Alice Mongkongllite / BuzzFeed
Postpartum mood disorders are far from rare. Statistics show that up to 1 in 7 women may experience postpartum depression, anxiety, or obsessive compulsive disorder. These disorders make it hard for parents to get through the day, and seriously affect their ability to take care of themselves and their families. They do not discriminate and can affect any new caregiver, regardless of income, age, race or ethnicity, culture or education. And yet new parents of color, in particular, often face a host of unique stigmas and barriers when it comes to assessing and treating postpartum mood disorders.
This is an online conversation between five parents of color about the challenges they faced in identifying and treating their illnesses, and what we can do to make it better.
Before we get started, who are you?
Pooja Makhijani: I am an American expatriate living in Singapore. I write children's books, essays, and articles; develop educational media and curricula; and have written about my mental health for WashingtonPost.com. My writing has also appeared in the New York Times, The Rumpus, Quartz, and elsewhere.
Sharline Chiang: I am a Berkeley, California–based writer, editor, book coach, public relations strategist, and maternal mental health advocate. I have written about my PPD experience for Mutha and Hyphen. I have also written for BuzzFeed, OZY, and Center for Asian American Media.
Tyrese L. Coleman: I am a writer, wife, mother, and federal employee living in Hyattsville, Maryland. Because I'm not busy enough, I'm also a student in the writing program at Johns Hopkins University and fiction editor for District Lit. My writing has appeared in PANK Magazine Online, BuzzFeed, the Doctor T.J. Eckleburg Review, the Tahoma Literary Review, and elsewhere.
MK: I am a Vietnamese-American scholar, teacher, and writer on race and religion, queer of color politics, mental health, and Asian-American motherhood. (I'm going by my initials for privacy reasons.)
A'Driane Nieves: I am a United States Air Force veteran, writer, artist, speaker, and postpartum depression and anxiety survivor living with bipolar disorder. My writing has been featured on BlogHer, Upworthy, EverdayFeminism, and Postpartum Progress. I am the founder and creative director for Tessera Collective, an online platform and nonprofit dedicated to empowering women of color in their mental health.
The actual experience of a postpartum mood disorder is different for everyone. How and when did yours manifest itself? What was it like?
Makhijani: I alternated between boredom and rage. One minute, I would be staring out the window as my infant rolled around on her play mat; the next, I would feel the urge to throw things and scream. I snapped at my husband a lot, I admit. I also was consumed with intrusive thoughts that always involved blood and gore and, ultimately, death. Images of her — of us — impaled or decapitated would flash before my eyes all the time. It was terrifying and anxiety-inducing.
I imagined often what would happen if I ran away. I made plans, I made maps, I planned bus routes. At first I decided that I would first give up my daughter to my parents (or whoever else wanted her), and then I would just run away so no one could ever find me to give her back to me. Then I made plans to take both our lives. But, ironically, I couldn't make good on any of those plans because I was so unmotivated and anxious all the time. I just didn't have the energy to step out the door.
Coleman: I also thought about blood and gore — all the bad things that could happen to them, all the bad things I could do them. I remember being on the miniature trains in Oakland, California, holding one of my babies. We were winding through the woods up very high in the mountains. I looked over and thought, What if he fell over? What if I threw him over? The shame and guilt I immediately felt! And yet it still didn't occur to me at the time that those thoughts were happening because I was dealing with PPD. I just told myself to stop, to never think that again. It was terrifying to have those kind of thoughts and not know where they were coming from.
Nieves: I knew the first night in the hospital that something was wrong. I remember holding my son and feeling as though I wanted to break out of my skin and run away. Lack of sleep and his constant crying (or his older brother whining) were my top two anxiety triggers. I coped by trying to keep everything neat and organized. I spent so much time on my bathroom floor, trying to cool my body down from the sweats my anxiety triggered. It was relentless and would come in waves, leaving me exhausted and shaking. I had moments of sadness, but they were usually triggered by guilt over the detachment I felt toward my son. Bonding with him was difficult. I also experienced rage that would catch me off guard. I remember screaming one time after my oldest spilled some milk, and while I was screaming I was saying to myself, "What the hell is wrong with me? Who am I right now?"
