Post-Adoption Depression Is A Problem We Don't Talk About Enough

No one who adopts is ambivalent about having a child. Adoption is a long and typically arduous process, spanning anywhere between nine months and nine years . It requires home visits, medical checks, parental training courses, letters of reference, sometimes hefty fees. To put it mildly, it takes a lot of commitment.

So when a child is finally placed, some adoptive parents can be blindsided,  if, instead of simply overjoyed, they feel overwhelmed, sad or anxious.

For Kathryn Connors, a social worker living in Toronto, becoming a parent wasn’t easy. She and her husband had been trying to have a baby for five years, and had several miscarriages. So in 2012, when they finally got the news that they’d been chosen as the adoptive parents for a sibling pair — a three-and-a-half-year-old girl and a one-and-a-half-year-old boy — they “were so unbelievable excited,” as Connors told HuffPost Canada.

But once the kids arrived, something shifted. Connors fell into a deep depression and was paralyzed by anxiety about not being a good enough parent. She was so scared she would screw up, she said, that she retreated altogether. She barely interacted with the children, and in those first few months, she hardly ever even got out of bed.

“I was worried that I just wasn’t meant to be a parent,” she said. 

When a close friend, also an adoptive mom, urged her to get help, Connors initially felt deeply resentful. But part of her knew her friend was right. She saw her doctor, who diagnosed her with something she had never even heard of before: post-adoption depression syndrome (PADS).

“I knew postpartum depression existed,” she said. “But I didn’t actually know there could be chemical changes in adoptive parents. I just thought I was going crazy.”

What is post-adoption depression syndrome?

The term has been around since 1995, although it’s still relatively unknown outside of adoption circles. PADS, which can affect parents of any gender after an adoption, goes way beyond the normal nervousness many new parents feel. It’s natural to be daunted by the gravity of caring for a child with whom you’ve been entrusted, but what Connors and many other adoptive parents report experiencing goes beyond that. 

Like postpartum depression in parents who give birth, post-adoption depression has symptoms that include sadness, anxiety, panic, intense fatigue, and debilitating feelings of inadequacy.

“Post-adoption depression involves a lot of emotions rising... It brings a lot of isolation,” Julie Despaties, founder and executive director of Adopt4Life , told HuffPost Canada.

PADS is believed to affect somewhere between ten and 32 per cent of adoptive parents. And research shows it affects adoptive parents of all genders .

Post-adoption attachment can be difficult for everyone 

Most of the 30,000 children  in the child welfare system in Canada are between the ages of eight and 18. That means that by the time those who are adopted arrive at their permanent homes, many have experienced a lot of instability, including multiple moves through foster or group homes or between the homes of extended family members. They’ve also experienced the trauma of loss, and, in most cases, neglect or abuse. For those reasons, it’s often difficult for children, especially older children, to bond with their new parents right away.

That can manifest in challenging and confusing behaviours that make the realities of parenting very different from the fantasies of family life that adoptive parents most likely nurtured, during the long adoption process. About one in four adopted children in the U.S. has a diagnosed disability by the beginning of kindergarten, which is double the rate of children raised by both biological parents. Because so many adopted kids experienced trauma at such a young age, adoptive parents often need to use specialized parenting strategies  to get kids to trust them and to help them develop. 

The reality of getting to know and learning how to parent an older child with complex needs isn’t always as simple as the “instant love” rhetoric we tend to associate with parenthood, adoptive mom Siobhan Rowe wrote for Focus on Adoption magazine. Some adoptive parents might feel instant love for their new kids, but if that doesn’t happen automatically, that doesn’t mean there’s something wrong with you or with your kids. “Hearing other people’s stories can be a big part of realizing that,” Despaties said.

Many parents feel shame or guilt when feelings of love don’t occur immediately, even though it’s very normal, especially for older children, and not an indicator that the relation will not one day be strong.

Find people who get it

Getting to know other adoptive parents and listening to their stories can be a really effective measure in combatting PADS, Despaties said. “Before children transition into new homes with their new families, it really is important for the new parents and caregivers to grow their network of support.” 

Adopt4Life is an Ontario organization, but there are similar groups across the country that can connect adoptive parents with people and resources to help. B.C. Adoption , New Brunswick Adoption , and Adoption Options in Alberta are some good provincial groups. You can also get in touch with the Adoption Council of Canada or talk to your adoption workers for more local resources.

What treatment might look like

There’s no one-size-fits-all way to deal with PADS. Connors, with her husband and therapist, worked out a system where she started with the little bit she felt capable of handling, and worked up from here. Initially, she just cuddled with the kids while they slept, allowing them to bond with her without her having to do anything too stressful. The next step was to help get them ready for bed, and so on, until she felt confident enough in her abilities to be a hands-on parent. The whole process took about six months.

Another important part was just recognizing that it was okay for her to be struggling. “I realized I wasn’t some saviour who was saving children from foster care who had special needs,” she said. “I was a mom who was learning new skills and struggling with my mental wellness. It’s okay to be both to be a good mom and to struggle with my mental wellness.”

The first step of treatment is to consult your family doctor. Most medical practices are doing phone or video assessments now, which makes connecting easier given the ongoing COVID-19 pandemic . They may consider prescribing antidepressants, and/or suggest therapy. For some adoptive parents, unresolved feeling around infertility or pregnancy loss may need to be explored.

If you’re in a situation where you fear harming yourself or your children, go to the emergency room.

It’s also a good idea to let your adoption worker know. Connors said she was terrified that if she admitted what she was going through, the children she had fought so hard for would be taken away. But now that she actually works in the adoption field, she knows that isn’t what would happen. Adoption workers are there to help — they’re the ones who will connect you with resources.

Once Connors did finally reach out, she said, all that happened was that she got help, free of judgment of any kind.

PADS in a pandemic

Any new adoptive parent trying to figure it all out during the pandemic may find themselves at higher risk of becoming depressed or anxious. As with postpartum depression, isolation and a lack of outside support or relief from parenting responsibilities can exacerbate post-adoption depression.

“The fact that children are not in daycare or not in school can be very, very challenging right now,” Despaties said. “It’s hard when your little munchkins wake up at 5, and they occupy the entire space. It’s really, really hard for people to be able to carve time that to nurture themselves.”

She says putting in time for self-care is crucial. Whether that’s before kids wake up or after they go to bed, making sure you’re well-rested, well-fed, getting enough exercise and connecting with people who can support you are all really important parts of being a loving and supportive parent .

Meet-ups and support groups can be a lifeline for new adoptive parents  experiencing PADS, and while they’re not happening in church basements or coffees hops right now, they’re still happening virtually, so again, connecting with a local organization to get connected with a community is key.

Moving forward and healing

Connors is so open about her experience in part because she knows how immensely helpful it can be to struggling new parents. “Just hearing someone on the other side of the phone saying, ‘Yeah, this is exactly what happened to me,’ — just that validation, I think, is a small step towards healing,” she said. “Just giving people the language to understand how to ask for that help is huge, because there’s so much fear and guilt.”

She and her husband are now the happy parents of three. When her third child arrived a few years after her first two kids, she felt equipped to identify any early warning signs of PADS, but it just didn’t happen.

“I knew what to look for,” she said. “So we had stuff in place, and that really made a world of a difference.”