Managing The Mental Load Of Motherhood

During my freshman year of college—at the young age of 18—I received a diagnosis that would both snap much of my past into focus, and shape how I moved through my life as an adult: generalized anxiety disorder. They may seem like three ordinary words, but for me they were life-changing. Everything suddenly (finally!) made sense. When I think back to my childhood, I realize anxiety is woven throughout every memory. I would obsess over hypothetical scenarios, have really catastrophic thoughts, and obsess in irrational ways.

I managed my way through school and started my career before finding a wonderful therapist who introduced me to cognitive behavioral therapy (CBT). With the help of the tools learned in CBT, I have been able to live a full and wonderful life.

But when I found out I was pregnant with my first child, I was concerned about my potential for postpartum depression (PPD) and anxiety (PPA). Who wouldn’t be?

To my surprise, I found that pregnancy actually suited both me and my anxiety. I was feeling really good and in control.

And then COVID happened.

Surely, I thought, this was where my anxiety might overwhelm me. But instead I found myself managing a very uncontrollable situation with grace—and calm. I even remember thinking, I got this!

And I did “have this.” For a while. My beautiful baby boy was born and while there were the usual challenges all new parents face—those first few weeks were hard—I found comfort in the fact that it was a struggle my husband and I faced together.

I told myself adjusting to our new life would take time.

I thought what I was feeling and thinking were normal.

Fast-forward a few months. I was now back to work (from home during quarantine) and trying to get into my new groove. But that was easier said than done. I found that expectations had changed and people were working much longer hours. Despite having in-home help with my son, I found myself struggling to juggle being a new mom and an exemplary employee all day, every day and night. It was exhausting. And overwhelming. And there were more than a few moments that I found myself feeling hopeless by it all.

It wasn’t until after a check-in with my OB at around four months postpartum that I found out the thoughts and feelings I was having were not, in fact, normal. Instead, my brain had just become really conditioned to struggling with and overcoming catastrophic thoughts and irrational fears since I was a child. Great. My OB referred me to Northwell Health’s Zucker Hillside Hospital’s Perinatal Clinic and encouraged me to consider medication for my depression and anxiety.

If I’m honest, doctors have suggested medication before, but I’d always been strongly against it. I viewed it as “giving up”—a waving of the white flag. I always thought society looked down on those who took medicine for mental health issues. I bought into the stigma that medication was for the weak. I was too strong and too proud to let that be me. But then it hit me—my mental and physical health are no longer just about me. I need to be at my best for my little boy.

Now, after a few months on medication, I understand the value and I’m glad I did it. Here are a few things I’ve learned the hard way:

• It’s possible to show up every day and give 100% when you’re struggling inside. A person with high functioning anxiety may appear to be an overachiever because symptoms are typically masked in overdoing, overthinking, and over-performing. I will never forget a performance review at my last employer, where my boss reported that I “cared too much” as an area for improvement.
• People with anxiety may naturally have anxiety about starting medication. Finally relinquishing control and trusting the process is what helped me make the choice to start. But it also took a few years of CBT to accept that I am not a failure because I need help in the form of medication. If I had diabetes and required insulin, would I be too proud to take it? If I had a broken bone, would I choose not to wear a brace or take pain relievers? Of course not. In order to end the stigma associated with mental health, we need to start with our own stigmas.
• The airline safety brochures in the seatback pocket in front of you have it right: In the event of an emergency, put on your own oxygen mask before assisting others. This concept has been tremendously helpful in my parenting and life in general. You must take care of yourself before you can take care of others. It’s not selfish to make your own needs a priority.
• Postpartum depression, anxiety, and other perinatal mood disorders are not one-size-fits-all. I participated in perinatal group therapy as part of my journey and found it very helpful to sympathize with other new moms that were having similar struggles. Not all of us had the same exact issues, but it was helpful to realize that everyone navigates the challenges of being a new parent differently. Suffering from PPD/PPA can feel very isolating. Please know that you are NOT alone and many moms may have felt the same as you. Do not be too proud to reach out to friends or family members. They will likely be able to relate.
• Saving the most important for last: Taking medicine will not change who you are or your personality. I still am who I am, and I may still care “too much.” I just no longer have the same reactions to situations that used to cause me extreme physical and emotional stress and sometimes even pain. I can now breathe easier and have time to process situations before having reactions. The very heavy weight that I have been carrying for several decades has been lifted and it feels wonderful.

• Feeling overwhelmed after giving birth? Know the signs of perinatal mood or anxiety disorders.
• 5 things I wish my wife (and I) knew about postpartum depression.
• A candid look at what the law requires for postpartum depression screening—and how we can do better for new mothers.