Postpartum depression is a real phenomenon, but there are many misconceptions about it. The sea of reliable and unreliable information on the internet keeps people from understanding how postpartum mood disorders work, why they happen, and how to help the women who get them. Here are the five biggest myths out there:
“Postpartum depression makes women kill their children.”
This is the most dangerous and pernicious myth about postpartum depression. It is not true, and to understand why, let me describe the three types of postpartum disorders.
- Postpartum Blues – When a woman feels sad and moody during the first ten days after giving birth, this is postpartum blues. These feelings go away quickly without needing treatment beyond some tender loving care. Anywhere from twenty-five to eighty-five per cent of women who have babies experience some symptoms of postpartum blues.
- Postpartum Depression – When a woman feels so sad, lonely, and hopeless such that she finds it difficult to function for two weeks or more, this is postpartum depression. It is very similar to the major depression people in general experience. A woman can get great relief from therapy with a psychologist, and/or anti-depressant drugs like Zoloft.
- Postpartum Psychosis – This refers to the rare occasions when a woman who has had a baby in the last month has a psychotic break with reality. She may hear voices, have delusions and hallucinations, and may consider hurting herself or her child. She needs to be immediately hospitalized and treated with anti-psychotic drugs and/or mood stabilizers. One of the most famous cases is Andrea Yates, who believed she was possessed by the devil and thought the only way she could only save the immortal souls of her five children was to kill them, which she tragically did. About one per cent of women who have babies suffer from postpartum psychosis, and this is the only postpartum condition that presents that kind of risk. And even so, ninety-four per cent of women with postpartum psychosis don’t harm their children, so we are talking about very few women here.
“Postpartum depression is caused by hormones.”
Women’s hormones get mistakenly blamed for so many illnesses people imagine women to have – PMS, baby brain, and menopausal meltdown. And postpartum disorders are no different. Hormones play a small role, but not the one you think.
For the fleeting tearfulness or irritability many women experience with postpartum blues, it is very likely that decreasing hormones in the first few days after childbirth are responsible. But the big surprise for most people is that hormones play no meaningful role in the development of postpartum depression – the longer and more serious depression that about ten per cent of new mothers experience.
The most powerful cause of feeling depressed after you have a baby is being depressed before you had the baby. Also important is how things are at home – do you have someone to give you a break to take a shower? Are you happy with the participation of your partner? Does your baby nap? All of these are more important in predicting whether you will get postpartum depression than changes in hormones.
“If you have postpartum depression, you are a bad mother and don’t love your child.”
This myth speaks to the image of the ideal woman: someone who always is happy and gets great satisfaction from caring for her children – a tough image to live up to. When my first daughter was born, I was traumatized by an unexpected cesarean delivery. I was isolated and had no friends who were mothers and there was nothing I could do to stop her colicky crying for hours. My daughter was beautiful and healthy and of course I loved her, but my daily circumstances made me severely unhappy. It didn’t mean I was a bad mother, just a human one.
“Postpartum depression can’t be prevented.”
One of the worst conclusions people make when they mistakenly believe that postpartum depression is caused by hormones is that it is unavoidable. This couldn’t be further from the truth. Obstetricians and midwives can screen their pregnant patients for current depression to identify women who are likely to need help. As part of childbirth education, women can be encouraged to marshal all the social support they have for the first weeks of motherhood to ease that transition. Hillary Clinton wasn’t kidding when she said it takes a village.
“Postpartum depression is just a woman’s problem.”
Postpartum depression hurts everyone. A new mother’s feelings of sadness and hopelessness can make everyday life hard to get through for her, but they also impact her family. Babies of mothers with postpartum depression are at risk for emotional and developmental delays and deficits. If she has older children, her depression can alienate them and create emotional distance. Her relationship with her partner may suffer as well. When postpartum depression is treated or even prevented, everyone benefits.
If you want to know more about how everyone gets it wrong when they blame women’s emotions on hormones, read my new book The Hormone Myth: How Junk Science, Gender Politics, and Lies About PMS Keep Women Down, available at booksellers everywhere.