When Catherine Cho’s son was only two months old, she and her husband James travelled with him from their home in London to the United States, where the rest of their family live. They planned to introduce the new baby to friends and family during an extended cross-country trip. Everything was going fine until they arrived in New Jersey, where they would be staying with Cho’s in-laws.

The house was hot and stuffy, the new grandparents were overprotective, and Cho developed mastitis and insomnia. Then one morning, she looked into her son’s eyes and saw the devil staring back at her.

From there, Cho rapidly spiralled into a full-fledged postpartum psychosis. Her husband rushed her to the emergency room. Over the next four days, her condition continued to worsen, and she was transferred from the hospital to a psychiatric facility. She remained there for eight more days, until medication finally helped to loosen the grip of her psychosis enough for her to return to her husband and young son.

When she was finally reunited with her son, she didn’t recognise him. As she held him, she noted that he felt “heavy, like an unfamiliar weight”.

She looked at him: “My son, I reminded myself. And I felt nothing.”

Catherine Cho provides a rare glimpse of what it’s like to completely lose yourself in motherhood

In Inferno: A Memoir of Motherhood and Madness, offers an unflinching account of her descent into – and recovery from – postpartum psychosis. Postpartum psychosis is both rare and and the same could be said of Cho’s book, which is remarkable for its harrowing and moving descriptions of what it’s like to experience psychosis from the inside.

While that would be reason enough to recommend the book, Inferno also tells a more universal story about early parenthood, After all, isn’t motherhood always characterised by a certain degree of loss, by a transformation so profound that you’re forced to leave your old self behind and forge ahead in search of a new identity?

Cho’s story is that of new motherhood, only taken to the extreme

Cho paints a detailed picture of what it’s like to lose yourself completely, to no longer know who or what you are. As such, her story is not so much a divergence from the experience of new motherhood as a more extreme version of it. 

She describes what it’s like to see danger lurking everywhere, to see demons in the eyes of your newborn son. This is the stuff of nightmares. Then again, isn’t a certain preoccupation with danger and identifying potential threats inherent to caring for such a tiny, vulnerable and completely helpless being?

“I had never heard of postpartum psychosis before my own diagnosis,” writes Cho in Inferno. “Pregnancy had brought a list of worries – I was so preoccupied with the idea of losing my body, it had never occurred to me that I might lose my mind.”

Sarah Menkedick reveals how our fears can take over our lives

Sarah Menkedick, Ordinary Insanity: Fear and the Silent Crisis of American Motherhood, also opens her book with a list of worries that can plague parents-to-be during pregnancy – and afterward, for that matter. Like Inferno, Ordinary Insanity brims with (potential) dangers – more toxins than demons, perhaps, but just as menacing.

Like Cho, Menkedick describes a form of mental illness – postpartum anxiety, in her case – that reveals more about “normal” motherhood than you might expect. (Of course, you could argue that any exception exists only in relation to a particular norm, and can therefore reveal something about that norm.)

When Menkedick was pregnant with her daughter, she discovered mouse droppings in her home. A Google search revealed that there was a small chance that the droppings could contain a certain pathogen, congenital cytomegalovirus (CMV), that could make her sick. While she herself would at worst suffer a mild cough, CMV could ravage her developing fetus’ brain. Menkedick describes the “hot tingling of horror” that came over her upon reading this. She began frantically cleaning and disinfecting everything she could get her hands on and didn’t stop for the duration of her pregnancy.

After discovering the mouse droppings, she became obsessed with identifying anything that could poison her growing baby: the glyphosate in her oatmeal, the chemicals outgassed by her new mattress, the microwave, the preservatives in her granola, and so on. Once her daughter was born, she fixated on the dangers of lead paint. And as her fears grew, her world began to shrink.

Menkedick was suffering from postpartum anxiety. This, too, is a form of “losing your mind” – one that is not as abrupt or extreme as psychosis, but as Menkedick found out, is just as undermining in its own way.

When it comes to fear, how much is too much?

Menkedick’s book delves into the world of postpartum anxiety. Unlike postpartum depression, postpartum anxiety is not an official diagnosis found in even though it appears to be more common. According to a 2013 study cited by Menkedick, 17% of mothers in the US struggle with increased anxiety levels shortly after giving birth, whereas “only” 5.5% suffer from depression.

A certain amount of worry is normal, writes Menkedick. After all, being alert to potential dangers is among the main tasks of new motherhood. But at what point does healthy fear give way to something bigger, something that dominates every waking moment and leads to compulsive thoughts and actions? Sooner, Menkedick asserts, than you might think.

Menkedick lives in the US, and her book can be read in part as a critique of the current political and cultural climate. This climate makes it all too easy for mothers to find themselves mired in the “personal horror show playing in an individual psyche, crafted by individual values and priorities” that is an anxiety disorder.

Raising a child has become a private matter, leaving many mothers feeling isolated and overwhelmed

Though the US may lead the pack when it comes to rampant individualism, and the glorification of a certain kind of motherhood, Menkedick’s analysis is equally applicable to many other cultures.

Take, for example, the privatisation of motherhood that Menkedick describes: if raising children was once considered a job for the community as a whole, it has now become a private matter, leaving many mothers feeling isolated and overwhelmed.

