“I spoke to Ruth and Hunter earlier,” Dr. Lisa Gibbons says quietly as I take a seat in her office. “They’ve given me their perspective on what’s happening, but I’d really like to hear yours.”
I’m embarrassed to be here. Ever since I arrived at my family GP I’ve felt hot with shame and guilt.
Hello, I’m Beth Evans. Psychologist. Wife. Mother. Crazy person.
I know better than most that mental illness is nothing to be ashamed of. I also know better than most that in some professions, being diagnosed with a mental illness is the kiss of death to a career. That’s why I’m just scared enough to come here today, but far too scared to admit why.
“They overreacted,” I say, lifting my chin stubbornly. “Ruth has forgotten what it’s like to have an infant. And Hunter has never had a child before. He just doesn’t realize that it’s normal for me to be a little strung out. And you know what’s going on with Dad. I’m cleaning up his house, and it’s stressful. There are genuinely overwhelming environmental factors weighing on my mind.”
If I can convince her, I can relax. If Lisa believes me, then maybe I’m actually fine.
“Okay, then,” Lisa says mildly. She leans back in her chair and links her hands behind her head—a picture of relaxation and ease. I desperately envy her. I’m sitting stiffly, knees and ankles close together, back ramrod straight. I’ve linked my fingers in my lap, but I hold my elbows locked tightly. I’m vaguely conscious my body language is sending a message I really don’t want to send, but even so, I can’t convince my limbs to relax. “Ruth feels that you haven’t been yourself lately. And to be honest with you, I was concerned, too, after your visit with Noah a few weeks ago. I’ve known you a long time, Beth. I’ve never seen you quite so...distant. Withdrawn.”
“Withdrawn?” I repeat the word, testing the feel of it in my mouth. Ruth said the same thing.
“Ruth mentioned she’s noticed the same.”
“My routine has changed. We both worked in downtown Bellevue so it was easy to see one another for lunch. Now getting out of the house with Noah takes me so long, and I still find it so stressful when he gets upset while we’re out and about. I’ve still been going to Sunday dinners every week...but it’s true that we don’t always stay long after we eat these days because I always want to get Noah home to bed before it’s too late. Once upon a time, Hunter would be dragging me out the door hours after we finished the meal, because Ruth and Dad and I would be drinking wine and chatting at a million miles an hour. But that’s changed. Everything is changing.” I’m rambling now, trying to distract Lisa’s eagle eyes. It doesn’t work.
“Beth, I was talking about the way you’re interacting with us, not your routine. Do you remember that visit with me two weeks ago?” I think back to my last visit when I came in for a wellness checkup with Noah. My memory suggests that the visit was uneventful, and I don’t remember doing or thinking or saying anything out of the ordinary. I shake my head. “You were concerned about Noah’s weight. Remember?”
Ah, yes. Noah was on the fiftieth percentile for height and weight in the first three months of his life, neatly following the projected increase on the growth chart. And then in his fourth month, he suddenly dropped down to the forty-second percentile. I had a feeling that was my fault. Maybe I wasn’t feeding him enough, or maybe my milk wasn’t satisfying him.
“Yes, but perhaps you don’t remember that there was a good reason for me to be concerned,” I remind her stiffly.
“Beth, as I told you at the time, a drop of eight percentile on the growth chart is nothing. Most parents would take my reassurance when confronted by something like that, but I could see you were still anxious, and you weren’t hearing me out. I actually made a note to check in on you next week. A first baby is an immense adjustment. It’s okay to admit you’re struggling.”
“I’m not struggling,” I exclaim, crossing my arms over my chest. “I’m tired. That makes me a little irritable. Taking a while to adapt is hardly a clinical condition.”
“I’m not so sure about that,” Lisa murmurs with a very gentle smile. “I know you work with children, but I’m sure you’ve heard of postpartum depression.”
“I’m definitely not depressed,” I say without hesitation. “I know what depression is. I’m not sad at all, other than a reasonable amount of sad because of my father. I’m just...” I’m not myself. I guess I am unusually irritable, but then again, I can’t relax at the moment, so even that makes sense. And yes, I’m probably agitated, too, but that’s just because everything that’s happening with Dad. Plus, I’m running on so little sleep. Most of my problems are my circumstances, and the truth is, I’ve probably made the worst mistake of my life in having Noah, and I can’t say it aloud because what kind of a mother admits she doesn’t enjoy parenting? I chew all of these words up in my mind but I can’t say them aloud, and because I have to say something, I just repeat the words that seem to be my new personal motto. “It’s just hard, that’s all.”
