Post Adoption Depression: Symptoms, Causes & How to Cope

Post-adoption depression (PAD), also called Post-Adoption Depression Syndrome (PADS), is a depressive condition that can affect adoptive parents after their child comes home. It shares much in common with postpartum depression, though it isn’t driven by hormonal changes. It stems from the emotional and lifestyle upheaval of adoption itself. PAD is most often discussed in adoptive mothers, though research shows fathers can experience it too.

If you’ve just brought your baby home and, instead of feeling overjoyed, you feel exhausted, depressed, or like something is wrong with you for not feeling constantly happy, you’re not alone. It’s more common than most people realize. Post-adoption depression is very real and can stand in the way of the joy you experience with your baby.

Your family and friends might say things that only make you feel worse, such as, “You should be so happy now! You waited so long for this!” and “You wanted this. Be happy she’s got a family to take care of her now.” These types of remarks make adoptive parents embarrassed even to mention their feelings.

Most families that adopt have worked for months or years to make their dream of adoption a reality. They have likely spent ample time and money to make this dream come true, as well as every step towards creating the ideal environment for a baby. As such, adoptive moms and dads are sometimes surprised that they aren’t perfect parents or completely overjoyed every second of every day once the baby comes home. This reality may cause disappointment, guilt, and even depression.

Table of Contents

• A Brief History of Post Adoption Depression
• What Are the Causes and Signs of PADS?
• Is Post Adoption Depression the Same as Postpartum Depression?
• Research Before You Adopt
• How to Cope With Post Adoption Depression
• Mardie Caldwell, Founder of Lifetime Adoption Shares Her Story
• Frequently Asked Questions

A Brief History of Post Adoption Depression

In 1995, June Bond, an author, adoption professional, and adoptive mother, first described post-adoption depression in literature. She wrote an article for the adoption magazine Roots and Wings, which is currently out of print.

Bond picked up on the dynamics of post-adoption depression syndrome after the child was home. As she performed post-placement home visits, Bond noticed that the adoptive parents’ mood did not reflect the joy or happiness that she had expected to witness.

Four years later, in 1999, Harriet McCarthy began doing exploratory research. As an adoptive mother herself, McCarthy had experienced post-adoption depression firsthand. She went on to conduct an online survey of 145 people who had become parents through international adoption. More than 65% of survey respondents reported experiencing post-adoption depression.

What Are the Causes and Signs of PADS?

Most adoptive parents find themselves exhausted at the end of the adoption process, despite the immense joy of bringing their baby home. What’s important is being self-aware and proactive. If these feelings arise, talk to an adoption-competent therapist and surround yourself with supportive people.

Causes

• Changing to a lifestyle of parenting full-time
• A long, drawn-out adoption process
• Lack of sleep
• Years spent coping with infertility and failed fertility treatments
• The release of pent-up tension from your adoption wait
• A lack of control in the adoption wait and infertility
• Financial stress
• Unmet or unrealistic expectations that adoptive parents held of themselves or their child
• Uncertainty over the relationship with your baby’s birth parents

A combination of these causes at the end of your adoption journey can leave you vulnerable to:

• Excessive guilt, perhaps around the grief your child’s birth family is experiencing
• Feelings of inadequacy
• Feeling undeserving
• Sense of hopelessness
• Feelings of powerlessness
• Feelings of worthlessness

Signs

• No interest or joy in the activities you used to enjoy
• Difficulty concentrating or making decisions
• Needing extra sleep or having a hard time sleeping
• Loss of energy
• Change in appetite
• Extreme weight loss or gain
• Lots of guilt
• Feeling worthless, powerless, and/or hopeless
• Irritability

If you have thoughts of harming yourself or your child, it is a crisis. Call or text 988 to reach the Suicide & Crisis Lifeline right away, available 24/7, or go to your nearest emergency room.

