"I was a hot mess," says Alethea Clark of Menomonie, Wisconsin, recalling the turmoil she felt after her second child was born. "I said, 'Something isn't right with me. As a mother, you're supposed to be happy.'"
Alethea had no problems with her first child's birth. So after her second was born, she thought she just had the baby blues, and it would pass. But as time went on, Alethea wondered why she didn't want to deal with her baby. When her daughter cried, Alethea just wanted someone else to take care of her. Then the situation became more serious.
"After feeding her one night, I was holding her and rubbing her toe when I heard a voice in my head," Alethea says. "I had this urge to hurt her toe. I thought, 'This is enough.'"
Alethea made arrangements for family members to care for her children, and then she checked herself in to Mayo Clinic Health System for inpatient behavioral health psychiatric care. She was eventually diagnosed with a type of postpartum depression called postpartum psychosis.
Postpartum psychosis is rare, according to Emily Sisco, a certified nurse-midwife in Obstetrics and Gynecology at Mayo Clinic Health System in Eau Claire, Wisconsin. However, 1 in 9 women suffer from depression or anxiety after giving birth, known collectively as perinatal mood disorder. While postpartum baby blues pass within a couple of weeks, perinatal mood disorder can be diagnosed anytime during the first year after giving birth. In some cases, the disorder may linger longer than a year.
"It's kind of a perfect storm," Sisco says. "Even if it's welcome and exciting, adding a baby to the family — be it your first or your fifth — is a major life change. Then there are hormone changes and changes to your daily life pattern. Sleep deprivation is a big one."
Women who suffer from perinatal mood disorder tend to blame themselves, Sisco says. Like Alethea Clark, they hear that having a new child should be joyful, and they wonder what they have done wrong.
"It's very clear that there's nothing that they do to trigger this," Sisco says. "This is something that could happen to any woman — even one doing everything right."
To catch postpartum depression as soon as possible, screening for depression needs to be part of every woman's postpartum care. Mothers who show signs of depression or anxiety should receive treatment immediately. That may include counseling, medication or referral for psychiatric care.
Sisco adds that while breast-feeding is considered to be a bonding time that can help protect against postpartum mood disorders, when it is not going well, it can be a source of anxiety. If a woman is breast-feeding and has problems, it is important to get help from a lactation consultant.
It was a two-year struggle for Alethea, but she says she now is doing well. She no longer needs medication, and she is able to care for her children. Alethea says she's glad she made the decision to put their safety first and seek help. She hopes other women can learn from her experience.
"Know yourself," Alethea says. "When you know something is wrong, don't be afraid to say something to a family member or doctor."
Sisco says women can be assured that help is available.
"They should know that they're not alone and that other women experience this, and it's nothing they've done wrong," Sisco says. "There are lots of resources available once you reach out and open up about it."