Alice Mongkongllite / BuzzFeed
MK: I don't remember very much from the first year of my daughter's life. In hindsight, I think I battled depression on and off for the first few months, and then really hit the lowest point around nine months postpartum, when my daughter's sleeping "regressed." Sleep. So much of my experience revolved around sleep, the lack of it, the management of it — how much has she slept, when will she need to sleep again, when will I get to sleep again, did I just miss my window, why is she awake and crying already? Nursing her to sleep, rocking her to sleep, holding her while she slept so that she wouldn't wake, wouldn't cry, crying while she slept, crying when she woke. My life was just an endless, exhausting cycle of care for her. I wanted to run away; I wanted to die.
I remember lying in bed, wishing I could die and resenting so much that I couldn't. Dreading the next hour, the next round, the never-ending cycle. I remember looking at my baby and feeling nothing but despair. I remember thinking, Why can't I do this? How come other moms don't feel this way? What is wrong with me? So I picked up the phone and texted my husband, "I think I need help." Then I went online and ordered a book on postpartum depression.
Chiang: I was deeply exhausted from the birth on, and sleep deprivation leveled me. I was often too tired to eat, and too hungry to fall asleep. The messages around me told me it was part of being a new mom. I didn't feel like I had permission to stop breastfeeding, so I assumed I would never have a real chance to rest — ever. Soon into the second month, I stopped being able to sleep and was in what I now understand to be panic attack mode 24-7. I became unhinged. I became OCD — couldn't stop washing and rewashing bottles and pump items, cried when I had to wipe a tear off my child's face because I was sure I would infect her and make her blind. I was so tired I felt like I wanted to die, just so I could rest. I started talking loudly to myself. I had trouble connecting thoughts. It was like the real me was watching this new "crazy" me take over.
I had images of killing my child and myself, images that felt often like urges. All day long I felt like jumping out of moving cars, out of buildings, grabbing knives, grabbing strangers. I fantasized about cutting off my breasts so I could stop breastfeeding, about running away and hiding out in a hotel or getting on a plane. I wondered how to buy a gun so I could take myself out. I was sure everyone would be better off without me. I had no idea that I had PPD, or that it could manifest as all these symptoms. I thought PPD meant you had to feel sad, or to cry. I didn't feel sad; I was just exhausted, unhinged, and terrified. I just thought I was very flawed, a failure at being a mom, and very weak.
How did race and culture play into your postpartum experience? Were there expectations or stigma specific to your community that made it harder to get the acknowledgement or treatment you needed?
MK: As a Vietnamese-American, war and refugee displacement form the context in which sacrifice, family, motherhood, and daughterhood are understood in my community. The second generation, within the Vietnamese diasporic community but perhaps also of immigrant communities more broadly, struggles deeply with how to articulate its suffering next to the immigrant generation's. What is motherhood compared to the collective suffering of a people who have been killed, displaced, exiled, forced to rebuild from the ashes so that future generations may live?
Coleman: I just never thought it was anything people talked about. I considered all moments of despair, ineptitude, and struggle to be things you dealt with privately, because black women already have so much of the world against them that you cannot give the world yet another reason to doubt you. That's with everything: work, school, relationships. Everything has to be perfect. It's even hard for me to admit it now, because I don't want to lift the mask of the "Strong Black Woman."
Nieves: Tyrese, I struggled with that too — that Strong Black Woman archetype that tells us we have to be silent about our pain and deal with it privately, or that what we're experiencing isn't a big deal. What added another layer of shame for me in my experience was the stigma surrounding mental illness in the church, which is also a very patriarchal institution. I was an active member of my church, but had no one to talk to about what I was dealing with. When I tried, I was basically told my struggles were a direct result of my "not living right." I was an unwed single mother of two. I was told that I needed to get married and to be a better Christian, pray harder, serve more. I had no support from the other women and mothers in my church, and my family wasn't supportive either. They don't discuss mental health issues, despite a prevalent history of mental illness, so I couldn't even talk to my mom.
