“Sarah, I am diagnosing you with complex PTSD and generalized anxiety disorder.” So said the impossibly beautiful psychiatrist, a dead ringer for Rosamund Pike, sitting across from me in her office at Toronto’s Women’s College Hospital. My GP had referred me to the hospital’s Reproductive Life Stages Program, which helps women with mental-health issues related to their reproductive systems, to learn whether it was safe to keep taking antidepressants for my persistent depressive disorder while trying to get pregnant. Instead, I walked away with a bonus diagnosis of two new illnesses. At 33, I had achieved a Triple Crown of mental-health problems.
I left the appointment dazed and upset, no longer questioning whether I should go off my meds when I tried to get pregnant but second-guessing if I should even try to have a baby. As someone with multiple chronic, serious mental illnesses, was it responsible for me to be a parent? If I had a baby, would I be able to take care of him or her?
The problem was, I really wanted a child.
My husband, Brandon, and I both love kids. The night we became exclusive, we joked about baby names. Brandon, whose last name is Lee, insisted we should name our hypothetical son “Bruce Wayne Lee,” after his two favourite Bruces. Which wasn’t much worse than my secret favourite, Kermit (once a dignified name of Irish origin before the damn frog stole it). I was 31, in love, and the family I wanted finally felt within reach.
Until that day at Women’s College Hospital. When I went for my consultation, I was ready to hear some hard truths. After all, while 23% of Canadian moms experience depression and/or anxiety after birth, women with mental illnesses are more likely to develop mental-health complications both during and after pregnancy thanks to hormonal shifts. Then, there’s all the typical new mom lifestyle upheavals — zero sleep, isolation, not knowing what the eff you’re doing — a perfect storm of experiences so overwhelming, they can also trigger postpartum depression and anxiety. “Exhaustion is a real thing. We now know all mothers need more help than they have historically had,” says Dr. Nichole Fairbrother, a clinical psychologist who studies perinatal mental health at the University of British Columbia.
“I left the doctor's appointment dazed and upset, no longer questioning whether I should go off my meds when I tried to get pregnant but second-guessing if I should even try to have a baby.”
It wasn’t just my own health that worried me — it was my future son's or daughter’s. Children with a depressed parent are two to three times more likely to develop depression. Studies suggest there could be a link between maternal anxiety during pregnancy and a variety of health issues for the fetus, from low birth weight to developing ADHD. What scared me most of all, however, was no matter how much support I had, I knew my future children would be affected by my illnesses at some point. What if a stressful day at work triggered a panic attack and I had to miss one of their soccer games? What if they assumed my absence meant I didn’t love them? Worse yet, what if they blamed themselves for my health problems?
Admittedly, feelings of inadequacy, guilt, and shame affect all mothers. The concerns I harbour about how my mental illnesses might compromise my ability to parent reflect a societal tendency to hold mothers to astronomically high standards, judging the hell out of them when they fall short. This pressure has always been there, but it somehow feels worse today when there’s always a perfect-looking parent in your social media feed. In a Refinery29 survey of 500 Canadian women about motherhood and social media, 82% said they compare themselves to other moms online. Most mainstream media representations of motherhood don’t help. And I’ll admit, this idealized maternal martyr — the kind who bakes cookies like Martha Stewart and gives sage advice like Marmee — was once the kind of mom I once fantasized about being. (Which is also pretty typical of someone with anxiety: We tend to accept nothing less than perfection, even though, intellectually, we know no one can be perfect.)
And yet, when I thought of the alternative — a life without kids, without the joys of bedtime stories and swim lessons, and yes without the overwhelming, exhausting worries, too — not having baby never felt like an option for me.
As I write this article, I'm about to give birth to my daughter. I’m trying not to stress about whether my mental-health struggles will make me a bad mom and instead see these experiences as part of my strength — at least that’s what my therapist tells me to do. Through consultations with my doctors, I’ve decided to keep taking the medication that doesn’t exactly cure my depression, but does sound the edge off my worst moods. I’m also trying to be as prepared as possible, but not rigid, understanding that that one’s pregnancy and post-birth plan involves flexibility and a willingness to adapt when things just aren’t working. For example, while I’ve decided to give breastfeeding a go, I’ve promised myself I’ll supplement with formula if the burden of being my baby’s only source of food ever feels overwhelming.
What mothers don’t expose ourselves to is equally as important. With that in mind, I recently deleted Instagram from my phone; it didn’t help to judge myself against the (literally) filtered version of motherhood we see online. I love Jennifer Garner as much as the next Alias fan, but I don’t need to watch videos of her making pudding for her three kids in her immaculate kitchen.
I’m also learning how to ask for help. Brandon will take as much time off work as he can when the baby makes her big debut, and I’m leaning on my therapist and support groups. Like with any major life change, counselling and community can help identify fears and create strategies to surmount obstacles. Over the last few months, I’ve realized coping mechanisms don’t have to be complicated; for me, they can be as simple as asking a friend to check in on me once a week. By mothering through mental illness, I hope to teach myself and my daughter a valuable lesson: women shouldn't have to be perfect.
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