You Couldn't Understand This

The unexpected truth about postpartum...

EDITION NO. 019

**Content Warning**: This essay discusses the lived experience of postpartum depression.

She was born on a Wednesday, the night before Thanksgiving, which meant turkey dinner à la hospital kitchen.

I remember feeling a mix of exhaustion and disbelief, knowing that everything had changed and that our holiday plans were now completely out of reach. I've never looked at a Thanksgiving meal the same way since.

All our holiday plans were thrown out the window—no driving out of town to see family, no taking our toddler to the mountains to see snow for the first time, no date nights while the grandparents took over.

Instead, I was in a hospital bed, wearing a stiff, starched gown, a prisoner under the harsh fluorescent lights, our new daughter in the NICU, the Macy's parade playing on the TV.

It wasn't supposed to happen like this.

She wasn't expected until after Christmas.

But my body had other plans. It refused to hold her in any longer, and she arrived suddenly as if my body couldn't contain her anymore.

It happened so fast that I didn't even have a hospital bag packed.

I sat contracting at the foot of our bed, calling my husband to hurry home from work, while our toddler ran around the house in her Santa footie pajamas. We had no time to wait for someone to come over to stay with her, so she came with us to the hospital.

"You should be glad you're both okay!"

"You should be grateful you made it to the hospital!"

But I wasn't feeling anything like that.

I was tired of people telling me what to feel.

I was numb to it all, dissociating to survive what was otherwise overwhelming. I began to shut down emotionally as if I were watching everything from a distance without truly being present.

In the days that followed her unexpected birth, the numbness grew, existing in its own right as a protector from the overwhelming grief that lay dormant within me. But I had no awareness of the dissociated state I was in at the time.

Being thrust into the holiday season after a traumatic birth experience was completely disorienting. The pomp and circumstance of forced holiday merriment was unbearable, a total disconnect from my joyless state.

The things I used to enjoy in previous years—like decorating the house, baking cookies, and watching holiday movies—now felt burdensome, as if the joy they once brought had been replaced by an overwhelming sense of duty and exhaustion.

Most mornings, I could scarcely get out of bed.

The late nights awake with a colicky baby bled into early mornings. I’d finally fall into bed just as the rising sunlight began to seep through the cracks of our draped windows, and I’d mourn another night passed without sleep.

The need to dissociate grew so strong that I became disconnected from my body entirely—forcing myself to eat, forgetting to go to the bathroom, even forgetting to brush my teeth.

But it didn't end there—I found myself growing detached from my babies as well, unable to fully engage or feel present with them.

I learned to go through the motions.

I learned that most people are completely oblivious to the weariness of being new parents, or how disconnected we are from grief as a society—where we couldn’t recognize it even if it stared us in the face.

For instance, the pressure to always appear happy and grateful as a new parent can make it nearly impossible to admit when we are struggling, leading many to hide their pain instead of seeking help.

I certainly couldn’t see it in myself. I just thought, “You’re really bad at this whole mothering thing,” or, “Your kids would be better off without you—they’d probably thrive with a different mother.”

To add insult to injury, I felt disdain for a body that had failed me and my baby so miserably. But no one, including myself, could see the invisible state of grief that had overtaken me.

"You should just be glad you were able to have another baby!" was another classic line people shared, desperately trying to change my bleak outlook. Our preterm baby and I were struggling with breastfeeding, which only added to my belief that my body had messed everything up.

And it was true: I had struggled with hypothalamic amenorrhea from years of overexercising, undereating, and engaging in my eating disorder.

I thought my body was broken beyond repair. I never thought it possible to have children.

So shouldn’t I just be grateful for these two beautiful babies? Wasn’t that enough?

Dark, I know, but real. I couldn’t escape the reality I was living in. The only way I could survive was by existing in a numbed state.

Years later, I came to learn it had a name: postpartum depression.

I didn’t know that’s what I was living through.

I just thought I sucked at being a mom.

I thought postpartum depression meant tearfulness and sadness, not disconnection.

I didn’t understand that the numbness was depression too.

I cried out of sheer overwhelm and exhaustion, not because I felt sad.

I didn’t feel anything.

And now I understand how depression protected me from being overcome by the intensity of grief that stormed within me.

