You have talked about adoption stress. Is this the same as post-adoption depression? Who is likely to experience it and how can it be prevented?

The term “post-adoption depression” has been used to explain the feelings of sadness that are experienced by many adoptive parents after adopting. Unlike postpartum depression, which may be caused by significant physiological and hormonal changes (e.g., a sudden decrease in estrogen and progesterone in the bloodstream), post-adoption depression is the feeling of sadness that is often experienced after the attainment of a long-term goal which has required time, money, effort, emotional strain, and patience.

Post-adoption depression is a symptom that falls under a much larger umbrella– what I have called “adoption stress.” The latter refers to the feelings, thoughts, actions, and the physical and spiritual reactions of all parties who are involved in the adoption process (e.g., a mother who places her child for adoption, an adoptive child, an adoptive parent, a compassionate case worker, etc.).

We can better understand and appreciate the depressive symptomatology experienced by many adoptive parents if we first consider 1) pre-adoption stressors, 2) stress associated with the acquisition of an adoptive child, and 3) post-adoption stress. By focusing solely on post-adoption depression, we miss the causative or related stressors that contribute to the adoptive parent’s feelings of sadness.

For example, the attainment of the long-term goal of having an adoptive child often opens the door to seemingly insensitive questions from others about infertility and prior losses. These questions will likely stimulate unresolved feelings, and may cause adoptive parents to revisit pre-adoption stress. The acquisition of an adoptive child is often colored by serious medical concerns, “misunderstandings,” and heartbreaking disappointments. And, the post-adoption experience is often marked by tremendous life changes, new responsibilities, and a future marked by uncertainty and fear.

During a recent therapeutic session with a group of adoptive parents, we explored a number of participants’ feelings of sadness. Suddenly, one mother exclaimed, “I didn’t sign-up for this!” Her comment was met by applause from several of the participants. Her statement underscores the complex continuum of “before, during, and after” stressors that are faced by adoptive parents.

How can we prevent post-adoption depression? First, we must educate all people involved in the adoptive process about adoption stress. If more people understood that the feelings, thoughts, actions, and the physical and spiritual reactions were a normal response to a very stressful, multifaceted experience, fewer people would struggle with conflicted feelings. We must also focus our attention on parents who have been prone to feelings of depression and do not fare well when faced with considerable stress. We must encourage them to become involved in support groups or counseling. If we do this prior to parents entering into the adoptive process, we can ultimately decrease the post-adoption stress that is experienced by many adoptive parents.