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Turning Sadness into Contentment

Extremes of Mood
At one time or another, many mothers will experience forms of sadness that are so intense or chronic that they are in the clinical range. Please see if any of the descriptions below apply to you. If one does, you should consult with a professional right away.
  • Postpartum depression (PPD): Depressed mood continuing past the "baby blues" (three to seven days postpartum); suffered by at least one in eight mothers. Often accompanied by severe anxiety or panic, spontaneous crying, agitation, insomnia, obsessional thoughts, disinterest in the baby, or suicidal thinking. In the extreme, there may be psychotic delusions, often related to the baby. Making things worse, it is common to feel guilty about being depressed at a time when a mother is "supposed" to be happy.

    After an episode of PPD has seemed to resolve, there may still be an underlying disturbance in the endocrine system, or unstable or low mood; these possibilities should be discussed with your doctor if you have ever had an episode of PPD.

  • Dysthymic disorder: Chronically low mood that occurs during most of the day, more days than not, for at least two years. (But remember, you don't have to wait two years before seeking help!) Some days can feel okay, but then the dark cloud descends again. Often coexists with anxiety, feelings of guilt or inadequacy, brooding about the past, or major depressive episodes.
  • Clinical (major) depression: Feelings of extreme sadness or despair lasting two weeks or longer, accompanied by hopelessness, fatigue, disturbed sleep or appetite, poor concentration, difficulty making decisions, feelings of worthlessness, withdrawal from family or friends, or suicidal thinking. When you add up the number of individuals who get depressed, the typical length of a depressive episode, and its impact on both functioning and experience of life, women worldwide are more burdened by depression than by any other health condition. About 8 percent of mothers are clinically depressed at any given time, and this rate jumps to 12 percent among women who have recently given birth. Of course, the percentage of mothers who will ever be clinically depressed is higher than that. Also, the number of mothers who have depressed mood, but do not meet the stringent criteria for clinical depression, will be greater than those who are clinically depressed.

    Depression is best treated through the teamwork of:

    • You. Sometimes the first step is the hardest: admitting to yourself that you are in fact depressed. But once you do, you can reach out to the many resources that can help you. Remember what worked the last time you were depressed; you probably found some things that helped, and there's a good chance they'll work this time, too. Stick with it, and you will almost certainly feel better.
    • Your partner. He can support you through understanding, extra help, affection, and encouragement. It might help him to read about depression in such books as An Unquiet Mind by Kay Redfield Jamison, M.D., or Noonday Demon by Andrew Solomon. He also needs to take extra care of himself in order to keep being supportive of you. (It's important, as well, to reach out to your friends.)
    • A therapist. There is more evidence that psychological factors cause depression than biochemical ones, and studies have shown that psychotherapy is as effective or better for many people than antidepressants (and without the side effects), plus is generally more successful at preventing relapse. And a person can certainly take an antidepressant while going through therapy; a combination of treatment methods is sometimes more effective than either one alone.
    • A physician. Depression is a common complication of insomnia, chronic pain, illness, or medications (including oral contraceptives), and you should rule out these possibilities with your doctor. In general, depression should be addressed through a combination of social support, stress reduction, optimizing physical health, psychotherapy, and, if necessary, medication.
  • Bipolar disorder: Fundamental instability in mood, marked by at least one manic episode. Features of a manic episode include abnormally elevated or irritable mood, decreased need for sleep, grandiosity, distractibility, racing thoughts or speech, bursts of activity or agitation, or sudden shifts in mood (e.g., from euphoria to anger).

    Bipolar disorder and major depression carry a serious risk of suicide. The death of a mother by her own hand is a devastating loss and a lasting wound for her children, and there are always better options. Psychotherapy and medication are highly effective, and people usually rally behind a mother when she lets them know she's really hit bottom. If you have been contemplating suicide, even abstractly (e.g., "the children would be better off if I were gone"), please immediately tell someone who cares about you, as well as get professional help from a licensed therapist.

Key Ways to Turn Sadness into Contentment

  • Take time to mourn the things you've lost since becoming a mom.
  • Pay attention to everything that's going well.
  • Talk back to helpless, pessimistic thoughts.
  • Keep your sense of humor and perspective.
  • Make it a priority to get out and have some fun.
  • Find support among friends.
  • Take time to be grateful.
  • Get professional help for depression or other mood disorders.

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From Mother Nurture: A Mother's Guide to Health in Body, Mind, and Intimate Relationships by Rick Hansen, Jan Hansen, and Ricki Pollycove. Copyright © 2002 by Rick Hanson. Jan Hanson, and Ricki Pollycove. Used by arrangement with Viking Penguin, a member of Penguin Group (USA) Inc.

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