What If It's Not Postpartum Depression? Understanding Matrescence

“When a baby is born, so is a mother—each unsteady in their own way.”

These are the words from Alexandra Sacks, a reproductive psychiatrist who works with pregnant and postpartum women, author, speaker, motherhood podcast host and is a leading expert in Matrescence. In a 2018 TED talk, she discussed “Matrescence”, a term coined by anthropologist Dana Raphael in the 1970s, which refers to the physical, emotional, and psychological transition a woman undergoes as she becomes a mother.

In her speech, Sacks boldly described the context of transitioning into motherhood—not the romanticized version of tranquility, bliss, and fulfillment, but the unfiltered version of it—the identity crisis, the loneliness, feeling of being alone, or lack of enjoyment.

Sacks opened her talk describing a pattern where a woman calls her up, that woman has just had a baby, and she’s concerned about not being good at motherhood, even wondering if she is suffering from postpartum depression. But when Sacks goes through the symptoms, it turns out that the new mother is not clinically depressed. Still, the new mother is not reassured.

In her article in Psychology Today, other concerns she gets from clients are:  “I love my baby but I don’t have the right maternal instincts.” Or, “I’m not enjoying this, mostly I feel tired.” Even those who feel guilt in this phase will describe it as: “I feel so guilty because I wanted a baby more than anything, but sometimes I find myself feeling bored and even resentful.”

How many of us mothers have probably been in that situation, where we wonder, this is not how it’s supposed to feel like?

We all probably thought that motherhood would dot the i’s and cross the t’s—it will make you whole and complete; content and fulfilled—until it happens to you, where you feel lost, anxious, and insensible.

The transition phase: from woman to mother

I remember when I first gave birth, I was crying and feeling helpless, just because my baby wouldn't stop feeding. Yes, imagine that, I was crying because the baby was feeding non-stop. I was sleep-deprived, I was urinating in an adult diaper, and I was breastfeeding and having my meal at the same time—I couldn’t even enjoy my meal alone.

Experts say that a newborn baby needs to feed every 2 hours but mine was hungry every 30 minutes—I could be exaggerating, but that’s how it felt! Breastfeeding is supposed to be natural and calming, that’s what I thought, but there I was, curling my toes in pain—I swear, the baby had blade lips for sucking, my nipples felt like they were being cut!

Suddenly, there was no more, “five minutes pa,” because I would have to wake up and feed the baby, or else, intense crying would fill the entire apartment compound. And it was not as simple as show the boob and let the little monster consume your liquid gold—she liked to be tapped gently so she could go back to sleep. And you can’t even be vocal about these thoughts—I could almost taste the guilt and shame of being labeled as a “bad mother.”

We all probably thought that motherhood would dot the i’s and cross the t’s—it will make you whole and complete; content and fulfilled—until it happens to you, where you feel lost, anxious, and insensible.

"Matrescence is the normal, often challenging, adaptation to motherhood." -Alexandra Sacks, MD

Discomfort is not a disease

Unlike traditional narratives that portray motherhood as purely instinctive, Matrescence recognizes that becoming a mother is a gradual process of growth and adaptation, not an illness that needs to be addressed.

Much like adolescence, Matrescence is a period of significant transformation as women adapt to motherhood. Sacks mentions that it’s not a coincidence that Matrescence sounds like adolescence. Comparable to transitioning into young adulthood, Sacks explains, "...it involves a profound identity shift, hormone changes, and emotional adjustments, but it’s not a mental health disorder." But since Matrescence is not in the medical vocabulary, it’s being confused with a more serious condition like postpartum depression.

She adds, "While postpartum depression is a clinical condition requiring intervention, Matrescence is the normal, often challenging, adaptation to motherhood. Recognizing this distinction helps in understanding that the struggles of early motherhood are part of a complex but natural transformation process.”

Sacks makes a comment that there are much developmental books about adolescence and yet, we do not have a word to describe the process of transitioning into motherhood—until Raphael finally introduced the term Matrescence in her book Being Female: Reproduction, Power, and Change—and yet, the term is scarcely used today.

And so she asks, “We know that it's normal for teenagers to be all over the place, so why don’t we talk about pregnancy in the same way?”

Normalizing matrescence and talking about it

Acknowledging Matrescence helps normalize these experiences and emphasizes the importance of self-care, support, and emotional well-being during this critical life stage.

Sacks would like to describe the concept as a series of “push and pull.”

“Oxytocin helps the human mother’s brain zoom in, pulling her attention in, so that the baby is now the center of her world. But at the same time, the mind, her mind, is pushing away, because she remembers there are all these other parts to her identity, other relationships, her work, hobbies, a spiritual and intellectual life, not to mention physical needs: to sleep, to eat, to exercise, to have sex, to go to the bathroom—alone, if possible, this is the emotional tug of war of Matrescence. This is the tension the women calling me were feeling. It’s why they thought they were sick,” Sacks explains.

“When you preserve a separate part of your identity, you’re also leaving room for your child to develop their own.” —Alexandra Sacks, MD

Sacks believes that,“If women understood the natural progression of Matrescence, if they knew that most people find it hard to live in this push and pull, if they know that under these circumstances, ambivalent is normal and nothing to be ashamed of—they would feel less alone, the would feel less stigmatized, and I think it would even reduce rates of postpartum depression.”

And so Sacks encourages mothers to talk about Matrescence with friends, other mothers, and with the partner. She thinks that, “When you preserve a separate part of your identity, you’re also leaving room for your child to develop their own.”

How to deal with the transition

This transition can be overwhelming, as mothers often balance the joys of nurturing and nourishing their little ones but get in contact with feelings of anxiety, loss of independence, and societal pressure.

Remember to be kind to yourself during the transition phase. Psych Central summed up some tips to manage yourself as you go through Matrescence and these can be translated into:

Sleep when your baby sleeps

Try to rest or nap whenever your baby sleeps. Babies often have irregular sleep patterns, and resting alongside them can help you regain lost sleep.

Share caregiving duties with your partner

Talk with your partner about how to split caregiving tasks. This can help reduce stress and ensure both of you have time for self-care.

Exercise

A little exercise can boost your mood and energy. But a word of caution: consult a healthcare provider before starting any new routine.

Take personal time

Self-care isn’t selfish. Spend some alone time to relax like watching your favorite series or getting a postpartum massage.

Set visitor boundaries

Plan a visitor schedule to manage guests and avoid overwhelming days. It’s okay to say no when you need a break.

Meal prep ahead of time

Plan and prep meals in advance to ease stress on busy days, helping to keep your energy and mood stable.

Embracing this concept and knowing that this experience is not unique to you should allow society to be less judgmental of what we go through as new moms—that this is just a phase, like what adolescence is, and what we truly need are better support systems for new mothers as they navigate this transformative journey.

Do you still think what you feel is postpartum depression? Here are the warnings signs you should not ignore.