Post Adoption Depression:

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A Parenting Transition

When I first heard the term, post adoption depression (PAD), it seemed like a paradox. After all, once the paperwork, home study, waiting and expenses, (not to mention the stress) were over, wouldn't the moment of finally holding one's baby be a time of rejoicing? For many it is, but, for some it's not, and instead they experience post adoption depression. This reaction may catch people off guard, especially when it can't be explained by hormones, as is the case with post partum depression.

June Bond coined the term, post adoption depression, in a 1995 article for Roots and Wings Magazine. It refers to a combination of symptoms that may include: depressed mood, irritability, diminished interest in most activities, significant weight loss or gain, insomnia, or sleeping too much, feeling worthless or excessively guilty, difficulty concentrating, and suicidal thoughts. The severity of PAD may vary and should be taken seriously if you have five or more of these symptoms during a two-week period. Whether an incapacitating depression that requires treatment, or simply "the blues," PAD is a very real phenomenon.

The subject of PAD hit home when my husband and I returned from China with our daughter in 1999. During those first few days of life with ten-month old Emma, I noticed that my husband wasn't happy. He seemed distant with Emma and he wasn't bonding at the same rate as I. I grew concerned because this was an enormous, irrevocable change in our lives. At the same time, Steve was exhausted, suffering from a virus he contracted in China. As social workers tend to do, we processed our feelings. We realized that because he is a "slow-to-warm-up" kind of guy with change, it was taking time for him to connect with our new daughter. However within a month of our return, with the illness gone, there was a marked improvement in his relationship with Emma. They were bonding and I could see that he was happy.

After reading about PAD and reflecting on my own experience, I have a greater appreciation for those who suffer from it. As with any major life milestone, there is a natural "let-down" response. One simply cannot sustain the emotional rush indefinitely. Also, there may be hidden losses. Whether giving birth or adopting, the losses can include giving up or putting on hold a career, juggling family needs, and adjusting priorities in the marriage. For some people, the placement of a child can trigger unresolved feelings of infertility. For others, the day-to-day reality may be quite different than one expected, especially if one has adopted an older child or a child with special needs. Adopting a baby from an orphanage brings many challenges. There may be medical and developmental issues that take time to resolve.

Given the myriad of reasons for PAD, it is not surprising that it occurs far more often than adoption professionals realize. Clients, now new parents, are often hesitant to talk about it, fearing it will jeopardize the placement. However, a well-trained professional can help new parents prevent or mitigate post adoption depression. (See sidebar story.)

The main point is, don't develop preconceived notions about the initial adjustment period with your new child. Remember this is a transitional time for all members of the family, not just the child. Bonding takes time and you may be overwhelmed by fatigue, sickness, stress, and the new challenges of parenthood. Monitor your symptoms of depression and seek counseling and/or medical treatment if they persist and seriously impact day-to-day functioning. Talking to your social worker about any concerns prior to your child's placement, as well as during post-placement, can help to normalize your fears.

Finally, know that you are not alone and like all good things, transition takes time.

(Sidebar Story)
In Support of Post Adoption Depression Transition

Don't become isolated in your community. Enlist friends, family and neighbors to help with errands or domestic chores so that you can focus on bonding with your child.

Try to get out with your child every day. Especially in the winter, cabin fever can exacerbate feelings of depression.

If you have a predisposition to depression, you are at greater risk. Contact your mental health provider, counselor, and other support network to be on "standby."

If the loss of career (whether temporary or permanent) triggers an identity crisis, find new areas of competence and seek out opportunities for adult contact.

Don't expect perfection from yourself. Just do your best and don't feel guilty.

Establish time with your spouse/partner to nurture your relationship.

Recommended Readings

Post Adoption Depressions Syndrome by Judy Bond; Roots and Wings, Spring 1995, www.adopting.org/pads.html

Baby Shock by Jean MacLeod; Adoptive Families, Sept/October 2001

Post Adoption Depression: The Unacknowledged Hazard, http://www.eeadopt.org/home/services/research/pad_survey/index. html

The author, employed by Wide Horizons for Children, has 13 years of experience in the field of social work, five of which are in the field of adoption. She also has an adopted daughter and two adopted brothers. For more information about Wide Horizons For Children, please call 1-800-729-5300 or visit their web site, www.whfc.org
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