Post-adoption depression


Brianna Brash-Nyberg
Focus on Adoption magazine

Post-adoption depression is a common experience. In this article we tell the stories of parents who have been through it and share what you can do to find help.

What is post-adoption depression?

Like new biological parents, some adoptive parents will experience depression or anxiety* after a baby or child comes home. Most research focuses on biological mothers (and there’s very little on dads, even though we know they’re affected too), but a 2012 study published in Advances in Nursing Science found that between 18 and 26 percent of adoptive mothers also struggle with post-adoption depression.

Post-adoption depression can begin immediately or as late as six months after placement. Symptoms include significant sleeping and eating changes, difficulty concentrating, anxiety, hopelessness, guilt, exhaustion, depressed mood, loss of interest in previous sources of enjoyment, and thoughts of suicide. According to the Pacific Postpartum Support Services Society (PPSSS), the overwhelming and long-lasting distressing feelings of postpartum depression are different from the sadness and anxiety known as “the baby blues,” which many new parents experience.  Post-adoption depression is a serious condition that requires treatment, whereas the baby blues often pass on their own.

Girl hiding her face with handsWhat causes it?

According to Karen J. Foli, co-author of The Post-Adoption Blues: Overcoming the Unforeseen Challenges of Adoption, most adoptive parents who experienced depression after placement struggled withunmet or unrealistic expectations of him- or herself, the child, family and friends, or society.” Other significant factors mentioned in the 2012 study cited above included extreme fatigue, a lack of support, low self-esteem, martial dissatisfaction, and difficulties with parent and child bonding. Some parents I spoke to for this article also experienced traumatic events during their adoption processes that they believe contributed to post-adoption depression.

“No one talked about the struggles, isolation, and, quite frankly how awful the adoption experience can be,” said Jean, who adopted a preschooler from foster care. “That made me feel like a horrible person to experience those thoughts in isolation. Everyone tells you, ‘You’re doing God’s work,’ ‘You’re an angel,’ ‘I couldn’t do what you’re doing,’ ‘You knew what you were getting into,’ etc. and on the inside you feel like you’re dying.”

Nicki, who adopted a toddler, had a similar experience. “I found when I was low and crying when I put him to bed for the night I would reach out to family and they would react by saying, ‘Well, you wanted to be a parent.’”

After all the struggles, excitement, and expense of the adoption process, it’s tough for new parents to admit to being anything other than delighted. It doesn’t help that the media tends to portray adoption as a perfect fairy tale, which sets parents up for disappointment and guilt if their own experience doesn’t match up.

“I knew I should be feeling happy that I finally was able to adopt,” said Carol, whose son was 8 years old when she adopted him. “I felt disappointed because the child described to me was not what I got. I remember feeling like I had made a huge mistake. It felt like a life sentence. I felt hopeless, like nothing would change. I resented my social worker and I felt I had been deceived. I felt tremendous grief and loss and I had to mourn what I had imagined and accept my reality.”

How is it treated?

Post-adoption depression is very treatable. Usually, treatment involves a combination of therapy, medication, and self-help strategies tailored to the individual’s needs. Some parents recover after a few weeks; for others, it takes months.

Everyone’s journey will be different, but if you think you may be suffering from post-adoption depression, the first step is to acknowledge it and ask for help. This can be scary; you may worry about jeopardizing your current adoption placement or your chances of adopting in the future if you admit to struggling with a mental health issue.

This is unlikely to happen. Your adoption social worker will be familiar with post-adoption depression and may actually be able to help. “Use your case worker,” advises Nicki. “They have resources to help newly adopted children and parents with transitions and could help with finding other families who have experienced the same for support.”

In the long run, focusing on your mental health now might actually improve your parenting skills and your relationship with your child. “Our children’s mental health is linked to ours so we must take care of ourselves,” says Meredith, who adopted two school-aged children internationally. “Studies show that there is a direct correlation between parent mental health and children’s cortisol levels (felt safety). When steps are taken to reduce parental stress, children’s cortisol levels drop. Also, many of our children will have mental health challenges throughout their lifetime and this can be a great opportunity to foster conversation about mental health and normalize visits to mental health professionals, taking medication, etc.”

Post-adoption depression and attachment

We’ve all seen the viral posts on social media that feature photos of beaming families on their adoption day, with headlines like “I loved my child before I even met him!” or “We bonded the moment she was placed in my arms.”

These stories, while heartwarming, can also set adoptive parents up to feel disappointed and guilty if their experience differs. It’s common for attachment and loving feelings take time to develop—sometimes a long, long time. Post-adoption depression can make that process longer and more complicated and that, in turn, can exacerbate the depression. “Having children with attachment and trauma issues is very isolating and complex and exhausting,” says Jean. “Every fibre of your being will be tested. You will need support.”

Isobel, who adopted a preschooler, says that post-adoption depression definitely impacted the attachment process with her daughter. “I withdrew, which caused her to cling to me with such intensity that it worsened the situation. I could not give her what she needed, and I was not getting the help I needed.”

