The depression is a flu that will not abet. Most mornings, D drags himself into the living room on all fours. He lies face-down on the interlocking foam floor tiles, his upturned arms at his sides. The baby crawls over him, tugging his hair, drooling on his t-shirts. He doesn’t move.
He complains of headaches, nausea. He has nightmares. He’s cold all the time. No, he’s hot all the time. He never sings anymore when he moves through the house. Sometimes when he walks, I swear I can hear it, the depression. It’s a liquid sound. I can hear the cortisol sloshing around in his veins. I can hear the adrenaline drip-drip-dripping down the twisted cord of his spine.
D’s depression is the weather in our house, except there’s no forecast. Some days we wake to sunny skies, gentle breezes. We talk and laugh. We eat and nap. We watch the baby the way one watches a campfire, not for any particular reason, but because it is there and strangely fascinating in its combination of predictability and surprise.
Other days there are storms, rough winds, hailstones big enough to take chunks of flesh off the bone. D stomps angrily around the house. Or he stays in bed and cries. He rages, he weeps. He sleeps, or he doesn’t.
Maelstroms form unexpectedly, seemingly out of nowhere. And on the days they don’t, even when we’re smiling, listening to music, rubbing lotion onto the baby’s chubby arms, I am watching the sky. That fluffy cloud, is it a bunny? Or a dragon? Or a gathering storm?
To name it, I have since learned, is fully half the battle. So I will name it here: D suffered from postpartum depression.
I will name it here because we didn’t name it then, not in those tender months after our first baby was born. We knew there was a problem — a big, hulking bear of a problem — but we didn’t call it postpartum depression. We called it up all night and not enough resources. We called it fussy baby and reflux is brutal. We called it stress and bad sleeper and babies are hard even when they’re easy. We said we were tired. We said we hadn’t lined up enough help. We said we weren’t good at co-parenting a newborn. These things were true, but there was something else, too.
In hindsight, we should have seen it right away. By the time my son was two weeks old, I’d dutifully filled out the postpartum depression screening form no less than six times. In the last week, how often had I felt happy? All the time? Most of the time? Not very often? Never? Had I been able to laugh and see the funny side of life? Had things been getting on top of me? Had I been sleeping? Had I been crying? Have I been looking forward things with regularity?
It was annoying to answer the same questions over and over and over again, especially with a newborn precariously balanced at my breast, clipboard on my knee, straining to check the little boxes with my non-dominant hand.
Not once was my husband asked these questions.
I say that naming it is so important because that’s what the research says. A study in Scotland found that PPD sufferers who were encouraged to talk about their depression were more than twice as likely to describe themselves as fully recovered after three months than those who had not. Other studies list low social support and poor partner support alongside history of depression as major risk factors for PPD.
In fact, anthropologists have labeled PPD as a “culture-bound syndrome,” egged on in developed nations by individualism and social isolation. Countries that treat postpartum depression as a legitimate health concern, who name it and provide opportunities for treatment, have lowered risk.
In Pakistan, where the rate of postpartum depression is among the highest in the world, it is likely because they do not speak its name. There, if a mother is having trouble coping, they call it nahkay (tantrums). If she cries, if she doesn’t sleep, if she makes strange choices, she is pagal (insane).
Our biggest problem is sleep. D keeps saying he’s tired. He’s tired. He’s tired. He’s so tired.
Of course he’s tired. We’re both tired. We have a new baby. The baby doesn’t sleep. New parents are always tired. Isn’t that one of those funny things about parenthood that’s supposed to bond us in its universality? The baby never sleeps! Haha! We never sleep! Haha! We’re so tired! Hahaha!
But this is not a normal tired. This is not a loopy, slap happy, fuzzy-brained tired. Or even a dark-eyed, low-voiced, half-speed tired. This is an insidious, squeezing, swell-tide of sleeplessness that D carries on his back like a Buick. It moves past discomfort and he starts to worry that it might actually kill him. Already he can’t eat, his work is suffering, he doesn’t want to drive. He can barely follow a conversation through from one end to the other.
