It’s Complicated: Understanding Postpartum Emotions

mother-holding-childI will never forget the feeling that accompanied me when I was finally discharged from the hospital following my first son’s birth. It was a glorious summer day. The blue of the cloudless sky almost hurt my eyes after being inside for what felt like a long time. I sat in the rear seat of the car next to my newborn and looked out the window at familiar Chicago sights that were drenched in so many of my memories: Millennium Park, Buckingham Fountain, The Field Museum. I gazed at the glimmering lake and the yachts that were docked along the waterfront. And I was shocked at the strange sensation of not recognizing my own world. It was disconcerting. I knew these places, but everything felt so wildly different; it was as though I was seeing them for the first time. At that moment I grasped that while the world remained the same, I was already changed in ways that were still incomprehensible to me.

In those early postpartum months, I was not only getting to know my baby; I had to become acquainted with the new me. My emerging identity as a mother was a source of tremendous growth, but as is the case with any type of growth, it entailed losses. The loss of familiarity, of habits and routines, of ways of conceptualizing myself – the list goes on. The massive scope of growth and change meant that powerful emotions passed through me, sometimes pummeling me like an unforgiving November rain, at other times providing nourishment much like a gentle spring shower that paints everything it touches green. Awe, joy and gratitude were like that shower. Fear and anxiety – certainly not. Nor was the surprisingly fierce (and unjustified!) anger I felt sometimes when I nursed my son for what seemed like a hundredth time while my husband slept soundly two feet away from us.

The arduous process of adjusting, growing, shedding layers of oneself, grieving and crying (sometimes with joy, sometimes with despair) is known to all new mothers regardless of whether they are having their first or fifth baby. Sadly, it also tends to be carefully censored by women in an attempt to escape dreaded judgment that might follow in case of perceived failure to conform to the societal narrative of motherhood bliss.

The prevailing cultural narrative about motherhood holds that mothers should be simply happy and fulfilled in their new roles. As a society, we are uncomfortable with the notion that the mother’s wishes and needs could be at odds with those of the baby. The mother should not only be happy; she should be readily self-sacrificing. These are impossible, unrealistic expectations. Additionally, the Western world has elevated pursuit of happiness to the status of a central life goal and a driving force for our daily efforts. As a result, when happiness is not experienced at all times, we feel like we are failing in some way. Who wants to feel like a failure? Certainly not new mothers who are doing their best to meet the demands and challenges of parenting a helpless infant (and possibly their older children as well).

In response to the pressure to be happy, we may disavow the inevitable negative feelings, attempt to bury them deep inside ourselves. Yet if we struggle against them in this way, they tend to re-emerge and may even haunt us. This kind of tug of war with parts of our emotional reality almost always accompanies postpartum depression. It is, after all, easy for it to become a downward emotional spiral: we feel we shouldn’t feel what we are nonetheless feeling, judgments and withdrawal ensue and push us deeper into distress which we then continue to judge and so on.

When I was about seven days postpartum, I recall taking the elevator down to the lobby level of my condo building to pick up mail. On that particular day, I was worried and upset– complications I had experienced during childbirth caused tremendous, unrelenting pain when I tried to walk or sit. In a blues-induced haze, I questioned how I would be able to independently care for the baby in this state. I wondered if I had what it takes to be a good mom. I knew I desperately wanted to be one but when I reflected on what that meant, I discovered to my horror that the answer was not as clear as it seemed prior to my baby’s arrival. One day earlier I had spent several hours in the ER due to my baby’s jaundice. In that unsettled state, I ran into my neighbor, a sweet, gray-haired woman in her sixties. She exclaimed: “Congratulations! You must be so happy. This is such a wonderful time!” She said a few other things about how beautiful being a mother is and how lucky I am. I must have mumbled something affirmative, instantly feeling even worse.

My neighbor meant well and I hold no grudge against her. However, her assumption made no space for the possibility that my emotions about motherhood could be, well, complicated. They were more than that! They were intense, changeable and confusing, fueled by sleep deprivation, physical pain and hormonal flux.  What I needed most back then was validation: to hear that it was okay for me to feel so much and so intensely. What a relief it was to talk to other postpartum friends and be able to give voice to the entire spectrum of my emotions instead of just their rainbow-hued end! Over time, the emotional intensity decreased as the unfamiliar became more familiar and the new reality began to feel more like home I could rest in rather than a strange and not always hospitable land.

