Pregnant and Already a "Bad Mom"
The stigma of prenatal depression
In 1972, while pregnant with me, my mother experienced extreme feelings of sadness and apathy. I was her third child and she had never experienced such unshakeable emotional indifference. A trained nurse, she began to wonder if she was suffering some kind of medical or mental issue. She asked her OB-GYN if he had ever treated pregnant women for depression. “Only when they’re pre-psychotic,” was his oh-so-sensitive response.
Unable to shake her concerns, she decided to approach our family priest. “Stop watching soap operas,” was his invaluable input.
My mother never watched soap operas.
When she reached out to my father for support, his own ignorance and fears rendered him disabled. He couldn’t help.
So, my mother struggled, fighting not only depression, but also a whopping case of obsessive-compulsive disorder. Determined, she “pulled herself up by her bootstraps,” as we are fond of saying in New England, and reached out for help through a local mental health facility, finding a therapist who helped guide her out of the dark with a combination of talk-therapy and medication.
Of course, the mindset on “problems of the head” were not highly evolved in the backwoods of New Hampshire back in the early ’70s, so she kept her treatment quiet. Even in the privacy of our home, my mother referred to medication as her “pills” and her therapist as her “special friend.” (A term, I later told her in my teens, which made it sound like she had a secret lesbian lover, and wasn’t it better to just go ahead and say “therapist?”)
While we’ve come a long way with the identification and treatment of mental health disorders since then, we have miles to go as a society. There is still a stigma, a feeling of shame and embarrassment that accompanies the admission of such issues, as if anything related to the brain must be locked away in the attic like Rochester’s lunatic wife. But how is what happens in our brain different than any other “socially acceptable” health problem, like a thyroid imbalance or diabetes, which can be discussed openly? This philosophy of embarrassment is not only misguided, it’s also dangerous.
Had my mother not reached out and simply surrendered, sinking into the quicksand of depression, where would I be today? If my mother had not sought treatment, would I even be here?
A recent study conducted by the University of Texas Southwestern, funded by the National Institute of Mental Health (NIMH), compared the effects maternal depression had on children from mothers who were treated for antenatal depression versus those who went untreated. The study, called STAR*D (Sequenced Treatment Alternatives to Relieve Depression), followed moms struggling with depression and their children over a four-year period, starting in 1999. (STAR*D is the nation’s largest multi-site clinical trial on treatments for depression and was recently published in The American Journal of Psychiatry.)
In the conclusion of the STAR*D study, Dr. Trivedi, professor of psychiatry at UT Southwestern and the study’s co-author, reported that “The faster we can get mothers better, the greater impact on their children:In the long term, children will have a better outcome than if you take more time to get their mothers better.”
I’m sympathetic to all depressed mothers’ plights, not simply because of how it affected me in my childhood development, but because I too, have struggled with a mood disorder that surfaced during pregnancy.
Somewhere in between discovering I was “in the family way” and the time I shared the news with my own family, I had a bad day. I was cranky, moody, difficult. Then came another bad day. I cried for no reason; I let the answering machine pick up calls from well-wishers – calls I never felt like returning. I stopped going out with friends, only leaving the house when it was totally necessary and then not at all. One bad week turned into two, then three. I didn’t feel like watching TV or reading or cooking or even taking a shower. I slept. Yes, sleeping was my new hobby. “Get all the sleep you can now,” people said to me, “because when the baby comes you won’t get any!” I told myself I was just tired because it was my first trimester. But I was lying.
Even though I was conscious that the human body makes certain biological and hormonal accommodations for pregnancy that can seriously tweak brain chemistry – and knowing what my mother went through – I was reluctant to admit to myself, or to my husband, that I was trapped in the rising waters of depression and anxiety, unable to pull myself to shore. I needed help.
But how to seek help when you’re supposed to be a rosy-cheeked Earth mother basking in the joy and magic of your “with child-ness”? Who do you call when you’re stuck in a bottomless sadness, torturing yourself with the million-dollar question: “Does this make me a bad mother?”