Okay, I tell him, I’ll take tonight. All night. And you can catch up on sleep. It sounds like a simple favor, but it is a task of Odyssean proportions. The baby only sleeps in twenty-five-minute bursts. Between them, he needs to be bounced, bounced, bounced for an hour or more while he screams. When you’re the parent on duty, there is no sleep, only occasional respite from the sedation Olympics.
But I do it.
In the morning, my eyes are hammered glass. I blink and blink but they won’t clear. The muscles in my throat are sore from shushing the baby. I hand him to D, feeling like Atlas releasing the globe.
I ask, How do you feel? like a Dickens orphan asking to hear a story about a feast.
Oh, D replies, I couldn’t sleep at all.
In cisgender men, it’s more properly referred to as postnatal depression (PND), I guess because biological males can’t technically be postpartum. Some studies estimate that as many as one in 10 men may suffer from PND. But it’s still routinely left out of medical literature on the topic.
Neither postpartum nor postnatal depression has its own listing in the DSM-V (the definitive resource for psychological diagnosticians). In order for a diagnosis to be made, the sufferer first must meet all the criteria established for a “major depressive episode,” and then meet the qualifier that the depression begin during pregnancy or in the first four weeks after delivering a baby.
This, of course, leaves no official recognition of non-birthing parents who suffer from postnatal depression.
Another good name for it would be postpartum aggression. When the sadness recedes, rage is often waiting to replace it. This is the more elusive villain. D knows my tolerance for rage is lower. He knows to hide it from me.
The evidence is apparent, though, even when I try not to find it. There are the loud thumps coming from the living room when I’m feeding the baby in the nursery. The way he places the baby gently, so gently, in my arms and then slams the door so hard I think the walls of the house might come down around me.
One morning the diaper pail won’t open correctly. I kneel to examine it. There is a dent the size of a cantaloupe in its metal belly.
Did you kick the diaper pail? I ask.
D nods and says, It was already broken.
Once, he punches a hole through the drywall in our rented house. I’ll fix it, he says.
I don’t ask if he means the hole in the wall, or the punching of the hole into the wall. I sit in our dark car in the cool garage and cry.
In the middle ages, they called it witchcraft. They blamed young women for being weak and succumbing to demonic possession. They also called it contagious and tied new mothers up in rooms far away from the rest of the family, where they wailed and writhed and spat.
They may have been onto something. Not that depression is actually contagious, but it’s impossible to be really happy when your partner is in despair.
As the baby’s first few days turn into his first few weeks, I start to get the hang of things. I take the baby out to run errands or for long walks when the fall air is warm enough. I even wade into housework and emails and personal hygiene. I consume food at semi-regular intervals.
All this while, D continues to exist as a puddle of pure devastation, a fine powder that covers every surface in our home, one that could blow away at any moment.
We experienced the detonation that all new parents do. The bomb has gone off. Our old lives have been leveled. I am ready to put our new life together. I’m ready, I tell him, to enjoy our baby.
D replies, I just don’t see any way to do that.
In Malaysia, they sometimes call postpartum depression hantu, a ghost, a demon. Hantu Meroyan is spawned by blood, afterbirth and amniotic fluid. She makes a baby fuss and a mother cry. She can be preempted by rituals, or thwarted by sharp objects: a ring of thorns on the doorstep, a knife under the mother’s pillow, pineapples in the kitchen.
One night, D’s insomniac delirium imagines me into a hantu. He is failing to quiet the baby and I stagger in to help. My silhouette looks unfamiliar in the darkness of the blackout shades. He spies me, and shrieks so loud it terrifies me. I shriek back. He screams. I scream. The baby screams.
D falls to the floor. Oh my god, he says. You looked like a fucking ghost.
I laugh, exhausted and tingling with adrenaline. D laughs, too.
No, wait, he’s not laughing. He’s weeping.
Just go to bed, I say. I try to say it gently, but, in truth, I’ve grown immune to his tears. It’s a kind of extreme exposure therapy. I think, This again? When I hear his voice crack to accommodate a rising sob, I roll my eyes secretly in the inky envelope of our son’s darkened room.
