Hello from the Other Side (of postnatal depression)

What a ride

The daffodils are beginning to bloom in our garden just as I have started halving my daily dose of sertraline. It is the third time I’ve weaned myself off, and my god, I hope it’s the last. Sertraline is a common type of anti-depressant known as a selective serotonin reuptake inhibitor (or SSRI for short), which increases the levels of serotonin in your brain and gives you a general mood boost for as long as you continue to take it. It is often used to treat depression and anxiety, which is why I started taking it in the autumn of 2020, a few weeks after the birth of my daughter, Olive.

It was my first experience of brain-altering depression. In fact, I feel pretty lucky that I managed to go almost three decades of my life without suffering from any major mental health issues, particularly in this crazy old world. It felt like somebody had hijacked my head like a terrorist hijacking a plane. I went about my day, fully bonded and besotted with my newborn baby, but the world was in complete grayscale, covered in a thick fog. I was plagued with despair all day long, unable to see joy in anything until my lovely midwife told me to speak to a doctor and they immediately prescribed me with a daily 50mg dose of sertraline. By Halloween, the medication had removed the low lows, although it had also removed the high highs, which kinda sucked. More on that later (betcha can’t wait).

Olive at three weeks, enjoying her first view from the Poet Stone in Steep

Growing up in British society where everything is fine, feelings don’t exist and everyone is semi-repressed, I have made a conscious effort to talk openly about postnatal depression (yes I AM fun at parties). It’s the usual thing - in the early days of parenthood, I met so many other mothers who were struggling but didn’t feel like they could mention it unless I opened up the conversation first. But even in the last five years of going through this stuff, it wasn’t until this week that I heard somebody else use the same language to describe their experience - the fog.

This person was the author Chimamanda Ngozi Adichie, who recently spoke to Emma Barnett about how she lost her ability to write as soon as she fell pregnant:

‘When I could not write, it was terrifying. And it felt like being shut out from myself. And it’s a really frightening place to be, because writing fiction is the thing that gives me meaning. I wanted to write fiction and I couldn’t, and I just really felt terror. I thought, what if I never write again? I’m not sure if it was entirely physiological, but something changed when I fell pregnant. I couldn’t get back into that magical place where I could write fiction.’

Fun fact: Something does change when you fall pregnant. According to current research, a woman’s brain undergoes more significant structural changes during motherhood than in adolescence. Let’s just soak that in. Remember how turbulent and confusing and emotional your teenage years were? New mothers are going through it all again, just a little bit worse.

Chimamanda then went onto explain how she felt foggy - she couldn’t think as clearly, and thinking clearly, for her, was so important. And I can’t tell you how comforting it was to hear her use these words. You know how people sometimes refer to their depression as a ‘black dog’ that follows them around? It can be a way to identify and contain something that feels otherwise uncontrollable. For me, I used the image of fog to visualise my postnatal depression. It was the best way for me to describe to my husband how my brain was functioning that day. In the late evenings, particularly, the fog would descend completely. It was almost as if it took extra energy to keep the fog lifted, and when I was tired, my brain couldn’t keep it at bay anymore.

Unlike Chimamanda, who wisely seemed to accept her inability to write, I tried to plow through and keep creating, particularly in pregnancy when I was plagued by productivity guilt and felt the need to make the most of my ‘time off’ growing an entire human child. There is a floral pattern I painted in June 2020, just before my due date, which I was determined to finish so that I could send out my latest issue of printed seasonal essays I was writing at the time (you can find digital copies of them all in my Treats library). The pattern was a blue and pink arrangement of dog roses, which I completed, sent out and moved on. But still to this day, when I look at that painting, I am hit with a wave of nauseous revulsion. My brain did not want to create anything, and although I managed to force my way through it, the process was - at risk of sounding melodramatic - mildly traumatic. I don’t even want to share the pattern here because I genuinely hate looking at it.

One of the worst things about my form of PND was how logically inescapable it felt. I am generally quite an optimistic person, as well as a problem solver and a self-improver. If there is an issue in my life, I will work towards sorting it out in some way, even if it isn’t a black-and-white, easy fix. But not only was I feeling absolute despair at everything (at my worst I couldn’t stop thinking about how everyone on earth was going to die - such fun), there was absolutely no reasoning myself out of it. Nothing I could think or say to myself would make me feel better. And at some points, I got so fed up at feeling sad that I ended up feeling angry instead - and it was quite nice. I was so irritated at all the pointless wallowing, I tried instead to direct those feelings towards something with a bit more punch and pizazz. Why was I so unlucky to be affected like this? Why were other women allowed to enjoy motherhood without all this crap? Why were my hormones so ridiculously unreasonable?

