Letters to the Editor
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A few important questions
According to the Associated Press, up to 80 percent of women suffer from what the bill refers to as "baby blues," defined as "mood swings, feelings of being overwhelmed and irritability." For about 10 to 20 percent of new mothers, these postpartum depression symptoms are more severe, and can happen any time during the first year of a baby's life. And then there are the unfortunate mothers who suffer from postpartum psychosis, which the AP says strikes about one in 1,000 new mothers, and can make you "lose touch with reality" and experience "delusions, auditory hallucinations, paranoia and hyperactivity." For these poor people, having a baby makes their minds behave like they're on drugs.
These figures raise some questions in my mind. First, a qualification: I'm not a mental health professional (although I worked in a psych clinic for some years) and I'm not intending to question the very real mental health suffering that some mothers endure after giving birth. And yet...the 80% who suffer from "baby blues" seems to me to be what one would expect, given the hormonal swings, the massive change to the mother's life circumstances, changes in her relationship with her partner (if she has one), changed social roles and expectations, a far shorter period of bonding allowed under maternity leave (in the US, at least) than is desirable, and other factors. I can understand that. In fact I'd be surprised if only a minority of women experienced some blue feelings in the immediate postpartum period.
Moving on to the other figures is where it gets interesting for me. Ten to twenty percent of new mothers experience more severe depression in the first year after the birth. OK, that sounds like a major problem. First, though, we need a more precise definition of "severe"--are we talking suicidal depression? Bedridden and unable to function? Completely withdrawn from family and social life? Neglecting the baby? Or just a more prolonged, chronic depression than your typical mood swings and "blue" periods, if still able to function? Does the "severe" refer to the deepness of the depression or the length of its presence? And more importantly, what percentage of women in a statistically valid sample would be expected to experience at least one episode of moderate to severe depression in any given year? If I had to guess I'd say 10% or so would be a reasonable estimate, but I could be wrong.
The last stat I find the most intriguing. One out of 1000 new mothers can be expected to suffer from postpartum psychosis, as described in the passage quoted above. I guess my question is, out of the population as a whole, what percentage of people suffer psychotic episodes in any given year? What percentage of people are prone to psychosis--whether chronic or episodic? One out of 1000 people isn't very many--that translates into only 300,000 people of all ages and genders in the Unites States. Certainly many millions of Americans seek mental health treatment in any given year--from mild talk therapy and counseling sessions to psychiatric treatment with intensive medication and in some cases hospitalization. Is it so far-fetched to think that a small percentage of those people--a few hundred thousand in the country as a whole--suffer from severe mental illness, up to and including schizophrenia and other psychotic conditions?
I guess what I'm getting at is this: Is it possible that what we're considering PPD is actually just the normal level of mental illness--mild to severe--that we'd expect in our population of mothers, as opposed to a completely unique syndrome or condition precipitated by pregnancy and birth? Or, at most, a slight enhancement of the normal level of mental illness we'd find in this demographic, caused by the peculiar conditions surrounding pregnancy and birth and new motherhood? And, if either of those possibilities is indeed the case, are we creating a new syndrome or diagnosis out of thin air solely due to the sociocultural baggage that accompanies infancy and motherhood? (As in, our culture expects--unrealistically--ALL new mothers to be positively thrilled and glowing and boundlessly happy at their new status, and if some aren't we immediately begin thinking they're mentally ill?) Have we fallen into the trap of demarcating the full spectrum of normal mental illness among the population like this: If you're a woman who's depressed or psychotic and you're NOT a new mother, then you'll be diagnosed with whatever condition is appropriate based on your symptoms; if you're a woman who's depressed or psychotic and you ARE a new mother, then you'll automatically be diagnosed as suffering from PPD? Does PPD mean anything more than "any regularly diagnosed mental illness that happens to be diagnosed in a mother in the year or two after she gives birth"? If that's what it is, then why are we expending so much energy to create an unnecessary new syndrome? Is it only due to the social expectations that would cause many people to treat judgmentally a new mother who's not always beaming with joy? Since our society, unfortunately, still judges the mentally ill contemptuously in far too many situations, is PPD little more than a contrivance to deflect society's harshness towards the mentally ill away from new mothers--to give them a convenient shield, as it were, by blaming their mental issues on the pregnancy and birth itself?
I'm not saying I have the answers to all these questions, but I am curious. Would anyone care to share their thoughts on this topic?