Postpartum Depression: Real, But Still Stigmatized

For decades, thousands of people in dozens of organizations have fought tirelessly to reduce the stigmatization and ignorance associated with mental health issues and mental disorders. Mental illness is not something you can just “get over,” nor is it an invention of the pharmaceutical companies (although I’m sure there are some who believe that).

Even within this dedicated group of people who are all fighting for the same things — recognition that mental illness is just as real as physical illness — they is within-group stigmatization. Some mental disorders get the short shrift, or are thought to be less “real” or serious than other disorders. The National Alliance on Mental Illness (NAMI), for instance, only lobbies and advocates for what it considers to be biologically-based mental disorders, such as schizophrenia and bipolar disorder. They have historically had far less interest in other disorders, such as anxiety or personality disorders.

This saddens me. And it saddens me even further to see people knock something like postpartum depression, a very real mental disorder that affects thousands of mothers every year who have just given birth to their child, and then feel overwhelmed with depression. They often are unable to do even basic child care for their newborn baby, and feel hopeless, despondent, and listless, without motivation or energy.

Moms are in need of being taken seriously, of having their concerns heard. You’d think nobody would be against mothers seeking to get proper diagnosis, treatment and care for something that is at the very core of having a healthy family.

But you’d be wrong.

Senator Robert Menendez of New Jersey introduced the Melanie Blocker Stokes MOTHERS Act in the Senate to try and reduce the stigmatization that goes on around postpartum depression, increasing funding for education and screening programs to catch more mothers in need. But one senator — an obstetrician no less — doesn’t like “disease-specific” legislation, and has used a senatorial hold to stop the legislation from moving forward, according to Katherine Stone’s entry over at Postpartum Progress:

Senator Menendez indicated that much of the strong opposition to this bill continues to come from Senator Tom Coburn of Oklahoma who refuses to pass any of what he calls “disease-specific” legislation. Here’s the part that absolutely kills me: Dr. Coburn specializes in family medicine and obstetrics. Dr. Coburn has personally delivered more than 4,000 babies, according to his bio.

Thanks Dr. Coburn! What a great way to show your forward-thinking efforts, at the very same time the e-patient movement is gaining steam and people are looking to replace the old paternalistic doctor who “always knows best” with empowered, educated patients who work as true partners with their doctors.

And why is this legislation so controversial? I have no idea. The legislation under consideration would increase federal efforts to combat postpartum depression by:

• Encouraging Health and Human Services (HHS) to coordinate and continue research to expand the understanding of the causes of, and find treatments for, postpartum conditions.
• Encouraging a National Public Awareness Campaign, to be administered by HHS, to increase awareness and knowledge of postpartum depression and psychosis.
• Requiring the Secretary of HHS to conduct a study on the benefits of screening for postpartum depression and postpartum psychosis.
• Creating a grant program to public or nonprofit private entities to deliver or enhance outpatient, inpatient and home-based health and support services, including case management and comprehensive treatment services for individuals with or at risk for postpartum conditions. Activities may also include providing education about postpartum conditions to new mothers and their families, including symptoms, methods of coping with the illness, and treatment resources, in order to promote earlier diagnosis and treatment.

It is estimated that postpartum depression (PPD) affects from 10 to 20 percent of new mothers. In the United States, there may be as many as 800,000 new cases of postpartum conditions each year. The cause of PPD isn’t known but changes in hormone levels, a difficult pregnancy or birth, and a family history of depression are considered possible factors.

Sounds good to me. But Philip Dawdy over at Furious Seasons remains skeptical:

Here’s the thing that makes my scratch my head, however: women have given birth for many thousands of years and many have experienced “baby blues,” until recently without mental health screenings or psych meds of any kind and without a bunch of arm waving about post-partum depression (the advocacy on this issue is a phenomenon of the last decade). Broadly speaking, the lack of such supposed benefits does not seem to have harmed society a bit, although there are obviously individual exceptions.

With that same logic, Philip could be scratching his head about a lot of disorders where, prior to their “invention,” people seemed to get along just fine in society — attention deficit disorder (ADHD), PTSD, panic attacks, autism, Asperger’s syndrome, etc. It’s no surprise to anyone who’s studied women’s history to understand how repressed their voices have been in society until the past few decades. So is it any wonder that history isn’t filled with their accounts of grappling with postpartum depression? A woman would be an outcast from their own family for admitting such a thing even 50 years ago. Even possibly disowned or institutionalized. It just wasn’t said or discussed much.

Perhaps the saddest thing of all, though, is that people — in this day and age of instant connectivity and all of the wonders the Internet has brought us — are still against basic, simple things like education and information about these concerns. “What? You want us to spend money educating future moms on postpartum depression!??! Ridiculous!” I just don’t get it.

Postpartum depression is real, it affects thousands of lives every year, and is one of those quiet disorders that have flown under the radar for far too long, while mothers lived in quiet desperation that someone would listen to them and believe them when they said they were depressed after just giving birth. To be listened to, to be understood, to be heard. That’s all these mothers ask.

Read the full entry: Senator Blocking MOTHERS Act Is Obstetrician (Seriously).