Maybe the trouble with the sleep is that D’s body, after so much interruption, has forgotten how to sleep. What he needs, he believes, is routine. Consistency. Predictability. The sleep books are telling us the same thing about our son. The words hang in the air like extras from sugarplum dreams.
We make a new plan. I take the first half of every night and D, the second. When we swap at three a.m., I fall into bed like a comet coming out of orbit. I sleep so hard I barely wake when D brings the baby in to nurse. This is a good plan, I think.
Only, D isn’t sleeping. He says, I’m not tired so early in the night. I can’t sleep then.
So we swap halves. But D still can’t sleep. He says, I can’t sleep after all that bouncing and screaming. I’m too worked up.
I ask him, desperately, When can you sleep?
He says, If I can have midnight to five a.m., I could sleep. If I can just reliably have that every night, I will sleep.
Already I am so much tougher than I thought I was. Already I have done impossible things. I do this, too.
Eventually I stop asking him how he sleeps. It takes me a long time to stop asking; I am an optimist. But, finally, I stop. I spend too much of my day thinking about sleep and talking about sleep and never, I realize in a moment that nearly breaks me, never about my own sleep.
The answer is always the same: He never sleeps.
You could call it postpartum suppression, the change in hormones. We hear about hormones a lot when we talk about birthing mothers, but new fathers experience huge internal shifts of their own. Hormones like oestrogen, cortisol, vasopressin, testosterone and prolactin can all become suppressed in new dads.
It’s a kind of osmosis, maybe, the way changes in my body affect D’s body. It’s always been this way. When my periods are wild and irregular, I always know mine is coming because D has a headache for two days in a row.
When my thyroid medication needs to be adjusted, I can never tell, but D can.
I’m so tired, he says. Can you get your levels checked? And when I do, he’s always right. My T3 and T4 are too low, my TSH futilely rising to counteract it.
Sometimes it bothers me, especially when my period comes and I feel sick and exhausted. I’m wiped out, I say, wishing that maybe D would volunteer to grab my laundry from the basement.
Oh, me too, he says.
The differences in our personalities are part of why it takes us so long to call PPD for what it is. Every time I try to tell him, I think there’s something wrong here. I don’t think parenting should be THIS hard, he turns it back around on me.
You don’t get it, he says. This situation IS this hard.
When I try to point out to him that I am, in fact, the only other human on the planet with an intimate knowledge of exactly how hard our situation is, he says, Anybody else would be equally crushed by this. You’re just different.
It’s a charge I have to take seriously because it’s at least half correct. It’s true that coping is my superpower. I’ve always been calm, stoic; I’ve even been accused of being an emotional robot. I’m a consummate under-reactor, capable of seeing pretty much any situation as “totally fine.” It would not be out of character for me to take something in stride that another person would find incredibly difficult.
Whereas D has always had a lot of feelings. His feelings are a big reason why I fall in love with him in the first place. I use that phrase colloquially, though it never made much sense to me. There was probably a time in middle school when love felt like falling, like, Oops! Now I’m in love with someone! But not anymore.
I would say I climb into love with D at a slow, steady pace. It’s like moving up a particularly steep set of stairs: deliberate, not without effort. With each step I take, I think, Should I keep going? The answer is always yes.
His feelings are an amazing perk to go with his sense of humor and cologne-ad good looks. He’s sensitive. He cries during sad movies and sad songs and, sometimes, sad commercials. He’s very in touch with his emotions, very self-aware. Very able to express what he is feeling. So I trust him when he tells me there’s nothing wrong.
Now I see that this was the disease’s trick as well. It made the fog so thick around D that he couldn’t tell it wasn’t filling the whole house, that he was camped out under his own personal raincloud, that he was the only one hearing the thunder, the only one who was getting wet.
We could also call it postpartum obsession. D is an analytical thinker, a problem-solver. The baby is a cypher to be broken. D thinks, if we can just get all the variables exactly right, the baby will sleep. We talk about slow-wave sleep and sleep debt. About circadian rhythms and melatonin.
At one point, long after I’ve given up solving our son’s sleep problems, D tries to make a massive chart tracking every variable in the baby’s life: when the baby eats, when his naps are and how long, if and when he goes outside, if the sun is shining, how he slept the night before, the precise timing of his last dose of painkiller. He tapes it to our refrigerator, crowds the tiny squares with his indecipherable scrawling shorthand. There is no way for me to make sense of any of it. It hangs there for weeks, refusing to give any answers.
