Adoption Depression- Part 1

I am glad "anonymous" commented on my last blog post about the possibility of me suffering from PADS (Post Adoption Depression Syndrome) because its an issue I've been wanting to write about for several months. I was not sure how to go about explaining this condition to the non adoptive community but was also aware that the adoptive community will of course have their own opinions on the matter. I wasn't sure where to begin and to be honest, I still have no clue. But the door has been opened, which confirms to me that I should in fact bring it into the light, so here goes nothing...

Step one in my book is to explain what PADS is:

Post Delivery Depression, long recognized as an expected part of normal pregnancy and delivery is an issue that is openly discussed and well understood by the medical community and the public. Estimates vary, but between fifty to eighty percent of mothers who have given birth will experience the mildest form of PDD called "The Baby Blues." Of those, approximately ten percent will suffer a more serious form of Postpartum Depression which is of longer duration and has more symptoms. The cause of both these manifestations is attributed to hormone changes and imbalances. Families, physicians, and caretakers are alert for symptoms and offer unconditional support to new mothers during this usually brief crisis.

The public and medical attitudes toward PDD are a far cry from the silence and secrecy that surround a much more pervasive problem - Post Adoption Depression Syndrome (PADS). For those of us who are part of the International Adoption Community, in particular parents of orphanage children, we have the added complication of adopting children who are almost always older than newborns and have been in an institutional setting. In many cases, our new children are toddlers to school-aged, and their histories and language issues add an extra dimension to the possibility of their new adoptive mothers developing PADS. Over 65% of parents who adopt experience some level of PADS.

Why does PADS exist among the adoption community in such high numbers? There are a host of very concrete and understandable reasons. Most newly adoptive parents have spent literally years struggling to get to the point of having a child to parent. Their protracted and unfulfilled hopes, dreams, and longing may cause unrealistic expectations about exactly what it will be like to be a parent, and they are unprepared for the grief they feel when reality confronts the child of their imaginations. Adoptive parents may feel guilty about their feelings of ambivalence, resentment, or anger toward their new child. The belief in instant bonding or "love at first sight" is often an unrealistic one. Falling in love with a child is much like falling in love with a future mate -initial infatuation and euphoria give way to the lengthy and often difficult process of adjusting to the day to day presence of another human being. It often takes from 6 months to a year for a real sense of attachment to blossom according to many of the families polled. Being unprepared and unsupported, new adoptive mothers who become depressed often try to "tough it out" without asking for any help whatsoever. Many mothers worry that if they advise their agency or social worker (the ones they have spent months or years convincing of their superior parenting skills) that they are experiencing difficulty, those same agencies and social workers will think of them as unfit parents and, in the worst case scenario, remove the new child from their care. Consequently, a bad situation becomes worse because of lack of understanding and support. First line extended family support available to new birth mothers (and fathers) is often totally missing for adoptive parents. In many cases friends and family members don't understand why the new mother isn't completely happy and content now that she finally has what she's wanted for so long. Rather than disappoint and confound her family and friends, many new adoptive moms simply suffer in silence, filled with shame and guilt, feeling themselves imperfect or selfish.

While all of the above issues pertain to all adoptive parenting, our international community has additional components which load the deck. In almost no case are we adopting newborns. Among other things, we deal with grief over the loss of unknown histories and missed bonding opportunities. We see our children for a very brief time before the adoption is finalized and we often "discover" disturbing surprises about our children's backgrounds after the fact. Our older children come equipped with distinct personalities, some of which meld smoothly into our families, others of which are a jarring and daily reminder of our differences. We adopt children who have experienced an almost unimaginable amount of loss. We adopt children who have suffered the effects of institutionalism, hospitalism, and global neglect. We often adopt children with hidden academic, emotional, neurological and medical needs. Frequently, newly adopted children attach themselves to only one of the two parents, leaving the other parent saddened and disappointed. Add to all that the stress of out-of-country travel, jet lag, communication difficulties with our older kids and foreign country hosts, sleep depravation, and cultural shock. Our decks come loaded with the potential for frustration, powerlessness, and worry - a perfect prescription for the onset of depression.

While most post delivery "Baby Blues" are of very short duration, 77% of survey participants with PADS reported that they suffered their symptoms from two months to over one year with 45% suffering for six months or more. 85% of sufferers reported that their depression affected their health in some way (serious weight gain/loss was followed by sleep disturbances and headaches), 70% felt that PADS had interfered with smooth transitions and bonding with their new children. Clearly, Post Adoption Depression is a significant, multi-faceted issue that needs to be acknowledged, better understood, and unconditionally counseled and supported by the entire community!

- Excerpt from Rainbowkids.com- the Voice of Adoption

I feel like this topic will need to be covered over a series of blog posts because if you are like me, you don't have 2 hours to sit down and read everything there is to learn about the topic or even to listen to me blabber on about how PADS intersects with our journey as newly adoptive parents. So next time I will use the definition of PADS you have read through and connect it with where I am on the scale of this issue.


Kimberly said...

Hey Bethany. I'm attempting to get caught up on things, including your adoption journey. I know others (one a dear friend) who have or are dealing with PADS and appreciate your transparency. :) We just moved (last Monday) to North Carolina. Glad to be back on the East Coast. Exhausted though, ha. Had lunch with friends waiting for their 2 girls from Uganda (school age). DM or email if you would like me to connect you with them. Anyways, sending a hug from afar. Praying for you. :)

A. R. Campbell said...

I've never even heard of PADS, and that's probably because I haven't really sat down to think about it. Thank you for bringing this to our attention--and for being honest. I've been a nanny for a little girl adopted from China and been friends wtih several families who have adopted internationally. I am a little ashamed of myself that I've never heard of this problem. I have a feeling it's not because some of my friends haven't experienced it--they just didn't talk about it. So thanks for being honest and bringing this to my attention (I'm sure I'm not the only one who needs to hear about it).

Grace H. said...

Great post! I've adopted twice and my second adoption I think I MAJORLY had this. The first adoption a bit too, but not as bad as my second! Both of my kids came with troubles but nothing severe and were pretty good considering - which is why I felt so darned guilty about experiencing these feelings. And no, it's NOT something you talk about with people who have not adopted before! Great post.

- Grace