Alice Monkongllite / BuzzFeed
Makhijani: So much shame, fear, and secrecy surrounds mental illness in South Asian communities! I've heard the word "psychiatrist" uttered in hushed tones and death by suicide straight-up lied about. On top of that, new South Asian mothers are made to feel that a child is the pinnacle of achievement, and the only appropriate feeling on the birth of a child is joy. We're expected to perform a certain femininity: to nurture and transmit traditions, to uphold honor. And in Hinduism, our goddesses are often worshipped for their unwavering devotion to their husbands and children. I thought I was a feminist, but this sort of socialization runs deep, and it absolutely affected me.
Additionally, since 2010 my husband and I have lived in Singapore, where there is a tremendous stigma surrounding mental illness. Quality mental health care is scant and expensive, and Singapore is very patriarchal and paternalistic. I found it difficult to find a mental health professional who "got" me culturally here; several private therapists I met with were utter misogynists, and exhorted me to "shake it off" as my "duty" to my family.
Chiang: Mainstream — and maybe by that I mean majority-white — society is only still at the beginning stages of talking about PPD, and that's largely thanks to highly visible, mostly white female celebrities coming forward with their stories. So of course the Asian-American community is lagging in really understanding that PPD is a medical condition. We are raised to believe that you should keep your problems to yourself and be careful not to "shame" your family by making it known that you have a mental health struggle. To this day, my parents do not know I had PPD. They've talked openly about how they don't believe in therapists.
There is also the model minority myth, which affects the way others, like medical experts, see us, as well as how we see each other and ourselves. I had gone to see many medical professionals over the first three months and remained undiagnosed until one psychiatrist finally confirmed that I had PPD. She said she could see why no one thought I had PPD, because I looked too "together" — I wasn't falling apart in front of them the way I was at home.
Many of you have said elsewhere that hearing about others' experiences carried you through difficult times. How does being a person of color make a difference in how those stories are shared?
Coleman: What's funny is that it wasn't necessarily other women of color who made me recognize that something was going on. I belong to a pretty tight-knit Facebook group of mothers who share the same birth month as my boys, and the vast majority of them are white. My own feelings had been bottled up for so long, and these women were discussing how they had experienced the same feelings, openly, without filters. I started to recognize that I needed to seriously examine this; that maybe all of the lies I was telling myself to cope weren't actually working. It took white women sharing for me to come that realization, because women of color do not open up in the same way. But we have to. We need to.
Makhijani: I, too, belonged to a private Facebook group of (mostly) white, middle-class women who were very open about their therapists and their medication, in a matter-of-fact, nonjudgmental way, and what many of them described (and named) was familiar to me. I agree: Women of color are not so open. This is the culture in which our bodies exist, and there is great danger in communal silence.
Alice Mongkongllite / BuzzFeed
Nieves: Since I had so little support in my family and church community, I turned to the internet and found blogs from other women detailing their experiences, and found community support through #PPDChat on Twitter. But my experience was similar — all but two of the women I found online initially were white, and only one of those two could "risk" being so open about their struggle in #PPDChat. It was very hard to find women of color who would open up privately, let alone in public online spaces. I agree, there is danger in that silence. It kills.
Chiang: When I was having my worst symptoms and still didn't know what was wrong with me, I did find articles and essays online by other women who had survived or were surviving PPD. But they were all white, so I thought that I must have something else. I just couldn't relate. Only after reading one anonymous piece on Postpartum Progress by an Asian-American woman did I feel a sense of relief and comfort and say to myself, "OK, maybe I am not alone in this experience. Maybe this is a thing."
For me now, capturing and sharing stories of women of color PPD survivors is one of my most important missions. I have had another woman of color tell her friend that an essay of mine saved her life. I'm not saying this to brag. I know that A'Driane Nieves's work, for example, was a huge part of my recovery. We can save one another's lives.
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