Janine held her two-month-old as we spoke. Her arms were a bit stiff, and she looked uncomfortable. As little Johnnie looked up at his mom a smile began to spread across his face. Mom didn’t notice. She aims to keep Johnnie on a very rigid eating and sleeping schedule and describes how upset she becomes when her son doesn’t comply. She reads everything she can find on the Internet about baby care and is distressed because one person’s advise contradicts another’s.
Mom’s looked to me for reassurance, asking, “Are you sure he is growing ok?” Though Johnnie’s regular eating habits, his “output” (pees and poops), and his growth chart demonstrate a child who is growing well, Janine cannot be confident he is doing well.
Janine loves her baby deeply, but she is one of the 10% of postpartum mothers who suffers from postpartum depression.
Depression can present two ways in a new mother. Typically parents think of the “Baby Blues:” a mother who continues to be emotionally tender and tearful even after the first week of her child’s birth.
But Janine demonstrates the other face of postpartum depression: the hyper-vigilant mother who worries all the time. New parents normally present greater-than-usual vigor and intensity as they struggle with their early days of parenting, but a depressed mom cannot be reassured by those who are ready to help and give guidance. She finds very little joy in the job of parenting—and sleeps and eats poorly, even though her baby may do both well.
Postpartum depression research by Dr. Ed Tronick from Harvard University has identified behavioral changes in two-month-olds whose mother is depressed. While parenting has been described as a dance between a parent and a baby (a parent reaching out to understand and care for a baby, and a baby seeking care from a parent), the hyper-vigilant, depressed mother has difficulty participating in the dance. She doesn’t seem to see her baby’s efforts to connect with her, and she attempts to interact when the baby is shut down and unavailable. In this mother-baby dance, the partners are constantly stepping on each other’s toes!
Janine now understands what postpartum depression is, and she sees that without help she is putting both herself and her baby at risk. During the past month Janine has accepted both counseling and medication and now is smiling more. At Johnnie’s four-month-old visit with me, Janine is distracted when her baby starts to giggle. I’m happy to feel like an outsider for a moment as this “dance couple” linger in one another’s gaze.