From “Pre-” to “Post-” {when depression and mental illness follow you into motherhood}


File Aug 03, 5 50 18 PM

The journey into motherhood is universally dotted with speed bumps, roadblocks, and detours. While no mama’s journey is ever exactly the same, it is safe to say that no one has a completely smooth trip. 

Adding mental illness into the already complicated journey of motherhood makes for a particularly bumpy ride.

One topic that is fairly well-covered in most of the literature surrounding pregnancy is Postpartum Depression (PPD). Open any book on “preparing for baby” and you will almost certainly see the warnings about PPD–the accompanying symptoms and first steps to take in the case you see PPD creeping up on you; however, a rarer occasion is when you find yourself learning how to understand what it looks like to have depression before, during, and after pregnancy…and beyond.

I was diagnosed with Major Depressive Disorder (MDD) when I was 16 years old.

My mom has it. Her mom had it. My dad’s mom has it. Since it is so prevalent in my family, I was lucky that my parents noticed the signs and symptoms early and had me screened and treated at an early age. When my husband and I started talking about the possibility of getting pregnant, it was very important to me to have a conversation with my doctor about what it would look like to control my MDD safely through my pregnancy. Over a few years prior to becoming pregnant, with the help of my family practice physicians and therapist, I was able to decrease my SSRI antidepressant to a very low dose and still feel normal, happy, and high functioning. So going into pregnancy I felt strong, confident, and comfortable with my depression and the steps I had taken to ensure that I would not succumb to its nasty grips during pregnancy or after baby came.

When my daughter was born, we had a lot of hurdles to jump over at the beginning, not unlike what almost every single other mama goes through, as well. At the time, I thought what I was going through was significantly more difficult than what other new mamas go through. I was sure I was having the worst “fourth trimester” that had ever existed and that my struggles to cope had nothing to do with depression. Besides, my depression was well controlled! I had been medicated for MMD for years now! There was no way I could mistake depression for just a bad day–after all, MMD was my oldest enemy and we knew each other so SO well.

How could I have Post-partum Depression if I already had Pre-partum Depression??

They say hindsight is 20-20. This is especially so for someone who struggles with a mental illness like MMD. In the thick of depressive episodes that can accompany untreated MMD, it is impossible to see the light at the end of the tunnel. It’s not until you make it through that you are able to look back and see just how crazy the circumstances actually were. This was exactly the case for me after baby. At the time, it was impossible for me to see just how low I was, just how far I had fallen into the throes of a full-blown depressive state. Finally, rock-bottom came and I realized that I needed to adjust my treatments to effectively control my newly-mutated amalgam of pre-baby MMD and PPD. For lack of a better term, this realization was the most difficult of pills to swallow.

Now, almost two years after the birth of my daughter, I’m still getting to know this new modified version of my depression. The MMD I knew before is but a distant memory, and sometimes it’s still like I’m navigating the waters of depression for the first time.

A few hard-earned bits of knowledge I’d like to share with any of you who may be starting to navigate the waters of mental health challenges in motherhood for the first time:

Having a baby is a completely life-changing experience–for better and worse.  

Everything is going to change, including your MMD. Prepare yourself and more importantly, allow yourself to be extra kind and extra lenient as this transformation occurs. Confide in your closest friends and family before you give birth and ask them to look out for you. You will need people around you who will be able to pick you up when you cannot pick up yourself. Not only for your sake but now and most importantly, for the sake of your new baby.

You are not a failure

If your pre-baby MMD evolves into the PPD from hell, it is not your fault. Repeat: IT IS NOT YOUR FAULT. You are a warrior. You are a goddess divine. You have experienced the greatest ecstasy and the miraculous wonder of birth and you have lived to tell the tale. Your battle scars are not to be hidden! You are only stronger for taking care of your wounds, instead of succumbing to them.

There IS a calm after the storm

 There was a time in your life with mental illness when you thought you couldn’t go on when you thought it would never get better. But it did. And it will in this case, too. Try to hold onto the knowledge that this struggle is temporary and you will not suffer forever. This is where the first point is so extremely important–accept the help that your support system is offering you. Reach out and take hold of the love around you. You do not have to go this alone. There is hope and there are answers and this knowledge will help you row ashore.

Local Resources for Moms Struggling with Postpartum Depression

If you or someone you know is struggling with depression, anxiety, or other mental illness before, during, or after pregnancy, call your doctor for assistance. If the sufferer is you, your doctor will be able to assist you right away; if it is someone else, your doctor will be able to help lead you in the right direction to how to best support the situation.

For more information on Major Depressive Disorder or Postpartum Depression, visit the NIH National Institute of Mental Health.

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Megan Lombardo is mama to two awesome kiddos, proud wife to a family medicine doctor, and a professional musician and piano instructor. She and her family lived in Denver for a handful of years before embarking on their current adventure in the mountain town of Salida. Megan will be focusing on helping your family find the easiest ways to experience all the hidden gems and lovely family-friendly excursions that you can get to within a short drive of the Denver metro area. One of the greatest things about Denver is its proximity to the mountains—so get out there and explore! When she’s not blogging, you can find Megan hiking around the Arkansas River valley, having a beer at a brewery while chasing her kids around, listening to music at Riverside Park with friends, playing music with her husband, or (still) ripping out carpet and tearing down wood paneling in her 1899 home in Salida. Megan is excited to connect with all of you!


  1. So glad people are talking out loud about this, When I was a kid no one talked about anything, I’m sure my Dad became an alcoholic because he was depressed . After the birth of my second daughter which was 16 months after her sister ,I felt like I was in a tunnel with no end. After the wife in a couple we were friends with, was hospitalized with a nervous breakdown after her son was born and given shock treatment ,did my husband think that maybe what I was experiencing was real.
    Hats off to you for sharing and giving help to those who maybe still struggling alone. Much love to you , Sherry

  2. Thank you for posting this. Very well said. I, too, have suffered with depression, sometimes severe, since I was a teenager. It has taken years to get it under control. I remember my post-partum depression. It actually started in my second trimester. It was very difficult and I felt so alone and guilty. How in the world could I be depressed when I had everything that I had dreamed of having? So many people said to “get over it”, etc. Hopefully this will help others understand that it isn’t their fault and that there is help available. Thank you again for discussing this problem that affects so many people and for sharing your personal experience with depression.


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