In the past few years, postpartum depression has had a lot of press. Brooke Shields had it, Marie Osmond had it. Tom Cruise denied it exists. All good for raising awareness. Now we all know it exists, and maybe some of us know the warning signs. But no one talks about this: What if you have post-partum depression and you must continue working?

Three years ago, I was in this position. I haven’t written about it because it was bad. Very bad. I keep waiting for someone to write about what it’s like to have to continue working even with post-partum depression. I guess I will be the one.

Here is what you need to know about postpartum depression if you are the breadwinner of the family:

1. Take maternity leave. Even if you have to make it a little unconventional.
I was a freelance writer, with a husband who did not work, and we were living paycheck to paycheck. I thought there is absolutely no way I could take maternity leave. We’d starve.

But I tried to think of ways to craft an unofficial maternity leave by getting ahead with my writing. I didn’t tell my editors I was doing that, but my plan was to not have to write very much.

2. Plan ahead, for the worst-case scenario.
In our heart of hearts, we know that the best case scenarios don’t actually need planning for. So why make plans assuming best case? Make contingency plans.

I did that a little. Because I’m a freelancer and my husband and son are nearly uninsurable, for prior medical conditions, we usually have crappy, near-nothing insurance. But we raided the last of our savings to buy great health insurance for the baby and me, just in case something happened during delivery.

Other than that, I assumed that things would go smoothly when we got home from the hospital since this was our second child, and I already knew how to care for a baby.

3. Admit that no time off means you’re high-risk for postpartum depression.
The baby came early, and I was not really ahead on columns, and my book wasn’t finished.

So right after the baby arrived, I had to finish my book, which was behind schedule. And, my agent told me that there was no way I could promote the book when I was 40 pounds overweight. After all, there was a chapter about how bad it is for your image to be overweight. So I spent two or three hours at the gym every day.

The baby came everywhere with me—to my book publisher, to my agent, to my newspaper syndicate, to the gym. I breastfed in everyone’s office. I breastfed in the cardio room and the weight room.

I cried all the time, and I felt that I had no idea how to take care of the baby, but I looked okay in all my meetings, so I kept going.

4. Ask for help from people you don’t work with.
Then, one night, the baby was screaming and our three-year-old wouldn’t go to bed and my husband was telling me that I needed to get the three-year-old some milk and I was saying that he should and I’ll get the baby and he rolled his eyes, and then I took a knife out of the dirty dishes and stabbed my head.

I don’t actually remember doing it. I remember my husband saying, “Oh my god. There’s blood everywhere.”

Here’s how crazy I was: I just put the knife back in the sink and went to get the baby.

The next day I went back to my old therapist and told him. While I breastfed the baby.

My therapist said he didn’t think I’d ever hurt the kids, but he had to send me to the emergency room to be checked out. So I went there. With the baby, and my cell phone, and I handled edits for my Boston Globe column from the hospital hallway.

The doctor I saw wanted to admit me to the mental ward. I had a friend call all over looking for a hospital that could take me and the baby into a mental ward together, and not one could. “It’s a huge breaking point in the mental health system,” she said.

The psychologists did not want me to leave, but I was convincing, telling them that we would not be able to support ourselves if I did not work. And I was also convincing telling them that I did not want to risk losing my breast milk permanently by separating from the baby for a week in the mental ward.

The doctor said I could go back home with the baby but I couldn’t be alone with the baby.

5. Postpartum depression is one of those times when you should break the bank.
When I left the hospital, I told myself I would just ignore the doctor’s advice because it would be impossible to not be alone with the baby. My husband had to take our older son all over the city for school and activities. And we could never ever afford round-the-clock care.

But on the way home, I remembered Andrea Yates. I had always felt empathy for her, but now I felt like maybe I could be her. I know it came out of nowhere to her: first she was just sort of depressed, and then she was killing her kids.

Plus, I remembered two times when people had asked me how the baby was and I said, “Sometimes I want to slam his head into the wall.” Both times I got very concerned looks. So stopped saying it, but I knew it was not good.

So I hired someone to stay with the baby and me. Only then did I realize that I was terrified to be alone with the baby. I still cry thinking about how I was probably a danger to my own child. The babysitter was as much for me as for the baby.

