Toward A Better Understanding of Postpartum Depression

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emergency-stop-buttonThe following post is about a potentially triggering topic.

Please be aware of this as you continue and if you are in a particularly fragile or sensitive state, you may want to skip this post altogether.

This post will continue below the graphic to the left.

If you’re choosing to skip this post, here’s a really adorable video of a tiny hamster eating a burrito to watch instead.

Because well, a tiny hamster. Eating a burrito. What’s not to love???

(I’m kind of in awe of how fast the little guy chows down!)

 

 

 

Last night, on Facebook, I noticed a post by The Postpartum Stress Center:

 

Postpartum Stress Center FB Snapshot

 

 

 

 

 

As an advocate, one of the biggest things I fight is stigma and misinformation. Sure, I reach out and help women seek help as they battle against whatever form of Perinatal Mood & Anxiety Disorder they may have looming large over their lives, but the majority of time, I am correcting issues like the one Karen Kleiman (founder of Postpartum Stress Center) refers to above. The post refers to an article appearing at the Miami Herald’s website about a mother who attempted to drown her child. She also tried to poison and smother him when he was just two months old.

Nothing is more infuriating than reading an article about a mother who has harmed her child only to discover the only term used within said article is postpartum depression.

I cannot emphasize the following enough: Women with postpartum depression are highly unlikely to harm (and therefore kill) their infants. Women who struggle with postpartum psychosis, however, are far more likely. That said, at this point, the only person stating she suffered from postpartum depression is the mother. Her family admits she sought treatment shortly after her child was born but we do not have details. Yet one mention of postpartum depression and boom. We’re off to the races without putting the right saddle on the horse.

I reached out to Karen Kleiman for her thoughts about this situation. This is what she had to offer about Armour “blaming” PPD:

“Of course Armour blamed it on PPD. That’s all we talk about. PPD is so frequently used when referring to any postpartum mood or anxiety disorder. in fact, it is used when there is NO mood or anxiety disorder, such as the Baby Blues. So, yes, until we have a clear diagnosis (and even then, the diagnosis can be wrong) we need to be careful. That’s the media as well as the public at large. She is being judged by all of us.”

She is most definitely being judged by all of us, whether we want to admit it or not. All we can offer at the moment is conjecture, which is a dangerous thing if accompanied by misinformation as well.

Here’s a quick lesson:

Postpartum Depression, a commonly used umbrella term for the mood disorders on the Postpartum Mood Disorder spectrum, is also the term for one of the disorders on the spectrum. Postpartum Depression may consist of but is not limited to: sadness, crying for no reason, lethargy, lack of interest in previous activities/hobbies, distance from baby and family or social activities, anger, irritability.

Postpartum Psychosis, the most serious of the Postpartum Mood Disorders, often involves (but again, is not limited to): auditory or visual hallucinations, the inability to care for oneself and make decisions. Considered a medical emergency requiring immediate hospitalization, this particular disorder also carries the deadliest rate of both infanticide and suicide.

As you see, the two are quite different beasts. They are on the same “spectrum” as they are both mental disorders which occur after the birth of a child, but the signs and symptoms for both are of completely different degrees.

Karen continues, with this:

Let’s face it, even the experts disagree. The lines are blurry and they are getting blurrier instead of clearer. More and more cases are unfolding that are confounding experts and have us wondering what variables are related to what, if you know what I mean. So education is indeed the key. But education isn’t enough. Because mental illness isn’t crystal clear and many definitions merge into each other. So we also need compassion and patience. We need to stop jumping to conclusions, stop judging, stop presuming we understand what happened, and we need good assessments, good treatment, good journalism and continued advocacy. But in reality, we live in a culture that wants information NOW and they want it whether it is accurate or not. Sensationalism sells and we scaring the hell out of women who are just trying to understand and trying to heal.

How can we fight back? By continuing to do what we do. Get the right information out there. Spread it around as best we can. Journalists are fighting against deadlines and unfortunately, this doesn’t always leave them time to check their facts.”

What can families and friends do to better educate themselves in order to help loved ones who may end up fighting the nastier beasts on the Perinatal spectrum? They can do the following, according to Karen:

Again, women and their families need to be alert to changes in personality or behavior after a baby is born. If something doesn’t seem right, it probably isn’t. It is far better to overprotect her and be mistaken, than to miss the opportunity to get her the help she needs. Here is a link to our Emergency Room Guidelines, which will give you info about screening for psychosis.”

The number one thing to keep in mind, particularly if you think it can’t happen to you or someone you know, is that it can.

Postpartum depression and psychosis can happen to any one. It happens to loving mothers who have anticipated the birth of their baby with joy and excitement in their hearts. It is cruel, brutal illness that does not discriminate. It is no reflection on the mother, who is suffering. Surely, we can have compassion for mothers who are suffering.” -Karen Kleiman

The article at the Miami Herald pointed out that Armour had created a video, portraying her love story with her partner, and her joy about her upcoming birth. What went wrong? How could a happy mother possibly go from overjoyed to attempting to kill her own child? Therein lies the more important question and story, in my opinion. It’s a difficult story to write, to comprehend. But the more we write about it, with the proper terms and information included, the more we encourage mothers to step forward, courage in their hearts, to seek help before it is far too late.

