One of themes of this blog is that natural parenting renders women’s needs invisible. Whether it’s childbirth, breastfeeding, or attachment parenting, women’s pain, distress and mental health are ignored.
Why? Follow the money. Natural childbirth advocates ignore women’s pain in labor because they can’t treat it effectively; lactivists ignore women’s pain, frustration and inconvenience with exclusive breastfeeding because to accept it might mean a loss of market share; attachment parenting advocates ignore women’s mental health because that might cut into profits for the books and products that they sell.
[pullquote align=”right” cite=”” link=”” color=”” class=”” size=””]Postpartum depression is a disease not a mood change.[/pullquote]
But as Marianne Williamson demonstrates, natural parenting advocates are hardly alone in rendering women’s need invisible while clawing for market share.
Yesterday on her Facebook page, Williamson, a self described “acclaimed author and spiritual teacher” offer this bit of ugliness:
U.S. Preventive Services Task Force says women should be “screened for depression” during and after pregnancy. Their answer, of course, is to “find the right medication.” And how many on the “Task Force” are on big pharma’s payroll? Follow the money on this one. Hormonal changes during and after pregnancy are NORMAL. Mood changes are NORMAL. Meditation helps. Prayer helps. Nutritional support helps. Love helps.
Wialliamson’s ignorant, self serving justification for minimizing the seriousness of postpartum depression has not gone unnoticed. Suffers of postpartum depression and those who care about them have created a social media campaign on Twitter with the hashtag #MeditateOnThis, seeking to educate Williamson. Thus far it appears to be having little effect on Williamson herself.
Why did the USPSTF recommend screening for postpartum depression?
… Depression is … common in postpartum and pregnant women and affects not only the woman but her child as well.
What’s the advantage of early detection by screening?
… [P]rograms combining depression screening with adequate support systems in place improve clinical outcomes (ie, reduction or remission of depression symptoms) in adults, including pregnant and postpartum women.
… [T]reatment of with antidepressants, psychotherapy, or both decreases clinical morbidity.
… [T]reatment with cognitive behavioral therapy (CBT) improves clinical outcomes in pregnant and postpartum women with depression.
Williamson derides the USPSTF screening program as an effort to increase Big Pharma profits. Curiously, she fails to note the the Task Force recommended talk therapy and cognitive behavioral therapy as often as medication. And she fails to note that the Task Force highlighted the risks of medication for depression.
… [S]econd-generation antidepressants (mostly selective serotonin reuptake inhibitors [SSRIs]) are associated with some harms, such as an increase in suicidal behaviors in adults … The USPSTF found evidence of potential serious fetal harms from pharmacologic treatment of depression in pregnant women, but the likelihood of these serious harms is low…
Why does Williamson oppose the recommendations to screen women for postpartum depression? Follow the money. Women who are depressed are more likely to buy her books and attend her seminars. Screening women for depression and treating them with effective therapy undercuts her market share.
Williamson no different from natural childbirth advocates who insist that childbirth pain is “normal,” that treatment with ineffective methods that they profit from (waterbirth, hypnotherapy) is best, and that effectively treating it with epidurals is “giving in.” Williamson insists that the pain of postpartum depression is also “normal,” that treating it with meditation and prayer (her products) is best, and that effectively treating it with medication is “giving in” to Big Pharma.
Williams is a New Age “faith healer,” putting her needs ahead of effective treatment. She’s the updated version of those who advised prayer for diabetes or insisted that epilepsy was a sign of possession by the Devil. Her profit is more important to her than women’s need to live free of psychological pain.
I suggest that she meditate on this:
Postpartum depression is NOT a normal hormonal change.
Postpartum depression is NOT a normal mood change.
Postpartum depression is a disease, no different from diabetes or epilepsy.
While prayer and meditation may help manage the symptoms, they are not a treatment for postpartum depression any more than they are a treatment for diabetes or epilepsy.
Women’s needs MATTER. Women have every bit as much right to live without psychological pain as to live without physical pain.
Most importantly, women’s mental health is more important than your financial health.
I took your advice to follow the money, Marianne Williamson, and it led me right to your bank account. You’re like the natural parenting industry: your profits rest on demonizing what you can’t offer and promoting what you can, women’s needs be damned.
*sigh* I’ve had the ‘baby blues,’ and I’ve had real depression. There is no comparison. This woman is worse than stupid, she’s dangerous. The *worst* thing you can tell a depressed person is to ‘just get over it.’
Here goes off the tale of the Duchess of Cambridge’s euphorical, easier-than-breathing natural birth, bonding with her midwives and so on.
My SIL doesn’t have a team of experts whose only job is to make her look glamorous. But she looks it anyway in her first picture with Treasure. She only had herself to comb her hair, do her makeup and so on. She didn’t have an euphorical birth. Instead, she’s lying in ice packages because she’s all stitches. She hasn’t been allowed to hold the baby on her own, let alone breastfeed her. Looks like her labour was very short for a primip – 9 hours from, “A contraction or thaat yoghurt” to Treasure out and it was intense. But she looks glamorous anyway. Why not? She’s made up. She has a baby. She’s beside herself with joy. She looks far better than she feels. Actually, far better than Duchess Katherine. I suppose it’s not being forced to walk out and look glamorous that does it.
You can look glamorous and euphoric without easy natural labour.
lol, i couldn’t look glamorous and euphoric with an easy labor and a team of Hollywood grade cosmotologists.
I suspect I can’t either. But she somehow manages it. There are such lucky ladies. Must be a tradeoff for enjoying the pregnancy from hell. At one point, she was freaking out that Treasure would only endure chocolate. Some women crave chocolate after birth because they’ve been eating healthy. SIL is craving greens and fruit since Treasure firmly refused to be fed healthily for 8 months and a half.
Repeat after me kids: mental illness IS a real illness. Mental illness IS a real illness.
Thank you.
Didn’t they learn anything from Charlotte Beevan’s tragedy?
I thought we were one of the few countries where mental illness is treated as a second-rate illness, aka treatment is fucking neglected.
One can always learn something new…
The peri-natal Psychiatrist I was sent to see after my post-natal suicide attempt told me that as I was “intelligent, articulate and middle class” the statistics suggested I’d be fine and to come back if I wasn’t. Luckily for me he was correct, I am getting better (without medication I might add) and whilst I am seeing a Psychologist that’s for the original trauma as opposed to my son’s arrival (or at least it would be if I’d stop changing the subject and actually talk to her).
I think that’s why Williamson’s comments annoyed me so much. Women like me are told to get on with it, told to lean on friends and family, told to do all the “yummy mummy” stuff (Health visitor’s words not mine), the prayers, the mediation, told essentially to grow up and stop whining. Which is fine, that’s pretty much what I’ve tried to do in between the tears and hysterics and the self hatred and all the rest. However it’s that dismissal, that sense that all women go through the exact same thing and you’re just pathetic for making a mountain out of a molehill that makes it worse. No idea maybe every other woman out there could have had the same specific experience I had of childbirth and then pull up her cotton socks and get on with being a Mother without floods of tears and the odd breakdown, I don’t know. The part of me which is currently at war with my Psychologist would say “Yep”, but that core of rationality says “hell no”.
