Postpartum Depression Remains in Shadows Despite Awareness Efforts

Young mother looking out from the window with her babyThe stress and demands of a newborn can cause a new mom to feel “baby blues.” When a new mom doesn’t immediately experience elation she may wonder what’s wrong with her. It’s common for many women to take weeks or months to form a strong bond with their baby, but for some the symptoms can become serious postpartum depression.

Karen Kleiman, M.S.W. and Valerie Raskin, M.D. brought postpartum depression into the national spotlight with their 1994 book This Isn’t What I Expected: Overcoming Postpartum Depression. As a second edition was recently released, Kleiman notes that while more people know what postpartum depression is, not much has changed in terms of screening.

Women are asked to return to their obstetrician for a follow-up visit at six weeks. However, a study conducted at Johns Hopkins published in the Journal of General Internal Medicine found that fewer than half of women attend their six-week check-up. Even if they do postpartum symptoms may be months away from appearing.

Conversely, some women experience symptoms soon after delivery, and waiting six weeks to address depression could be deleterious to both the mother and child. Early detection is critical when treating mental disorders, and six weeks could turn into months as the physician attempts to connect the patient with appropriate treatment.

Some recommend the postpartum depression screenings with a family doctor or pediatrician. Others disagree whether this would be effective, given that many mothers would be reluctant to tell a pediatrician that they are experiencing difficulties. It’s common for women to put on a “perfect mom” face when they visit the pediatrician, hoping to not give the doctor any reason to believe there could be problems at home.

Kleiman notes that not only are women not talking with doctors about their symptoms, but they may not be talking about depression to anyone. Heidi Murkoff, author of What to Expect When You’re Expecting, says that women are still not talking about postpartum. However, Murkoff says that if she is in a discussion and she brings up the topic, she is flooded with responses. But until she raises the issue, women are not willing to volunteer that they have struggled with postpartum.

Symptoms of postpartum depression include sadness, fatigue, irritability, struggling to bond with one’s baby, social withdrawal, feelings of inadequacy and other symptoms. They are more intense and last longer than those generally described as baby blues.

Kleiman says that it may be the feelings of inadequacy that are most effective at preventing women from disclosing what they are experiencing. The desire to be a good mom is so overpowering that, ironically, it may prevent them from getting the help they need to care for their child.

Advocates stress that screening for postpartum depression only take 10 minutes, and that universal screening should be implemented. Some experts believe it could significantly improve the number of women who receive treatment.

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