It wasn’t until years later, when I processed the trauma of my postpartum experiences, that I could connect to it, understand it, and befriend it.

The grief came flooding out like it had been waiting for years to be set free.

This time, it didn’t overwhelm me, though it still hurt. But I was in a position to sit with it rather than dissociate from it.

This time, when I cried, it was over everything I had lost: my dignity, autonomy over my body, the belief that my body had failed me, the dream of the mother I’d be, the ideal birth that didn’t happen, the time lost with my children while I was in survival mode, the shame my body carried over breastfeeding struggles, the mothering I didn’t receive when I needed it most.

All of it had been stuck inside me because I didn’t know what to do with it. After years of processing, I could finally release it.

They say time heals all wounds.

I disagree.

I think some wounds are too deep to heal completely.

But time teaches us how to live with them if we allow ourselves to learn from the lessons they bring.

Over time, we grow in our capacity to tolerate the discomfort of the wounds we carry. We learn to take care of ourselves while living with those wounds, rather than pretending they don’t exist. We learn how to alleviate the pain without dissociating or self-destructing. We learn what’s needed to care for the wound—how to properly clean and dress it, rather than covering it up with a bandaid.

No, time doesn’t heal all wounds.

But we grow more resilient in carrying them without losing heart or hope.

Holidays can amplify pain for many reasons—they bring up memories of what we hoped for but lost, and they often come with expectations of joy and togetherness that can feel completely out of reach when we’re struggling.

During the holiday season, the contrast between the festive atmosphere and our internal reality can make feelings of grief and loss even more intense.

Everything around us seems to demand celebration, but it’s hard to celebrate when our hearts are heavy.

The holidays tend to remind us of what we’re missing, whether it's the family we wish we had, the experiences we feel were stolen from us, or the idealized version of ourselves that we long to become.

This November, our late preterm baby turned 13.

She is lively, curious, and resilient. I could never have imagined in those early days after her birth that we would ever get to this place—that the sleepless nights would end, or that I would know motherhood to be anything other than the dark hole I existed in.

Watching her grow into the vibrant young woman she is today feels like our beauty-from-ashes story—a testament to resilience, hope, and love despite the struggles we faced.

Despite my struggles, she has come into her own. My struggles didn’t define us but helped us find our way back to each other.

Her birthday, and the holidays in general, are still tinged with grief.

I’ve come to accept that it will always be this way, and that acceptance has brought a kind of peace.

It has allowed me to honor both the joy and the sadness that coexist, without denying or suppressing either.

This balance helps me move forward, recognizing that both emotions have a place in my journey.

But instead of dissociating out of survival, I’ve learned to expect it and let it move through me without overwhelming me.

There is a cathartic release in crying, in recognizing what I lost—what I missed out on in those early days when depression kept me numb and unable to connect deeply and securely with my baby girls.

I’ve learned to extend compassion to my postpartum self, who was doing the best she could to survive something so painful.

I don’t need to put on a facade and pretend I’m something I’m not. I’m safe to sit in grief without getting stuck in it.

I’ve come to acknowledge that motherhood is continually laced with grief and joy at all stages.

They cannot exist without each other, as much as we might wish they could.

On the eve of each child’s birthday, I sit down with them to do their “birthday book”—a tradition that marks the passing of time, helping me celebrate another year of their lives while acknowledging the difficult things that also leave their mark, etched into different memories.

After they go to bed, I often turn back to the earlier pages of their birthday books—ages 2, 3, 4. The ages that seem lost in the void of my depression.

So much happened during that time that I don’t remember, as I survived in that detached state. I let my fingers glide over their little drawings and handprint tracings, noticing how they wrote their names and the notes they left behind.

I’m sad I missed out on so much.

That grief is real and will always be there.

But I look ahead to the birthday book pages yet to be filled and understand that our journey doesn’t end with the years and memories we lost.

Each year, I write them a letter to put in their birthday books—maybe they’ll read them one day. I tell them how grateful I am for their lives, how much I’ve learned from them, and how they’ve made me who I am today.

I want them to know one day that my emotional absence in their earliest years was not their fault, that my inability to connect wasn’t because something was wrong with them.

As children often internalize our struggles as their own, it’s my responsibility to remind them that the struggles are mine.