I kept working. I kept seeing a therapist. And we went into huge debt in order to pay for the babysitter.

In hindsight, I wonder, What could I have done differently?

My career could not have handled a three-month maternity leave. But I should have hired the nanny at the first sign of trouble, even though it caused a lot of debt. I was so scared of spending money. I cut corners on things that I thought I could handle but couldn’t. And the biggest thing, in hindsight, that I thought I could handle, was being a working mom with no support system. No one can do that and stay sane.

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  1. Brooke
    Brooke says:

    Thank you Dale. It IS a wonder we both survived it… my fiance was so distant for so long after her birth (I had broken off our engagement after the rape… finding out I was pregnant by another man, in such a violent manner, did a number on my fiance’s view of the world and our relationship). I see so many articles about women killing their children and always ask myself, how could they? But then when I think back to how crazy I was with my firstborn… all the screaming I did… imagining what it would be like to deliberately run my car into a telephone pole with her in the backseat… I came very close to what these women experienced. I realize that despite receiving any help, something in me still stopped me from taking my thoughts too far. I imagine it was because I had school to keep me busy and my fiance’s mother often took my daughter when she was inconsolable. I also became very involved in my church and singing on the worship team, so I was able to pursue something outside of motherdom. Sometimes I still lose my temper but it’s nowhere near the frequency of psychotic behavior I exhibited back then, and I no longer fantasize about harming them… I am so grateful every day for my children. I would like to have at least one more — however, half of me is afraid that I’ll encounter that severe PPD again (while the other half is hopeful because of the ease with which I had my second). I look back at journal entries from that time, and that was a completely different person.

  2. Amy
    Amy says:

    I can’t tell you how comforting it is to know that someone out there can just lay it all out with such frankness. I would sometimes slip in such disparaging remarks about the baby when I had post-partum and received my own share of shocked glances. Mine is 3 1/2 and I love him deeply, but still am suffering some after-effects. I think that a lot of other women feel that way and had those very thoughts…but edit themselves with such success that they are deluded into believing that they never had those socially unacceptable thoughts. It perpetuates that whole “it’s not real” thing, plus the whole “you are crazy” thing. How come MEN don’t get it? I think you hit the nail on the head. Something’s got to give, and it almost always is Mom. Giving her sanity.

  3. Kristal
    Kristal says:

    Hello I am kristal, I just wanted to say Thank you for being so open and honest. I also suffer from PPD. How are you able to juggle all that and raise two babies? I can barely handle one.

  4. RA
    RA says:

    Thank you for your post. I’m also a working mother currently dealing with PPD. My baby is almost 11 months now and I’ve been dealing with PPD since he was almost 3 months old. It’s been REALLY REALLY tough, trying to deal with the work/life balance. I went back to work for a month when my baby was 3 months old. I went down-hill after one month at work. My doctor ended up taking me off of work for 2 months because I was not functional. I returned part time for the next few months. I love working parttime. I just returned full-time recently, and it’s been a real struggle dealing with the PPD and longer working days.

  5. Karen Carswell
    Karen Carswell says:

    Penelope,

    I have started my own journey through blogging about my postpartum depression at http://amothersojourn.wordpress.com and I am so pleased to find that other woman have spoken out as well.

    Thank you for sharing! When you find time please tune into my blog, I would love to hear your thoughts.

    Karen

  6. MM
    MM says:

    I realize this is a very old post, but I just had to comment.

    THANK YOU for addressing this so candidly. I’ve struggled with depression for most of my life. Genetic makeup and an abusive childhood. After years of infertility and pregnancy loss, it was just exacerbated. So I was prepared to have PPD with my son several years ago. While it was it really tough first three months, I can’t say I had anything more than the baby blues. But pregnant with my second one, due in July, I’m very nervous. Life is just harder now. Compound the stress of a newborn, along with a toddler, along with a bad economy, along with a job that I hate…I’m really nervous how this PP experience will be this time around.

