Episode 22: The Signs I Missed: A Postpartum Mental Health Story and What I'd Do Differently
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Erin Leech (00:24)

Hey friend, welcome back to In the Middle of It. It's May, which means it's Mental Health Awareness Month. And that is a topic that is near and dear to my heart for lots of reasons — mostly my personal experience, as you know if you've listened to any other episodes. But also my previous career, before coaching and before photography, was in college health promotion. So I was involved in a lot of mental health awareness work with college students then. And it's really nice that I get to talk about it again in a different way in this new career of mine. It's kind of a full circle moment, which is really cool.

Today I want to talk about the signs that my mental health was personally unraveling — specifically the ones that I missed, overlooked, cast aside, and just kind of ignored because I thought I was supposed to be able to handle everything. I waited a long time to finally get help because I just thought it was me not being able to get through it. And I also want to talk about what I would do differently if I had experienced that all over again, because I really believe that if I had understood what was happening to me in those moments a little bit earlier, things would have been a lot less challenging. Or at the very least, I would have just gotten help sooner.

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Erin Leech (03:08)

There's a lot of conversation about the early days of postpartum and looking out for signs of anxiety and depression and whatnot. And yes, in the beginning there are so many hormone shifts — our hormones completely plummet in so many different ways for the first week or two, and they continue to shift over literally years, just maybe not quite as drastically. But the part that took me by surprise — and I think was a lot of the challenge in recognizing that I needed some help and that it wasn't just me — is that the first six weeks were totally fine.

I had a lot of structure holding me up that I didn't really even realize I was leaning on. Scott was home, people were coming to visit, they were checking in, sending text messages, bringing food. There was just this constant flow of people, especially with your first child.

And then six weeks went by, and that was when Scott went back to work. The visitors stopped coming. That whole newborn bliss started to fade — everybody assumes you must have it together by now, right? Or at least that's maybe the expectation. And for me personally, my closest people weren't available to help very much, just the reality of life and schedules and illnesses and injuries and all that kind of stuff. So I went from having this constant hum of presence and support to just me and Leon every day.

And also being a first time mom, I just didn't realize what life would look like logistically — being home alone with the baby every day. That's hard. It's very isolating just in general. And everyone prepares you for those first days at home, the first weeks at home, but no one prepares you and says, hey, by the way, all of the support and love and attention and everything that you're getting right now is going to go away. So be prepared for it, and here's what you can do to get ready. No one told me that.

And again, it's just the expectation that at six weeks, eight weeks, whatever — you're settling in, you're finding your groove. When people do ask how things are going, it just feels different. It's like when we normally ask each other "hey, how are you doing?" and you give the generic "yeah, things are good" even if things are not good. It feels like that's just the expectation of the conversation sometimes. So in general, you just end up stopping talking about it, because still struggling doesn't feel socially acceptable — especially depending on who you're talking to. If it's your best friend or your mom, maybe you can be honest. But there is a huge gap between all of the support you get in the beginning and what you don't get after however long it is.

For me, it coincided with the end of Scott's paternity leave, and when that attention and support started to fade around six weeks — plus what I know now is a peak in fussiness and general newborn intensity between six to eight weeks — all of that happened at the same time for me. Which made it even more challenging.

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Erin Leech (08:49)

So let's talk about the signs specifically. Looking back, they were definitely there. I just didn't know what I was looking at. Even being well-versed in psychology and mental health, and being a pretty self-aware person in general, I still just didn't know what to look for — because postpartum was an entirely new experience for me. And I've always had some form of mental health challenges. Postpartum just made things a hell of a lot worse.

The first sign — and this is the one I think most people don't recognize in themselves — was the rage. I was angry a lot. Snappy and irritable. I'm sure Scott and even people like my mom felt like they couldn't do anything right by me. And for a long time I just felt like it was sleep deprivation, adjusting to the new life, being stressed — which, yes, all of that was true. But what I've come to understand about myself is that my anger, the rage, the irritability — those come out for a lot of different emotions. Anxiety, grief, fear, loneliness, isolation. When I start to feel emotions that are too big and too hard to sit with, it typically just comes out as some form of irritability and anger. For lots of reasons I don't need to get into right now, that is a more comfortable emotion for me than feeling anything else — even sadness.

