From PPD to ADHD: How Motherhood Revealed My Neurodivergence
Written by Jen Kwok
Jen and W in the snow
Photo courtesy of the author
It was early 2020, and I had just started venturing out into the world more regularly with my seven-month-old son–shortly before the world would shut down due to COVID. For a few brief months, W and I took swim lessons, went to yoga class and attended the new parent group at our local library. Getting out of the house was especially chaotic in those early winter days, and I was never quite sure if the activities were worth the schlep.
Instead of sitting on the floor in our quiet home, we were now sitting in a sea of gray diaper bags, amongst a dozen other exhausted parents and squirming babies. There was solidarity in sleeplessness, and community in wiping drool off of everything. Some days it was more worth it than others. But unbeknownst to me, the very last conversation I would have at our very last parent group would change our lives and make every schlep worth it.
As I was packing up to leave that day, the postpartum doula who facilitated the group asked me how I was doing. I casually mentioned that I was starting to dry up and wean my son off of breastfeeding. Plus, it was exciting that he was now able to eat oatmeal with a spoon and feed himself yogurt dots.
I was totally caught off guard by her immediate concern: “Are you feeling OK? How’s your energy? How is your mood?”
This normally chill lady was now making super intense eye contact with me, and I had no idea how to respond. I was surprised by her line of questioning. I hadn’t considered the fact that I should feel anything other than terrible. Wasn’t it normal for all of us to be completely tired, anxious and overwhelmed 24/7? I looked around the room and saw myself reflected in the other moms with peeling nail polish, unkempt hair and milk stains on our shirts. Even the only dad there looked like he could have used a bubble bath.
The strong eye contact continued: “You should go to the doctor and get checked out just in case. Primary care, OB, maybe even a psychiatrist. Can you make some appointments soon?”
I wanted to say “OK” so that the doula would go back to her characteristically relaxed state. But instead, her question made me realize that I didn’t have any healthcare providers in the local area. We had moved from New York City to the suburbs, and in the postpartum swirl, I had completely neglected my health and personal care. I hadn’t seen an eye doctor or gotten a haircut in over a year. I thought that’s just what all moms did. We sacrificed and didn’t waste time on things that weren’t part of making sure that our babies were clean and fed. Things were fine. They were barely fine, but they were fine.
“Let me know if you need any recommendations,” she offered.
My son quickly moved away from breastfeeding, in favor of banana pancakes. And things kept being barely fine until they weren’t. As my son weaned, I could tell that my anxiety and overall mental health were too much to handle–even for me, someone who had self-identified as “being really good at depression” since adolescence. I had gotten off medications and supplements when I became pregnant, and now with the one-two punch of post-weaning hormonal changes, I was truly in the thick of postpartum depression.
W with food
Photo courtesy of the author
By some miracle or scheduling, one of the psychiatrists recommended by the doula had a single slot available on the one day of the week that we had a babysitter. I sat down at the first appointment and rattled off my well-practiced mental health history with ease. I was a PDP (Professionally Depressed Person), now with PPD (Postpartum Depression). I knew the whole rigamarole.
Everything went as expected, and we were almost done when the doctor pulled out a sheet of paper and started asking what seemed like a bunch of random questions. I don’t remember the questions exactly, but they were somewhere along the lines of:
“When you have a task that requires a lot of thought, how often do you avoid or delay getting started?”
“How often are you distracted by activity or noise around you?”
“When you’re in a conversation, how often do you find yourself interrupting other people?”
“Are you prone to daydreaming?”
Partway through the questions, I was amused.
“Um…is this a questionnaire about what it’s like to be me?,” I quipped.
“It’s a questionnaire for ADHD, I’m just trying to be thorough”, she said before rattling off the remaining questions. I answered almost all of them in the affirmative. I was surprised–but not shocked, when the doctor told me I had ADHD. She told me I could undergo further testing before being prescribed medication, but in many ways her questionnaire was already a second opinion to my lived experience. I told her I was very sensitive to medication, so she prescribed me a small dose of Prozac for depression and essentially a child’s dose of Focalin for ADHD. I started the Prozac first, and life went from endlessly treading water to holding onto a pool noodle with one arm. A couple weeks later I started the Focalin.