In the Netherlands, where I live, parents receive more support than their US counterparts, including paid maternity leave and parental leave for partners (though the latter is a fairly recent development). But here, too, parenting is seen as something that parents have to figure out on their own, and it’s still the mothers whose careers tend to suffer as they struggle to meet the many demands of modern parenthood.

Consider, too, the long shadow cast by psychoanalytic theory, which has ensured that mothers are still considered to bear primary responsibility for their offspring’s physical and mental well-being. Carrying a burden that heavy with virtually no support is enough to make anyone crack.

Madness, loss, transformation: a journey every new parent makes

Both Cho’s and Menkedick’s books were released this year – a year in which a global pandemic has only added to the pressures felt by many parents, not to mention

The two books are very different: Inferno is a memoir made up of the author’s own recollections and experiences, while Ordinary Insanity contains not only Menkedick’s personal experiences but those of countless other women. 

Menkedick’s work also differs from Cho’s in that she seeks to analyse and interpret these experiences from psychological, political, and historical perspectives. Inferno offers a direct, seemingly unfiltered view from the inside, while Ordinary Insanity is full of reflection and context.

Cho, a Korean American, zooms in on the role of tradition and ritual within Korean culture, from stories handed down through generations to methods for warding off evil spirits. Menkedick, on the other hand, chooses to zoom out: she interviews women from a variety of different socioeconomic and ethnic groups, exploring how our social status shapes our experience of motherhood. For example, she traces the history of black midwifery in the US, showing how black midwives were systematically forced out of the profession by the white medical establishment,

Postpartum psychosis is, of course, a very different condition from postpartum anxiety – it’s (thankfully) much less common, but also easier to diagnose. Cho was hospitalised almost immediately, while many of the mothers interviewed by Menkedick had to wait months – or even years – before receiving help, understanding or a diagnosis.

Despite their differences, the two books have something important in common: they both testify to the madness, loss and transformation that are an inherent part of becoming a parent, whether or not you’re also dealing with psychosis, depression or an anxiety disorder.

Becoming a parent is an unpredictable transformation

“My identity was no longer my own,” writes Cho of the first few weeks with her newborn son. “It was as though I’d transformed without knowing it, and without any warning that I would be.”

In ‘What You Can’t Expect When You’re Expecting’, philosopher L.A. Paul describes becoming a parent as a “transformative experience”. The choice of whether or not to start a family is a complex one, she writes, because it’s impossible to know in advance what it will actually be like to have children, or even what kind of parent you’ll be.

It’s a choice that can only be made from the position of a non-parent, with a non-parent’s insight and self-knowledge. Having children transforms you into someone completely different; you’re reborn as a parent.

It’s impossible to know in advance what it will actually be like to have children, or even what kind of parent you’ll be

Before this transformation takes place, you have no idea what kind of parent you’ll be, whether you’ll even enjoy parenthood, or if your newfound self will resemble the parent you imagined yourself being. All you can do is commit to undergoing the transformation and wait to see what happens next – and who you’ll be when you emerge on the other side.

Cho and Menkedick share their own personal transformations, which were more arduous and extreme than they ever could have imagined. Menkedick describes how her transition to motherhood was marked by grief. She missed both the woman she had been before becoming a mother and the mother she had expected to become – someone less fearful and more adventurous than she turned out to be. Cho tells of feeling nothing for her son in the months after she was discharged, only going through the motions, behaving as she imagined a mother would without actually feeling like one.

It’s tempting to see Cho’s psychosis and Menkedick’s anxiety disorder as aberrations (even if Menkedick argues that anxiety disorders are much more common than most people realise). But perhaps it would be more accurate to think of them as being located at the extreme end of a spectrum that is always at least somewhat disruptive.

The transition to parenthood can be accompanied by grief, depression, anxiety or even psychosis. But as Menkedick writes, it’s a process that can also be a source of strength, if only we take it seriously. “Becoming a mother is one of the few experiences in life that really remakes a woman ( ... ) and there is opportunity here: to connect, collaborate, elucidate new visions, and change the status quo.”

In order to accomplish this, she continues, we would do good in sharing more stories about what motherhood can be – including the sad and scary ones.

Someone once told me that motherhood hadn’t changed me all that much, that I seemed mostly unfazed by it. I’m pretty sure they meant it as a compliment. But why is it, I wonder, that we’re so quick to celebrate that which stays the same in new mothers, rather than the parts that are changed and transformed? Could it be that we still don’t talk about those parts enough, that we don’t share enough of ourselves?

“Stories of motherhood,” writes Menkedick, “are elemental as bone and teeth.” Inferno and Ordinary Insanity offer precisely these kinds of stories. They’re not exactly light reading, but that’s not the point. The point is that they’re honest, and with honesty comes wonder, connection, empathy – and acceptance.

It was translated from the Dutch by Megan Hershey.

Dig deeper

Photo of two young girls playing inside a pink net Meet the parenting expert who thinks parenting is a terrible invention There’s no shortage of books, magazines and websites offering parenting advice. But the idea that parents can turn children into better and more successful adults if only they use the right methods is completely misguided, says developmental psychologist and philosopher Alison Gopnik. Read the article here The pandemic has highlighted a crisis in US maternity care. Its causes are as old as history Modern hospitals have usurped the black midwives who offered holistic care in the home. The trend is more to do with racism, patriarchy and profit than better healthcare. Read Sarah Menkedick’s article here