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Postpartum depression and substance abuse: There is light at the end of a tunnel

posted Nov 11, 2013, 8:25 PM by Megan Black   [ updated Nov 11, 2013, 8:32 PM ]

            Women have approximately 280 days to prepare for a newborn following conception. It is common knowledge that once the new baby arrives that it will change her life infinitely. Most women prepare for their baby’s arrival by reading books, organizing a nursery, clothes shopping and picking a name. However, some changes such as a mental health disorders are hard to prepare for.

            For certain women, following the birth of their baby, they develop postpartum depression or a perinatal mood disorder. Depression is among the most disabling disorders for women in their childbearing years. For women aged 15 to 44 years around the world, it is second only to HIV/AIDS in terms of total disability encountered in a lifetime. Consequently, the combination of adjusting to motherhood while suffering from postpartum depression causes some mothers turn to substances to help cope. A national survey conducted in the United States from 2002-2003 showed that 14.9% of postpartum women who were aged 15-44 years reported binge alcohol use and 8.5% reported use of illicit or non-medical drugs. Alcohol and drugs can “cause a spike in pleasure chemicals in the brain, allowing a low mood to lift and feelings of negativity and stress to disappear,” for this reason one can understand why mothers might turn to substances during the postpartum period.

One woman anonymously shares her struggle with alcohol abuse following birth,

I am an alcoholic. And a drug addict. I have been in recovery for 15 years, since I was 20 years old. I currently have 17 months clean and sober. At 8 months pregnant, my husband's mom died suddenly, and it took much of his time and energy to process his shock and grief over this loss. After I had my son, my mom's cancer (which had been in remission for several years) returned full force and she was given 2 years to live. I was flattened by postpartum depression and anxiety, which despite my clinical background, totally pulled the rug out from under me.

My return to alcoholism and addiction began slowly and insidiously. My anxiety was so severe that I found myself unable to eat or sleep for several days in a row. My OB prescribes a low dose of Ativan to help me. It worked beautifully.

I began to question whether I was ever really an alcoholic. After all, doesn't every one party when they are in college? Granted, not everyone goes to Harlem in the middle of the night to score drugs off the street. Nor do normal college kids have take a medical leave from school because their drinking and drugging is so out of control. But I was convinced that as an adult and a mother, I could now handle drinking responsibly. I cleverly found a therapist to tell me that she didn't think I was an alcoholic, and she even encouraged me to try drinking again. I hadn't had a drink in so many years, I didn't even know what to order. "What do you like to drink?" I asked her. 

"White wine," she replied, with a small smile, "I love to have a glass of cold white wine at the end of the day." My husband and I went to Vegas and I ordered my first glass of white wine in over ten years.

I wish I could say my story ended here -- that I had somehow grown out of my alcoholism and could enjoy that ubiquitous glass of wine at the end of the day without consequence. Unfortunately, it didn't work out so well for me. I spent the next few years battling alcoholism and addiction. I stayed sober during my second pregnancy and controlled my drinking while nursing. At 7 months pregnant my mom's cancer took a major turn for the worse. She died exactly two weeks before my daughter was born. After I brought my baby girl home from the hospital, the grief, pain, sadness and anxiety I felt was indescribable.

I had all the rationalizations. I believed I was a better mom when I was under the influence of pills and alcohol. I was more relaxed, more able to deal with the stress of raising young children, more present, more in the moment, generally happier and able to function.  I prided myself on the fact that I was never abusive. I never screamed at my children or put my hands on them in anger. I took them to the park and made them organic, homemade baby food. I had the perfect image of peaceful "earth mama" down pat. I somehow believed that this persona mitigated my alcoholism and addiction, which was now spiraling out of control. 

I knew I needed to get sober again. When I wasn't under the influence, my anxiety was off the charts. I literally felt like I was jumping out of my skin. I kept breaking my own rules: no drinking until they were asleep was quickly replaced by holding out until 6pm, then 5pm, then 4pm. I needed more and more of those little pills to simply get me through the day. My husband was terrified, but didn't quite know what to do because he had never dealt with an addict before and I was such a brilliant liar and rationalizer (as all alcoholics and addicts must be to justify their using).

Things got really bad. Without going in to all the gratuitous details, my husband came home on a Friday afternoon and told me the jig was up. Unless I could immediately get sober, he was sending me to a detox treatment center for 28 days the following Monday  Of course, I couldn't stop drinking and using. I was in the middle of a run and my body was completely physically addicted. On Monday morning, he dropped me off kicking and screaming at a treatment facility. In that moment, Debbie and I were the same person: desperate, broken mothers who had come within millimeters of losing our children because of our addictions. I knew that I had to get sober or I would lose everything.

I never thought my alcoholism would progress enough to warrant me having to go into treatment. Being separated from my children during that time was the most painful experience of my life. I was dripping in shame. I felt like the worst mother in the world. It took me a long time to realize that my addiction didn't care about my children. It didn't care about my family, my accomplishments, my master's degrees, or my career. It only cared about getting me drunk and high, isolated and alone. That is the very essence of the malady.”

Substance abuse is not only dangerous to the new mother but also to her baby. “Women who abuse drugs can do irreparable damage to their babies both physically and emotionally, at a time when these children are incredibly vulnerable.” The good news is that there is help out there. In particular “an individualized program and flexibility are among the top recommendations of the professionals interviewed by Social Work Today for treating pregnant or postpartum women addicted to alcohol or other drugs.” Some other treatment options include psychotherapy, counseling, self-help support groups, treatment programs, exercise, healthy diet, nature, forgiveness and gratitude.


Dennis, C., & Vigod, S. (2013). The Relationship Between Postpartum Depression, Domestic Violence, Childhood Violence, and Substance Use: Epidemiologic Study of a Large Community Sample. Violence Against Women, 19(4), 503-517. doi:10.1177/1077801213487057

Carroll, & Wu, L. (2013). Postpartum Substance Use and Depressive Symptoms: A Review. Women & Health, 53(5), 479-503. doi:10.1080/03630242.2013.804025