I was, and still am, furious at nobody. But of course, I wouldn’t have changed anything. I would go through the whole process a thousand times to have my two babies, because they are (obviously) the greatest human beings to ever grace the earth. Fortunately, I was wise enough to dose up on sertraline as soon as I fell pregnant with my son, Ash, who was born in 2023, so I could skip over the existential dread and get straight to the good stuff.

I knew from very early on that there was something super powerful about my hormones, but it wasn’t until I talked to my doctor a couple of months ago that I started to piece together a theory - not based on any medical experience, but on my own gut feeling and relationship to my body. For one thing, I breastfed both of my children until they were two years old, which I loved. One of the side effects of breastfeeding is that your periods can take a while to come back after giving birth, but for most people this is usually a few months. Mine took the full two years to come back after having Ash, which would have been fine except for the fact that I know my brain would not return to ‘normal’ until I no longer had any postnatal hormones flushing through my system. So although I wanted to continue breastfeeding for two years, I was also really looking forward to feeling myself again once my periods returned.

I spoke to my doctor about this, and she reckons I have very high levels of prolactin, which is the calming hormone that regulates breast milk and also helps chickens lay eggs. On the positive side, this is probably why I’ve found breastfeeding and co-sleeping so enjoyable, but on the downside, it has not only suppressed my menstrual cycle, but has also lead to me experiencing a really weird condition called Dysphoric Milk Ejection Reflex (or D-MER for short). I’ve actually taken part in a study about this because, like a lot of women’s health issues, it is completely under-studied and very few people have heard of it.

Essentially, it meant that in the first year or so of breastfeeding each of my kids, I felt a massive dip of despair for around ten seconds every time they started a feeding session. One of the theories around this is that as prolactin levels rise to encourage milk flow, it suppresses oxytocin, a hormone that helps us feel happy, secure and loved. If my prolactin levels are higher than normal, it would make sense that my oxytocin was suppressed harder, leading to these strange moments of dysphoria. I only discovered it had a name when I was Googling the effects, and as expected, it was incredibly reassuring to know I wasn’t the only one to experience it.

With time and medication, postnatal depression has become something entirely manageable in terms of my day to day life. But as I mentioned earlier, although the sertraline took away the low lows, it flattened my mood at the high end, too. I have missed feeling little moments of euphoria and delight at simple things. And I have also missed my real creative brain, which has been on the worst rollercoaster ever. Yes, I’ve managed to write books and get things done over the last five years, but the process has become ten times harder, like wading through treacle every time I have a task to complete. I’ve lost a lot of confidence in my work, and often struggle to see the value in what I do, or understand why people would want to read my writing. C’est tragique! And having always been a very ambitious and self-motivated person, I’ve felt myself losing sight of all the things I love doing. As a result, I’ve been inconsistent and unsure in what I’ve produced over the last few years, particularly in places like Substack, where writers have to guide their own path.

The good news is that with my hormones and sertraline both waning in power, I am very slowly, veeeeery carefully beginning to feel like myself again. I’m not quite at the level of Gordon Gecko taking on Wall Street with his filofax, but I am beginning to have the clarity of thought that Chimamanda spoke about in her interview. I still get the fog now and then, particularly if I haven’t had much sleep. Last night I was trying to brainstorm ideas in the bath, saw it was past eight o’clock and, like the tide suddenly turning, recognised that it was time to avoid getting lost in the fog by opting to get lost in a book, instead. (I am currently obsessed with the Dr Ruth Galloway archaeological mystery series by Elly Griffiths, chef’s kiss.) I am living with my fog, and day by day, she is diminishing.

I remember being in the depths of despair and feeling like there was absolutely no way I would ever feel happy again. I couldn’t imagine seeing the world in technicolor. But here I am! Battered, bruised and kind of anxious these days, but I think I’m out the other side of the best and worst five years of my life.

The sun shines! I’m off to sit in the garden.

The much less despairing 2025 version of me enjoying a spa last week with my ma and ma-in-law

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If you liked this post…

• You can listen to Chimamanda Ngozi Adichie’s interview with

  Emma Barnett
  on BBC iPlayer

• You can find out more about Dysphoric Milk Ejection Reflex on La Leche League International

• Find information and support for postnatal depression and perinatal mental health on Mind