Graphic by Penelope Taylor ’20
BY IVY LI ’21
Today, the phrase “postpartum depression” is not considered unfamiliar psychological jargon. The concept of postpartum depression was first explained in the British Journal of Psychiatry in 1968, attributing depressive symptoms often experienced after birth to factors such as hormone level fluctuation and external stress. Postpartum depression is characterized by low mood, fatigue, poor concentration, loss of appetite and insomnia. It can be seen as a prolonged, severe version of “baby blues”: mild irritability, fatigue and anxiety that occurs after childbirth.
Data collected by the World Health Organization shows about 10 percent of pregnant women and 13 percent of women who have just given birth experience mental health complications, with the most common disorder being depression. Beyond the mother’s suffering, postpartum depression can result in neglect and even harm to infants. This impaired bond between mothers and their babies in early developmental stages may lead to later cognitive and behavioral problems in children.
“The Center on the Developing Child at Harvard has applied the metaphor of ‘serve-and-return’ – which best supports early brain development,” said Kelley O’Carroll, a professor in the psychology department at Mount Holyoke. “In the case of postpartum depression, that pattern of responsiveness is interrupted.” O’Carroll explained that if the interruption is chronic, it can inhibit language development, physical development and emotional development.
Last week, the U.S. Preventative Services Task Force, a national panel of health experts, reported their findings on early prevention programs and later intervention programs including physical exercise, expressive writing, educational programs and advice. Among these, counseling programs were met with the highest rate of success. Specifically, 39 percent of mothers who participated in cognitive-behavioral therapy programs “Mothers and Babies” or “Reach Out, Stay Strong, Essential for New Moms,” have reported a reduction in depression.
This early counseling is crucial in identifying women who are at risk and in eliminating full-blown depressive symptoms later on. This is especially true for women with one or more of a broad range of risk factors, according to the panel members. These factors include but are not limited to a family history of relevant psychological symptoms, recent life stresses from divorce or economic strain, traumas like domestic violence or personal losses. Others may come from unplanned parenthood, low socioeconomic status and education or an unsatisfying marriage or employment.
In terms of other prevention methods, the panel also studied potential side effects that some medical treatment, such as antidepressants Zoloft and Pamelor, can cause: mothers prescribed such medication have reported instances of dizziness and drowsiness. These common side effects do not necessarily cause harm to mothers, but are not as effective as postpartum therapy.
In many cases, treatment is too costly or inaccessible for parents to take advantage of. Postpartum therapy is not widely offered and so the cost of transportation and childcare is prohibitive. Dr. Felder, quoted in the New York Times, said that some online lessons or apps might be helpful in preparing mothers with coping strategies and encouragements, while saving their time in commute. The panel also recommended insurance coverage for mothers to defray associated costs.
“Unfortunately, there is a great deal of stigma surrounding [post-partum depression],” said Hannah Knapp-Broas ’21. “People report feeling guilty for being unhappy following the birth of their baby, since society expects new parents to be joyful.” Many who suffer postpartum depression are hesitant to report that they are struggling, or don’t even realize their feelings are worth reporting. “Even until today, more related educational programs and social workers should be established to promote care for the mothers,” said Knapp-Broas.
As the word “depression” is still considered a social taboo in many cultures, new mothers are labeled “too sensitive,” “weak” or “needy”. Their feeling of reluctance and shame stops them from seeking professional help, makes interventions and treatment more difficult, letting their depression go unnoticed.