I reached out to Dr. Kenneth Johnson, the chair and professor of obstetrics and gynecology in the Nova Southeastern University College of Osteopathic Medicine, who was quoted in the Miami Herald article, offering him a chance to clarify the statement used in the piece. This is his response:

“I of course agree with you that even with severe postpartum depression it is very rare for mothers to harm their baby.  Postpartum psychosis is more severe and more likely to be associated with risk to the mothers baby.  Separating the two conditions is very difficult clinically as there is almost always overlap with severe depression when psychosis is evident.”

He is right, and Karen Kleiman makes the same point in her article at Psychology Today. The difficult issue with Psychosis is that until there is a break, it’s very difficult to discern if the person is struggling with severe depression or with psychosis. Psychosis is always a medical emergency and requires immediate attention.

Another thing to keep in mind, particularly given that July is Minority Mental Health month, is the lack of education regarding mental health issues among minority populations. A’Drianne Nieves, who blogs at Butterfly Confessions, is passionate about speaking up about mental health issues and the lack of resources, voices, and education which exists today. She had this to offer about Armour’s situation:

Education, man. Distinction between illnesses & awareness about the range of their symptoms. Doctors need to really start educating women on this. She didn’t have PPD. Whatever treatment she received I’m sure it wasn’t adequate or last long enough or maybe they just misdiagnosed her. Her family-did they know the symptoms of psychosis? What to do? Who to call? Education. Education, especially in minority communities is lacking and is a critical need.

A’Drianne also offered this on her FB page when sharing the Miami Herald article:

This is why we need more awareness on postpartum mood disorders and their symptoms among women of color. FACTS. We need FACTS on the wide range of symptoms and distinction between each illness. Facts and support/access to resources…..This is why #MinorityMentalHealth Month matters. This is why we need to keep advocating and have more people of color SEEN in the mental health advocacy space, especially online and in mental health magazines and other publications/literature.”

The media is not only getting their facts wrong, they are increasing stigma. As Karen so brilliantly states in her piece at Psychology Today, ” Journalists, Doctors, Everyone: Let’s Get it Right”:

“Let’s get it right. Lives depend on it.”

They do depend on it. The wrong description or sensationalized information causes women and their families to fear help instead of embracing it with open arms. I have lost count of how many times a mom told me she can’t take medicine because her partner is afraid it will turn her into Andrea Yates. Or how many of us must avoid the Internet when sensationalized stories are bandied about with horrible comments attached – comments which range from the pitied to the enraged to the downright vicious. Comments which categorize all of us with a Perinatal Mood Disorder as monsters. We are not monsters, you know. We are you. We are your mothers, we are your sisters, we are your daughters, your cousins, your wives, your aunts…we are the cashier at the store, the accountant down the hall, the lawyer defending you in court, the doctor you take your children to when they’re sick, the employee at your favourite restaurant, the postal employee who delivers your mail, we are every woman and we are just like you with hopes, dreams, and lots of love to give. But we live in fear as we struggle because the media paints what we fight with such dark intense strokes.

Journalists are inching closer to getting it right but there’s still a long way to go. A long, long way.

If you see a story which includes misinformation, reach out. Contact the journalist. The paper. Write a letter to the editor. Speak up.

We owe the women on this road behind us a smoother ride than we have had on our own and in order to do that, we cannot afford to remain silent.

If you are a journalist writing about Perinatal Mood & Anxiety Disorders, reach out to Postpartum Support International for the facts. Or if you’re pressed for time, you can find them online at their Get The Facts Page. If you’re a mom or have a loved one struggling with a Perinatal Mood & Anxiety Disorder, there’s plenty of help out there. You can reach out to Postpartum Progress, to Postpartum Support International, or use the hashtag #PPDChat on Twitter. You are not alone and there is help. Don’t let stigma fool you into believing you’re a monster. You’re not. You are loved, you are not to blame, and there is absolutely a light at the end of your tunnel.

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About Lauren Hale

Lauren Hale tells it like it is about Perinatal Mood & Anxiety Disorders over at My Postpartum Voice. She is also the founder of #PPDChat, an online Twitter & FB Community dedicated to supporting moms on their journey by harnessing the power of the Internet. You can find her on Twitter @unxpctdblessing.

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Comments

  1. Well said, bravo. It is so incredibly frustrating to see this same thing keep happening over and over and over again.

    I can personally attest to the whole “misdiagnosis” thing. My PPOCD was totally overlooked and labeled as PPD even though I had the triggering thoughts.

    Cue Esther feeling inspiration.

    • I hear ya. My PP OCD was diagnosed as “Major Depressive Episode.” Um. No. It’s not, but okay.

      Thank you for the compliment and if you write something, please share!

  2. Thank you, Lauren, for this excellent article.

  3. Jerad Fry says:

    My wife had Postpartum Psychosis and it nearly destroyed our family. We had no idea what was wrong with her but, she suffered from audio and visual hallucinations, and would just go crazy at the drop of a hat. She would have violent episodes toward me and become super mad at me for no reason at all. I love my wife so much and would never give up on her she is amazing. But that was the hardest thing I have ever dealt with and I did it pretty much alone. I just thank god I was the main child care giver because she would not have been able to handle the stress.