Dr Tara Lynn Frankhouser never would have hurt her first son, but in the throes of postpartum depression she was afraid to hold him too long.
The doctor never expected that the postpartum depression she’d watched her patients suffer through might strike her too.
Dr Frankhouser was shocked by her own ability to continue to conceal and deny her agony, even on her most desperate days, and now sees that her patients probably try to hide their symptoms from her too.
Six years after her first son was born, Dr Frankhouser has been able to face those fearful times and write an account and analysis of her own the debilitating condition to help doctors like herself identify the often hidden signs of postpartum depression.
Depression has blurred many memories of the first several months of her eldest son’s life, but Dr Frankhouser bravely recounts the horrors of feeling like a danger to her own child and overcoming shame and denial.
‘A lot of women put on a really good show,’ Dr Frankhouser says. PPD is ‘something you want to hide. We are perfectly capable of pretending for an hour that we have it all together for dinner with the family or a doctor’s appointment.
‘I was perfectly capable of that,’ she told Daily Mail Online.
Dr Frankhouser says that the standard questions at follow-up obstetrical and pediatric doctor’s appointments – ‘So, how’s mom doing?’ – are not always adequate.
For months, ‘I would always say “Yeah, I’m fine, I’m great,” and they took that at face value,’ she says.
In reality, once her husband, Charles, went back to work, she found herself petrified by being alone with an often crying newborn in a house steeped in alien baby bottles, diapers and breast pumps.
Outside the door to her son’s nursery, Dr Frankhouser writes that she remembers thinking ‘what mother cannot soothe her own child for fear of her own actions?’
That sort of self-blame is exactly what the doctor and other clinicians have to try to combat with new mothers, who want to be ‘super-moms’ she says.
‘You really can’t take what [patients] are saying at face value, when they’re coming to see you every week and not getting better.’
Dr Frankhouser went over and over to her doctor in the months following her first son’s birth, complaining of ‘headaches.’
Finally, she writes, she had the ‘out-of-body’ experience of telling her husband and then her doctor what she was going through, after crying herself empty.
When her doctor asked if she had thought about hurting herself or her baby, Dr Frankhouser remembers her agonized reply: ‘I wouldn’t hurt him. I don’t want to hurt him. I just put him down and walk away when I feel like I can’t take it anymore. But that’s not the mother I feel like I should be.’
That fear, ‘of society labeling a woman as a bad mother can lead to shame and avoidance in seeking treatment,’ Dr Frankhouser writes.
About three million people develop PPD each year in the US. The condition shares similarities with other forms of depression, but the hormonal changes and poor sleep common to new mothers can exaggerate symptoms like insomnia, irritability and difficulty ‘bonding’ with the baby.
These clinical descriptions of symptoms just don’t do justice to what women like Dr Frankhouser go through, as she recalls in her research.
Feelings of aggression nor antipathy toward their new baby can be a symptom of more sever forms of PPD, but they’re only made worse by a depressed mother’s guilt and fear of stigma.
‘His first six months were kind of a haze,’ she told Daily Mail Online. In writing about her PPD, she says she ‘got back some of those memories – for better or worse.’
Now that she has gotten past her own, Dr Frankhouser has used her experience as motivation to destigmatize postpartum depression (PPD), empathize with patients, and screen every new mother that comes into her office in North Carolina to be sure they get the mental health care they need.
Dr Frankhouser was used to addressing the many stresses of pregnancy and new motherhood while she was doing her osteopathic residency in family medicine.
But when she got pregnant with her first child in 2013, Dr Frankhouser found she had to ‘change her role’ to be a patient.
In a newly-published account and ethnographic study of her experience, she writes of the clear memory of being ‘forever changed by bringing my son into the world,’ and the joy of bringing a happy baby home.
Through examining her own PPD, she identified four themes in ‘the cultural ideologies of intensive mothering and the stigma of mental illness: essentialism, failure, shame, and avoidance.’
She says that the ‘essentialism’ of the intensive experience of early stages of mothering is perhaps under-addressed.
‘A big one for mothers is how connected they are with breastfeeding. It was never successful for me,’ says Dr Frankhouser.
For the first month after her first baby was born, she hardly slept, pumping every three hours around the clock, just trying to be able to feed her son with her own milk.
‘It’s terrible to feel like you can’t pull it off, when society tells you [that] you should be able to. Even if they don’t want to watch you in public, they still expect you to be able to do it,’ says Dr Frankhouser.
Most estimates say that about five percent of women are physically unable to breastfeed, but in one recent study more than 90 percent of mothers had trouble breastfeeding, at least immediately after their babies were born.
Finally, ‘I gave myself permission to stop,’ Dr Frankhouser says. ‘Now I see moms that come in and beat themselves up. I tell them that they can supplement, their baby can have a bottle and it’s okay.’
Once Dr Frankhouser accepted that it was okay to experience PPD and to bottle-feed her baby, she got the help she needed and started taking antidepressants.
Fast-forward six years, and Dr Frankhouser and her son are happy and healthy. She now has another son, age two, and a daughter, age four. She says that when they came along, she and her husband quickly recognized when PPD started to creep back into their lives. She returned to her antidepressants.
‘I think sometimes it’s scary to think about putting something extra in your body when you’re pregnant, but everything we do and feel affects the baby and it’s all a matter of weighing the pros and cons and having the conversation with your doctor,’ she says.
Now, Dr Frankhouser screens every new mother – and many fathers – she sees for PPD, even if they say they’re doing ‘great.’
‘I don’t know if there’s a perfect question to ask,’ she says.
‘I think the best thing we can do is ask open-ended question and give the parents – can’t exclude fathers from that either – give them the space to talk.’