Post Adoption Depression Syndrome or PADS is very similar to PND. The symptoms are the same but this is a condition that is not widely talked about. It is in fact a condition that is very much brushed under the carpet and talked about in hushed voices due to the fear of disrupting an adoption placement and a child being removed from their adoptive parents and put back into the care system.
The symptoms of Post Adoption Depression Syndrome are listed in a Factsheet by Adoption UK as:
Either a consistently low mood or marked reduction in the feeling of pleasure must be felt, accompanied by some of the following symptoms.
- Feelings of anxiety, panic, inadequacy, being overwhelmed by responsibility, being slowed down, inability to get any enjoyment out of life, worthlessness, guilt, low self-esteem, loss of identity, loneliness.
- Physical symptoms: aches and pains, stomach problems, back problems, sleep problems.
- Tension headaches, lack of energy, fatigue, lack of concentration, forgetfulness, loss of or gain in appetite.
- Mood: irritable, angry, despairing, pessimistic.
So what can cause depression in an adoptive parent? Reports suggest that it is the primary carer who is most susceptible. Depression can effect men as well as women. If you think about it logically though it's hardly surprising that the figure is so high......
So what happens next? You wait anxiously to be matched and have an emotional decision when a match comes. Is this your child? You decide yes or no. Both outcomes are filled with emotion. Once you are matched the anxiety continues because the match has to be approved by another panel. Adopters are discouraged from bonding with their prospective child in case the match is not approved by panel. Of course you're going to bond. That bond is so important to you and your child. It's ridiculous to discourage those emotions. We're not robots who can turn their emotions on and off.
home to accommodate your new child and then, once you are feeling really tired after all the painting and buying and preparations, you meet your child. The anxiety and excitement surrounding meeting your child for the first time is indescribable. You then have a period of generally 1 to 2 weeks of introductions where you tear up and down your local county (generally) having to arrive at some ungodly hour to greet your new son or daughter as they awaken or go to bed and generally get to know their routine and their likes and dislikes. Slowly you take over that routine and try to absorb everything their Foster Carer is able to share. You have to cope with being in someone else's house (and they with you being there) which can feel awkward (I am incapable of changing a nappy quickly with a FC watching!). Then, when you are even more tired than you knew it was possible to be before meeting your child, you are allowed to take your child home.
You arrive home exhausted and excited. The day has finally arrived. You may have fallen in love instantly with your child or you may not know how the heck you feel. All you know is that you are now a parent. That first night when your child is sleeping in their room can bring about emotions you didn't even know you had within you. What you are expected to feel by those around you is excitement, happiness...all your dreams have come true.
Then the hard work really begins. Helping your child settle in. At this point you are probably so tired you just want to head off on a long holiday in the sun but you need to put all your energy into your child. Your child is unlikely to be a baby who might sleep during the day. This child is probably up and about and busy all the time. You probably won't get a break from being No. 1 Entertainer as well as being a therapist and cook and washer of more clothes than you imagined it was possible to wash during a week. Your child may be very unsettled and need a lot of reassurance. You may already have another child who feels angry and unsettled by the arrival of their new sibling. You will probably spend half the day wondering what on earth you are supposed to be doing. You tie yourself up knots second guessing everything that is going on around you and hoping you're doing a good job.
I'm painting a dark picture and I don't mean to. I'm trying to explain the emotions and exhaustion involved in an adoption. This is also an incredibly happy time. It is the best feeling in the world when your child comes home but there is so much more tied up into it than that. Don't forget the fact that you will have weekly Social Worker visits, which will generally bring with them some mad and panicky cleaning to prove you are coping and on top of everything.
Add to all this the anxiety around your child becoming legally adopted which can take many, many months post placement and I ask is is any wonder 65% of adopters experience a period of depression? I wonder if the figure is actually higher? The pressure and stress and expectation is very high throughout the whole process.
For me, all this has particular significance because I have suffered from several periods of depression in the past primarily linked to recurrent miscarriage and I was very anxious that this would prevent me from being able to adopt. I recovered from each period of depression with the aid of counselling and anti-depressants but I was left with a susceptibility towards becoming depressed. Add to this the fact that I am Coeliac and over the past few years have experienced periods of anaemia from malabsorbtion of nutrients. Anaemia makes me feel very tired, not always ideal with two children around. I'm a fairly healthy and robust person generally though and get on with things to the best of my ability. Whilst I was very tired after we adopted Katie and felt quite overwhelmed at becoming a parent whilst negotiating the adoption process, I wouldn't say I was depressed after she arrived at all. It did take a while before I felt like I was back to myself again though.
Once we met Pip we were in the deep end again of introductions and managing not just ourselves but Katie as well. Katie had a long period of difficult behaviour during this time, which was not unexpected but was challenging and I felt torn between all the different needs and roles in my life. In addition I felt under enormous pressure to resolve the issue of Pip's weight. This really weighed (pardon the pun) heavily on me and was the topic of endless conversation with Social Workers and health professionals. People constantly commented to me about his weight and I suspect I felt all this more deeply due to anxieties about my own weight which is currently increasing at a rate of knots.