I asked the Health Visitor for help not long after I came home from hospital and she said “Well if you were poor we’d refer you to Home Start” and then went to talk about a couple of other things but they were all geared around the basics like going to the shops or being taught how to play nursery rhymes, stuff I was forcing myself to do anyway so it was deemed helping me would be a waste of resources and I (and more importantly my son) would either sink or swim. Midwives, Health Visitors, family.. they suggested all sorts of “hippy” things from co-sleeping, continuing breastfeeding, shared baths, baby wearing, bonding with your uterus (who knew there were uterus knitting patterns) so many weird things in fact I think I could sustain a blog on the subject of unhelpful tools for dealing with post-natal depression but nothing practical at all.
*imaginary hugs*
How awful that you were treated that way! “Bonding with your uterus” WTF? I hate how bonding is treated as (a) a magical cure-all, and (b) something that we have complete control over.
I’ve got one of the uterus knitting patterns saved on my ravelry page. It is somewhat cute with big eyes and I thought the giant happy smile could represent my section scar plus it’s got pom poms…. which I’m assuming are meant to be the ovaries (biology not my strong point) and pom poms make everything awesome right?
Although to be fair, she didn’t go into details of how to bond with a uterus just suggested I try it.
I like the dissected frog one
I might learn to knit to make a dissected frog.
Erin, that all sounds deeply unhelpful.
I’m often more worried about the “middle class, intelligent, articulate” patients.
If the sort of person who has the coping skills to manage a high stress career and various life stresses without difficulty and who always looks immaculate and has a positive attitude is suddenly sitting in front of me in her pyjamas, unkempt, unwashed, crying and telling me life isn’t worth living and that she’s tried all the common sense things the HV suggested and has loads of family support, it suggests things are really bad.
The lonely young mum who is isolated in a high rise flat and struggling with the basics of parenthood is, in many ways, an easier fix.
“If the sort of person who has the coping skills to manage a high stress career and various life stresses without difficulty and who always looks immaculate and has a positive attitude is suddenly sitting in front of me in her pyjamas, unkempt, unwashed, crying and telling me life isn’t worth living and that she’s tried all the common sense things the HV suggested and has loads of family support, it suggests things are really bad.”
this is exactly my philosophy, too. you’ve expressed it perfectly.
Ah but you’ve pretty much summed up my problem. As my Psychologist says “I’m my own worst enemy”… thanks to Mummy dearest’s conditioning when I was a little girl, I’d rather pull my own nails out and stick needles in my eyes than leave the house in my pajamas.
At least it’s getting to the stage where I can laugh about aspects of it and certainly in the run up to getting my first psychologist appointment this website and it’s motley crew of commentators helped more than all the various NHS minions I encountered added together so here is a heartfelt thank you <3
She can meditate while I take my Zoloft and Ritalin. I figured out I could breastfeed on a low dose of morning Ritalin, started taking Zoloft, and I feel like a million bucks. I didn’t think it was that bad. It was. Being properly treated is awesome.
Her comments were certainly completely out of line and unscientific, but there is an underlying problem with recommendations like these, and it is money. Depression screenings cost time and money. I am not debating their usefulness or necessity, but the reality is, that somebody has to pay for it. I’ve mentioned it before, but there is a sub section of “natural childbirthers” that make that choice due to financial reasons. Yes, hospitals/doctors will treat them if they can’t pay. Yes if their income level is right they qualify for aid. All that being said, for a group of middle classers (especially among those opposed to government aid) commitment to “natural parenting” is about the cost.
The problem is, is that these people are too embarrassed to admit that it is about cost, but if you keep your ears open you will hear it. We saved so much money using a birth center, breastfeeding is cheaper, big pharma this, OBs just want more money that.
Yes, they could take on debt or empty out their savings account, but if you have a high deductible or are a self pay patient you feel each procedure in your pocket book. These ladies, sometimes with significant pressure from their husbands, walk into a hospital room and announce they want anything that is not free to be removed. They bring their own diapers, their own advil, their own pads. They see a midwife because she is cheaper. They don’t want the baby warmer because they’ll be charged. You can forget about using the nursery. They leave as soon as possible because they will foot the bill for the “extra” stay. They would gladly take an epidural, but they know the cost, so they bare the pain. They don’t want to risk a VBAC, but they remember the operating room fees from their last C-section.
The worst part is, is these families would never dream of saying they based their decisions on money, at least not to most people in their lives, so instead they buy the woo. And then to make themselves feel better about the woo they sell it to others. They don’t mean to, but it happens. These women are part of a cycle of abuse that never gets talked about. They are asked to be their own abusers, and sometimes they become the abusers of other women. Under duress they choose to make the hard financial choices for their family even if it means getting subpar care for themselves and sometimes their baby.
I will say it. I did the best I could with some of my own prenatal care to avoid the cost of going to the doctor as long as everything at home looked fine. I did my own urinalysis. I checked my blood sugar with a glucose meter at home and skipped the test since my numbers looked good, we checked the babies heartbeat with a fetoscope. I waited until the last second to go to the hospital. I brought my own everything right down to the chux pads. I wanted an epidural when the pain became terrible and I was near to passing out, but I didn’t say a word. We left early against medical advise. I use cloth diapers. I breastfeed.
I am not the only one. I know others. If you listen closely you will know them too. Next time someone with a high deductible or no insurance says they want a natural childbirth don’t assume they want it for the same reasons as some of the quacks out there. Every woman is an individual and every woman has a different story. There are some despicable promoters of natural childbirth out there, but there are strong and amazing women doing the best they can with what they have as well.
I battle myself on this all the time. With my second, I kept thinking about how much the epidural was going to cost me and I had to keep reminding myself through the whole labor that I was worth it. Every time I fill an expensive prescription for the family, I remind myself and my husband that health care is not the place to cut corners. We have had to make a lot of lifestyle adjustments to afford our health care to make sure we don’t go without (ramen and mac and cheese is a staple at our house). And we are lucky that I have a good paying job.
is it at least organic, gmo, whole grain, free trade, gluten free, vegan, homemade ramen?!?
/snark. i’ve been there
Any providers out there ever had a patient be up front about this issue? I’d be curious about their reaction/opinion. I have a close friend who is very up front about being self pay and got very little cooperation from her providers. She was hoping for information about exactly how much each prenatal test cost and what items would cost during labor and delivery. She was shut down and shamed for not “putting her baby first.” It seems like there should be a way to equip women with the information and support necessary to get the most “bang for their buck”. I know that labor and delivery are always unpredictable, but there should be itemized cost list more readily available to patience who ask.
We have a lot of poor patients in the area I practice in. Actually, a fair amount of them are upfront that cost is an issue but I know that there are more patients who don’t talk about it, mainly those that seem well off but may not be. Hell, I have to weigh cost as part of the decision making for every medical test because our insurance isn’t great (and I’m a HCP!) I’ll never forget the year that we finally paid off our deductible only to have hubby’s employer change hands in August and we got a new insurance and new deductible then. As soon as we paid that, it was January again and, you guessed it, new deductible again! That year, we spent $7500 just in deductible and a few thousand more in copays. In the US, more and more patients have “high deductible plans” and have to pay a lot out of pocket. I have had patients ask how much procedures and tests cost and we can call and ask, but the problem is it varies so much from facility to facility. There isn’t a lot of transparency in pricing in healthcare in the US. It is frustrating for patients and providers alike. The system doesn’t work and routinely bankrupts families.
wow. thanks for sharing that raw, honest perspective.
Whoop! YAY! Congratulations all around. I bet you’re beyond excited. Do they live close to you, or is an airplane involved in you getting there?