Carol also experienced attachment-related challenges. “I often did not like my son,” she says. “He would tantrum for up to four hours for no apparently reason. When he was through he would want me to cuddle him, which was the last thing I wanted to do. I would cuddle him anyway, but I often did not feel empathy. Even though I knew he was a child in care with a history of trauma, in the moment all I felt was angry that he was making my life so miserable. Then I would feel guilty for feeling this way.  I had to work really hard at doing the right thing by him even when I did not feel it. I had to believe that in time the feelings would come. Eventually they did. I’m now going through my second adoption. I have similar feelings but now I understand that it is a process and that I am going to be okay.”

Isobel’s story

It started about a month after placement. Our daughter was definitely experiencing grief and it came out in rage, which was directed at me. She was extremely violent to the point where I had to cover up the bruises at work so that no one would ask questions. It brought on PTSD from my own traumatic experiences. I would lock myself in the bathroom and cry on the floor.

The first few months post-placement we were on our own, in an intense trauma tornado. Everyone involved in the placement was on vacation and so was our family. We had no support. I was withdrawn and wished that someone, anyone, would take her or me away. I was to the point where I felt that my wife and kid would be better off without me. This went on for a little more than a month.

My partner ended up putting me on the phone with a crisis support team, which allowed me to recognize that I was experiencing post-adoption depression. We sought out a therapist and she gave us tools to help alleviate the situation. Our therapist recognized and affirmed that we needed help, and that we were also valid human beings experiencing our own loss, on top of parenting a stranger. The transition counselor involved prior to our therapist was not sensitive to that.

I have made self-care a priority. I have organized time away from our child, as does my partner. She is babysat for five hours on Mondays and sleeps over at her grandparents’ house on Thursdays. The break from her is strengthening our bond. I have time to process all the emotional needs she has, alongside my own, and I have time to decompress.

I still have bad days and when I do, I leave for a couple hours and it helps. I have finally started to have moments where I can recognize this beautiful little girl is mine and I am fond of her. I do not yet love my child—I am sure I will in time—but she does not go an hour without hearing me tell her I love her, and she has recently started calling me Mom. I am learning to be easy on myself. All of that love and feeling like a family will come. For now I just take it one moment at a time.”

Meredith’s story

Two years ago our children joined us after a nightmare five-year adoption process. We adopted a sibling set from another country. Both of our girls suffered severe trauma. One also had a moderate attachment disorder, and the other was developmentally delayed with a severe attachment disorder. My husband and I both suffer from secondary trauma. I have a PTSD diagnosis caused by what I went through during the adoption, which included someone kidnapping our children, me having to go into hiding and flee the country during a visit, and large-scale campaigns to lobby our government to help us bring our children home.

I started struggling with post adoption depression six to eight weeks after our children arrived in our home. We have  biological children as well and I had struggled with postpartum depression and anxiety, so I was able to recognize the signs quite early and talked to my doctor about going back on medication.

Honestly, to some extent it continues two years later. Despite medication and therapy, it has been difficult for me to move past due to the severe trauma behaviours we are still dealing with in our home. I’ve found it difficult to access supports for our whole family. I feel thankful to have connected with a great trauma-informed counsellor.

What other parents want you to know

Every adoptive parent I spoke to for this article had the same message for other struggling parents: you are not alone, and this is not your fault. Here’s some other advice and encouragement they shared.

Ask for professional help as soon as possible. “Don’t be afraid of medication and there’s no shame in counselling,” says Meredith. “If you have experienced any sort of PTSD, depression, or anxiety, or have any past experiences of trauma, be prepared. Visit your therapist prior to placement and make appointments to see them a month or two after placement,” adds Isobel. “You need a safe place to deal with all of that inner turmoil, chaos, and upset without your child picking up on it.”

Cut back on responsibilities, simplify as much as possible, and get all the practical help you can find or afford. “Those first couple of months post placement, that is your Everest,” says Isobel. “There is no preparing for what is about to happen to your life. Those first couple months post placement are our labour and delivery.” Hire a house cleaner or babysitter, buy premade meals, etc. Reach out to friends and family and ask them to do some shopping or laundry, watch your child while you sleep, or just come and keep you company.

Seek out people who “get” you. “You may lose friends who will never understand, but you’ll gain a new support system,” says Carol. “My best friend was there for me on those days I felt I could not go on. She assured me I was a good mom because most of the time I was convinced I sucked. I also connected with other adoptive moms who had gone through the same thing.”

Prioritize self-care as soon as possible. “You will want to strangle anyone who mentions self-care [at first] because you probably will not get around to it in the first month or two,” says Isobel. “But when the dust starts to settle and you feel like you can finally come up for air, then load on the self-care. Take breaks, go for walks, meditate, take five minutes to breathe alone. Do anything to feel like yourself again.”

Know that along with the hard times there will be moments of pure joy and exhilaration. “In the end, if you persevere, you will see it is worth it,” says Carol. “That your child is worth every bit of heartache you experience.”