In this modern world of immediate connectivity and infinite information, many sufferers of maternal depression will reach out online in search of scientific answers or a sisterhood of support. Of course, many of the ante-partum depression “facts” you will find have not been vetted, tested or proven, which sadly doesn’t keep them from appearing and reappearing on various “medical” sites, creating more misconceptions and narrow-minded fears about mental health, further boosting your fears that you’re a social pariah.
And as for the supportive sisterhood? I’m not saying it doesn’t exist, but one certainly shouldn’t expect to roll right from their Google search to the entry of the Red Tent. You laugh but, before I got pregnant, in my incredibly fertile imagination, I had woven a lovely fantasy of Motherhood. I imagined that news of my fertility would reach the high priestesses and I would be led to the Tent. One of the elders, gorgeous and wise, wrists stacked with bangles, would fold back the entryway flap and offer me a cup of homeopathic herbal tea as she guided me into the mystical teepee of maternal wonder to share the secrets of those who birthed before me. But you know what I found when I Googled “pregnancy, depression, treatment with antidepressants”? An angry posse of she-witches, winding up to stone any depressed, drug-addled, baby-poisoning, interloper who wandered into the Province of All-Knowing Supermomdom.
After my depressing trip around the World Wide Web, I came clean with my husband and my doctor. Together we decided that the one-two punch of talk therapy and Prozac would be the best way to knock my depression out. And it was the right call. Within weeks it was like I had been pulled out of the dark and the future seemed bright once again.
Even though I was hopeful and feeling better, I was reticent to share the secret of my chemical savior. I feared the judgment, even from friends, that would follow my admission. After all, I know several mothers who won’t let their kids eat sugar or wheat. Some even pump and dump after a gargle of Listerine, just in case! And here I was deliberately introducing Prozac into the placenta. And, as I had learned online, everyone has an opinion about expecting mothers taking antidepressants and how “selfish” it is to willingly endanger their children.
Those who judge so harshly and force the conversation to be about “mother’s health vs. baby’s health” have never been depressed, I’d wager. They lack the understanding that depressed mothers who go untreated can endanger their unborn children in entirely different ways: not getting to regular appointments, neglecting self-care, eating poorly, sometimes even drinking or smoking during pregnancy, in some cases suicide.
And therefore the myth of guaranteed maternal magic is detrimental. When a newly pregnant woman finds herself in the crosshairs of her desire to be the brimming icon of beauty and fertility seen on magazine covers and the reality of the consuming, terrifying, pounding storm of antenatal depression, she must believe that that she can safely reach out for assistance without fear of rejection or admonishment.
Being depressed did not make my mother “pre-pyschotic” or a “bad mother.” It made her an exceptional mother, a brave mother, a mother who fought through extraordinary pain so that she would be able to fully love, nurture and protect her children. And is that not the very definition of “mother?”
Today I am good – better than good. I am the mother of a happy, hilarious, intelligent, extroverted three-year-old. When I remember the darkness, the struggle, I pull my son onto my lap and breathe in his delicious smell. I make monkey noises that send him into peals of laughter, and soon I am laughing too.
Depression and I may be destined to meet again, but now I know my enemy and if I must return to battle, I am ready and I am well-armed.








There was a recent article in the NYT about the Chinese tradition of postpartum confinement. By being pampered and fed well, I wonder if it helps combat depression http://www.nytimes.com/2011/06/05/nyregion/bringing-an-asian-tradition-for-new-mothers-to-new-york.html
You rock. Thanks for sharing.
It doesn’t make you a bad mom. However, why mess with doctors when you can find happiness naturally with the homeopathic remedy sepia 30c hpus?
Oh my god, THANK YOU. I suffer from depression and have taken a low dose of Citalopram throughout my pregnancy. I feel this was the most responsible thing I could do for my child, and I am so sick of people feeling that they get to have a say in that very personal decision.
And Dawn, telling people not to “mess with doctors” and just use a homeopathic herb for depression is condescending at best, dangerous at worst.