A bus. Six and a half hours from here to there. Seven and a half, perhaps, because it’s current;y a white fairy-land here.
Thanks, thanks! Beyond excited, indeed.
OT: She’s here! Not-So-Little-Treasure arrived! At 5 am the Intruder was like, Perhaps we’re having a baby now? For two hours now? At 12 am she was here. Everyone healthy, SIL recovering with her 9multitude of) stitches, baby looks glorious.
I am an aunt!
congrats, Auntie!
Thanks! Can’t stop smiling!
Hurray, hurray, hurray! Congratulations! Go get yourself lots of newborn snuggles!
Thanks, thanks. That’s the plan. After all, I am the one assigned to them.
Hooray!
Yes, yes!
Great news! Congratulations!
Great news indeed! The not so great part is that Treasure’s auntie might soon suffer a dislocated jaw… At any rate, a great day!
Congratulations!!!
Thanks! Sooooo thrilled!
Serious question: is there a correlation between depression and education level?
Yes, but in a roundabout way. Lower levels of education are correlated with lower levels of income which are correlated with single parenthood, decreased social support, increased relationship violence, increased stress, compromised ability to obtain treatment, on and on and on we go… all of which influence depression.
While Marianne Williamson is entirely irrelevant in my life, her opinion on the treatment of PPD (and by extension, mental illness in general) nonetheless angers me. I’ve not had PPD, but I did decide to kill myself a little over four years ago. My faith in God played a significant, central role in climbing out of that hole – and a large part of that was knowing that He gave people the brains and abilities to make antidepressants.
I simply REFUSE to be ashamed for taking antidepressants. They helped me think straight which helped me deal with things I needed to deal with. So, please, everyone: Just shut up if you can’t find it within yourself to be supportive of someone, especially a new mother, who is seeking help. Get on board with her doing what she needs to do or get out of her life.
People are living in misery and even dying because of the shame and stigma. That breaks my heart. Mamas, you take those pills if you need them. You are beautiful and awesome and it’s one-hundred percent fine for you to do so.
Very important comments, Marie. Why should ppl with a serious illness be embarrassed for accepting effective treatment? Depression is not a failure of will, and accepting treatment is a rational choice – whether it is talking therapy, medication or both.
Depressed people should be as ashamed of taking anti-depressants as diabetics should be of taking insulin. As in, not at all and outside of extreme faith-healing circles, there’s no shame attached to it.
Ugh, just had this forwarded to me. Where do these grand statements come from? Thoughts Dr. T?
http://www.eurekalert.org/pub_releases/2016-01/tl-tli012716.php
I’m working my way through the new Lancet series on breastfeeding that claims that 800,000 lives could be saved if breastfeeding rates were increased world wide. I’m having trouble figuring out how anyone can make that claim when the countries with the highest infant mortality rates are the countries with the highest breastfeeding rates. Infant mortality seems to be far more closely tied to per capita income than to breastfeeding.
I used the authors’ data to create a scatter plot that shows absolutely no correlation between breastfeeding rates and infant mortality. Apparently they base their claims NOT on population data but on small studies.
My quick look made my head spin. Looking forward to your analysis. And yes, it looks like all the “lower SIDS, diabetes, asthma, breast cancer…” claims are coming from smaller studies and being assigned. Or something haha…
Here’s the scatter plot that I made comparing breastfeeding rates at 1 year with infant mortality rates. This certainly doesn’t show that breastfeeding saves lives:
Why, no. No it does not.
To paraphrase “The Princess Bride”: You keep using that data. I do not think it means what you think it means.”
😉
I’m looking forward to your analysis. That was the first of many things in that link that screamed “where in the heck did that come from?” A lot of what’s parroted there seems to be wishful thinking that’s not backed up by actual science.
I wish I could talk MrC into paying for a few additional journals. We get biophysical, biochemical and pharmaceutical journals, along with one generalized science journal, but no medical journals. I’d like at least online access to the big ones, but he won’t go for that.
You might be able to get the Lancet articles for free if you sign up at the Lancet.
I don’t doubt that breastfeeding is better than formula made with contaminated water, but it seems like you could save a lot more lives by giving people access to clean water instead of promoting breastfeeding.
Oh, I absolutely agree that breastfeeding is better if there’s no stable access to clean water, but the number quoted seems awful high. The other wtf moment was when they started talking about “near universal rates” of breastfeeding. What world are these people living in to think that’s possible, let alone desirable?
And I’ll go check out what the Lancet site has to offer. Thanks!
And I would bet that policymakers aren’t interested at all in doing things that would be necessary to truly encourage “near universal” rates, e.g. paid maternity leave. Nah, this will just turn into another excuse to shame mothers by using some silly advertising campaign or locking up formula.
Nope. The city of Washington DC is trying to implement universal 4 month paid parental and family leave. That sound you hear, crickets chirping.
We need massive overhaul to maternity leave, yes, but there will always be those women who, even with the offer, *want* to work. And I don’t find any shame in that (and I’m not suggesting that you do, just conversing :). I went to school for 9 years just to land the entry level position to do what I do. I love my job. My workplace is very progressive and would grant me over 6 months off with full pay to stay home after having a baby. I voluntarily return after 2 weeks every time. Because I want to. While a year off is cool, for me it means loss of crucial cumulative on-the-job experience, being less likely to get promotions, putting off major projects (many of which are grant funded and have timelines), playing catch up with policies and practices that change while I’m away – everybody else will keep progressing in my absence. A year away would not be without significant “cost,” even if it is financially compensated.
Oh I totally agree. My job is the same way. It’s really hard to get back in the groove if youve been gone a while. I don’t have any paid maternity leave but it’d be a tough call how long to take even if I did. Taking leave is not just about breastfeeding and should be a choice for all parents, but it certainly shouldn’t be a mandate.
And, you know, clean water could benefit a lot more people than just formula fed infants 😉 It’s probably a worthwhile endeavor.
Simply giving women access to clean water and quality food would probably increase breastfeeding rates by itself. It’s probably hard to breastfeed properly when you don’t have enough food for yourself or need to walk ridiculous distance daily to get contaminated water that might make you sick. But yelling at women to magically breastfeed more is less expensive.
Lots of sensible comments correcting her on that post – hopefully they don’t get deleted.
You have to wonder about the gullibility of the believers who can only “follow the money” to pharmaceutical manufacturers who make well-tested products, but can;t “follow the money” to snake-oilers who sell their untested workshops and populist books.
OT: Just checked out this Marianne’s FB page and guess who’s a fan? My dumb ass, home birthing, organic maple syrup producing, “cancer isn’t real” acquaintance who I referenced in another post. The irony! This right here explains a lot about Marianne.
Heh…your acquaintance sounds like the girl I knew who fell into that stuff, too. Right down to making her own syrup…
As a currently pregnant soon-to-be mother suffering from antenatal depression… No. Meditation and prayer are not enough. Nutrition hasn’t been enough. Even exercise hasn’t been enough. The weight that has dragged me under so often these past five weeks of depression is something I can’t manage with my own interventions.
It’s taken decades of education and campaigning to raise the profile of PND as an illness and encourage people to get help.
Sufferers hardly need people like this dragging it all back down again.
I am so very sorry you’re going through that. Haven’t had AND, but PPD kicked my butt, to say the least.