We have come to associate any sign of emotional distress in the postpartum period with mental health disorders. In this overly simplistic take on postpartum emotions, little space is left for the normal sense of existential crisis experienced by new parents. Thus we not only perpetuate cultural narratives that silence and make difficult the acceptance of women’s negative emotions in the postpartum, but we also all too readily pathologize their presence. We need to find the gray area in this black-and-white portrayal of postpartum psychology. In recognizing that negative emotions are part and parcel of the postpartum landscape, we can begin to greet them with compassion instead of rejection and judgment. This kind of stance supports women’s ability to move through the painful emotions, clearing way for other feelings.

Needless to say, there are times when normalizing emotional experiences is inappropriate. All too frequently postpartum women report to me as they initiate psychotherapy that their primary care providers, pediatricians, partners and friends insisted that their depressive and/or anxiety symptoms were simply part of new motherhood. Postpartum mental health issues are very real and there is nothing worse than telling a woman who is experiencing unrelenting sadness or anxiety that what she is feeling is normal. This is invalidating and will make the woman feel more confused, lonely and less likely to seek professional help.

How can new mothers know whether the emotions they experience are a manifestation of postpartum mood or anxiety disorder or a normative, albeit unsettling and distressing reaction to large-scale changes occurring in their lives with the baby’s arrival? The key distinction has to do with the fundamental nature of emotions, captured in the very Latin root for the word emotion: emovere, which means to move. Quite simply, our emotions are meant to be in motion – they have a short life cycle with a beginning and an end. The medieval Persian poet Rumi writes evocatively about emotions in a beautiful poem “The Guesthouse”:

This being human is a guest house.
Every morning a new arrival.

A joy, a depression, a meanness,
some momentary awareness comes
as an unexpected visitor.

Welcome and entertain them all! (…)

Our emotions are thus meant to be temporary guests, commanding perhaps all or most of our attention at particular times, but then retreating to make space for other emotions. Postpartum blues – experienced by majority of women in the first two weeks following childbirth – is marked by especially intense emotional arrivals and departures. Indeed, the existential, social, psychological and physical upheaval of having a baby ensures that all sorts of emotions visit us with varying levels of intensity throughout the first postpartum year (and beyond as we face new challenges associated with toddlerhood).

In up to 1 in 5 women, sadness and anxiety overstay their welcome. Once they take up permanent residence in a woman’s mind and heart, they begin to dictate what other emotions are allowed entry, commonly barring joy, awe, gratitude –all those “lighter” emotions that allow us to begin enjoying and deriving positive meaning from our new reality. This is when women start to sense that something is not right; often it is confirmed upon clinical assessment that they are indeed experiencing symptoms of a postpartum mental health disorder.

Psychotherapy can be enormously helpful in empowering women to approach these unwelcome guests with compassion, mindfulness and nonjudgment. Women learn to unpack and challenge myths of motherhood that flatten and distort what are complex emotional realities. One of the statements I frequently hear from new mothers I work with as they finish their treatment is that they have come to feel a sense of gratitude for having struggled in the first place – their pain taught them powerful lessons about the workings of their minds, their thoughts, beliefs, emotions, expectations, values, relationships. They have learned to face their pain and in doing so opened up to vast stores of joy.

As an acclaimed researcher and storyteller Brené Brown says in her popular TED Talk: “we cannot selectively numb emotion. When we numb [hard feelings], we numb joy, we numb gratitude, we numb happiness.” Numbing does not work. There is no growth without pain. The emotions that we seek to numb will pound on the doors to our hearts until the whole house rattles and shakes and we can no longer focus on anything else but the pounding. We do not need to love all of our emotions but we need to learn to greet them anyways – and if we can do so with compassion and willingness, we eventually find our way to equanimity and peace.

It is humbling and marvelous at once to realize that the little human being who entered my world and suddenly turned it upside down managed to teach his unsuspecting mom such vital life lessons! The learning never stops….