    While I can’t necessarily PREVENT PPD, your beautiful candor, and the many heartfelt confessions in the comments section, has spurred me to “schedule” a conversation with my husband and his sweet mother (the one that helped me the most last time around). I want them to be prepared to keep an eye on me. I want them to support me in specific ways so that if I am to have more than just the baby blues this time, that they be prepared to help somehow. Obviously, details of what to expect and what to do are fuzzy at this point in the game, but I feel that it’s a necessary prep point for this coming child. Thank you for inspiring me to do it now and not procrastinate.

  7. Lisa Earle McLeod
    Lisa Earle McLeod says:

    And men wonder why we get so angry when they walk past the laundry.

    thanks for the honesty, I conducted a three day seminar when my youngest was 4 weeks old, in between teaching an enthralled crowd of 50 how they could close more sales, I went into the ladies room and cried at every break.

    I’m 10 years older and wiser and I wish like hell I had cut myself more slack.

    If men had babies there would be mandatory paid maternity leave fo 1 year, even for people who are self-employed.

    Said the trying not to be bitter, I love my kids, and really do believe I chose this life woman.

  8. emily
    emily says:

    I was a part-time nanny for a 3-month old baby whose mom was suffering from Post Partum depression before I arrived. I never understood before this post why she had hired me since she worked from home, and didn’t fully understand why she was SO grateful to hand the baby over to me when I arrived each morning. This post really sheds some light on that. She was a GREAT mom, but was totally overwhelmed and depressed and scared to be alone with the kids (3 month old AND a 4 year old).
    Extra help with a baby is a luxury that not everyone can afford. But if you can afford it, do it. She told me later that having me there finally let her enjoy being a mom.

  9. Annabel Candy, Get In the Hot Spot
    Annabel Candy, Get In the Hot Spot says:

    I had post partum depression too and found I could totally relate to Adrea Yates. Once someone asked me if my baby was good and I said NO! There was a terrible awkward silence after that and I learned to always smile and say yes to that question. But that made me lonely because I was lying and pretending life was great when it sucked.

    I hated my life and never realised I was depressed. I just thought I was the world’s worst mother. But then a counselor said I was depressed. I stopped working and took anti-depressants. That solved the problem. Being a mum is stressful, working is stressful, working and mothering is too stressful for new mothers. Working women are more at risk of postpartum depression than other mothers. Something has to give.

    Hope you’re all better now. I think it’s good to have been there. I know the signs now and take better care of myself. I never want to go back to that black place again.

  10. Izzie
    Izzie says:

    Thank you for your honesty. I had my (only) child, a son with Asperger’s Syndrome, at the ripe ol age of 35, which was old in 1994. I didn’t know a damn thing about babies; I was good with animals, nurturing and caring for them so a baby? Why not? HA! Having suffered from undiagnosed depression prior to the pregnancy, the bottom of my world dropped out after my delivery. My baby didn’t sleep, nursed all the time, so I got no sleep, had no short-term memory, was always freezing cold and crying and unable to even talk about what the heck was going on. I can totally relate to smothering, shaking my crying baby…it is awful and you feel like such a horrible person. You are supposed to unconditionally love this little being, but you are not YOU.
    Thank you for sharing – you make it safer for the rest of us to share too.

  11. noonethateevermatters
    noonethateevermatters says:

    I’m so lonely and depressed, I would love to hold a baby. My daughter has gone to school. I would appreciate a new life that I don’t have to take home.

  12. Punkin
    Punkin says:

    I say thank you to you for your story. I had my first child and I am dealing with PPD. I wasn’t the one who recognized it. My husband was. I thought I was perfectly fine, but looking back on it, the tiniest, smallest of small things would set me off, and I would blow up in to this huge ball of rage. (ex: the kitchen sink was not turned off all of the way and was drip…drip…dripping and my husband and I got into a fight that almost ended our marriage). I give kudos to you for giving in and spending the extra money. Because yes, you might have debts to pay now, but you have to think, no matter how big the debt is, there is no amount of money that could have brought your child back if you hadn’t gotten that babysitter. Thank you for your bravery.