Please don’t take this at all the wrong way, as I don’t know your background, but–did you know that some antidepressants are considered okay to take during pregnancy? Apparently, care providers are becoming increasingly aware of AND, and in general more willing to prescribe for it during pregnancy. I honestly didn’t know this until I read a (for once, sensible) blog post by a mom who had it and wrote about getting a script and subsequently becoming herself again, thanks to a smart OB. On the off-chance you haven’t, please bring this up with your midwife or doctor; they want to help you! (And if they don’t, I recommend running, screaming optional, to another care provider.)
I wish you the very best of luck in finding a treatment program that will help you! Congrats on the new kidlet, too. 🙂
Antenatal depression sucks. I’ve had it both pregnancies, though I discovered when I finally started taking meds during my first pregnancy that I actually struggled with depression period. Pregnancy made it worse for me, especially after I developed ICP and couldn’t sleep.
Hang in there *hugs*
imaginary fist bump in solidarity. ‘though for me, exercise has only ever left me feeling tired and grumpy, even when my brain and hormones are behaving.
Haha like 2/3 of USPSTF’s recommendations do not include medication. Swing and a miss…
And I’ve heard the lactivist rhetoric that “breastfeeding reduces PPD rates.” In what WORLD is this true? Does anybody know what study they use to cite that claim? Is that like WHO data of women in underdeveloped nations? WTF was the methodology and inclusion criteria, because, ummmm, logic and my own two eyes tell me a far different story.
I think that PPD is multi-faceted, as are most things, but I can’t help but shake the feeling that if lactivism didn’t exist, PPD rates would drop. JMHO.
I’m afraid I can’t remember which study it was, but the actual result is that SUCCESSFUL breastfeeding is associated with lower PPD rates. Unsuccessful breastfeeding is associated with a higher rate of PPD.
Makes sense, though I would further surmise that successful breastfeeding and formula feeding would/could result in equal rates of PPD *if* lactivism wasn’t real. Part of what boosts one’s positive feelings – or creates negative feelings – is the potential for shaming via lactivism. Thank you for some explanation!
I suppose that it could be going in the opposite direction too. Women who are suffering from PPD may have a harder time maintaining breastfeeding.
It’s the whole “correlation does not equal causation” thing.
Also associated with a higher rate of PPD was not initially planning to breastfeed, but ending up doing so.
Interesting tidbit. I quickly thought of a couple reasons why that would be, but I wonder what the real reasons for that are. Were the reasons studied or just the occurrence?
I really need to find this study …. :/
…a quick search does not turn up what I’m looking for but reveals that many of these PPD studies find “lack of social support” somewhere in the top three for significant predictors. Social support goes beyond the family and friend unit. Social support could be the societal norms and values with which many identify and use to judge your maternal worth.
Found it! http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4353856/
It’s worth noting that all of the major associations reported are for mothers that were not depressed during pregnancy. There are also some interesting tidbits about how breastfeeding longer than 6–8 weeks is not associated with significantly lower rates of PPD.
I just did a quick read through (while also trying not to throw something through a window because MrC is listening to the republican debate). My first impression was that it confirmed what any person with 101 level college psychology might have hypothesized. When we want to do something and fail, we have a higher risk of depression. When we want to do something and succeed, we have a low risk of depression. When we don’t want to do something and get cajoled/forced into it anyway, we have a really high risk of depression.
Like CSN0116, I’d love to see a repeat of the study, particularly among that last group, in the wake of increased lactivism and BFHI.
The reasons weren’t studied, as far as I can tell. (I’ve linked to the full study in a comment below.)
Thanks. I just clicked on the link a few seconds ago.
As for reasons, my hypothesis would be a cycle of guilt and resentment started by societal pressure that says that good mothers only breastfeed. So mom wants to, or needs to formula feed for whatever reason, then feels guilty because of the messages received by society, then she resents the baby because she’s doing something she doesn’t want to do or it’s not going well, then she feels guilty for resenting the baby, then she redoubles her efforts, but it still doesn’t work/make her happy and then she resents the baby again, then she feels guilty for that and on, and on and on.
I’m certainly not a doctor or mental health professional, so I could be way off.
Your theory makes perfect sense to me.
I’m trying to understand how – in real life – one intends not to breastfeed but ends up doing so. Because that seems to be the population at greatest risk. I understand that it’s societal pressure, but I’m at a loss for what it actually looks like. You only have a handful of time to decide whether or not to initiate breastfeeding before your milk will dry up and make things difficult. What psychological warfare happened to these women in those precious first days?
Also, this data is from the 1990’s. To see a replication with the insanity we have occurring right now!
And funny that any lactivist would use this paper to support the breastfeeding is the best thing ever campaign. This paper shows nothing. It actually shows that unless under extremely preferable circumstances, breastfeeding is dangerous to mental health. And where it is beneficial, it’s only so for about 4 weeks (ceasing by 8 weeks postpartum if I read correctly). Woopie.
Personally, I think this paper shows that it’s easier to breastfeed when you’re not depressed. The arrow of causation doesn’t necessarily run the way lactivists think.
My guess? BFHI.
An acquaintance of mine had this happen. She started off wanting to exclusively FF, but met an…okay…LC at the hospital who helped her figure out what some of the previous problems she had with breastfeeding were, how to work around them, etc. (I say “okay” in that from what mom says, the LC wasn’t at all pushy and did give good advice, but I do want to know why a LC was sent to the room of a mom who was planning on FF in the first place.)
In that particular instance, baby nursed very well, and after a couple of sessions with the LC, mom said, “eh, what the heck, it’s (relatively) free, and it’s working” and went home breastfeeding. Problem is, mom eventually got tired a couple of months in of being the only source of food and comfort. Ordinarily, not an issue, just switch to formula, but that happened at about the same time that they hit a nasty financial downturn, yet stayed juuuuuuust high enough income that they didn’t qualify for financial help with paying for formula, meaning that mom feels trapped into breastfeeding for another 8 months or so until kid can be weaned onto cow’s milk.
While it’s not the only factor, it’s a strong factor in her subsequent PPD: she can’t get a real break, as pumping doesn’t work for her, baby’s nursing all the time so mom’s very touched-out, and another 8 months seems interminably long to someone who’s in the throws of PPD. Bleh.
Fwiw, if you have a preemie the nurses (in my experience) will do whatever it takes to get you to breastfeed. Plus, when you’ve got a sick baby, it’s a pretty easy sell, whatever your previous plans.
I can almost defend them in those cases even if my (unsurprising) inability to breastfeed (my preemie was my third kid) plus everything else did make the inside of my brain a pretty awful place. At least for preemies breastfeeding has some *actual* health benefits.
I’ve said before that the only reason I’d try breastfeeding, pumping, et all again is if I had a preemie. As you say–actual health benefits, right?
Where I get really, REALLY angry is when it goes from “encouragement” to outright bullying. Shortly before I left the local LLL FB page for good, a new mom posted on there, near-hysterical. Sick preemie twins delivered at 28 weeks the previous day via CS due to mom having an infection. Nurses kept telling her that if she didn’t hurry up and produce breastmilk, her babies could die. Mom was posting while sitting on the bathroom floor, 24 hours post-CS, and pumping. Of all the commenters, I was the only one who asked if she’d eaten lately, showered, been able to sleep at all, had someone to talk to and help with the kids in the NICU. Everyone else? “You can do it, just don’t stop pumping!” Because, you know, mom’s health doesn’t matter at all now that she’s had babies. Plus, she’ll totally hit optimum milk production on no sleep, no personal care, neglecting her own medical issues, and so on, all with nurses blaming her for any downturn in health her babies might have because she must just not be trying hard enough to produce…
And, even worse. Mom’s of preemies have more trouble producing breastmilk in the first place. And a higher risk of PPD. I can’t imagine that the two don’t feed off of each other and create a nasty little hate spiral. They certainly did for me.
