The arrival of a newborn is undeniably one of the greatest milestones in a mother’s life. The tiny onesies, picking what colour the baby’s room should be, an outpouring of love and support from family and friends are some of the things to look forward to in the weeks and months before birth.
But something switches, seemingly without warning after birth. The excitement, joy and love you felt for your little one all seem to have disappeared almost overnight. It’s supposed to the happiest time of your life but somehow you feel as if you’re at your lowest. You may even feel a sense of resentment toward the newest addition of your family but of course, you can’t tell anyone that because that’s not what you’re supposed to feel as a new mother…right?
If this sounds familiar, you’ve most likely experienced postpartum depression. Postpartum depression (PPD) in Trinidad and Tobago is a shared experience a lot of new mothers face in Trinidad and Tobago. In fact, one in every four women in Trinidad and Tobago suffers from PPD, yet there are still few conversations and a lot of stigmatisation around it. This leads to a cyclical effect: mothers feel ashamed to open up, and because they feel as though they are the only ones having this experience, they suffer in silence, or, sometimes take extreme measures.
We spoke with two mothers who opened up about their experience with postpartum depression and how they worked their way through it as well as clinical psychologist Denise Jittan-Johnson who gave more insight into the disorder and the signs to pay attention to.
Meet the mothers
Rebecca* (26) is the mother of one daughter while Elizabeth* (35) has two children.
Elizabeth experienced postpartum depression with her second child. “With my daughter, it was an absolutely blissful experience but was the absolute opposite with my son,” she says.
“I tested positive for Zika 10 weeks into my pregnancy with my son and that changed the dynamic of the pregnancy. Instead of doing monthly checks to see if everything was okay, we were doing fetal scans. After the first visit, we were advised to abort (regardless of the stage of the pregnancy) if at any point if the doctors encountered any abnormality, if his brain wasn’t growing as it should or if his limbs weren’t developing. Every doctor’s visit was filled with great anxiety until he was born.”
“I’m generally not an anxious person but that just raised a level of uncertainty for me and may have been a trigger for my postpartum depression.”Elizabeth
Rebecca had a relatively normal pregnancy, however, she may have experienced some emotional triggers.
“I was very young and in my last semester at UWI,” she says. “I wasn’t in a relationship at the time that I found out I was pregnant. My daughter’s father was around and very involved in the lead up to birth but a lot of the time we weren’t on good terms. I was so focused on how things were going to turn out after the baby came, trying to salvage a relationship that a lot of the time I was sad, depressed, and even regretful of being pregnant up until the third trimester.”
At what point after birth did you start to feel like something was wrong?
Elizabeth: Even though I carried to term and had a healthy son, there was still a lot of testing. They monitor Zika babies for up to two years and my anxiety heightened post-birth. I didn’t anticipate how much life would change which is strange considering I already have a daughter. It was different with him, he was very needy, for want of a better word. He wouldn’t let anyone else hold him, so the demands were extremely great.
In the beginning, yes, there was a little euphoria: knowing that he’s healthy, has his 10 fingers and toes. I was grateful to be over that hump but about a month later a lot of really negative emotions started pouring in. Thoughts like I’m not doing enough, why is he like this, why isn’t this experience the same as with my daughter, etc. I also had issues with breastfeeding; it was a lot of little different things that compounded the situation.
Rebecca: It was about five or six months after giving birth to my daughter, I started realising that something was very wrong. I had pretty much adjusted to my new life, being a new mother. I was a single mother but I was coping and adapting. A lot of negative feelings from the pregnancy were starting to resurface, a lot of resentment toward my daughter’s father, I wasn’t getting along with my mom, I was very submerged in negative and it felt like it would never go away. There’s this complete sense of hopelessness.
When I was wrapped up in all of that I’d lash out, I would become very explosive and I was very volatile. It was this intense pain and it felt like it was never going to being okay, in those moments it felt like the end of the world. It was very overwhelming.Rebecca
“The process of pregnancy and birth is a physically tolling process,” says Clinical Psychologist Denise Jittan-Johnson. “Not only are there observable body changes but overwhelming hormonal and neurological changes as well. Studies have shown that upward of 60% of women experience significant feelings of sadness, crying spells, mood swings, and anxiety in the first few days following the birth of a child.”
Women who have pre-existing psychological challenges with anxiety and depression are at a higher risk of developing PPD, she added. Those who are also at greater risk are those who have financial, social, or relational challenges. Women who have minimal support from their partner or extended families are also at greater risk.