And that might be the case for another mom as well. If you find yourself constantly snapping or just feeling off, acting really different from yourself — maybe pause and just think about what's actually underneath all of that. Because the rage for me was never what it looked like on the surface. It was a signal to something else. And there might be something underneath that for you too.

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Erin Leech (11:47)

The second sign that I was really struggling is that I did not recognize myself anymore — but I kept going, and I told myself I was fine. I still got up every day. I was still a mom. I was still doing what I needed to do. I was still functioning. And technically I was still doing what needed to be done.

So I would reason with myself: well, things can't be that bad because I'm doing it. This is fine. This must just be what adjustment feels like. This is just life with a baby. I just kept writing it off as normal. But I also couldn't find myself in any of it. The version of me that's ambitious and a dreamer — she was still there, but she felt very far away in terms of actually being her. It kind of felt like missing a long-distance friend. Like, she's still there, you love her, you have this connection you could pick up at any time, but it takes a lot to be in her presence and hug her. I just missed her. And I did not know how to get back to that woman — and did not realize for a long time that there really was no getting back to her. I had to just reconfigure. I had to recalibrate.

And overall, again, I just kept functioning. I was quote-unquote fine. But functioning is not the same as being okay. You can be doing all the things and still not be okay. You can be fine without being okay. That sounds very confusing, but it is true.

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Erin Leech (15:18)

The third sign — and I kind of touched on this earlier — is that everything within me got louder. And by everything, I mean specifically around mental health. I've talked before on the podcast about being diagnosed with OCD and ADHD, which realistically I've had for the majority of my life. I just didn't get actually diagnosed — ADHD at 28, and OCD just a couple of years ago around 32.

And in those early months with Leon, everything that was already within me got turned way the heck up. Anxiety and intrusive thoughts, emotion dysregulation — all of it turned up to a volume I had not experienced before. And I have been through trials and tribulations with my emotions and my mental health. This was by far the worst ever.

And similar to the functioning-while-not-okay thing — my interpretation of all that was just kind of written off as being stressed, sleep deprived, having a lot going on. I didn't realize that postpartum is actually a huge trigger for a lot of mental health challenges, especially when you already have something going on. I had no idea what to expect. I knew about hormones — you hear about pregnancy hormones all the time — but I just didn't know specifically what my own mental health history would look like coming together with all of that. So I just absorbed it as: this is just me. This is how I am. Things are a little bit worse now because of course I'm adjusting. And I just cast it away.

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Erin Leech (18:01)

The fourth sign is a much quieter one, but very much real. I was physically present but totally mentally elsewhere. I could be folding laundry and off in la-la land thinking about photography work I had to do, or daydreaming about what life used to look like, what I wanted it to look like, wondering if I was ever going to get there, wondering if it was even possible anymore. Sitting on the couch feeding Leon and thinking about a million different things. Just really going through the motions sometimes.

And it makes total sense, because a lot of the time in the beginning of Leon's life I felt like a complete stranger in my own life, in my own house. I did not recognize myself or anything else around me anymore. And it was incredibly jarring to go through that.

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Erin Leech (20:02)

And finally, the fifth sign — and this was the biggest one, the straw that broke the camel's back, so to speak. I could see how it was affecting everyone around me. Of course, Scott — it was very obvious that it was affecting him. But especially even Leon, and how he would respond when I would get super dysregulated and distressed and have what I just kind of ended up calling my outbursts, my moments. Even the dogs, honestly. As soon as Leon would start crying, they would make a beeline for upstairs, because they had started to associate his crying with my emotions — and unpleasant ones at that.