Another possibility is – mom loses job, decides to BF to save money since she’s home anyway. Job loss sucks.
Blah, blah, something, something oxytocin love hormone, something, skin to skin, something, something, breastfeeding, blah, blah, bonding, baby wearing, something, blah, blah NO PPD!
Come to think of it, she’s right. From personal experience, I do have a family member with anxiety disorder whose doctor quickly prescribed him medication, saying that CBT and counselling just wouldn’t work for Oliver.
After reading this post, I am utterly outraged. How dare he assume that cats can’t respond to talk therapy!
She’s right about prayer helping. I felt really depressed and so I prayed to Joe Pesci. And Joe Pesci appeared and gave me a hug and some Zoloft so now I feel better.
All Hail Pesci!
I feel like I should share a positive story. I was really lucky and had awesome doctors for the most part when I was in my pregnancy/childbearing years. I’ve had minor depression and anxiety issue since my teens, and given that and my difficult pregnancies, my doctors tended to stay on top of things, so the PPD remained “mild”. I was able to manage with intense therapy until the last baby. When my youngest was in the NICU, I managed to get pneumonia, on top of everything else. I was going downhill fast. I had a 3 year old, an 11 month old, was trying to maintain my full time job as a teacher, had gone on leave at my part time job as adjunct community college professor, and had dropped out of my Ph.D. program. The pneumonia was just the nail in the coffin, so to speak. My psychiatrist wanted to prescribe an SSRI. My insurance wouldn’t cover it and at that time, there wasn’t a generic available. I went to my GP for the pneumonia and broke down. He sent me away saying he’d do what he can and would call me. A few hours later, he called me and said he’d managed to scrounge up enough samples to get me through for a couple weeks, and I could pick them up any time. I picked them up, and when I opened the bag, not only were there a whole bunch of samples, but $200 and a note that said “use this to fill the rest of the prescription”. I told him I couldn’t take that money, but he insisted saying “I’m rich, I’m single, I have no kids. What else am I going to spend my money on?” I’m not sure what helped more that day: the pills or the knowledge that there are doctors out there who really are that amazing.
My ob caught my depression pretty quickly too, and the copay to see the shrinks isn’t too bad.
Oh, that warms my heart! What a mensch.
What a fantastic human being.
What an extraordinary story! Heart-warming!
I worked on USPSTF reviews during my residency training–that is, I was one of the people helping shape the recommendations put forth by this committee. I can assure you that none of us received any incentives or payment from “Big Pharma.” In fact, where I trained, the hospitals and clinics had recently (in ~2006) stopped allowing pharma reps even to provide us lunch or free pens, as had been the norm in the past. I missed the free food (not having to pack lunch or make time to get to the cafeteria is wonderful as a busy resident) but it was totally worth it not to have as much risk of being swayed by possibly biased input….
Thanks for your comment, and being a great reminder of Pablo’s First Law of Internet Discussion: Regardless of the topic, assume someone knows more about it than you do.
In this case, it’s you. YOU know more about it than any of us. I love it.
YESSSS!
OTOH, you don’t find a lot of people on the anti-vax pages saying “I co-wrote the vaccination schedule” or radical-HBers daying “I did the original research that helped minimise pre-mature labor”. In fact, none.
aw, thanks. happy to be able to add value. I’ve certainly learned even more from reading about everyone’s insights and experiences here over the years than I’ve contributed, too! 🙂
Humph. I’ve suffered from GAD my entire life – have been in talk therapy for years. After noticing my anxieties pick up both in my previous postpartum window and in the current one, am requesting to finally go on medication. Medication has hardly been the first-stop for my psychiatrist; it’s instead been the final stop when talk therapy and CBT have failed to stop the constant (and escalating) feedback loops of my brain.
Both of my parents have dealt with anxiety their whole lives as well. I come by it honestly.
But I suppose in the all-natural world, I’m sure it’s my own failures as a person. Clearly I just eat too many GMOs.
I really hate it when the champions of Nacheral sneer at people on medication for mental health, calling them drugged and sheeple and the like. When I needed medication, getting it _cleared_ my mind. It made me feel like I could finally think again.
Depression for me felt like I could not get out of my head. Things would happen around me and I couldn’t absorb any of it. Days would pass and I would hardly notice. SSRI’s let me wake up.
I don’t even remember most of DD’s first year, that’s how bad it was. Nonstop cyclical depressive/suicidal/obsessive thought patterns. Can’t remember the first time she smiled, or said “mama,” or any of that. I think I remember the first time she laughed, but I’m honestly not sure. Don’t remember the first time she crawled, or stood. I do remember she loved baby pears because I worked that into a goofy baby song about her. All I could think about was what a horrible failure I was, how everyone else thought I was a horrible failure, how nothing would ever work well again, and I should just kill myself. It took about a year to get out of that cycle “naturally,”–read, for the PPD to go away on its own without help.
Thank God for antidepressants, which I’m starting as soon as this baby’s born. I’m good now, and I want to keep it that way. I, and my husband and kids, deserve that.
I was on a non-stop rollercoaster of emotions. I was either really ‘up’ and happy or I was in tears and inconsolable. And the worst part was that I would swing from one end to the other with very little provocation.
There was NO middle ground. Medication GAVE me that solid middle ground so counselling and talk therapy could help me understand my triggers and work towards managing the lows.
It really blows my mind that these Nacheral (I love that by the way) freaks seem to believe that our doctors write us the script for the meds, pat us on the head and then just leave us to drug ourselves into oblivious little sheeple. When in fact they also recommend counselors/therapists and then do follow up appointments to see how the medication is working. If it’s not working or the side effects are intolerable, they try something else.
It is NOT a ‘one size fits all’ system. Cos they know everyone is different and what medication works for one person won’t work for another. Prozac made me more suicidal. Citalopram stabilized me and made me functional.
Prayer and meditation? Yeah try meditating when your baby is screaming with hunger and you can’t get a moment to yourself. Or are you supposed to meditate while breastfeeding to enhance the bond or some crap?
People like this make me so angry.
I had PPD and it felt like I was locked in a block of ice, emotionally isolated from everyone and everything. I was functioning, but nothing was fun and I couldn’t feel happy, or even sad for that matter. Medication reversed that. It took some time, and talk therapy was also involved, but I got to feeling normal again.
I look forward to that point.
Same here. My doctor is strongly suggesting trying out a tricyclic antidepressant for my joint issues because diet and exercise just isn’t working at the moment. Now, to the all-natural folks, that’s giving up because I’m not willing to starve myself on whatever diet they’re selling, or buy their untested and unregulated supplements. It’s utterly ridiculous.
