divulge, it had come “down to” pharmacotherapy support. I also recognized that there was PPD and then there was the system I worked in, which SSRIs were not going to fix.
So if there is any doctor mama out there reading this, especially feeling insufficient, feeling like her culture stigmatizes mental health, and feeling like she just can not make this work, please seek help. Talk to a friend, schedule that appointment, and find a therapist, a counselor, or a coach. You are not alone!