Everything felt affected by what was happening inside me. Even our moms. I could just tell people were walking on eggshells around me. And that was the moment I knew I couldn't keep explaining this away. It's not nothing. It can't be just me, because I would never intentionally behave in ways that would cause all of this distress to my family. I don't want them to feel this way. I don't want to feel this way myself.

It was one thing to tell myself I was managing and getting by. It was a whole different thing to look around and see the toll it was taking on everyone else too. And that was the moment I knew something really had to change. It was a day in mid-November, and I finally had a conversation with Scott where I was willing to figure out where to go from there — what kind of help I needed and what that would look like.

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Erin Leech (22:52)

And why did I not have that conversation earlier? Well, there's a few reasons — it's never just one, right?

The first was that I genuinely believed I should just be able to handle it. I had just had a baby, but this is what women have been doing forever. My mom did it, my mother-in-law, my nana, so many women around me have gone through motherhood and made it and been fine. So what's wrong with me that I can't figure this out?

And with that also came the feeling that admitting I needed help was admitting that I had failed. I did not want to admit that I needed support, that motherhood was different than what I had anticipated, that I needed something outside of my house.

But thankfully I've learned that needing help is not a character flaw at all. And actually, thanks to my therapist, I've come to realize and accept and embrace that asking for help is actually far stronger than just keeping it together and pushing through. Part of being able to handle motherhood is being able to say, I'm not doing well right now. I need some help. It might feel like that's giving up, but at the end of the day it's incredibly courageous to be able to speak up and get the help that you need — whether that looks like a neighbor coming over for a little bit, a friend hanging out for the afternoon, having some baby-free time, or something bigger like in my case, the day hospital program. There is a lot of strength in admitting that you're just having a hard time. And it's a completely normal response to this massive life change you just went through.

We would never ask anybody else who's going through a life upheaval, hormonal crash, sleep deprivation, and whole life reorganization all at the same time to just call it normal and deal with it. But that's pretty much what moms are asked to do.

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Erin Leech (26:43)

And even in moments when I really wanted to ask for help or find support, the logistics of getting help felt like more than I could manage. Instead of seeing it as help and support and relief, it felt like more work. Finding a babysitter or a nanny or a daycare, doing all that research, going on the visits — just the anxiety alone of bringing Leon somewhere else or having someone come to the house and care for him felt so much bigger than what I was already experiencing.

The discomfort of what I was experiencing was, ironically, more comfortable than actually getting help — because getting help meant I would have to deal with the anxiety of leaving Leon and trusting someone else to take care of him. At the time, with all of the OCD that was flaring up, that just felt impossible. So I decided: I would rather stay like this than deal with all of that. Even if getting through those challenges and relinquishing some control would in the long run mean I had more space, could actually feel a little better, and could be a better mom.

I felt like I was just going to white-knuckle it and get through this. I'll take care of all of that when I have a little bit more bandwidth. But that time never really comes. Life gets a little bit more manageable eventually, but more bandwidth doesn't really just show up.

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Erin Leech (30:22)

I also did not get help because I didn't fully have the language for what was even wrong yet. I knew I was not okay, but I found it very hard to articulate exactly in what ways, or how I was feeling about it all. And without knowing what's going on or what to ask for, I just kept my mouth shut.

And that's a huge reason why I feel like it's so important to have these conversations and talk about mental health — not just in vague terms, not just "postpartum is hard," but legitimately the signs, the grief, all of the things I've discussed and more. Because this is just my own singular experience.

When you can hear something being named and described and articulated in a way that you recognize in yourself, suddenly you have a place to start. You can actually advocate for yourself and get some support in whatever way that looks like.

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Erin Leech (31:40)

So finally, I did that — around three or four months after having Leon. It was around November, and I hit a wall I could not just look past anymore. It was not a window pane. It was a brick wall, right there in front of my face, solid and clear as day. One particularly rough evening when I was going out for a networking event — it was just bad. I was not myself at all. And after that, I sat down with Scott and knew something had to change. I knew it, he knew it, I think everybody around me knew it. But I needed to be the one to say it out loud.