Yessssss. I had severe PPD a year ago this past December, and went on a family trip at the time. It was, hands-down, the worst week of my life: I spent the whole time on the verge of killing myself, just barely hanging on mostly because I didn’t want my daughter growing up knowing that Mommy killed herself at Christmastime. A year later–i.e., last month–I made the same trip, and it was so freaking telling. Same place, same people, same setup, but I actually enjoyed myself. I was happy much of the time, content most of the rest of the time, and when minor stresses came up, as they inevitably do, I handled them well and didn’t get into cyclical thinking about how I needed to kill myself because I wasn’t up to dealing with a pretty simple problem. Got back home, told DH point-blank “Yeah, my OB suggested I might want to go on prescription antidepressants starting in the hospital this time. There’s no suggestion about it. IT’S HAPPENING.”
The PPD seemed to diminish significantly after that first trip, and is gone now, but I’m never, EVER letting it back in my life again. It took my first year with my daughter, and I can’t do anything about that, but I can make damn sure that my daughter and her baby brother will have a mommy who might be tired, like all moms of newborns, but who isn’t fucking nuts in the bargain. (Pardon the language, but sometimes it needs to be used.) Right now, I feel like a normal human being, with normal concerns and joys and sorrows. I’m not spending all day, every day, going through a mental cycle of “DD cut her nap short, so she’ll never sleep well again, so I’ll never sleep, so I might as well kill myself now, oh, and breastfeeding didn’t work, so everyone knows I’m a horrible mom, so I might as well kill myself now.” That’s what every single day was like. Not going back there, and somehow, I think that will make me a rather better mom than otherwise. Medication will help me stay the “normal” me when all the hormones and body changes are trying to screw me over, and that’s a Good Thing, in my book.
For many people with disabling depression, it’s impossible to engage with talking therapy until their mood improves with medication. One is not more “moral” than the other. They both work, but both have advantages and disadvantages.
Talking therapies are relatively expensive, labor-intensive, slow to work and vere dependent on the provider-customer relationship.
Many people with severe depression would not be alive if it weren’t for effective medication, and the support of their health care providers.
These are the same type of people who set up their tables at the local emergency preparedness fair. While everyone else was handing out crank flash lights and checklists to help you get prepared for disasters of all kinds, the folks I am thinking of were peddling essentials oils. Because when there is an earthquake, flood or snow storm, essential oils will help everyone deal with stress.
I had to work the OKC Murrah Building bomb site in the aftermath of the bombing. In a couple of places within the perimeter, there were sites set up where you could get damn near anything you needed as a person involved in the aftermath. There were restaurants that provided free food, medical people with crapload OTC medications that you could use/take at no charge, ice packs, bandages, tape, gauze, disinfectant, antibiotic ointment, a place where you could get a tetanus shot, B12 shots, contact lens solution and cases, sunglasses, batteries, flashlights, socks, gloves, you name it, it was there.
The only woo-ish stuff I noticed was stuff like chiropractic treatment if you wanted/needed it, some massage therapists set up a spot where you could get a chair massage or a full body treatment if you wished. These folks had the dim lighting, soothing music, and some aromatherapy going, but it was not like they were saying that their services would fix everything. As a secondary support to the religious-based counselors and other mental health professionals who were donating their time to the rescue folks and the medical people who were doing the same, it was nice. Dealing with the whole person, if you will.
But EO’s, GMO-free, nutritional support stuff the woo folk peddle as a universal panacea would NOT have done the job. At all.
It bothers me that this is actually a thing. I don’t mind massage therapists and counselors who come to do what they can to help in the wake of a disaster but the EO people who want to tell you how each blend of oil needs to be a part of your emergency kit because it can help with stress, illness due to bad food or water or whatever makes me so mad. It does make me wonder how they are going to react if they do end up having to use that emergency kit and the EOs don’t magically help with anything.
i bet True Believers would be sure the oils did help. Placebos are like that.
Prayer will help depression. Fuck y’all atheists.
That’s OK. Atheists are less likely to suffer from depression in the first place.
In general. This atheist has massive MDD and was in terrible PPD after her second child. Thankfully taking meds in my third pregnancy prevented another big crash. Yay modern medicine!
Sorry, I thought given Sarah’s comment, it was “make up whatever you want to suit you” day.
Atheists don’t need dental work.
I’m an agnostic and my filling fell out the other week…
You just didn’t unbelieve hard enough! /s
It’s fine 😉 I knew you weren’t serious
??
I believe he was making a joke on the original statement that prayer helps depression, which has the natural conclusion that you pointed out. 🙂
Atheist women have tentacles where their genitals should be….
Oh wait that’s just me? …Maybe I should have that checked out.
I’m not an atheist. No amount of prayer, church attendence, or singing in the fracking choir has disrupted the near constant loop of suicidal thoughts.
I don’t really understand this post. All I can get from it is that you’ve had suicidal thoughts, which I’m very sorry to hear. I’m not an atheist either, as it happens.
You said fuck all you atheists, essentially for thinking prayer doesn’t work. You’re assuming we’re atheists when many of us aren’t. You swore. and I pointed out that prayer does not work for everyone, even people who attend regularly. My pastor has had to have therapy. My minister father needed therapy.
Right, I think you might have misunderstood then. I have a problem with Ms Williamson demonising pharmaceutical intervention and making blanket comments like ‘prayer helps’ which are a bit of a fuck you to atheists, from where I’m sitting. The fuck y’all atheists isn’t what I think. It’s what I think she’s effectively saying.
ahh. sorry for my confusion, then.
That’s ok. As I say, I’m sorry to hear about your experience of suicidal thoughts, and hope you are accessing something that works for you. Fair enough if that did happen to be prayer of course, I don’t doubt that some people find it beneficial, but it’s hardly a panacea.
Oh man this “yay prayer” business isn’t sitting well today – I just saw a post from an fb-friend/acquaintance who had hundreds of people praying for a positive outcome, and who still suffered a horrifying loss. I’ll stipulate that taking a moment to be mentally focused (and positive?) isn’t a bad idea at almost any time, but prayer isn’t going to change outcomes, it’s just not, you have to use that more focused mental state and apply it to what’s going on! Personally in the face of this tragedy I was informed of, I’d rather donate to a charity that works towards decreasing the chances that these issues ever hurt anyone else. I’m reminded of the Spaceballs “Do Something!” sequence…
Poe’s law strikes again. Never forget the /sarcasm tags other me. (This other Sarah is not really another me)
And fuck you right back. Signed – An atheist who doesn’t suffer from depression.
Sigh. Have a look at some of the other posts around this.
Wow, people really aren’t getting that Sarah was paraphrasing the original article.
Yes, it’s a concise statement of the natural conclusion of Marianne’s thesis. -Atheist
It’s something this Christian just doesn’t get, either. I mean, if you just want to go with scripture, prayer’s important, but actions are just as important. I mean, when Jesus managed to get Himself misplaced three days into a trip back home, I have no doubt his parents prayed about it–but they went to look for him, too! When Herrod wanted to kill Him, His parents, I’m sure, prayed about it–but they got out of there immediately! Those are just two examples off the top of my head, but since when is prayer supposed to substitute for action?
Grrrrrrr.
Ah, but as with diabetes, if you only do XYZ then it wouldn’t exist!
Why, yes, i am feeling sardonic.
OT but has the maternal death rate really risen in the last 30 years? Like was it really safer for my mother to deliver in the hospital that it will be for my daughter? Got a woo filled reply to a comment I made on facebook and the commentor believes American maternal and infant mortality rates are going backwards for the first time in 200 years. I really have a hard time believing that having witnessed a birth 30 years ago vs
my own birth last year.
http://www.skepticalob.com/2010/03/hold-handwringing-is-maternal-mortality.html
Keep in mind population changes too…how many pregnant women in North America had obesity, type 2 diabetes, hypertension 30 years ago? How many women got pregnant after a transplant? How many survivors of childhood cancer are there today vs 30 years ago?