Societal expectations tell us that this is meant to be the happiest moment of your life, that once the baby is born you forget all the pain that came with it. This societal pressure causes a significant proportion of women to not talk about these feelings and believe that something is inherently wrong.Denise Jittan-Johnson, Clinical Psychologist
Postpartum depression may be mistaken for ‘baby blues’ at first — but the signs and symptoms are more intense and last longer, and may eventually interfere with the mother’s ability to care for her baby and handle other daily tasks. Symptoms usually develop within the first few weeks after giving birth, but may begin earlier ― during pregnancy ― or later — up to a year after birth.
Did you feel comfortable enough to open up to others about what you were going through?
Elizabeth: I didn’t feel comfortable to open up to anyone including my partner or my mother because everyone perceives me to be this very ‘together’ individual. There was one time I tried to bring it up with my mom and she casually said oh you’ll be fine, sort of dismissive about it.
Rebecca: I tried to talk to my daughter’s father about what I was feeling because I felt like he didn’t understand what was going on; this was his first child as well.
The challenge with postpartum depression and other maternal issues is that it’s taboo, says Jittan-Johnson. “New moms are expected to be glowing and happy. When challenges are discussed feelings are often minimised and overlooked. Persons in the family are caught up in their excitement in welcoming the new addition and often forget to check in emotionally with the new parents. This disconnect can cause new moms to shy away from discussing their struggle, which can lead to the escalation from baby blues to full-blown postpartum depression.”
Do you think there are enough support services in T&T for mothers with PPD?
Elizabeth: No. People are still very dismissive about what it is. I think a lot of them think oh, you’re just not sleeping or eating enough. So even when the feelings become really extreme you start to question yourself and whether you should take what you’re feeling seriously. When I started speaking with other mothers, they said that they talked themselves out of what they were feeling.
Rebecca: I don’t think there are enough support services for women or expecting mothers to get information or to know what to expect. I also don’t think a lot of women understand why it happens or even what it is when it does. We’re not having enough conversations about this and it’s sad because this can happen to anyone…literally. The happiest person, the one with the great spouse, all the support, money…
Postpartum depression is not a personality flaw or character weakness. It is a result of physical, hormonal and lifestyle changes that come with giving birth and having a vulnerable new addition to your family that is completely dependent on you.Denise Jittan-Johnson, Clinical Psychologist
What should family members and friends look out for in new moms to determine if she needs help?
In the first two weeks after birth, Jittan-Johnson indicates that there are a few red flags to look out for including withdrawal. “If she isn’t engaging or seems distant in conversation; doesn’t appear to be connecting with the newborn; seems to struggle to complete daily tasks (including self-care and childcare) or has harmed herself, spouse or tried to harm the child, it’s time to seek help.” Other signs include:
- Withdrawing from family and friends
- Loss of appetite or eating much more than usual
- Inability to sleep (insomnia) or sleeping too much
- Overwhelming fatigue or loss of energy
- Reduced interest and pleasure in activities
- Intense irritability and anger
- Fear that you’re not a good mother
- Feelings of worthlessness, shame, guilt or inadequacy
- Diminished ability to think clearly, concentrate or make decisions
- Severe anxiety and panic attacks
There are new moms who suffer in silence because of shame, guilt, or even resentment toward their newborn. What advice would you give expecting/new moms about those feelings?
Denise Jittan-Johnson: It’s so important for mothers to know that these feelings are extremely common. They are a result of a complete shift in your life and a huge physical toll your body went through. Hormonal fluctuations are real the punchline of a joke. Sleep deprivation contributes to the irritability and mood swings.
Ask for help. You don’t have to do everything on your own. There is no shame in reaching out for emotional support from friends, family, or a professional. Talking about your struggle can sometimes be all you need to process your feelings.
Those Instagram/Facebook photos are fake and staged! You will be covered in poop/pee/dribble and feel completely gross at times. And it’s okay to take time for your own self-care.
Postpartum depression affects women from all walks of life. It isn’t something that discriminates against age, race, or social educational or economic status. Ask how the new mom is feeling… start the conversation.
The Ministry of Health has various Mental Wellness Centers throughout the country and private psychology practitioners, like Douglas and Associates, are also available, along with this list of registered practitioners.
*Names have been changed to protect the identity of the mothers.