It’s time to talk about post-weaning depression

Soon after I stopped breastfeeding my last baby (okay, toddler—she was nearly three), my in-laws offered to take the kids overnight so my husband and I could enjoy some much-needed couple time. It happened to be the day of March for Our Lives, and I’d spent it trudging down the boulevard holding a sign, listening to stories from grieving parents who had lost children to gun violence. My kids were perfectly safe at my in-laws’ house, but I wasn’t used to being apart from them and my anxiety—always simmering just below the surface—boiled over.

Dinner and a movie with my husband were good distractions from my worries, but when we came home to a silent, dark house empty of children, it just felt wrong. I walked into my girls’ room as if to check on them, but instead of seeing their sweet sleeping faces and hearing their gentle snores, there were empty beds. My heart pounded as a terrible feeling of doom came over me. I started to sob and couldn’t catch my breath, ending up curled in a ball on the lower bunk, clutching my daughter’s teddy bear.

What was wrong with me? Sure, I missed my kids, but this wasn’t just melancholy. It was a full-on panic attack and not at all normal for me.

I suspected my state had something to do with the hormonal changes from recently weaning. Unfortunately, as much discussion about the challenges of breastfeeding and postpartum depression have entered the mainstream, there is still very little information available about post-weaning depression or anxiety. So little that it’s not even an official diagnosis.

However, the practitioners I spoke with knew exactly what I was talking about.

So what is post-weaning depression?

“It’s totally a real phenomenon,” says Dr. Ellen Vora, MD, a holistic psychiatrist in New York who estimates that 60% of her breastfeeding patients experience ‘blues’ after weaning. “They feel sad, more anxious, more irritable.”

That certainly sounded like me. Other symptoms can include tearfulness, hopelessness, irritability, and difficulty sleeping.

“I have definitely seen plenty of women get blues with weaning,” says Dr. Jessica Schneider, MD, an OB-GYN in Los Angeles. “I have always assumed that most of it is hormonal,” she explains, outlining several significant hormonal shifts that occur when breastfeeding stops. “As we wean, our prolactin levels go down, which may cause some depressive symptoms. Our estrogen levels go up, which is why we get our periods back, and the hormonal swings can cause mood symptoms.”

There is also the loss of mood-boosting oxytocin, sometimes called the cuddle hormone, which keeps anxiety at bay. In a study published in Life Sciences, oxytocin was shown to relieve depression in mice and was even more effective than antidepressant medication. So, for some, it could be possible that stopping breastfeeding may feel like going off an antidepressant.

It appears that the onset of symptoms is typically two to three days after weaning, though there can be a delay. Since post-weaning depression isn’t talked about much, women may be caught off guard by unexpected mood changes. After weaning, “the assumption is, ‘I’ll be free, I won’t have to rush home anymore, it will be a relief,'” says Dr. Aarti Mehta, MD, a reproductive psychiatrist in Chicago. “So, when there is depression or anxiety, it’s a surprise.”

Are you at risk for post-weaning depression?

Post-weaning depression may be more likely when a mom is conflicted about ending the breastfeeding relationship. “Some women feel guilty that they aren’t breastfeeding for longer. Or sad that the baby weaned before they had planned,” Schneider says. “A few patients have told me that they really enjoyed nursing and because it was the last baby they were having, they were sad because they knew they weren’t going to nurse again.” (I fell into that last category, for sure.)

Women who experience mood swings during their period and/or experienced postpartum depression are more likely to be affected by weaning, Vora says.

Post-weaning depression prevention + treatment

Weaning abruptly can make hormonal changes more dramatic, so Mehta recommends tapering off slowly, such as dropping one feeding per week.

“Allow yourself to grieve properly,” advises Vora. “Give yourself an afternoon to process it rather than moving on with your life.”

In addition to talk therapy, Vora stresses the importance of self-care, including eating nutrient-rich foods, getting more sleep, and getting help with household chores through outsourcing. “Reallocate some funds toward getting groceries delivered, help with laundry, and help with drop-off and pick-up to take some of the burdens off of Mom.”

The good news is that post-weaning depression generally only lasts a few weeks. If it continues, then there is probably more going on than just hormonal changes. “It’s a call to action, to look under the hood” and get some help, Vora says.

If depressive symptoms persist longer than a week or two, Dr. Mehta sometimes prescribes a short-term course (around six to nine months) of antidepressants. Though she adds that only 1 to 3% of patients experience depression lasting long enough to warrant medication.

I was in that 1 to 3%. Having never been on antidepressants before, I was scared to try them, despite strong encouragement from my doctor. Would my personality change? My creativity? But as it turned out, all that changed was my fear and sadness. I only wish these solutions were apparent to me from the outset, or that I’d been educated about post-weaning depression before I’d suffered through it.

With a little help from SSRI’s during a rocky time, I was finally able to be the mother I wanted to be. I was ready to move past breastfeeding and embrace my kids’ newfound independence — though I continue to hug them way more than necessary.

This story originally appeared on Apparently.