There are so many women living into childbearing age and surviving pregnancy who wouldn’t have done just a few decades back also. An entire cohort who are only able to feature in maternal mortality rates because advances in modern medicine have kept them alive longer than they ever would have been before. That’s not to say more doesn’t need to be done, it absolutely does, just that some women who now die during pregnancy and childbirth would have died in childhood not so long ago. That increase in life expectancy for the cohort is a wonderful thing, but it’s going to have an impact on maternal mortality.
http://www.skepticalob.com/2014/03/changes-in-us-maternal-mortality-the-crisis-is-not-what-you-think.html
I have struggled with depression since I was 11 years old. I’ve been given every stupid bit of “advice you can imagine, some of it by doctors. One fine doctor told me that losing weight would cure my depression. Yea, that’s not how that works.
Anyway, I think it does need to be taken more seriously and screened during and after pregnancy. I scored pretty high on that inventory they give out during various points in your pregnancy, and the nurse brushed it off as anxiety due to previous miscarriage. She wasn’t wrong, I did have anxiety because of that, but I was having panic attacks and thoughts of self harm if I had another miscarriage.
Depression and anxiety is so pernicious because it flares up in response to completely normal things. Like it is easy to excuse your mental reactions because how you are reacting feels like a rational response to stimulus. For me at least I don’t realize how disordered my thinking is until the damage has been done and another year of my life is wasted.
You mean I’m not the only one? Part of the reason it took me so long to get treated for PPD is because I’m so used to casually thinking of killing myself that I didn’t realize I was in trouble until I was in really bad shape.
You can’t “pull your bootstraps” out of depression. When it is severe it can interfere with basic things. I couldn’t sleep, I was a freaking zombie. Funnily enough I was exercising until I lost complete interest in it due to the depression.
I also learned that the daily anxiety attacks I had most of my life were not normal once I was on meds… who knew?
It’s funny. My therapist encouraged me to meditate (or something similar), to take walks and get some exercise and fresh air and to eat healthy foods.
I also talked to her weekly. For free – because, sliding scales and broke student.
And she helped me more than 100 marathons or all the grapes in Napa.
And when she couldn’t help me, she made it possible for me to get on anti-depressants. And I kept seeing her weekly. And meditating, walking and eating healthy.
Funny how that all works. If this woman thinks she’s invented a new way to battle depression she is way behind the trenches.
It’s like the folk who sneer that doctors will just put you on statins if you have high blood pressure instead of telling you to eat better and exercise more. Turns out, they can give you drugs to control your blood pressure _while_ encouraging you to eat better and exercise more (if you are indeed eating badly and not exercising enough).
The amusing thing, to me, is that NONE OF IT worked until I got on anti-depressants. I was lucky, I only had to take them for a very short period of time. All the behaviors she had taught me, all the tricks, all the actions – it only worked once the anti-depressants were added to the mix.
I’m still depressed. I’m not on anti-depressants anymore because it’s manageable thanks to the tools she gave me. If they ever fail, I’ll go back on SSRIs faster than you can sneeze.
I had a similar experience – PTSD rather than depression, but Zyprexa turned my symptoms down enough to _allow_ me to benefit from therapy.
I am very glad that my practice refused to allow you medication without talk therapy. TT with no meds? Fine. But if there was one single pill involved, you were in TT or you wouldn’t be there.
It truly was helpful. And I credit TT for being able to stay sane after all these years.
“Have you tried not being depressed?” Notice my snark.
“Just think happy thoughts!” “Just calm yourself down!” “Just get some more exercise!” “Why are you only feeling ‘just okay’?”
“Just” is the most condescending word in the English language.
I think that was a Ruby Wax joke. “Just cheer up!” “Oh, yes, I hadn’t thought of that.”
“It’s all in your head!”
Why, yes.
My family’s personal favorite.
Why are you struggling with that broken bone? It’s all in your ankle.
“Of course it’s happening inside your head, Harry, but why on earth should that mean that it is not real?”
Williamson and those other New Age twats also think perimenopause symptoms shouldn’t be treated because it’s natural. There’s no reason to suffer from debilitating hot flashes, anxiety, sleeplessness, etc. just to earn your nacheral badge. Yes, hormone replacement therapy can be risky but now there are antidepressants that can treat symptoms. I’m on a very low dose of Cymbalta and it’s done wonders for me.
I love my Cymbalta!
Dumbest thing I ever heard. I have a friend who is a spiritualist and encourages meditation and whatnot. But in conjunction with modern medicine! I suffered from very mild PPD as my doctor caught it very early and took medicine and meditated. I don’t know if the latter did anything but it made me feel like I was doing something possibly productive so I continued.
Ugh, I hate people who decide they know all about mental illness, usually insisting that it doesn’t exist. How nice for them, to not have to deal with it, hopefully no one they love ever does either. They are on par with the ones who insist that cancer patients are sick because of something they did or didn’t do, and chemo will just make them sick and line the pockets of Big Pharma. Of course, people like Williamson don’t have cancer (or mental illness), because they do it RIGHT. That attitude is just gross.
https://www.youtube.com/watch?v=0tG7–NqyCc
I can’t help but notice that all of her “solutions” to PPD, (meditation, prayer, nutrition) put the onus for getting help back on person experiencing depression. My experience with post-partum anxiety and depression was that I was in no position to help myself. I could barely function enough to get out of bed and look after my child, much less establish a meditation practice or cook complicated, healthy meals. Not saying my experience is universal, but I know I’m far from alone on this.
She needs to STFU about mental illness, which is obviously something she knows nothing about. There’s already enough stigma out there.
Right. When you’re depressed (not to mention, while dealing with a newborn, often exhausted from lack of sleep and hungry from lack of eating at regular times), it’s a hell of a lot easier to grab a half-gallon of ice cream than it is to chop up lettuce and veggies and protein and add some dressing and so on. And I don’t say that lightly: it’s just so many steps to have to take that it’s pretty much impossible for some people when intensely depressed. I was one of them.
Putting peanut butter on bread was more than I could manage most days for the first six weeks or so postpartum. If I didn’t have a fridge and freezer full of meals from caring friends, I don’t know what I would have done.
and a microwave, which i don’t have
It’s not just the food prep that can be overwhelming. I mean, it’s one thing to have the lettuce, veggies and protein ready to go in your fridge to make a salad, but realistically, actually having those items ready to go involves at least some degree of meal planning, plus grocery shopping. Plus healthy food tends not to last as long, which requires more planning and more shopping than buying less healthy convenience foods. There’s a lot of planning and effort involved in healthy eating.
Also boxed macaroni washed down with wine feels so much better than a salad when you are in a dark place.
and the dark chocolate raspberry truffle ice cream for dessert. Or breakfast.
Amen to all of that. Plus, grocery shopping with a newborn can mean major stress right there–DD would shriek throughout most store trips, so I’d try to only go every two weeks for the first few months. Not really conducive to a daily salad, that.