SO SO SO happy you are willing to share your story and speak out for all the mothers out there in similar situations. It is so much more responsible to admit that you have a problem and seek a solution for it than to pretend that the problem doesn’t exist. Sometimes medication is the answer, even when others look down upon us for making use of it. I have been on medication for many years, and have been taking a reduced dose of it throughout my pregnancy. People have outright accused me of harming my baby by doing so, but my question is: would it be better for me to eat practically nothing, never get off the couch, and skip my doctors appointments? Of course it wouldn’t. But people who haven’t been there can’t understand what you’re going through when you’re dealing with something like that.
I am so proud of you! You are wonderful in every sense of the word!
Good for you! Thank you for sharing your story, you’re an inspiration, and congrats on your son.
Dear Dawn, Way to miss the point. Dear Anna, You might have just saved someone. Well done, mama. xo
At it’s worst, my antenatal depression had me fantasizing about cutting the baby from my body and thinking up ways to suicide that would ensure the baby died quickly with me. If my options are “kill the baby” or “take some prozac”, it’s fairly clear what the better option is. I wan lucky that my depressiong and anxiety cleared up just before the birth after extensive therapy, but even then, if my choices were “be a depressed, emotionally unavailable mother” or “be a happy, engaged mother on prozac”, again, I think the decision is fairly simple.
@Dawn: “However, why mess with doctors when you can find happiness naturally with the homeopathic remedy sepia 30c hpus?”
Uh, you’re kidding, right? Your remedy is a placebo at best and a crock at worst. Homeopathy is woo, pure and simple. Why mess with quack remedies when you can find peace medically with an actual doctor?
I, too, suffered from depression while pregnant. While I did not sink to where I felt I needed medication, I often wondered why I wasn’t the glowing Earth mother I had expected to be. Fortunately, I did not suffer PPD after my children were born, but I remember feeling so alone in those feelings when it should have been the happiest time in my life. Good article, and very important!
My PPD was so bad I wouldn’t dare have another child. My daughter is an only child & at 10 yoa, I can tell her why: “mommy was very ill after the birth, some women get diabetes or other complications from
pregnancy, I got a mental illness”…
You made the right decision. It’s better to take medication under the guidance of a doctor than to “suck it up” and risk harming yourself or your baby. I started to suffer from depression in the last month of my pregnancy because I was put on disability (I would have PAINFUL contractions for hours if I exerted myself at all, even vacuuming the living room or wandering around Target. I had a really hard time breastfeeding at first, and those things, combined with my type-A personality and sensitivity to my hormone changes, had me in the psychiatric ER at 3 months postpartum. I was overwhelmingly depressed, especially after going back to work and dealing with a lot of stress there, and I had really terrifying thoughts of awful stuff happening to my son. My mom tried to talk me out of going on Zoloft and saying it was probably nothing, but I’m glad I trusted myself enough to know that I was really ill and didn’t want to live my life that way. I wish I’d seen the signs sooner, since I was living in a fog and missed a lot of sweet cuddly newborn moments while I was depressed. I hope that the more open people are about PPD, the less likely women will be to think they’re bad moms for being depressed. It’s not their fault, no matter how anyone makes them feel.
Thank you for sharing this. I too went on anti-anxiety medication during my pregnancy. I was a wreck the entire first trimester, sure that I would lose my second pregnancy like I had my first. When an appointment glitch rendered my NTU scan impossible I had a complete breakdown I knew then I had to go on something. I was very lucky that my OB and psychologist were completely supportive and I was able to start on Zo.loft right away. I’m so glad I did. The second half of my pregnancy was so much more manageable than my first. Thank you for sharing this. I wish more people would speak of their ante-natal depression and anxiety. Maybe then it wouldn’t be so taboo.
