What Is Post-Adoption Depression?

Adoption advocate June Bond first coined the term “post-adoption depression” in a 1995 article in Roots and Wings (a now out-of-print adoption magazine). In 1999, Harriet McCarthy—who had experienced post-adoption depression firsthand—began doing some exploratory research. She conducted an online survey of 145 parents who had adopted internationally. More than 65% of survey respondents (some say the number is 77%) reported experiencing post-adoption depression. It’s explained well, and succinctly, in this New York Times Health article.

Since 1995, and especially since 1999, research on post-adoption depression—and whether it is a legit, “real” type of depression—has continued to increase. Now, it is frequently referred to as post-adoption depression syndrome or PADS.[1] There are scientific, scholarly, and evidence-based publications out there on what is now considered to be a very real diagnosis.

But a more parent-friendly, “layperson” resource is The Post-Adoption Blues: Overcoming the Unforeseen Challenges of Adoption (Rodale Books, 2004). It was written by two well-known authors and advocates of PADS, Karen J. Foli and John R. Thompson. These authors possess not just the writing and research creds that a good author needs, but, they themselves are adoptive parents (a married couple). Nancy J. Evans Hall talks of this book in her article, Post-Adoption Depression: Finding Help and Finding Hope: “At the heart of The Post-Adoption Blues are the expectations parents hold of the post-adoption experience and how the differences between those expectations and reality create stress and depression. This book also gives these emotions a name—post-adoption stress and depression—and compares them to postpartum blues and depression.”

Symptoms

So, what are the symptoms? They’re many and varied. They can include generalized feelings of sadness, loss of self due to the new parenthood role, worthlessness, guilt, and shame; sleeping problems (either too much or too little); changes in appetite; increased anxiety and/or insecurity; irritability and outbursts of anger; and thoughts of harming oneself and/or one’s baby (suicidal ideations). They can also include not being able to make simple decisions; not feeling motivated or interested in doing regular activities of daily life or engaging in hobbies/interests that typically are pleasurable; experiencing constant tension headaches; feeling generalized aches and pains with no definitive physical cause; lacking concentration; being overly forgetful, and experiencing overwhelm by the new parenting and family responsibilities.

Causes

PADS has its own set of stressors—different from those of the much more well-researched and well-documented diagnosis of post-partum depression (PPD). With PPD, the causes are physical—fluctuations in hormone levels from being pregnant and undergoing labor/delivery, changes in body shape/function, and other physical issues. But with PADS, the causes are emotional, explains Hall, who also wrote What I Wish I’d Known About Post-Adoption Depression.

Causes of PADS are unique to the adoption experience—an incredibly emotional journey for any family, for many, many reasons. PADS onset can be traced back to infertility (and, perhaps, lack of success with it despite years of time, energy, and costs); feelings of low self-worth; social rejection due to delayed membership in what I call the “parenthood club”; and (this one was most powerful for me, personally) the inflated expectation of a perfect family and immediate bond following adoption. Add to these stresses, perhaps, an underlying mistrust that the new child may not accept the parents as his or her own forever family, and a genuine fear that bonding may not be ideally achieved. Add on top of that the long, tiring journey (usually, a physical one in addition to emotional) that the adoption process always is, and the stressors of adoption costs.

In Post-Adoption Depression: Finding Help and Finding Hope, Hall encourages those who think they might be suffering from PAD: “Do not be afraid to ask for help from your adoption worker, or friends or family. The only way you can deal with this is by getting help. Counseling and medication will help to alleviate some of the symptoms.”

Research on PADS Continues

Since that seminal article by June Bond in 1995, more research has been done on PADS. It’s gotten a little better known as something that adoptive parents may deal with, but, in my opinion, it needs to be even better known. Its mystery needs to be picked apart, its message spread widely—the message that “this is a real thing” and “you are not alone.” Seek help.

Many of us adoptive parents either don’t know that PADS exists or don’t want to admit we have it. We have too much to lose. Have risked too much already. Exposed ourselves enough already—in those dossiers, psychological tests, background checks, and home studies. We’ve had so many losses already. So, no—we aren’t willing to admit that maybe we’re not as happy as we “should be”—even now that our family is complete, even now that our child is home.

We’re Doing the Best We Can

As adoptive parents, we have to remember that our kids aren’t going to be whisked away from us just because we’re having a hard time adjusting. Our caseworker isn’t going to proclaim us as “less than” or “not good enough” if we call her up and ask her, honestly, how to deal with a grieving child or how to get our baby to sleep through the night or why it seems to be taking forever for the bonding to happen. Our agency isn’t going to take away our already-adopted child just because we’re experiencing depression post-placement. We are simply human beings, doing the best we can—always, always doing the best we can.

And the first step is being brave enough and willing enough and vulnerable enough to admit that we need some help—and asking for it.

For more information on PADS, read Melissa Giarrosso’s 2015 article on overcoming post-adoption depression and bonding issues.

For Further Reading

There’s so much out there—do a quick search on the web, and you’ll see. But, here are some good resources to get you started.

Post-adoption Depression: Parental Classes of Depressive Symptoms Across Time

Depression and Anxiety Among Postpartum and Adoptive Mothers

Postadoption Depression

The ‘Blues’ Can Surprise Even Adoptive Parents

Post-Adoption Depression: Stressed, Depressed, and Parenting? How do We Cope with Ourselves and our Parent as Well? [Editor’s Note: This is a PDF.]