The doctor told me to try doing a task while on the medication and to see if I noticed a difference. The task I chose was picking up my dog’s poop in the backyard. It was something that needed to be done and that I had been putting off for obvious reasons. Repetitive tasks like that were almost impossible for me. My mind would wander off and soon I would mulching, pruning, texting on my phone or simply staring up at the sky. Also, it was poop.
I took the Focalin and waited about twenty minutes. Then I stepped outside, ready to tackle the poop. I noticed that my mind had slightly more presence to it, similar to having just completed a yoga class or meditation. I stared down at the grass and focused on walking towards the first dog poop that I saw. I picked it up.
“Find the next poop”, I told myself. I made my way to the next poop. And the next poop. And the next poop.I was a dog poop cleaning machine. As I walked around with the bag full of dog poops, I was overcome with a feeling of joy. I started to cry. I felt like I was in control of my brain. I was completing a task I had set out to do. I was a real, adult human being who could–uninterrupted–pick up my dog’s many poops.
Then, something else happened. I noticed my emotions, and I was not overwhelmed by it. I experienced joy and relief and thought, “OK Jen, just finish picking up the poop.” And I did. For the first time in my life I was able to feel and identify an emotion without being completely swept away by it. At that moment, I was more successful than I could have ever imagined. It just happened to be with poop.
The days and weeks after were difficult. COVID happened and everything shut down. I kept seeing the psychiatrist–virtually, now. She helped me understand my ADHD diagnosis. I learned words like “executive function”, “time blindness”, “hyperfocus” and “impulse control”. I read all the books and articles I could find on the topic–and there were a lot. I realized that the intensity of motherhood had caused my brain to shift a million times a day–draining my attention span, which was already at a deficit. The medication continued to help, but I also used the extra time at home to start Bullet Journaling and learning how to set timers for household chores.
The psychiatrist told me that she had many patients who first came to her with severe anxiety and depression–including postpartum anxiety (PPA) and postpartum depression (PPD), and ended up also uncovering a comorbidity with ADHD. She specialized in working with women and girls, many of whom came in struggling at various “transition points” in life, including: going from high school to college, college to work–and yes, the transition to motherhood. For so many of us who were previously undiagnosed, ADHD was an underlying issue that we had unknowingly developed many coping mechanisms for throughout our lives. But the barrage of changes that came with motherhood–along with hormonal fluctuations, lack of sleep, emotional exhaustion, etc.–rendered those coping mechanisms ineffective.
For me, going through the depths of PPD lead to an incredibly liberating diagnosis of ADHD. Medication is a personal choice–and it’s still not the entire answer, but when I tell people about the effects that medication has on my brain, I use the following analogies and examples:
Jen & W
Photo courtesy of the author
It’s like putting glasses on my brain. It’s like all these years I’ve been driving around and bumping into things because everything was blurry, and everyone else was like “What’s wrong with you? Why can’t you see that?”
I used to look at my living room and think: “Couch, dog, plant, plant, plant, oh I should water the plants, rug, I love my rug, dog, is my dog hungry?, orange, maybe I should buy some oranges, why is that shelf crooked?”. Now I look at my living room and think: “Living room”.
I used to be unable to eat while music was playing “in the background”. For my brain, there was no such thing as “background”. Any music would stimulate my brain and open up worlds upon worlds where I was considering the phrasing, chord voicing, emotional content, and EQ on the drums. Now, I can hold several things in my brain at once and eat dinner without being pulled into an alternate universe.
Getting diagnosed was only the first part of my journey in understanding my own neurodivergence–and ultimately my son’s neurodivergence as well. If there are two takeaways from my experience, they are this:
I tell every friend who is becoming a first time mom that the hormonal changes of pregnancy and weaning from breastfeeding might trigger depression–and to look out for it and find support as soon as they can.
Receiving a diagnosis like ADHD is an amazing opportunity for self discovery and self acceptance. It’s a chance to get to know your own unique brain and how to best work with yourself.
