The minute she laid eyes on her adopted son, a seven-month-old Guatemalan boy, Michelle Brau knew something was wrong, she says.
Instead of joy, she felt dread. Instead of wanting to comfort the infant, she found herself not wanting him at all.
The negative emotions blindsided her, Ms. Brau says. She and her husband, Jim, had yearned to adopt and add to their family of four biological kids.
"I love children," says Ms. Brau, who lives in Springville, Utah.
But she couldn't bring herself to love her healthy new son, nor a second boy, aged 2, whom the couple adopted from Guatemala months later.
Ms. Brau says she assumed her affection for them would grow with time. For more than five years, however, she avoided their hugs and was more strict with them than with her other children, she recalls.
Consumed by guilt and shame, she told no one about her inability to bond with the adopted boys.
"I felt like a monster," she says. "I longed to be dead."
When she finally confided in her husband six months ago, he did some research online and concluded she had post-adoption depression, a condition being studied by researchers but not yet recognized as a psychiatric disorder.
According to adoption professionals, post-adoption depression can range in severity from a few weeks of the blues to a major depression that lasts months or longer. Like postpartum depression, it may bring intense feelings of anxiety and guilt, fantasies of running away, and suicidal thoughts.
Ms. Brau consulted two therapists, she says, but her feelings of desperation did not change.
So this spring - nearly six years after they adopted the Guatemalan children - the Braus contacted an agency to find them a new adoptive home.
"These boys deserve so much more than I can give them," Ms. Brau says, adding that her depression has lifted since the adoption was dissolved last month. "I feel like me again."
The Braus' case may be extreme but the potential consequences of post-adoption depression are recognized by a growing number of adoption professionals.
Left untreated, it can lead to the breakdown of the adoption, says Brenda McCreight, an adoption counsellor in Nanaimo, B.C. "I've seen it break up marriages too."
Post-adoption depression didn't have a name until 15 years ago, and it remains a new area of research. Early studies suggest it's "as prevalent, or more so, than postpartum depression," says Karen Foli, who co-authored The Post-Adoption Blues with her husband John Thompson, a child psychiatrist.
A study published last month in the peer-reviewed Journal of Affective Disorders found the rate of depression in women after adoption was about 15 per cent - the same rate found in women who have given birth.
Dr. Foli, a professor of nursing at Purdue University in West Lafayette, Ind., is partway through a study to assess whether the tools used to diagnose postpartum depression are valid to screen for post-adoption depression. Unlike mothers with postpartum depression, who have a biological explanation for their bleak mood, adoptive mothers cannot attribute their depression to a sudden drop in estrogen levels (although some researchers suggest that nurturing an adopted child may trigger hormonal changes).
"We desperately need to understand it more," she says.
The syndrome appears to be more common in women than in men, Dr. Foli says, since women tend to be the primary caregivers. Stress, sleep deprivation, lack of social support and a history of depression can put women at greater risk for post-adoption depression, according to experts in the field.
Also, many adoptive mothers have no parenting experience, notes Sandra Scarth, president of the Adoption Council of Canada. For a career woman who has enjoyed years of freedom, the demands of parenting can be a shock, especially if the child isn't attaching to her well.