“Sweetheart,” Lisa murmurs softly. “I’ve got five kids myself, remember? I know it’s hard, and no one tells you what a shock a new baby is to the system and so mothers often end up feeling like they’re the only one struggling to keep their heads above water. But there’s a difference between that level of struggle and the level Hunter and Ruth described. Depression doesn’t always look like simple sadness. Sometimes its muddled up with anxiety and irritation and a general inability to manage your way through the ordinary world. Sometimes it’s intrusive thoughts you can’t shake, or feeling like the world has been drained of color. Sometimes it’s like everything leaves you feeling inexplicably flat. Some depressed patients report that finding motivation to tackle simple tasks is completely overwhelming, or figuring out how to do things they’ve done a million times is suddenly impossible. Does any of that ring a bell for you?”
I clear my throat, but force myself to shrug nonchalantly.
Don’t label me. God, Lisa, please don’t label me.
“Sure. Some of that sounds familiar, but that doesn’t mean I’m depressed. Any of those things can be explained by sleep deprivation, or genuinely stressful circumstances, or even just me attempting a task I’m not good at. Right? I mean, think about it. What if what Hunter and Ruth have decided is me being crazy is actually me just being a particularly inadequate mother? That’s a legitimate possibility that you can’t dismiss just because it’s easier to slap a diagnosis on me and send me on my way.” My voice breaks, and Lisa’s expression softens.
“Do you trust me, Bethany?” she asks. It was Lisa who prescribed the pill to me when I was sixteen. Lisa who helped us navigate Dad’s conditions, in between specialist appointments. Lisa who helped Hunter and me through six long years of infertility. I swallow the lump in my throat.
“Of course I trust you.”
“You’re a wonderful, caring woman and your love for Noah is evident. You aren’t failing here, even if it feels like you are. You know every bit as well as I do that depression isn’t weakness. It’s a matter of brain chemistry. Postpartum depression is no different. Pregnancy and childbirth are immensely taxing on a woman’s body and it’s not at all uncommon for a new mother to develop depression in the postpartum period. In fact, some studies suggest as high as ten percent of women suffer from it.”
“I don’t even think I can talk to you about this today,” I whisper, suddenly breathless. “I’m just so tired.”
A loud, humiliating sob bursts from my lips. Lisa leans forward to take my hand in hers.
“Let me give you some medication to help you sleep tonight. Everything feels worse when you’re exhausted.”
“But I’m breastfeeding...” I protest through my tears.
“I’ll prescribe a drug that is safe for occasional use. And Hunter can feed Noah formula just for tonight so you can have a long stretch of rest. But I do want you to give the matter of his feeding some serious thought, because the next thing I’m going to suggest is that we try you on a low dose of Prozac, and that’s not recommended for breastfeeding mothers.”
“But...”
“I promise you, formula is totally safe. Sure, there are benefits to breastfeeding, but Noah has already enjoyed many of those benefits after five months, and in any case, your health is far more important than anything breastfeeding can offer Noah.”
“The only thing that’s working is the breastfeeding,” I blurt hoarsely. “It’s the only thing I’m actually good at when it comes to him.”
“I know it feels true, but it’s not true. You’ve got a healthy, happy baby and you’re doing a terrific job.”
“I can’t...” I start to protest, but trail off. Lisa hands me a box of tissues and I take a handful.
“I hear what you’re saying about your exhaustion, honey, so let’s put a pin in this conversation,” Lisa says quietly. “Let’s get you some rest, and then tomorrow I want you to come back in so we can make a plan moving forward. Does that sound okay? You don’t have to do anything you don’t want to do, Beth. But let’s not make any decisions until you’ve had some sleep and you’re feeling rested.”
I leave her office with a prescription for sleeping tablets. Hunter and Ruth are in the waiting room, side by side, both holding magazines they aren’t actually reading. When they see me, they dump the magazines onto the coffee table and rise. The wariness in their gazes sends a punch of guilt to my gut.
“What’s the plan?” Ruth asks me quietly.
“Sleeping tablets for tonight,” I whisper. I’m still teary, overwhelmed and exposed by the events of the day.
“And then?” Hunter asks. I shift my gaze to his. I’ve found a home in this man over the past decade. Arm in arm, we battled to have this baby, facing miscarriage and infertility and heartache after heartache. That’s exactly why it’s so hard for me to lean on him now. But as he stares at me in this waiting room, I don’t see judgment or disappointment. I see only concern and love in his eyes, and some of the resistance I feel to accepting his or anyone else’s help starts to crumble.
“Tomorrow,” I croak. “Tomorrow we’ll reassess.”