And thankfully, right around that time, a friend had told me about the day hospital program at Women & Infants in Providence. Courtney, if you're listening, I am forever grateful for that one conversation. It seriously changed everything.

She had visited me at my photo studio and knew I had just had a baby — I think I had Leon with me at the time — and asked me, so how are you doing? And I gave the glossed-over answer: yeah, things are rough with a newborn but we're okay. And she said, no, but like, how are you doing?

And it's really meaningful — as a quick side note — when someone is vulnerable enough themselves to hold that space for you. To ask you truly how you're doing and take time out of their day to actually give a damn. Courtney wasn't my best friend or anything like that, so she didn't have to do that. Her son is just a little bit older than Leon, so she got it. But just with her asking that question, and me feeling like there was a door I could walk through, it gave her the opportunity to tell me about the day hospital program. I kind of bookmarked it at the time, and then ultimately pulled it back up when I had that conversation with Scott and decided to give them a call.

I went in for the initial assessment, and honestly everything about it was great — until she started to talk about the actual logistics. Monday through Friday, nine to two, for on average two to four weeks. And my reaction was: whoa. How am I even going to do that? How am I going to nurse and pump? How is Leon going to nap somewhere that isn't home? The room was bright as all get-out and loud with a dozen other women talking and playing videos for the educational components. How the heck does this even work?

Which, obviously, should have been my first indication that it was going to be fine — because the program has been running for a really long time and it's clearly effective. It might not be easy, but it's possible.

And what I realized at the end of it all was: this time is going to pass anyway. In reality it's only a few weeks. Those three weeks are going to pass whether I do the program or not. And I knew I needed it.

I was also worried about the financial commitment. By the time I got to the initial assessment, it was January, so our annual out-of-pocket max had reset after having Leon. I knew it was going to cost us some money — it ended up being around $1,200 [FLAG: possible transcription error — Erin mentions a dollar amount that gets cut off; check audio for exact figure] out of pocket. But I decided: the cost of not doing this program is way more than whatever we'd have to pay. I might as well use this time to do something that's actually going to make things better.

And so I did it. I figured out the logistics that felt impossible. I navigated all of it — the early mornings, getting us out of the house, nursing and pumping, [FLAG: possible transcription error — Erin mentions navigating "a big feeding challenge, what we discovered" and "sleep challenges that were actually feeding challenges" — check audio for full context] — and not to be dramatic, but that program possibly saved my life, definitely saved my marriage, and the ripple effect out to my family was definitely not subtle.

That's also where I got my OCD diagnosis. But I'm going to save that for another episode coming soon, because it deserves its own conversation entirely.

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Erin Leech (39:40)

So if I could go back and do things differently — or if I had a best friend who was about to have a baby — here's what I would tell her.

First: recognize when your support may start to fade, and build in some other kind of scaffold for yourself rather than white-knuckling it alone. Whether that's when your partner goes back to work, when the visitors stop, whatever that looks like at six weeks or twelve weeks — that is not the moment to put your head down and push through. That's the moment to deliberately look around, find your people, and build your village.

It takes a village — it truly does. And unfortunately we do not live in villages anymore like we used to. So we have to be intentional about creating those connections on our own. Knowing that you can call upon this person or that person. And even if you never actually need to reach out for support, sometimes just knowing that's your network is enough to help you manage better. It's like this weird placebo effect kind of thing.

And I would even say: take it a step further and reach out to those people proactively. Say, hey, I know life is about to get really crazy when so-and-so goes back to work — if I need help, would you be willing to come over? Because then they're primed. They're ready. They know that if you do reach out, it's for a real reason. And that's definitely going to change their response and their demeanor when they're around you.

Because if you don't ask, people are not going to assume you need help and offer it. They think you're fine because you look like you're managing. You have to tell them otherwise.

