In recent years postpartum depression has gotten an increased amount of attention in the public eye. With celebrities like Gwyneth Paltrow, Kendra Wilkinson, Hayden Panettiere, Chrissy Teigen, Bryce Dallas Howard, Carnie Wilson, and Courtney Cox who have come out to speak about their own experiences with postpartum depression. They have help to shed light on the fact that too many women have been suffering in silence. The more information and awareness that can be brought to the issue of postpartum depression is always going to be beneficial. However, we still have a very long way to go. There is so much information that is lacking, misconceptions, and downright misinformation that still leads to stigma and feelings of shame that make many woman fearful to speak out about what they are going through. Often times our own healthcare professionals are left with little resources and lacking a full understanding of the scope and magnitude that comes with mental illness during pregnancy and the postpartum period.
MORE THAN JUST DEPRESSION
I can remember the first time I heard about postpartum depression. I can remember Brooke Shields speaking out about her struggle after her first child was born. I remember the battle with Tom Cruise and his opinions on medication to treat postpartum depression. What I remember learning about postpartum depression was that the mom was sad, had no energy, no motivation no bonding with the baby, didn’t want anything to do with baby, didn’t feel any connection or love towards their infant. That was the limited education and knowledge that I had on postpartum depression, the picture that I obtained from media. My guess is I am probably not the only one that the extent of knowledge and understanding of postpartum depression looks fairly similar to that. For some that suffer from postpartum depression the above description is the exact picture of their personal experience. This, however, is not the exact or even similar to what other women experience who struggle with mental illness during pregnancy or the postpartum period.
There is more than just postpartum depression. There are postpartum anxiety disorders that moms can cause constant, overwhelming worries. There’s postpartum Obsessive Compulsive Disorder (OCD) that can bring about scary intrusive thoughts, Post Traumatic Stress Disorder (PTSD) which can bring nightmares, flash backs and make a new mom easily startled and there is postpartum psychosis, which is the most rare of all the disorders, but extremely important for our mothers to be able to recognize the symptoms or have family members who can recognize the symptoms and understand the severity of it and the importance of ensuring treatment. All while understanding that with help mom can go on to live a healthy, happy, and thriving life as a wonderful mother. We still have far to go to get to a place where women don’t feel that they have to suffer in silence, to sit in shame, out of fear of judgment, out of fear that their child will be taken from them, out of fear that healthcare providers will misunderstand what they’re saying and will react in ways that end up being traumatic and more harmful to our moms.
Many women equate postpartum depression with a lack of bonding with their child, crying all the time or immense sadness so they immediately assume they are not suffering if those aren’t the exact symptoms they are experiencing. Instead, they’re worried all the time, or they have the scary thoughts that keep coming in their mind that they can’t control, or they can’t sleep or their uncharacteristically irritable, and so many other different symptoms and scenarios playing out constantly. But the lack of common knowledge and understanding of all the possible complications that the postpartum woman and a pregnant woman can go through, keep these women held captive in a secret suffering. They don’t identify with the little bit of common knowledge that they have postpartum depression, so they don’t know what to call it or how to identify it. They are scared that they are the only ones and feel isolated and alone. They’re afraid that what they’re going through means something bad. That it makes them bad or defective as a mother. And it is bad. It is bad because the last thing we should be allowing as a society is our women who are bringing new life into this world to be left alone, suffering on the battlefield called postpartum, all while having to put every once of any life that is left in them into someone else. It’s like asking someone who is already drowning to play life guard and to save the lives of the other poor swimmers out in the ocean, while they themselves are barely able to bob their head out of water long enough to catch a full breath. It doesn’t make sense.
COMMON MISCONCEPTIONS
Many women do not realize that they are susceptible to a postpartum mood or anxiety disorder during anytime within that first 12 months after giving birth. This Is not only being missed by moms, but it has also been missed by healthcare providers. We are not screening our moms enough throughout the first 12 months after giving birth and we are often times not asking the right questions. Obstetricians see moms 6 to 8 weeks after giving birth and they are done. Pediatricians aren’t screening enough, if they are even screening, shortly after the mom is giving birth and they are done. Focus is completely shifted to baby and the new mother is left to be, assuming that all is well, and everything is fine. Women don’t have a common knowledge of knowing that this can occur six months postpartum, eight months postpartum, eleven months postpartum. They don’t know to be aware when they wean their babies from nursing or that when their menstrual cycle resumes again that this things can also trigger postpartum illness.
It is also important for women and family members to understand that struggling does not always start in the postpartum period but that many women start to experience symptoms of depression, anxiety, or mood instability during their pregnancy. This can be an indicator that they will indeed experience a mood or anxiety disorder post-delivery, but it is also just as important to realize that it may be severe during their pregnancy and they may need to seek out professional treatment and need additional support from their partners and support systems.
We also need to lay a better foundation for good understanding of what the baby blues are. Baby blues typically include mood swings, weepiness, difficulty sleeping, and anxiety. The baby blues can start a few days postpartum and last up to two weeks. If symptoms are lasting past two weeks, it is not “just the blues”. If it is lasting longer than two weeks than it is more sever than the blues and mom can benefit from getting help, to aid in recovering faster and not having symptoms worsen. Yes, there are adjustments after giving birth and having a newborn. The newborn stage is a blessed time and cruel time all at once. However, we must be really careful that we are not just dismissing what women are saying they are experiencing as “normal” postpartum difficulties, challenges or adjustments. We need to implement additional follow up and more services to better ensure that new moms get the help they need. We need to be careful that we are not saying “it’s OK what you’re going through is normal for new moms”. I am afraid we are confusing the word normal, when we really mean to say common. Anything that meets criteria for any perinatal mood or anxiety disorder is not “normal”, unfortunately it is however, common. All too common. And all too often missed.
WHAT DO WE DO
I don’t write all these things to strike fear and make it seem that there is so much more doom out in the postpartum and pregnancy world than we are telling women. On the contrary, my desire for women is to live lives of freedom and power and struggling with a mental illness without the understanding of it and without knowing that you can fully recover from it leaves women enslaved to pain and suffering. For many moms I think the lack of knowledge and understanding of what really can occur leaves them stuck, scared to go forward, left to their own thoughts and surmises of what is happening to them. They don’t realize it is common, that it can be treated, and that they are not the only one.
So, what do we do? How do we change things for our women? How do we make safe spaces for them to speak out and get the help that they need without creating more stigma? How do we educate women and family members and healthcare providers so that there is an air of security and assuredness that when they do speak out they will be taken seriously, they will not be handled in a haphazard way where people are panicking and looking at them as if they are monsters, shocked by the things they are disclosing? How do we ensure that they will be handled compassionately and that they will be given the appropriate care with a chance to get better? What women need to hear is that they can get better. They need to hear there is a name for what they are going through, that it is real and that there are professionals who know how to help them get through it and beyond it. They need to know that they do not to have to feel ashamed and they need to feel from society, our culture, our professionals, our healthcare system, and our mental health professionals that we are not ashamed of them, that they are not less than.
To any mama out there struggling during your pregnancy or postpartum I need you to hear me. You are not defined by this. You do not have to take blame for this. You are not the only woman to have experienced this. There are women that you admire, women that you think are amazing mamas, women that you look up to, that have had their own battle and they have overcome and you can and will get better too. And I believe that our system of how we handle the mental and emotional wellbeing of our pregnant and postpartum women will and can get better as well, we just have to keep the dialogue going.