    -KJ125

  13. thenewamericanmother
    thenewamericanmother says:

    Thank you so much for your story. I have been searching the internet the last few weeks about postpartum depression because I have realized that I have a problem and I have been looking for some sort of insight. Honestly this makes me feel so much better and I don’t mean that in a bad way. I am just glad that I decided to tell my Dr sooner than later. I felt so stupid telling my husband how I felt and then my dr. I almost didn’t say anything. I am hoping that I start to feel better soon, right now I feel like freaking out all the time, but good enough to put on a good front and get through the day. Hopefully I won’t have to fake it for much longer. I just am glad that there are other women/mothers out there who are willing to tell their stories, how they really are without the sugar coating or clinical data. It makes me feel real. if that makes any sense at all.

  14. LibbyG
    LibbyG says:

    Thank you for posting this. I have a one month old baby girl. I am married to the love of my life and my baby is gorgeous, happy & healthy- yet, I am severely afflected with postpartum depression. I am now on Zoloft and just ordered some homeopathic remedies. I have joined support groups and tomorrow starts counseling. I am also considering accupuncture. I am desperate to find something to help. I am a bag of nerves and so anxious I can not sleep. I, too, find myself scared to be alone with the baby- completely overwhelmed by the responsibility and change. I hope all women out there with PPD can find the help they need. It’s a terrifying and scarey place to be.

  15. LibbyG
    LibbyG says:

    BTW- I moved from Portland, OR to New Jersey around week 3 of my daughters life to move in with family. My husband still is in Portland- we both knew I had to go somewhere else to get the support I needed. Otherwise, going into debt to get a round-the-clock nanny would have been another very helpful and good alternative.

  16. LibbyG
    LibbyG says:

    to thenewamericanmother- don’t stop trying to get help. There are all kinds of wonderful support groups, doctors, friends, etc that understand and acknowledge PPD and the people who just call it the “baby blues” and say you will just get over it are not helpful and just don’t understand how serious this is!! Here is one number 1-800-328-3838 – it’s a number for a baby blues/postpartum.
    Another number is found on this website:
    http://www.babybluesconnection.org/
    I have called them- just to talk and spoke with a women who went through a very severe PPD depression herself, so she understand. She said she didn’t enjoy being a mother till her son turned 2. Don’t be embarassed to be honest – I know what you are going through and it’s very, very real. I’ll be thinking about you. And as my husband says- “one shovel full at a time”… one step at a time.

  17. mary
    mary says:

    Great article. I had bad post partum depression after my 1st son was born and I felt completely alone. Exercise really helped me feel better. I found a great product called sphere O sculpt from Fit your world. I was able to get a good cardio workout at home. All of the workouts were short so I could sneak them in when I had time. Give exercise a try, it really can lift your mood.

  18. kevin blumer
    kevin blumer says:

    great article i had a friend who was suffering form this but she would not talk to anyone about as she was afraid people would think she was mad and she was very afraid of loosing her baby the story turned out ok she did eventualy goto her doctor and he sorted her out

  19. Survivor
    Survivor says:

    I just found this post via a link in your homeschooling post. I did end up in a mental institution 10 days after my first child was born and was separated from her for 9 days because the hospital had a policy that children under 18 couldn’t visit. I was suffering from postpartum psychosis (what Andrea Yates was diagnosed with, affects 1 in 1000 women), which meant that basically having a baby made me go insane. I feel that the medical community that we encountered at the emergency room the two times we went weren’t prepared with dealing with women in such situations and as such my condition deteriorated to the point that I ended up in the mental hospital. I was lucky to have an amazing family as my support system. If I hadn’t, I don’t know how I’d have been able to recover.

  20. Survivor
    Survivor says:

    I just found this post via a link in your homeschooling post. I did end up in a mental institution 10 days after my first child was born and was separated from her for 9 days because the hospital had a policy that children under 18 couldn’t visit. I was suffering from postpartum psychosis (what Andrea Yates was diagnosed with, affects 1 in 1000 women), which meant that basically having a baby made me go insane. I feel that the medical community that we encountered at the emergency room the two times we went weren’t prepared with dealing with women in such situations and as such my condition deteriorated to the point that I ended up in the mental hospital. I was lucky to have an amazing family as my support system. If I hadn’t, I don’t know how I’d have been able to recover.

