Snappy mental health campaigns encourage people to “talk to someone.” So what do you do when that help is still out of reach?
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Since having my second child six months ago, I’ve been going through the motions of diaper changes, breastfeeding, tummy time and naps, but I feel far from OK. My heart is constantly racing, my skin tingles with fear and, when things are really bad, I feel completely paralyzed. Postpartum anxiety has crippled nearly every aspect of my life. I’m functioning but not fine.
We’re becoming more familiar with postpartum depression, but studies show that postpartum anxiety is about three times more common, with anxiety affecting about 15 percent of women during pregnancy and 17 percent of women during the postpartum period. From physical recovery and financial adjustments to identity shifts and changes in personal relationships, the transitions that arrive with a baby are life altering, so it’s completely normal to feel anything but normal.
In fact, some degree of anxiety is a perfectly appropriate response to wanting to provide the best possible care for your baby, notes Katy Kamkar, a clinical psychologist at the Centre for Addiction and Mental Health and an assistant professor at the University of Toronto. “It’s very common to have a lot of anxiety and worries when you’re pregnant and after you give birth,” says Kamkar. “But if it starts to cause distress and/or interferes with your ability to take care of your baby or yourself or engage in your daily responsibilities, postpartum anxiety may be present.” For the past six months, “increasing distress” has been my default.
After the birth of my first child three years ago, I dealt with postpartum depression and still remember the crushing weight of emptiness and despair I felt at the time. When my husband and I welcomed our second daughter this past summer, I vigilantly checked in with myself daily. I didn’t recognize any of the same emotions I felt with our first child, so I figured I was out of the woods. Sure, I was having a hard time sleeping and, yeah, I’d get irrationally anxious if I had to leave the house, with or without my kids. What if I was out alone and got into a car accident? What if I brought them with me and something happened to either one of them? I’d either feel morbid or obsess over the minutiae of the last mistake I made—trivial things like forgetting important diaper bag contents. But I didn’t cry all day and I trusted myself to be around kitchen knives without thinking about self-harm, so I was good, right?
Wrong.
My daily check-ins went pretty well for the first month, but by the second month, I started to feel increasingly anxious. The anxiety hasn’t lessened, but it continues to show up in unexpected ways. I regularly sneak over to the crib to watch my sleeping baby’s chest rise and fall rhythmically and it makes me feel satisfied, but that soon wears off and I’m compelled to tiptoe back to the crib to watch again. At some point, I started needing to make sure my toddler was breathing, too, so I move back and forth between the rooms every night until I force myself to go to bed.
I’ve been even more troubled by the anxious feelings that don’t have much to do with the well-being of my children but with me. While I’ve always been a harsh self-critic, anxiety has put a megaphone to that nagging voice in my head, and it’s deafening at times. I’m usually not a homebody, but whenever I leave the house, whether it’s a trip to the grocery store, a rare girls’ night or a date with my husband, I struggle. My chest is tight, I feel jumpy and I’m preoccupied with not forgetting something or praying that I’ll reach my destination and get back home safely. The whole time I’m out, I feel clammy with a sense of dread that something bad is going to happen to me while I’m gone.
The duty of mothering and the look of reverence in my kids’ eyes when they see me are both fulfilling and frightening. I find myself trying to swallow the constant ball of nerves at the back of my throat. My head hurts, my mind races and, as a result, I find myself speaking louder and faster whenever I’m anxious. My toddler started saying that she “didn’t want to hear Mommy’s mad voice anymore,” and it broke my heart that I couldn’t explain that Mommy wasn’t mad, just anxious. The oddest thing is the sense of dissociation: My brain feels like it’s split in two, with the rational side saying “Girl, what are you doing?” while the anxious side rages away.
As I’ve done in the past, I’ve admitted to myself that I need help. Then I say it out loud. But as difficult as recognizing that you need help can be, actively obtaining said help has proven to be even more challenging.
It took me some time to get an appointment with my doctor, so a friend sent me the contact info for mental health services at a women’s health clinic. I called their intake line and left a message and, after not receiving a call back, I tried again a few days later. I finally spoke to the intake nurse, who quickly told me that they were booked up and only taking on patients who had post-traumatic stress disorder from a traumatic event within the past two months. “Does giving birth and having serious anxiety count?” I asked. It didn’t.
When I finally got in to see my OB-GYN, he determined that I was dealing with postpartum anxiety. He asked if I still had the contact number for a therapist I saw a few years ago, so I tracked it down and gave her a call. She was more than welcome to see me, but I learned that her $150-an-hour rate wouldn’t be covered under my new insurance plan.
My heart sank: I knew I wouldn’t be able to afford her services. However, she called me back a week later with a gracious proposal: She offered to give me a bit of a discount, so we agreed on a number that worked for both of us and I asked her to let me know her schedule so that I could book an appointment. Over a month passed and I never heard from her. Perhaps the discounted rate pushed me down the list of urgency.
I now know first-hand the many obstacles to acquiring mental health resources. Capacity is lacking, and when your issues don’t register as a priority, it’s demoralizing. Financial constraints can cut you out of the race altogether, leaving you wondering what your next move should be or if you even have options.
Snappy mental health campaigns encourage people to “talk to someone” and “just ask for help,” but when that help is still out of reach, what’s the point? As frustrated as I feel, I know I’m still in a relative position of privilege. Thinking about women across the country who lack insurance coverage or money to afford care, who don’t have doctors that know their history and can help with trusted referrals or who don’t even have accessible mental health resources available to them makes me feel even more despondent.
I’ve decided to take matters into my own hands. I’ve started using a meditation app and try to squeeze in a few minutes at the start of my day. I work out at home when I can get the little ones down for a nap. I journal a lot. And I make sure to stay in constant communication with a trusted circle—most importantly, my husband. When I look at him with panicked eyes and say “I can’t,” he knows when to take the babies and let me calm down and he knows when to help me push past the hurdle to remember that I can.
There’s a saying I often think of, “It’s always darkest before the dawn,” and I think I’m starting to see a glimmer of light. I recently found a directory of black women therapists in the Toronto area and, after some trial and error, I’ve finally found one. Seeing a skilled and caring practitioner is important to me, but being able to work with someone who shares core identity traits is even more so.
I have goals of being able to go out without panicking and not overreact to my kids’ normal behaviours when my heart won’t stop racing. I want to feel free and be more fun, so I’m determined to do what I can to get there. I was home alone with my five-month-old when I had my first intake call with my new therapist. Even in that initial call, I felt prioritized, validated and heard for what felt like the first time. I swung my befuddled baby around while kissing her cheeks and cried, “She listened to me!” It felt like a small but crucial victory. Happy, healthy babies need happy, healthy moms, so I refuse to let postpartum anxiety win.
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