D is anxious. He worries, constantly. I am recovering from a brawling, dangerous birth that ended in alarm bells and oxygen masks and a room that filled with doctors so quickly it was as if they teleported in. When it’s time for our son’s first visit to the pediatrician five days post-birth, I tell D I don’t think it’s a good idea for me to go. I can still barely walk to the bathroom without blacking out. Leaving the house feels impossible.
But D is afraid the baby will die in the car seat on the eleven-minute drive to the pediatrician’s office. I don’t like the way his head looks in there, he says.
I tell him, It’s a car seat. They make it for infants. It’s safe.
D won’t take no for an answer. He’s not just worried about the baby. He’s worried about me, too. He tells me I need to come with him to the appointment, or he will take me to the hospital. He steadies me as I struggle to the car. I sit in the back and watch the baby, who does not suffocate. In the waiting room I fill out the postpartum depression evaluation form again while D reads emails on his phone.
When the appointment ends, the pediatrician says, The baby is fine; it’s Mom I’m worried about. He suggests we call an ambulance if things don’t improve, but I wave him off. Stubbornly, I make it back to the car, ten steps at a time, between long rests in the winding, sterile hallways. If I am in the hospital, I think, who will take care of the baby?
Here is my postpartum confession: I hated him.
I hated D so much I could barely look at him. This sniveling, mushy annelid. Didn’t he see me? Look what I was doing. I, too, was parenting a fussy newborn. I, too, was working a stressful job. I, too, was pushing aside exhaustion to care for our baby. Only I was doing it more! I was up all night. I was using what precious energy I had to convert calories into breast milk. The baby wouldn’t drink from a bottle, or a syringe, or a spoon, or the fancy supplemental nursing system the lactation consultants swore would work, so I was doing Every. Single. Feeding. I was doing it amongst wildly fluctuating hormones and thyroid numbers that, three months after the baby’s birth, still weren’t balanced correctly. I was doing it with fresh stitches, with aching breasts, while actively bleeding. But I was doing it!
And what was he doing? Crying, kicking things, slamming doors, punching walls. To me, he seemed like a soap-opera housewife, in the grip of some inflated tragedy, flopping around the house.
I blamed him. Why couldn’t he just suck it up? Why couldn’t he calm down? Why couldn’t he just summon some grit and get the job done?
I had only one friend that I confided in. She asked me, Is he still your buddy?
No, I said. Not even close. I just want to be alone so badly, but I need help.
D was my unlikable coworker who I could barely tolerate. But we had this big job to do. And we just had to do it.
It’s all easier when it finally has a name. When we bring the second baby home, I believe that everything will be different. The birth, which had nearly killed me the first time, is so easy that when the nurse announces, You did it, Mom! I turn to D and say, What the hell was that? We line up a postpartum doula to come twice a week to give us regular breaks. This little guy isn’t colicky. He doesn’t fuss. There’s no reflux. He sometimes falls asleep, all on his own, without us exerting any effort at all.
I joke to friends that I think I am experiencing postpartum optimism. Everything is love and light. This is so much easier the second time!
Except for D. He is struggling, immediately. D sleeps in the bedroom or on the couch while I spend the nights in the nursery, catching naps between feedings in the big, reclining glider. In the mornings, I feel pretty okay. But after only three days, D is wrecked from sleeplessness. The baby’s crying, even rooms away, seems to wend its way directly into his limbic system.
I nurse the baby and hand him to D for a new diaper. By the time he’s fastened it around our son’s small hips, D is fully sobbing.
Why is this happening again? I ask him. Everything should be different this time. Everything should be okay.
That kid, he says. I swear, he says. The crying, he says, is like kryptonite.
I ask D to fill out the postpartum depression screener and he agrees right away, calling it up on his smartphone. An eight or a nine suggests a possible postpartum mood disorder. A score of ten or greater indicates depression. D scores a 12.