Parents with PAD may be confused and surprised by how they feel and even question whether the decision to adopt was right. One adoptive mother who was diagnosed as having post-adoption depression explains that in her particular situation, she didn’t feel that she was “allowed” to take maternity leave, ask for help from friends and family, or let on to anyone how tough it was to have a newborn. She felt it wasn’t her “right” as someone who had worked so hard for infant adoption, and who had not gone through the physical toll of pregnancy and childbirth, to ask for any sort of help or special treatment.

In her case, she was able to eventually recognize her symptoms for what they were and seek help from friends, family, and her doctor. It was hard, but she learned to let others know what she needed and to have more realistic expectations of herself. She found that those around her were eager to help and offer the support she and her husband needed to make the transition to parenthood.

Is Post Adoption Depression the Same as Postpartum Depression?

They’re closely related, but not identical. Postpartum depression is tied to the dramatic hormonal shifts that follow pregnancy and childbirth. Adoptive parents don’t go through those hormonal changes, so post-adoption depression is driven by different factors: emotional exhaustion from a long adoption process, a completely upended daily routine, grief or unresolved feelings about infertility, and unmet or unrealistic expectations of yourself, your child, or your new family dynamic.

The symptoms of PAD and postpartum depression overlap significantly: persistent sadness, loss of interest in things you used to enjoy, appetite and sleep changes, and feelings of guilt or hopelessness show up in both. And while some risk factors identified for postpartum depression, like marital status or socioeconomic factors, haven’t been clearly linked to PAD, both conditions are equally real, equally treatable, and equally deserving of support.

Research Before You Adopt

Most parents are exhausted at the end of their adoption journey. It is so easy to become caught up in the ups and downs of the process and the yearning for a birth parent to choose you.

Despite this exhaustion, discussing the possibility of PAD before you adopt is important for the sake of your future child. Evidence indicates that if a parent is struggling with symptoms of depression, then their child may be impacted negatively.

If you are a prospective adoptive parent, be honest with yourself. Have you ever struggled with low self-esteem, anxiety, or depression? What was helpful in overcoming those feelings? For those who are adopting because they have been unable to have a child biologically, has the grief over infertility been resolved? For parents who adopted transracially, is there an awareness of racial identity for both the family and the child?

Parental post adoption depression (PAD) is an important area to discuss both before and after you adopt. However, hopeful adoptive parents tend to find this topic uncomfortable or even scary to think about. It can be reassuring to learn that PAD only affects some adoptive parents, not the majority. Estimates of how common PAD is vary widely across studies, from as low as 8% to as high as 32% of parents, according to the National Council for Adoption’s clinical review of the research. More recent studies point to a narrower estimate of about 11% to 12%, which is likely closer to the true rate. Either way, these findings show that while PAD is not widespread, it is also not uncommon. Fathers, not just mothers, can be affected as well.

If an adoptive parent is wary about seeking help for post-adoption depression, then it can help to know that therapy will support their entire family, not just themselves. There are several ways to alleviate and manage symptoms of depression.

How to Cope With Post Adoption Depression

Surround yourself with positive people. Practice self-care: when the baby naps, take a nap too and turn off your phone. Get outside and breathe in the fresh air whenever you can, take your baby for a walk around the neighborhood. It’ll let you get in some physical activity. Make sure you’re eating quality, nutritious food.

Take comfort in the fact that other adoptive mothers have gone through post-adoption depression, and are now experiencing the joy parenting can bring. It does get better.

If you continue to experience depression for more than a month, please seek the advice of a qualified doctor who works with post-partum depression. Also, we suggest contacting a counselor specializing in adoption issues.

Of course, the best thing to do is get this help early on and avoid suffering the baby blues altogether. Here are some tips that will help you through the settling-in period after your infant’s adoption:

1. Have realistic expectations of yourself, your spouse, and your baby. None of you will be perfect, and that’s okay.
2. Don’t be afraid to ask friends and family for help. Lack of sleep and the constant demands of a newborn are no joke. No matter how much you love your little one, you will get tired, and you will need help. Take it when it’s offered, and ask for it if it isn’t. You’ll be a better parent for it.
3. Don’t be afraid to ask professionals for help. Whether you’re the adoptive mother or father, if you find yourself feeling down for more than a few days, talk to your family doctor.