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Erin Leech (42:47)

And I would also say: don't wait to tell someone you're not okay until you're about to fall off a cliff. Don't wait until you're at the absolute edge. Maybe when you're like four steps behind the edge, at least. You don't have to be in an absolute crisis to deserve support. You don't have to be in any form of crisis to deserve support, let alone hitting rock bottom. Just kind of struggling is enough. Just things being hard is enough. Not feeling like yourself is enough. You don't need a more serious reason than that. It's enough.

Good is not necessarily the opposite of better. Good is just a foundation. And even if what you're currently experiencing is technically fine, you can still have a desire for things to be better and ask for support to get there. You can take a more proactive approach and say, hey, I know this is just going to be hard. It's not hard yet, but would you mind coming over on Fridays? Could we meet up at the playground? Recognizing those pockets of time where you might need a little bit more support, and arranging for that before you actually experience the hard times.

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Erin Leech (45:32)

And when you do ask for support — whenever that is — what I would really love to do differently, if I could change just one thing, is to not make it mean anything about myself.

I made myself feel terrible for needing any kind of support. When breastfeeding didn't work out, I literally told myself: well, if I could just figure this out, if I could just make it work, if I hadn't created a baby with oral issues, then I wouldn't be costing my family money by needing to buy formula. I put all this pressure and burden and guilt on myself when it had nothing to do with me. I told myself that if I could just handle motherhood, if I could just get my act together, then I wouldn't need to be spending this money on the day hospital program. I was not compassionate with myself at all. And it just made everything so much harder to get through.

But it had nothing to do with my fitness to be a mom. It's not a character flaw. It's not a failure. It's not a sign that something is fundamentally wrong with me. It's just a really hard season. The first few months — if not longer, for some babies and some moms and some families — are just really hard. Especially if you have existing conditions that magnify what the hard looks like.

You are not your emotions. You are not the intrusive thoughts and the spiraling. Those things are happening to you. They are not you. At the time I just didn't have the tools to handle them. But thankfully, with some wonderful providers and a lot of resources, when I stopped making them about my identity — that's when I could actually start doing something about them and release the guilt and the burden I was carrying around that made motherhood feel so incredibly heavy.

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Erin Leech (48:44)

So if you are currently in the thick of newborn land, or even if you're three years into motherhood and you still feel like you're running on fumes and kind of low-key pretending that you're not — I hope that after listening to this, you have a little bit better feeling about things. What you're experiencing and what you're feeling does not make you a bad mom. It just makes you a human being who is doing something really freaking hard. And you probably needed more support than you have or had. Or maybe you haven't asked for it yet because you've been telling yourself you should just be able to figure it out.

You do not need to handle this alone. We were never supposed to handle any of this alone. But unfortunately, modern day society has created this isolation of moms and taken away the whole "it takes a village" thing.

If you're in Rhode Island or somewhat local and you're struggling, I genuinely recommend looking into the Women & Infants Day Hospital program. Like I said, it was a total lifeline for me. And if you're not local to Rhode Island, there are other programs like it across the country — I will say I've learned there are not many, which is a complete oversight and disservice to moms. But do a search, talk to your OB or your midwife, or find a therapist who specializes in perinatal mental health. They can help you find connections and resources. And even before that, just one honest conversation with someone who loves you is a perfectly great place to start.

Thank you so much for being here. I am Erin Leech. This is In the Middle of It. And just remember — you are never, ever alone. I'll see you next week.

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EDITOR'S NOTE — FLAGS TO REVIEW:

1. (Around 37:53) — Dollar amount for out-of-pocket cost: Erin mentions the day hospital cost "around $1,200" but the sentence gets cut off in the transcript. Check audio for the exact figure she lands on.

2. (Around 38:30) — Feeding/sleep challenge detail: Erin mentions navigating "a big feeding challenge, what we discovered" and "sleep challenges that were actually feeding challenges." The transcript is fragmented here. Check audio for the full context of what she's describing.