Being sick in mind and heart was not a byproduct of becoming their mother; on the contrary, they helped me find healing and my way back home.

I wish we normalized grief more in motherhood.

Not to wallow in it, but to recognize its rightful place along our journey rather than fight it, ignore it, or dissociate from it—all of which only intensify it and cause more pain.

I wish mothers had more support to navigate grief because it was never meant to be something we shoulder alone.

In our individualistic society, we are often never more alone than when we become mothers. When someone who loves and cares for us bears witness to our grief and doesn’t try to change it, we are safe to sit with it and let it pass through us, as it’s meant to do.

The holiday season, in particular, is filled with unexpected shadows of grief.

During a time when we’re “supposed” to feel joy, excitement, and cheer—let me remind you it’s okay to feel exactly the way you do.

You don’t have to change your grief to make others comfortable. There’s nothing wrong with the way you feel. You don’t have to ignore it to push through. You have permission to opt out of what isn’t honoring you and the season of life you’re in.

Through it all, you’re loved and worthy, exactly as you are—grief included.

Postpartum Depression and Eating Disorders

Statistics show that women with a lifetime history of eating disorders have a 4-5 times higher risk of developing a perinatal mood or anxiety disorder, like postpartum depression.¹

Not once during my perinatal care was I ever screened for an eating disorder, past or present—and even if I had been, I’m certain my provider would’ve had no idea what to do with that information.

At my one postpartum visit, six weeks after my daughter was born, I was handed a sheet of paper to complete, supposedly screening me for depression.

Being the good test taker I was, I circled all the “correct” answers.

I was terrified that if anyone knew what was going on inside me, they’d take my babies away.

I wish I’d known that my likelihood of struggling with depression or anxiety after becoming a mother was higher because of my eating disorder history—a massive risk factor in itself.

I was so focused on maintaining my recovery and not relapsing into my eating disorder that I was completely blindsided by postpartum depression.

I wish I’d known the early warning signs and how depression can evolve over the years; that even if you’re no longer considered “postpartum” by textbook definition, you can still be struggling with depression.

I wish more providers were educated on how to support mothers who have had an eating disorder and are navigating PMADs, and that meaningful resources were more readily available.

I wish impactful policies could improve preventive care, awareness, intervention, and treatment to transform maternal mental healthcare at a systemic level.

There is so much work to do.

While I may not have had this information and support during my journey into motherhood, I’m committed to helping the mothers and families who come after me, who deserve far better.

That is how I find redemption in my suffering—knowing it wasn’t all for nothing, that something can be learned from it, something can be gleaned to help others who are struggling.

In the meantime, while we work toward systemic change, we have to continue to stand for ourselves and others.

This is where I want to encourage you to be your own best advocate—to stay informed about your risks, including the link between eating disorders and perinatal mood and anxiety disorders (PMADs).

Learn the early warning signs of postpartum depression, anxiety, and other PMADs, and don’t hesitate to seek support if you notice them.

Awareness is a powerful tool in preventing these conditions from escalating and ensuring you get the help you need.

You Are Not Alone

If you are struggling with a perinatal mood or anxiety disorder, like postpartum depression or anxiety, please know you’re not alone and that there is hope for healing.

Postpartum Support International is a resource aimed at supporting individuals struggling with perinatal mood or anxiety disorders (PMADs), such as postpartum depression.

The Warmline offers compassionate, non-judgmental support, as well as information about local providers, support groups, and other resources. It is particularly valuable for mothers who are navigating challenging mental health conditions during the perinatal period and may feel isolated or unsure about how to seek help. This resource helps bridge the gap between recognizing one's need for support and accessing proper care.

When we reach out and allow others to bear witness to our suffering, we realize we’re no longer facing it alone.

The burden becomes lighter when we share it.

So, remember that you are not isolated on this journey. Grief, struggle, and the desire to heal are all parts of being human, and it’s okay to ask for help.

Together, we can bear the weight and move forward with hope.

Until next Sunday’s Supper…

Reference:

1. Eating disorders and perinatal mood disorders: Risk factors and prevalence data. American Medical Association. JAMA Psychiatry. 2023;80(3):232-239. doi:10.1001/jamapsychiatry.2023.4567.