Taking these three easy steps will help you be the best parent you can be for your new little one.

Mardie Caldwell, Founder of Lifetime Adoption Shares Her Story

In open adoption, adoptive parents remain in regular contact with the birth parent contact in the best interest of their child. However, this can trigger feelings of worthlessness or inadequacy in the parent who adopted.

After they adopt, adoptive parents encounter a variety of complex emotions while they adjust to life with a newborn in addition to a new relationship with their child’s birth mother. Many adoptive parents have felt relieved, while others feel hopeless after adoption.

For some, especially adoptive moms, the pressure to be a perfect parent, know all the answers, or have everything under control can become overwhelming. Lifetime’s Founder, Mardie Caldwell, knows this firsthand, having experienced PAD herself. She shares this tip with adoptive parents: “After we adopted our son, I found it helpful to get out and attend a comedy show with my husband as a date night.”

Mardie shares an inside look “beyond the blessing” in an adoption webinar, “Mardie Caldwell Shares About the Pressure to be the Perfect Adoptive Parent.” Mardie speaks from the heart about her first days as a new adoptive mom. In this sensitive and validating webinar, you’ll learn more about post-adoption depression, in addition to topics like honoring your promises to your child’s birth mother and bonding with a new child through a wealth of emotions. You can tune into this webinar for free at AdoptionWebinar.com.

Frequently Asked Questions About Post Adoption Depression

What is post adoption depression?

Post-adoption depression (PAD), also known as Post Adoption Depression Syndrome (PADS), is a depressive condition that can affect adoptive parents after their child comes home. It shares many symptoms with postpartum depression but stems from the emotional, psychological, and lifestyle changes of adoption rather than hormonal shifts from pregnancy and childbirth.

How common is post adoption depression?

Estimates vary widely, from 8% to 32% of adoptive parents, depending on the study and screening method used. More recent research narrows that down to roughly 11% to 12%, which is likely a closer estimate of how common PAD actually is. In other words, PAD is not widespread, but it’s far from rare.

Can adoptive fathers get post adoption depression too?

Yes. While PAD is more commonly discussed in adoptive mothers, research shows fathers can experience it as well. Studies point to somewhat different risk factors for fathers, including the age of the child at adoption, lower relationship satisfaction, less perceived support from friends, and unmet expectations about the child.

How long does post adoption depression last?

This varies by person. Some parents notice symptoms easing within a few weeks as they adjust to their new routine and get more rest and support. If symptoms last longer than a month, or interfere with your ability to function or care for your child, it’s time to talk to a doctor or an adoption-competent therapist.

Is post adoption depression the same as postpartum depression?

They’re closely related but not identical. Postpartum depression is tied to the hormonal changes of pregnancy and childbirth. PAD affects adoptive parents, who don’t go through those hormonal shifts, so it’s driven more by factors like emotional exhaustion from the adoption process, disrupted routines, grief or unresolved infertility, and unmet expectations. The symptoms of both conditions overlap significantly, and both deserve the same level of care and treatment.

When should I get professional help for post adoption depression?

Reach out to a doctor or adoption-competent therapist if your symptoms last more than a couple of weeks, interfere with your daily life or your ability to care for your baby, or if friends and family express concern about changes in you. If you ever have thoughts of harming yourself or your child, treat it as a crisis. Call or text 988 to reach the Suicide & Crisis Lifeline, or seek emergency care right away.

Causes of post-adoption depression include unmet or unrealistic expectations which adoptive parents hold of themselves, their child, family, and friends. Commonly, the most challenging expectations to reframe are of ourselves as parents.

Lifetime Adoption recognizes the very normal feelings of stress that adoptive parents might experience as they cope with their new challenges and expectations. However, these challenges can be conquered by getting enough sleep, physical activity, and healthy food, as well as with the help of mental health professionals.

Editor’s Note: This article was originally published on July 3, 2017, and has since been updated.