This is something that I think applies to all of the hot button topics of motherhood… I once saw a “What I wish I’d known when I become a mother” video where someone had a sign that said “Google does not have children.” At the time I didn’t get it, but now I do and I think it actually applies to motherhood and the internet in general. The internet gives equal voice to the fringes of parenting – from the ones feeding their kids Orange Crush and Lucky Charms for breakfast to the ones that believe that you should co-sleep until your child is 21. And what I’ve found is that the fringes (in my case the earth mama breastfeed-or-your-child-will-die! fringe to be exact) are the ones that have an amazing ability to cause me to second guess my decisions or make me feel guilty for not being a good enough mother. If you met the people in person who are making you feel bad online, you’d probably laugh at them the way we laugh at Maggie Gyllenhall in Away We Go. Ultimately, I think those “witches” you talk about that are out there are in the minority. What makes us feel like bad moms is that the internet gives the fringes a megaphone. There are so many more people who, while they may not make my choices themselves (ie diapering, breastfeeding, sleeping, having a glass of wine while pregs) would support my right to make that decision for myself. No matter what. Ultimately I think that the sisterhood *is* stronger than the witchhood and if it comes up again in your son’s life that you feel judged as a mother, that’s worth remembering…
Of course, I stumble across this article while in the midst of discovering, and trying to figure out the best treatment for, a bad case of ante-natal depression. I’ve always struggled with anxiety and have been in CBT and on medication, but this is different. This is can’t stop crying all day depression. I haven’t had time yet to get into a therapist, but my midwives and I spoke of this issue and I agreed it would be best to start a medication I know works for me to at least get the effects sooner rather than later. A therapist appointment is 2 weeks away–that feels like years to me now. And now, of course, I am fretting about PPD–is that the eventual result of ante-natal depression? I hope not. At least I have an amazing husband and family to support me. I know that some aren’t as lucky.
@mayasmommy: I too struggle with depression and anxiety and took antidepressants through both of my pregnancies. Still, I find that the pregnancy hormones, morning sickness and loss of routine make pregnancy a very trying time. I am currently in the 8th month of my second pregnancy and am just starting to have positive feelings about this little one. During my first pregnancy I was so worried about PPD, especially in light of my history. I assumed my difficulties with pregnancy would extend into the post-partum phase. I had a host of mental health providers lined up and at the ready for what I assumed would be my post-partum breakdown. As it turns out, I didn’t need any of those supports. As soon as my son was born I was EUPHORIC. It turns out that my body does not like pregnancy hormones and actually responds VERY positively when they are on their way out. My midwife says that she doesn’t worry about the women who feel crappy during pregnancy, but keeps an eye on those who feel great. Those hormones don’t last forever. As an aside, I also credit breastfeeding (which my specialist has no problems with even with the Antidepressants) with keeping my mood up and assisting with the bonding process.
My point is, don’t worry too much about what the future might hold. Nothing is inevitable or predictable. Take care of yourself today. If your appointment 2 weeks from now feels too far away, call your therapist and let him/her know that. I know it feels uncomfortable (I have made that call) but it’s important that you lean on your supports while you need them.
Thank you for sharing. I went thru some of what you described from the time I found out I was carrying till I delivered. My baby is almost 2 months old now and I am still depressed sometimes.
“Being depressed did not make my mother pre-pyschotic or a bad mother. It made her an exceptional mother, a brave mother, a mother who fought through extraordinary pain so that she would be able to fully love, nurture and protect her children. And is that not the very definition of mother? Oh thank you from the very bottom of my heart for this statement. I wish more people thought the way you do about mothers who struggle with mental disorders at any point in their life, be it while pregnant, after, or a long-term illness. Thank you so much for sharing.
Thank you for this article! My situation is somewhat reversed, although I have been diligently aware of the signs that me depression could be returning during pregnancy. I was being treated for bi-polar disorder, prior to my pregnancy, and did make the choice to discontinue the medications. My depression took a “remission” during my pregnancy. In my case, I was a high-risk pregnancy (gestational diabetes, pre-term 1st pregnancy, and high blood pressure). I continued with the “talk” therapy though, and with the help of my therapist, have had only minor bouts of sadness during the pregnancy, like most pregnant women. I fear what will happen postpartum. I may have chosen to not continue medication during the pregnancy, but there are many mommies-to-be that can benefit from it. I feel it is an individual, case-by-case of personal choice, and do not let anyone make you feel like a bad mom because you need the medication intervention. There are many medications that are available to us now. Some are believed to be safe enough to use during pregnancy. Just remember to be honest with your doctor and tell him/her about any symptoms that you may be having, even if they seem like nothing. Good luck mommas!
