Kelly Cope did not realize her symptoms were related to motherhood.
Her heart felt like it was going to beat out of her chest. Her limbs tingled. A muscle in her head wouldn't stop twitching, a constant reminder that something was wrong. But she didn't know what.
The Boulder woman checked herself into the emergency room twice, before a doctor diagnosed her with a postpartum mood and anxiety disorder.
"I wasn't even aware of the toll motherhood took on one's body. I had no clue," Cope says.
As many as 20 percent of new moms suffer with some kind of a postpartum mood disorder in the first year after pregnancy. But, like Cope, many go untreated because their symptoms aren't like the extreme cases you hear about in the news. The Texas mother who confessed to drowning her five children in the bathtub. Sudden explosions of violence against new babies. Attempted suicide. Postpartum psychosis.
Cope's disorder was the opposite; she was so afraid of harming her children or letting them down that she couldn't sleep when her husband was traveling for work.
"I used to think I wouldn't wake up and my kids would be home alone and they'd be by themselves in their cribs and no one would know they were there," she says. "It was a big snowball."
Her anxiety about being the "perfect" mom left her beyond exhausted, undernourished, irritable and "not the stable mom that I wanted to be," she says.
Plus, she says, she had never experienced depression or anxiety before, and as the oldest of four girls, she had a lifetime of experience caring for children.
"I thought, 'I've got this. No problem,' " Cope says.
But there were factors far beyond her readiness and previous mental health — factors that Cope could not control. Not without help.
'The baby blues'
Every new mom experiences "the baby blues," says Kate Kripke, a licensed clinical social worker who specializes in perinatal health.
Studies show that 85 percent of mothers experience severe vulnerability and impaired resilience to stress for about two to three weeks after delivering a child.
"I think the other 15 percent are lying," Kripke says. "Everyone I know has gone through that."
Postpartum anxiety is the most common complication with childbirth but the least talked about, she adds.
As many as one in five moms continue to have brain chemistry instability after those first few weeks, she says. This, combined with the external stress of relationship conflict, lack of sleep, poor nutrition, a sick baby, limited social support, a difficult childbirth or pregnancy and even disruption in the daily routine all make these women more likely to get clinically depressed, Kripke says.
No one knows for sure the cause of postpartum mood disorders, but we do know there's an immense build-up of hormones during pregnancy, Kripke says.
Within 24 hours of delivering the baby — at any point during the term, including miscarriages — those hormones dramatically drop, Kripke says. That plunge affects the brain chemistry.
Some personality types may also be more likely to develop a postpartum mood disorder than others, according to research by Stanford University.
Which makes this issue particularly relevant in a city like Boulder.
Women most likely to suffer tend to be perfectionists who like to be in control, the study found.
"We have a lot of those women here, either because they have been professionals for so long before having children, or they're uber-athletes and are used to mastery that way. And all that control went out the window," Kripke says. "When you've been really competent all of your life and suddenly you can't master the things you want to master — and there's a lot of pressure around motherhood here. A lot of 'shoulds.' "
That's why Kripke's career is dedicated to helping these mothers. She works at the Postpartum Wellness Center of Boulder, which includes two therapists, an intern who offers low-cost or free therapy, a psychiatrist, an acupuncturist and a couples counselor.
In late June, Kripke helped organize the local Climb Out of Darkness event, part of an international fundraiser designed to raise awareness about postpartum disorders. The hike was sponsored by Postpartum Support International of Boulder, a task force of 42 different providers who want to transform the way postpartum mood disorders are managed in Boulder County.
They train other providers how to recognize signs, reduce stigmas and where to send moms for help.
Kripke also writes several times a month for the blog PostpartumProgress.com, a leading source of information for struggling mothers, and she is the state coordinator for Postpartum Support International (postpartum.net).
Climbing out of the darkness
Some moms can't stop crying. Some can't sleep. Some can't focus. Some have no appetite. The symptoms vary, and some are an inescapable reality of parenthood. But when those issues get in the way of you living the life you want to live, Kripke says it's time to visit your doctor.
Sara Symons, a mother of two who grew up in Boulder, says her postpartum disorder didn't show up right away.
"I remember things being great," she says. "I just loved cuddling with him. It was awesome. But after a while, it became, 'I can't leave the house, go to the bathroom, take a shower.'"
These stressors were compounded when she began suffering various infections and pain related to the delivery.
"I just didn't want to be there anymore. I wanted to go away," Symons says.
The sooner you reach out for help, the sooner you will feel better — and postpartum mood disorders are treatable, Kripke says.
"We don't expect new moms to suffer," she says.
More severe cases may be prescribed an antidepressant. That's what changed things for Symons.
Acupuncture can be an effective, alternative treatment for milder cases of depression and anxiety, she says. A healthy diet, yoga, social mom circles, drinking enough water and getting enough sleep have also been shown to help, she says.
Trying to "push through it" or playing the martyr might only hurt your kids in the long run.
Studies show that lasting, untreated maternal depression and anxiety has significant consequences in childhood development; it's the leading cause of childhood depression.
It can be hard, Kripke says, "when the whole world tells you this is the happiest time of your life and you're having trouble."
It's the moms with the milder cases she worries about most.
"Those are the moms out there in the public saying they're fine, and when the door closes at night, they're crumbling. They're less likely to reach out for help," she says.
If you have a partner who is experiencing difficulties, Symons also recommends the book, "The Postpartum Husband," by Karen R. Kleiman.
"When you have postpartum depression, it's like you're on an island and the only other person on that island with you is your husband. And you've lost your mind," Symons says. "It helps for him to know that you are in trouble, but it's just the baby blues. It will help him guide you so you're not just flailing."