Maternal Mental Health | Stigma

In January I attended a seminar, titled Defeating the Stigma of Postpartum Depression, at The Motherhood Center of New York that discussed ways to reduce/eliminate the stigma surrounding Maternal Mental Health. Research suggests that postpartum depression is the most common complication following childbirth affecting 1 in 7 women. Symptoms of PMADs (Perinatal Mood and Anxiety Disorders) may develop during pregnancy or in the postpartum period, with symptoms developing 3 weeks to 3 months after birth but can occur any time during the first year after delivery. Women are more likely to develop depression/anxiety during the first year after childbirth than at any other time in their life. (national perinatal.org)

Mistakenly, many use the term “postpartum” when discussing postpartum depression when in actuality the term postpartum alone refers to the period 6 weeks after childbirth (with the perinatal period is from 22 weeks of gestations to the 7 days after birth). Therefore, the term postpartum depression (PPD) is the more accurate term to use used when a woman experiences symptoms that indicates there is a mental health condition. These symptoms include prolonged sadness, hopelessness, irritability, withdrawing, and any other symptoms associated with a mood disorder. But some women experience more than just postpartum depression which is why the newer and more broader term Perinatal Mood and Anxiety Disorder is being used more regularly. This broader term includes depression and anxiety in pregnancy, postpartum depression, postpartum panic disorder, postpartum obsessive-compulsive disorder, postpartum post-traumatic stress disorder, and postpartum psychosis.

Although I am in the mental health field, I learned about PMADs when I began researching my own symptoms after my second son and came across the term. I was not feeling the “typical” postpartum depression symptoms only and felt that there was more to what I was experiencing, so I began researching to find some answers and realized that I was experiencing both postpartum depression and postpartum anxiety.

I suffered with postpartum depression and anxiety for almost a year before I was able to really recognize what I was truly experiencing. I associated my mood changes and anxiety with feeling overwhelmed with a promotion at work and adjusting to being a mother of two small children. I remember expressing to my OB, during a routine check up, that I was experiencing an increase in anxiety, that I was a little worried about what I was feeling and that I felt I needed to take some time off of work. He asked me if I wanted a low dosage of anti-depressants, did not really ask follow up questions and when I expressed that I wanted to start with therapy first, he gave me a number to the behavioral health department and sent me on my merry way. To his credit, he is a great OB/GYN and I believe he did what he was trained to do.

It was the first time I mentioned being worried about how I was feeling and although he is a great OB/GYN I felt that what I was feeling was minimized which prompted me to feel that maybe it was not a big deal and it would eventually get better. I felt that as a clinician I had the necessary tools to figure it out and enough emotional support to get better. But through my experience, I learned that it doesn’t matter how much clinical experience you have, when you experience depression or anxiety, you experience it like anyone else and need the external help to cope and get better just like anyone else who is not in the field would.

One of the biggest barriers for women to access treatment, for postpartum depression or PMADs in general, is the stigma associated with Perinatal Mood and Anxiety Disorders (PMADs). Identifying, assessing, and treating PMADs is vital for optimal developmental and psychological functioning of the whole family. In many cultures women are just expected to get motherhood or “tough it out” or “deal with it”. For example, in my own culture discussing mental health and treatment is still taboo among the older generation before and fortunately it is getting better with my generation and the younger ones after mine.

It was just recently, that I begin speaking to my mother and aunt about my own experience. At first, they were dismissive but when I explained what I had been experiencing they recognized the changes in me and even shared their own emotional experiences of being single working mothers and admitting that they might have experienced a PMAD without knowing it.

Although discussion surrounding mental health among those of my generation and younger is getting better, I believe that speaking about PMADs is still difficult to do because of the influence of the older generation. I think it is easier to talk about how hard motherhood is and how overwhelming it can be because it’s an easier topic, but, when it comes to discussing matters like a mood disorder or anxiety, it can be scary and overwhelming. Sometimes, we feel that if we just “deal” with it, it will get better without realizing that the sooner you receive the help you need the sooner you can feel better.

In articles I have read and podcasts I have listened to regarding PMADs, the discussion of the negative impact of the lack of community that exists now on mothers and families as a whole. I also believe, that the lack of community contributes in part to a new mother or even a repeat mother in feeling isolated and alone. This why it is so important to reach out to other mothers, join groups where you can connect with its members and even going out of your own circle of friends to make new friends. Making new friends as an adult is not easy but it is not impossible either. You’ll be surprised at the connections you can make with new people that you meet.

Talking about it openly, spreading awareness, getting the necessary help and not shaming other mothers for their struggles helps with reducing the stigma surrounding PMADs. In the medical field, better perinatal and postnatal medical care for the woman and better PMADs screening is needed for early detection that can lead to appropriate interventions.

Luckily, the awareness is increasing and positive changes are being made, slowly but surely. I did not experience PMADs after my first son but did after my second when perhaps those around me, including my doctors, felt that I did not need the extra support. When in reality, I needed it even more after my second son because every birth experience is different. If you feel that you are not your normal self, you are probably right. Speak up, speak up multiple times and get the necessary help. “Your future self will thank you” is often used but I guarantee that your CURRENT self will thank you even more!

Click for additional resources and support click below:
Postpartum Support International: https://www.postpartum.net/get-help/help-for-moms/
The Motherhood Center: https://www.themotherhoodcenter.com/
Seleni Institue: https://www.seleni.org/
Postpartum Support Resources for New Moms: https://mommypoppins.com/new-york-city-kids/community/postpartum-support-resources-for-new-moms-in-new-york-city

With Gratitude,
Christy R.