  21. Nath
    Nath says:

    Also, believe it or not walking really helps your mood, it helps support having the chemicals in the brain needed to have a good attitude…everything plays a part. Walking can be stronger than prozac and helped 90% of people that went on a walk. Source: http://anxiety-remedy.net/uncategorized/anxiety-remedy-what-exactly-is-anxiety-and-what-can-be-done-about-it

  22. Wiggle
    Wiggle says:

    Gee whiz. I’m a bit surprised at some of the comments here. PPD is no joke. Women are made to feel that we have to give, give, give, and if we are intelligent women, why, we should be able to handle being the breadwinner, making the decisions, all while looking beautiful and fantastic caregivers. Has anyone noticed that if a father is single, or faces the same challenges that Penelope illustrated, everyone says, “Wow, look at that great dad!” Whereas we are just expected to do all of these things and if we say ” I need help!” we are unstable or weak. And top the poster who commented on the “wealthy family ” issue. Just because a person’s family is well off doesn’t mean that A)She would feel comfortable discussing this with them  B) They would be financially supportive and C) That they are even emotionally supportive.
    Thank you for sharing this, Penelope, you are a marvel.

  23. Chloe
    Chloe says:

    Thank you for the article. I too suffered debilitating PPD and antidepressants saved my life. I’m currently pregnant for the second time and am prepared for the first symptoms that indicate I need help.

    I wanted to note that as a Canadian, I was quite surprised that you were not allowed to have your baby with you in the mental ward. It is allowable here, and I believe it is truly beneficial for mothers suffering with PPD.

  24. Durba
    Durba says:

    I think you are very brave and also very kind to have written this article. You will help so many women. I too have sufferred from PPD as well as post-partum anxiety. I have had my husband tell me that I should not miss this wonderful time by being anxious and depressed when I should be joyous, having just had a baby. It was frustrating and made me feel worse because I then felt guilty. In India, people are so ill-informed about any mental ailment and there’s this huge taboo. You can’t mention “depression” or “anxiety” in public. You might lose your job, and face ostracisation from co-workers, friends and family. Everything is swept under the carpet here. I have help from my in-laws with my baby, although they are not at all friendly with me. When they help it just makes me feel like they are simply taking care of their kin (my daughter), and feel more alienated from them. I feel like they’re the family, along with my daughter and husband, and I’m the interloper. There are problems everywhere there are humans. And all of them have solutions. Thanks again for sharing.

  25. Leah
    Leah says:

    Right now, it is 2:54 AM and I can’t sleep. I have a 2-year-old and an 11 month old – both were c-section, both were bottle fed due to complications. I get along fine with my 2 year old and we spend lots of time together.

    When I look at my 11 month old – I think life would be better if he wasn’t born. I know it’s mean and I walk around guilty because he is a lovely little boy and all my family oohs and aahhs over him but nobody will give me a cent to help raise him.

    He was the product of failed birth control. His father lost his job when he was 2 months old, after I resigned from my job to take care of the boys.

    I look at him and resent him. Feel guilty. Resent him more.

    Today, I slapped him because he refused to sleep and stayed crying for an hour.

    An hour straight of crying and I slapped him on his leg and felt guilty. Resentment again. More guilt.

    I want to give him to someone who would take better care of him. More guilt.

    This is post partum depression. I love my son and I hate my son and I hate myself for hating my son and I feel guilty all the time.

    • Heather
      Heather says:

      It’s 12:30am here and I’m feeling very similar, except my son is almost 16 months old. He’s my first and only child. I’m a stay at home mom but I’m also in school. My husband works third shift so I’m alone with our son 19-20 hours a day. We only have one car and my husband takes it to work in the evenings so I’m stuck home alone most of the time. I cry every night. Lately I’ve called my husband while at work sobbing uncontrollably because our son is crying uncontrollably. He’s had to come home on several occasions, including tonight. Money is tight enough but when he leaves work it gets tighter. One of these days he’s just going to lose his job, and he will not find another one. Anger, guilt, resentment, more guilt… it’s a horrible cycle. I contemplate taking him to a hospital or police station and leaving him there. We are working on getting help for me and for us as a family, but it’s slow going. Every night it gets worse and worse and I just wonder how long I can put up with this.