The first ever mention of postpartum depression comes, like so many things, from Hippocrates. He made note of it in 460 B.C., calling it puerperal fever. He blamed fluid from the uterus, which he hypothesized could flow to the head after birth, causing imbalance, delusions and mania. His treatment suggestions consisted of bloodletting, closer attention to diet, exercise and baths.
Now we treat it with antidepressants and therapy and support, support, support. After D starts treatment, everything in our house changes. Not only is he better equipped to cope, and to help, but I’m not mad at him anymore. Or, maybe I am, but not in the same way. I have a new enemy now, postpartum depression, and D and I are finally on the same team.
I spend a lot of time on PPD websites and chatrooms geared toward partners of people with postpartum depression. Some of it’s helpful: offer positive reinforcement, be patient, ask for help. Some of it’s not: remember that she’s healing physically, she may be worried that her changing body isn’t attractive, try taking over a feeding or two during the night so she can get some sleep.
Every now and then I ask D, without pressure, without expectation, How are you feeling about the baby?
His answers hover between pessimistic and neutral. I nod the same way each time: once, dispassionately, and change the subject.
Until one day I ask, How are you feeling about the baby? and D says, I love him. I really do. And we cry together, sweet tears of relief that the storm is beginning to lift.
After the diagnosis, I tell our couple’s therapist that things are better in most ways, but the silence is hard. D doesn’t want to talk about his depression outside of home and therapy, which I totally understand. Mental illness is so heavily stigmatized in our culture, doubly so for postpartum depression, and I don’t even know the algorithm to calculate the stigma for men with PPD.
I tell the therapist that I’m glad D is getting help and that things are getting better at home, but I just feel so terribly alone.
I tell her, if my husband’s arms suddenly fell off, everyone would be looking at me and talking to me a certain way. They wouldn’t blame D (it wouldn’t be his fault he has no arms!), but they would see that he probably wasn’t carrying a full 50% of the weight. They would ask me, Oh my goodness, how are you? They would say, How can I help? They would understand, I’m sure this is hard for D, but my god, this must be so tough on you, too! They would see that I was carrying the team. That I, little, learning, fucked-up I, was the glue that was holding everything together.
Instead, people routinely ask, How’s D enjoying fatherhood? And I say, Great. He’s really enjoying it. And they nod their approval, perhaps wondering why I look so tired. Perhaps judging that it seems I’m not quite up to task of motherhood, that it seems a bit harder for me than it had for them. That maybe, for the sake of my growing family, I should try to summon some grit.
So what do we call it now? We call it D’s stuff around the baby. We call it no more kids and hasty vasectomy. We call it baggage and trauma that we bring with us into our other arguments. Sometimes D says our kids’ whole babyhoods are a blur, that he barely remembers them. I call that postpartum repression.
For years I carry these truths inside me like a secret. I occasionally say to D, I would love to talk to you about that time, tell you what it was like for me, either because it feels important or because a therapist tells me it is important to talk about it. But It takes me six years to make the conversation happen.
When I finally do, perhaps I have built it up too much in my head, Perhaps I have hung too many of my hopes for healing on this one conversation because when it’s over, I feel worse.
It goes, roughly, like this:
Look, I say, in so many words. Look at this thing I did. Look at this awful, hard thing I survived. Here, feel its weight in your hand.
D has his own fuzzy memories, his own feelings and ideas and villains to assign blame to. I watch him take this ball of hurt I have placed in his hands and gently remove some bits, re-shape others. Here, he seems to say, this is what it was.
When he hands it back to me I hardly recognize it. And having born it on my back all these years, I am not inclined to believe him when he tells me that is my experience.
I calmly, silently, put it back together. I tuck it back into its secret place. I do not ask to talk about it again. I don’t show it to anyone else.
Is that why I’m writing this now? Because I need someone to acknowledge the Herculean task that was being me in those early months? Is it so someone will forgive me for hating him when he was so clearly suffering? Is it the hope that another person in my position might see this and be seen by this, in a way I never was?
Probably, it is all those things. But it is also to do the hard work of naming, so that we can continue the harder work of healing. There’s a quiet magic that comes from naming your nemesis, your attacker, your ghost. This is ours.