Adoption is a path some parents choose after enduring perinatal loss. Once they make the decision to pursue adoption, the journey may include more months or years of waiting. But once the baby or child come home, it is a gift and, perhaps, a relief.
This makes sense. New parents are often filled with hope prior to adoption—and why not? Their family will soon be growing and the love in their hearts can be shared and multiplied.
What many parents who adopt may not realize is that, like with childbirth, the experience of sadness, depression, and the “blues” can hit, often harder than expected.
As a parent—who happens to be one who has adopted—I think awareness of these natural emotions helps normalize the experience. And by normalize I mean, knowing that these feelings are natural.
What is postadoption depression?
The signs of postadoption depression are clinical signs of depression. If you’ve suffered from pregnancy loss the grief you’re already confronting can be compounded.
Karen Foli, Ph.D., and John Thompson, M.D., are co-authors of the book The Post-Adoption Blues. Dr. Foli, a registered nurse, and her husband, John R. Thompson, a psychiatrist, have two children by birth and are themselves adoptive parents.
Dr. Foli, who is on the faculty at Purdue University, interviewed 21 adoptive parents about their adoption and depression experiences following the adoption, as well as 11 experts, professionals in the field of adoption. The adopted children’s range of age at placement was newborn to 12 years—the research was conducted when the children were between 12 months to 24 years respectively.
Foli’s findings were published in the March issue of the Western Journal of Nursing Research. She and colleagues published subsequent findings in the Journal of Affective Disorders in an article aptly titled “Post-adoption depression: Parental classes of depressive symptoms across time.”
“Many adoptive parents spend their time during the adoption process demonstrating they are not only going to be fit parents, but super parents, and then they struggle with trying to be the world’s best parent when the child is placed in the home,” Dr. Foli says.
While this can compound the grief and stress of pregnancy loss and fertility issues, it’s difficult for another reason—parents who adopt may feel such gratitude for the chance to grow their family, there can be a tendency to discount the suffering. “Adoptive parents also may experience feelings about their legitimacy as a parent, or even surprise if they don’t readily bond with the infant or child,” Dr. Foli says.
Dr. Foli took some time out to answer some questions for me. If you’ve suffered pregnancy loss and are considering adoption, her answers about depression following an adoption should not scare you, but rather inform you.
Meredith: What are some signs of post-adoption depression that may not seem obvious to new parents? What are the most obvious signs?
DR. FOLI: The signs of postadoption depression are clinical signs of depression. According to the Diagnostic and Statistical Manual (relates to the Fourth Edition), the book that professionals use to diagnose individuals, the signs and symptoms of depression include*:
- A depressed mood; feeling sad or empty
- Loss of interest or pleasure
- Significant (unintended) weight loss or weight gain
- Difficulty sleeping or wanting to sleep all the time
- Feeling like you can’t sit still/restless, or feel like you’re slowed down/can’t physically get going
- Fatigue or loss of energy
- Feelings of worthlessness or excessive guilt
- Diminished ability to think or concentrate or indecisiveness
- Recurrent thoughts of death or thinking about suicide/acting on these thoughts
*Five of the nine symptoms above should be present for the past two weeks and at least one of these five symptoms should include depressed mood or loss of interest or pleasure.
That being said, there might be other problems such as difficulty bonding with the child and the “typical” transition to parenting might be prolonged and exaggerated. There might be feelings of anxiety and even a “panic” that could be related to depression or other mental health issues.
Meredith: Can dads [and parents of any gender] experience this post-partum/adoptive depression as well?
DR. FOLI: Yes. The literature supports that there are “sad” birth fathers. The research I have conducted which surrounds adoptive fathers also indicates that fathers may struggle with depression as well. The signs and symptoms of depression, however, might vary from the mothers. For example, fathers may be more disengaged, angry, frustrated, and cope by spending more time at work, etc. We still have much to understand about this area.
Meredith: What does treatment for PAD look like? What does it entail-and what can parents expect? Does it have to include medication?
DR. FOLI: The interventions to help alleviate depression with adoptive parents are very individualized. For example, one mother who took great pleasure in her career was advised to stay home with her baby daughter and take an extended leave from work. This mom was also exhausted emotionally after the adoption process. But what was highly valued in her life had been disrupted. She eventually found a good therapist that she could talk with and secured the services of an excellent daycare for her daughter and returned to work. She rebounded from her depression, bonded with her child, and was able to heal. It took a lot of work on her part, and finding a therapist who was “adoption smart” wasn’t easy. But she did it.
Meredith: Do babies pick up on the mom’s depression? How would a parent recognize this-and what should a parent do?
DR. FOLI: I think the question is really: What are the outcomes for a child who has one or both parents who are depressed? We know from the postpartum literature that there are significant negative outcomes experienced by children who have a depressed parent(s). There has been one study with adoptive parents as well and we find similar effects. Indeed, one could argue that children who are adopted are more vulnerable and are experiencing a tremendous adjustment period. Parental depression’s effect on the child is an important reason to find effective treatments for the parents and why I can’t emphasize to parents enough that by helping themselves, they’re helping their children and families.
[If you believe you are suffering from postadoption depression, postpartum depression, or anxiety and depression related to fertility issues or treatment, loss or grief, or know someone who might be, please contact your physician or adoption agency (or both) for a referral to a qualified and licensed therapist who specializes in treating depression for the parents and the family.]
This post was written by Meredith Resnick, co-author of All the Love: Healing Your Heart and Finding Meaning After Pregnancy Loss.