      • Penelope Trunk
        Penelope Trunk says:

        Hi, Heather. I just wanted to say to you that I’m really sorry for all the pain you have right now. I can’t stress enough how much getting medication helped me. It’s easy to get in the US — postpartum depression is widely accepted as very serious and very treatable. I hope you will get help for yourself. The problems you list seem insurmountable from your vantage point now. The medicine will make you feel more in control of your situation. Really.

        Penelope

  26. lisa
    lisa says:

    Thank you for writing about how crazy it can get. I have had PPD three times, with the last time being the worst! My mom hid all of our knives which is crazy for me to say now looking back on it. We need to keep talking about it. It’s real and out there. Alot more than people realize. When I was sick the best advice I got was to talk, talk to anyone, talk to everyone. And I did…and I found that there isn’t one other mom out there that hasn’t had some form of PPD.

  27. Mi
    Mi says:

    well i’m not going to sugar this for you…
    around here that would have gotten your kids taken away by cps and then you could go be all crazy and in people’s face with issues and attitude all you like with no commitments

    Really if it’s so frustrating then let your kids go back to public school. You can teach them the important stuff at home but at least you’d have free childcare for a few hours a day.

  28. Nicola
    Nicola says:

    I know this post is years old, but I thought i’d comment for people like myself who may stumble across it. My second child is now 2 weeks old. Throughout my entire pregnancy I felt down. I didnt want to be pregnant and couldn’t wait for it to end. But now I f eel like it hasnt ended, its just got worse. I’m exhausted, lonely, anxious and don’t want to be in my life. It’s like i’ve made this huge mistake and can never ever take it back or get out of it. Which sounds awful! I absolutely adore my newborn daughter, she’s amazing. But I feel like she’s sucking the life out of me. I have lots of support around me, but cant help feeling like i’m all by myself in the world. Luckily here in the uk we get lots of maternity rights, and im not due back to work for about 8 months. But to be honest i’d happily go back tomorrow, just to feel normal again. My health visitor has been today and told me she is referring me to the mental health nurse for some councilling. Fingers crossed this helps before I start,getting really bad. I think when I told her how I keep imagining over and over again all the ways in which my baby might die, and how scared I was, she realised how ‘not right’ I am. Its really scary having no control over your emotions and state of mind.

  29. Erin Rose Bouvier
    Erin Rose Bouvier says:

    I really applaud this woman for being so candid about such a scary thing for women to go through. America is plagued by a “hush-hush” approach to the matters that are most important to NOT be “hush-hush” about. We need more people to be openly and bravely honest about difficult parts of being human. Then we can help one another come out of hiding and stop feeling so ashamed. I say this with regard to ALL of life’s horribly difficult problems, not just PPD. Drug-addiction, depression, anxiety, abuse, etc…we need to stop wearing social masks to hide the parts that hurt and are scary. And we need to stop harshly judging ourselves and others for being human.

  30. Carla
    Carla says:

    This is an old post, but I’ll comment anyway. I think it is a great point to plan ahead for post natal depression, just like you plan ahead for other issues in life.

    I let my partner know in advance about the one hospital which takes mother and baby together for post natal psychosis/depression (this is in Sydney, Australia). Looking into something similar in your part of the world is a good idea – or lobbying for it, if necessary.

    Looking into post partum doulas might be another way to prepare. Maybe there needs to be a section on your birth plan to cover this?

  31. VegGal
    VegGal says:

    I know you wrote this a few years ago, but it obviously helps many of us to date.
    On another note it really strikes a cord with me today. In two weeks I send my daughter to Kindergarten because I broke down an determined I have no support for homeschooling this year. This past weekend I semi-enjoyed a “No kids” weekend with family where-in my MIL agreed to watch my three kids. During this weekend a few people said to me “I”m glad you decided to put her in school because you need the break.” To which I wanted to reply, “I wouldn’t need this break if people would have stepped in a helped me when I was truly desperate for a break. Why can no one realize that waiting until my child is 5 is the wrong amount of time to wait to get this so-called “break” from caring for them? “

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