Post Adoption Depression

We are pleased to present this important article by Debbie Hoffman and Robin May, Ontario social workers who have done research on post-adoption depression which is not well-known and, as a result, may go under-recognized.  (Long)

One of the most neglected topics in adoption issues is the phenomenon of post-adoption depression. While we understand and support birth mothers who experience post-partum depression, we tend to make sweeping assumptions about the adoptive mother. We expect that since the adoptive mother did not birth her child and therefore will not experience rampant hormonal changes or the exhaustion of labour, she will be no less than elated and joyful when she becomes a mother. After all, she chose to build her family through adoption, she waited a long time for this, why would she feel depressed? Very often, the most unforgiving proponent of the “should feel happy” expectation is the adoptive mother herself.

While post-adoption depression impacts the entire family (adoptive fathers are susceptible), in most cases it is the adoptive mother who is identified as the one who is most significantly affected.  Typically, it is the woman who stays at home to take care of the child, and therefore has fewer opportunities for relief and diversion from the changes that have taken place. While adoptive fathers can be wholly involved and supportive, they also have outlets such as their work, routines, and everyday activities that have remained intact to diffuse their stress.

The clash between the expectation that she will feel love, happiness and an immediate strong bond to her child, versus the reality of feeling stressed, tired, overwhelmed and isolated, can lead to feelings of inadequacy, guilt and depression for some adoptive mothers.  Post-adoption depression can run the gamut from feeling blue and sad at one end of the spectrum, to feelings and thought of harming herself or the child at the most severe.  As long as post-adoption depression continues to be a little-known and little-acknowledged phenomenon, a shroud of secrecy and shame adds fuel to the fire as the adoptive mother struggles to hide and ignore her feelings.

Lisa and Dan had been waiting for six years when 10-month-old Natalie was placed for adoption with them.  After years of invasive infertility treatments, an intrusive home study process and the out of your control feelings of waiting for a match to be made, Natalie was their dream come true.

Lisa is a mature, successful, intelligent woman in her late 30’s who was shocked when she discovered, six weeks after Natalie’s placement, that she could hardly pull herself out of bed in the morning to face another day.  She imagined that she would be a doting, loving mother who sang lullabies, kissed away booboos, and could easily anticipate and satisfy her child’s needs.  Instead, she found herself exhausted and at wit’s end trying to figure out how to soothe Natalie’s irritability and what seemed like incessant crying and distress.  The harder she tried to be Super Mom, the more upset and anxious Natalie became.

Lisa, a high achiever in most aspects of her life, was devastated and feeling that she was a horrible mother.  “I figured I would just glide into being Natalie’s mother and love every minute of it,” Lisa said. “After all, I waited so long for her. I felt terribly guilty and ashamed to discover that I was not enjoying motherhood, and Natalie was not at all like the child I imagined.  I thought I would immediately bond to my child, but in reality, I wasn’t sure I even liked her, let alone love her.  Most of all, I was worried sick that these feelings would never go away.”

Lisa found herself in a chronic state of guilt, shame, resentment and anger, and as the weeks passed she spiralled into a deep sense of being stuck in a situation where she had no control.  Dan tried to support Lisa as best he could, but no amount of coaxing her out of her mood made any difference.  “It got to the point that I made excuses not to see friends and family.  I just couldn’t muster up the energy to give the impression that everything was okay.  I could hardly take care of myself, let alone Natalie, and I worried that being just a good enough mother to her those first few moths would have an ever-lasting, negative impact on her. There was no way I felt that I could tell anyone how I really felt, after all, I wanted this.  How could I not be happy?”

Like many adoptive mothers, Lisa felt that she had no right to be overwhelmed and depressed. It was not until she acknowledged that she needed help that she agreed to see a therapist.  “It was the best thing I ever did.  I quickly came to realize that I was not alone, and that post-adoption depression is a common, normal response for many adoptive parents.”

While post-adoption stress goes hand in hand with the transition that takes place within all adoptive families, for some this burden becomes overwhelming.  Though the rewards and joys of being a parent are great, the challenges can be draining, confusing and depressing.  Lisa was aware of postpartum depression but had never heard of post-adoption depression.  In fact, she was crushed by her feelings and blamed herself for the entire situation.  “I realize now that everything I experienced was normal and that I was not some awful, unloving mother.  It just got a bit out of hand in my case and I needed some help to get back in sync.  Once things started to make sense to me, I could change my expectations and be more realistic about what I could and could not control.  I was able to relax and just enjoy bonding with Natalie.  It was like the floodgates opened and all this love, pride and protectiveness toward my daughter came pouring out of me.”

Advice for Parents

The most important thing that adoptive families need to know is that post-adoption depression, although difficult to experience, is a normal occurrence, and that there is assistance and support in the community to guide them.  Don’t hesitate to get the help you need.

In the meantime, take care of yourself.  Pay attention to your physical and emotional health by doing things that will help you feel better. Don’t stand in judgement of yourself – just do your best.  You don’t have to be perfect.  And remember, like any other crisis – this too shall pass.

Note to Adoption Practitioners

As adoption practitioners, we must be sensitive to and more knowledgeable about the phenomenon of post-adoption depression.   We need to normalize this experience and help adoptive families feel safe to speak openly and freely about their feelings.

Post-adoption stress and depression should be addressed during the home study process as well as during post-placement visits.  The impact of depression would be less traumatic if the adoptive parents was aware that the potential of this experience exists, especially when there is a history of past depressive episodes, or if there is a family history of depression.

Take the opportunity to discuss strategies and supports available to the family both personally and professionally.  Help the family access resources and services that can make a difference. Even something as simple as finding time to take a long bath while Grandma babysits can help.  Many parents find talking to a therapist on a one to one basis helpful, others take solace in group support.  Postpartum depression groups welcome adoptive parents too.  After all, depression is depression!

The good news is that post-adoption depression is very amenable to treatment.  Most parents are able to get back on track and truly enjoy their children.

–Reprinted here with permission from the authors, Robin May, former Adoption Social Worker, and Debbie Hoffman, CAS Ottawa

Comment: If you think you might be experiencing issues relating to post-adoption depression or other post adoption issues, contact us at Milestones & Transitions, 416 486 1506 or info@mandt.ca.

—Posted by Patricia Fenton, MSW RSW of Milestones & Transitions