TCM has a very demanding job so I am the primary carer for our family. Life is very busy. I don't have much time to reflect but was aware that I started to feel emotionally disengaged from quite a lot of my life outside of the home but assumed that I was just tired or anaemic again. And that was how it felt, like everything was going on around me. I wasn't really sure where I was in the whole picture but I did know that I was supposed to be the conductor of this orchestra. I was supposed to know the score and somehow manage to bring it all together. A tall order and I suspect I was being overly tough on the expectations of myself. I noticed that I started to become very unemotional about things happening outside of the home and I felt less empathy towards others outside our family unit. I started to feel unmotivated about going to tap dancing and Reiki. I started to feel unenthusiastic about seeing other people. Actually there were very few other people to see because Pip napped during the day so we didn't see many people for several months. My world became very small, just me and Pip during the day and Katie after school. I spoke to a close friend most days and have always been honest with her about my feelings but I was distracted and struggling to feel interested in anything else going on around me. My blog has kept me engaged though and I love writing about my family and the life we have, warts and all. I didn't recognise that my feelings of being unmotivated and stressed and anxious and flat were depression though. Things got a bit better after the summer holidays and we picked up and carried on.
The Visitor. which was partly triggered by the time of year and partly by significant additional stress from a member of my family, which is still ongoing. That depression lifted to a significant effect after Christmas but I've recently realised that those feelings of unmotivation and unenthusiasm and feeling flat have continued and that I've probably had them now in one form or another for the best part of a year. I've noticed I'm eating and sleeping badly and questioning where my life is going a lot. I'm lethargic and exhausted. I feel like I don't fit in anywhere and have been feeling sensitive and invisible. Things have certainly not been helped by a lot of stress surrounding Pip's adoption and lots of delays getting to court and now a postponement of his adoption whilst the location of a birth parent is established. We have started contact with the Katie and Pip's middle brother, Kip, and, whilst this is very positive, it has not been without its stresses and concerns and it saps my energy significantly.
This second time adoption process has now been going on since September 2012. That's nearly 2.5 years and an immense amount of stress in our lives. The end result is wonderful. I adore both my children and love being with them but it's not actually the end result yet. We still haven't legally adopted Pip and we have no idea currently when the next court date will be. There is still that anxiety that Pip could be taken back into care however unlikely it might seem. At a review meeting this week our Independent Reviewing Officer (IRO) commented that I seemed resigned to it all. I asked him what else I could be at this stage? I am resigned to the fact that I have no control over any of this process other than looking after my family. Contacting the courts will not speed up the DWP's tracking process nor will it make the courts write a letter to the missing birth parent any quicker or bring about a response to that letter. I feel powerless and that doesn't help me feel motivated. I would ask why the issue of consent (or not) from birth parents is not tackled by the courts at the point when the adoption placement order is granted? Surely all the paperwork relating to birth parents should be tied up by the courts before a child is even placed with an adoptive family? It shouldn't be resurrected at the point of adoption when a contestment at that point causes strain on so many more people? Surely the courts should make a decision as to whether the birth parents can challenge an adoption before the child is placed within another family? The emotional impact on the adoptive family of all these uncertainties is ridiculously stressful.
I have realised that I'm probably suffering from mild to moderate depression and that
it probably is Pre/Post Adoption Depression but exacerbated by the amount of other things impacting on our lives. I'm functioning though, I've not taken to my bed. Katie is getting to school on time. I play with my children and do all that they need. I gain a lot of pleasure from engaging with Pip during the day and Katie after school. We do homework and go out and do lots of things but I do have to force myself to put on my entertainer hat on many days. I shower and wash my hair and even put make-up on and make an effort with my appearance (as much as you can make jeans look good!). I have conversations with the other mums at school. I am lucky to have some lovely friends I see during the week and their support has kept me going. If you met me you'd probably have no idea at all that I was feeling depressed but I emotionally switch off as soon as I've finished a conversation with someone or get in the car to go home from somewhere. I have nothing in me left for outside the home. I have little interest in anything going on around me that isn't my immediate family or friends. I'm fed up with feeling like I have a foot stuck in mud waiting for our family unit to be legalised. It's hard to make family plans when you can't just take off without approval from Social Services and we can't really get a passport (well not one in our name) for Pip to travel abroad and when you have to carry a medical consent card everywhere with you in case your son needs medical treatment.
I will just note though that I think the adoption process has really triggered how I am feeling. The intensity; the expectations on adopters; the stress caused by delays; the emotional exhaustion both pre and post placement; the feeling of scrutiny which is important for the assessment but can feel quite intense when under the microscope; the anxiety of how already adopted children will cope with the process; did I mention the endless delays? Oh yes I did. It feels like we have been in the adoption process for forever. It really shouldn't feel like this or take this amount of time surely?
I've decided to speak out and write about this although I do feel anxious at giving myself the label of being depressed particularly as our adoption isn't legalised but I feel it's important to speak out and let people know so that others can do the same and seek help. I am very confident I will get better. I'm cross with myself for not recognising how I was feeling earlier and why but life is just too busy to focus much on myself these days. In fact now I know I need help I feel more positive than I have done for months.
I'd love to hear other people's stories. Have you been effected by Post Adoption Depression? Did you feel able to let people know how you were feeling or did you feel too anxious about jeopardising your placement?