Thank you for this. With my first pregnancy I suffered with depression through the whole thing. I had no drive or energy to do anything. My doctor was never in the room long enough to listen to my concerns. He even brushed off my PPD concerns but felt like he could argue with me on whether or not I needed birth control at my 6 week check-up (He thought I didn’t need the birth control and that I was ready to have more babies now). No one listened to my concerns about PPD, even though I have a history of severe depression. It took two hospitalizations for someone to listen and help me. My son is only 2.
Thank goodness for my midwife. She is open to prescribing something during the pregnancy, will be starting me on something right after the birth and has a PPD support group.
A beautifully written memoir of a painful subject. Thank you for sharing. I hope your story will help bring less stigma and more treatment for those women suffering from depression. You did the right thing…taking care of yourself is the number one thing you can do for your baby.
Thank you for sharing your story. I too struggled with prenatal depression. I managed to get through the pregnancy without taking antidepressants, but am back on Wellbutrin now, even though I’m exclusively breastfeeding. I was having intrusive thoughts of harming my child that were too much to deal with (and my child is very “high-needs”). I recently went to see a gynecologist who was very judgmental of me taking Wellbutrin (“Doesn’t that get in the breastmilk” in a whiny, judgmental tone while raising her eyebrows and then suggesting I use formula when I’m incredibly proud I breastfeed) and I cried for several days afterward. A few weeks later, I went for a dental cleaning and when I “confessed” to taking Wellbutrin (because that’s what it feels like, right, to tell another person, because you never know how they’ll react), the dental hygienist (a mother of 4 herself) kindly looked at me and said, “Motherhood can be very hard”. I went away from that appointment feeling good about myself, whereas I’m still upset about the gynecologist’s combative and hostile manner.
Wow – I was just going to write one sentence and ended up pouring out my heart. Most of my family and friends don’t know I’m on antidepressants. I’m a psychiatric social worker myself and daily see how judgmental people are.
Hmmm…. I did a search with those exact parameters and found nothing but information supporting the medical advice that antidepressants are safer for a fetus than untreated prenatal depression (which can lead to PPD and the dangers thereof).
I guess if you only search forums you might get a negative reaction from women who don’t know better…
The author is very brave to write this because, unfortunatly, it is a taboo subject. I went through the same thing and felt like no one would understand.
I suffered from antenatal depression during this, my first, pregnancy. It was bad. I thought about terminating the pregnancy, and I became convinced that my life would never be happy again. It sucked. I did not take antidepressants because I just didn’t feel right about them. I can’t really put my finger on why I had a bad feeling about them, but I did. They weren’t the right thing for me, but I did do a TON of talk therapy. I went to a psychiatrist and a therapist at least every two weeks, and surrounded myself with supportive people. I was lucky that my husband and parents understood antenatal depression and did research with me. It was the HARDEST thing I’ve ever done, but I’m now almost in my 8th month, and I am nesting and being waaay more positive. I am taking steps now to try to prevent PPD, because I know my risk is higher.
Out of this entire journey, what struck me most was the utter lack of knowledge that antenatal depression even exists! So so so many women had no idea that you could suffer from this – especially if you never suffered from depression before. Thanks for writing this.
Thank you for your openness and honesty. I have suffered with OCD my entire life and it wasn’t until my second pregnancy that it became almost to the point that it was unbearable. My first child was five months old when I became pregnant with my second child. From the middle of the second trimester to delivery I was severely depressed due to the OCD issues I was dealing with. It got to the point I couldn’t leave my house. Although I chose not to take medicine I respect everyone’s decision to and given the choice again I would have reconsidered. It took approximately two weeks for me to feel the effects of the prozac I was prescribed after my son was born and although part of me is happy I chose not to take medicine during the final trimester the other part of me is sad because I missed out on precious moments of my first child’s life that I can never get back and I missed out on the immediate joy of my son’s birth. ***Please get help if you are having any type of mental issues during pregnancy. Find a doctor you can trust and go over the pros and cons. I chose not to take medicine because I wasn’t informed and because when I tried to talk about my depression to my OBGYN I was immediately given a prescription. I looked up the side effects and information on the web and was overwhelmed by all the negative information.