I was severely depressed during pregnancy. Trying to get someone to take me seriously was so hard. I didn’t need to go out to lunch, get a pedicure, to “be positive” or any of the other stupid suggestions I got. I was eating healthy and walking three miles six days a week. One care provider insisted that I couldn’t be too bad if I was showering, putting on makeup and not having trouble with making doctors appointments. The psychiatrists office called me finally to make an appointment—when my baby was four weeks old. I disagree with Ms Williamson’s opinion that women are being over treated for depression during and after pregnancy.
I had a really hard time getting depression treatment during pregnancy too. My OB’s assistant just gave me a pack of flyers with irrelevant stuff about substance abuse and poverty (neither of which are an issue for me). My OB was willing to prescribe an antidepressant postpartum, but only one that I knew from prior experience gave me bad side effects. And I literally walked into my campus health center and told them I needed a referral for postpartum depression, and they had nothing.
There’s a happy ending here—I found a postpartum support group and the mediator was able to get me in with a psychiatrist who specialized in new moms. But yes, I’m not convinced that OVER-treatment of women is the issue.
That is horrifying! I am sorry that happened to you!
I think I must have been extremely lucky. Maybe it’s because my babies were all in the NICU, but I got rapid help at the very onset of symptoms, so all I ever experienced was fairly mild PPD. The NICU staff, the hospital, my OB and my primary doc were all quick to band together to help. They even had a counselor come to the NICU so I wouldn’t have to go very far. I did wind up on SSRI’s with the third, but the rapid response in getting me into regular counseling was probably the most helpful thing for getting me through it.
“Not having too much trouble because you’re showering, putting on makeup and making dr appts” is a recipe for missing most depressed – including suicidal – patients. When I was most severely depressed and struggling not to commit suicide, I still showered daily, brushed my hair and dragged myself to classes. I also hoped that a car would hit me on my way to classes to end all the pain.
and some of us are more likely to take a shower if we’re going to the doctors. Early training.
No kidding. And if there is a time I leave the house without curling my eyelashes and a swipe of lipgloss, there is something really really wrong. It’s just what I do.
Since my (generic) anti-depressant medication costs less for a month’s supply (before insurance coverage) than an hour’s pay at the local minimum wage, Big Pharma must really be making bank off my PPD.
Absolutely. Spot. On.
But…may I confess a huge frustration? I have MANY patients with depression. It is, after all, very common. And I’m pretty good at finding them a good fit with antidepressants and supportive counselling. HOWEVER, there are almost NO psychiatrists any more!! My own daughter needed a psychiatric evaluation for medication change, and it took four months to get off a waiting list, even with great insurance and a willingness to pay out of pocket. Why is this? Around here, they are paid next to nothing, limited to very short visits. limited to very short terms of care. In short, it’s a miserable specialty to practice.
However, mental illnesses are mortal diseases. People DIE from untreated mental illness. So, what’s the point of identifying these folks if we aren’t going to make care available to them?
I was prescribed antidepressants by my family doctor. Is that an option where you live? Not ideal but better than nothing.
That’s fine, as far as it goes. I’m talking about situations (which are actually fairly common) where the first- and second-line therapies are working poorly and you’re wondering if you’ve got the right diagnosis? Or if the patient needs something unusual? People deserve a psychiatric evaluation at that moment, not what we Gyns and FPs have to offer them.
Yep, I understand. I’m in a big city with two major medical schools and the psych care is poor here too. Psych is a low prestige, low pay specialty and tends to be the default specialty for the med school dregs.
Not only that but it can be emotionally exhausting. I almost went into psychiatry (addiction psychiatry to be specific), but realized that I would be too emotionally invested and would likely end up more depressed than I already have a tendency to be. Plus, I like a lot of other things, so family med was a good choice for me. And guess what….I still do lots and lots of psychiatry. It’s really frustrating for me practicing in a rural area when I’ve reached the end of what I feel my expertise is and there’s one person to refer to, and their waiting list is 6 months if you’re lucky.
All my mental health care has been a mix of my family doctor and a psychologist (the psychologist I pay for and get reimbursed through my secondary insurance through work). The wait list for psychiatrists here are very long. Granted I have more manageable ones (depression/GAD), but I’ve paid a lot out of pocket when I have gone past my secondary insurance limit.
Don’t even get me started about the state of mental health care in the US. I won’t go into too much detail because it’s not my place to blab details of somebody who’s not me all over the internet, but in essence, you either have to wait months like you experienced or have a crisis that literally endangers lives. And many people with depression/anxiety/etc know the “magic words”, so a third party, even a parent, can’t get them help because they know what not so say that will trigger a response, leaving you to wait until they’ve actually made that suicide attempt and are in ICU before you can get them real help.
Yes, similar situation here in Australia. Psychiatrists just seem more and more inaccessible. As a GP I regularly have patients I would like to refer for review ( and indeed are out of my scope of practice eg first episode psychosis), but it’s frustrating that the only option you have to get them reviewed by a psychiatrist is to send them to an emergency department ! And forget less severe problems, it’s nigh impossible to get them in for a depression or anxiety review. Not enough of them, or they’ve closed their books for too costly etc etc . Every now and then an academic or politician will annoy the nations GPs by bleating about how GPs “overuse ” medication or “abuse” the publicly funded psychologist referral mechanisms etc ( driving up health costs ) and that they don’t refer enough to psychiatrists with more expertise, but missing the bleeding obvious fact that there ARE NO psychiatrists to refer to. *sigh * one of my top job frustrations. It’s ludicrous really, imagine the same scenario, if there were NO general surgeons to manage bowel cancer for example.
This seriously drives me up a wall, because it seems to me that letting women know about what mood changes to expect (i.e. what *is* in fact normal) is a fantastic idea so women won’t be shocked at what they experience. Offering support is in fact a great idea, and I don’t know of a single psychologist that doesn’t place great value in a positive support network – the phrase “adequate support systems” is in that damn report quoted above!! But to say that positive vibes are *always* enough? F*ck these people. Even if meds aren’t the best or preferred solution in a particular case, you can’t stop psychological crises by just wishing them away, ffs.
I think a somewhat-applicable analogy here is abstinence-only education, actually – for some people, looking at the comprehensive list of risks/benefits/methods of protection in the realm of sex, relationships, pregnancy and STDs, will incorporate or exclusively use abstinence in their life, and in certain cases it can be used to good effect. But just saying “this is the right way, ignore all others at all times” is wildly irresponsible and keeps people from safely managing their lives. And has worse outcomes.
I think these people don’t know the difference between something being “common” and something being “normal” or “acceptable”. PPD is more common than people think. Doesn’t mean it shouldn’t be treated. Childhood diseases were once common. Doesn’t mean they shouldn’t be prevented. Childbirth complications happen frequently. Doesn’t make them “variations of normal”.
High prevalence doesn’t mean something is ok or will just pass!.
“Ay, madam, it is common.”
Is she a Scientologist or something?
OT, but a good story in the WaPo this morning from a mom who was traumatized by the in-hospital death of her first child, chose a homebirth for her second child, and whose second baby nearly died at the hands of her midwife, who encouraged her to keep laboring at home with a stuck baby.
https://www.washingtonpost.com/news/to-your-health/wp/2016/01/06/my-nightmare-didnt-end-after-i-lost-my-child-8-hours-after-birth-the-ptsd-carried-over-to-new-pregnancy/?tid=a_inl
Predatory midwives. This woman needed trauma treatment, not a fucking homebirth. ETA: Just looked at the article photo and OMG what a cute baby!!
4th degree tear? That is horrendous. That would be traumatizing. Maybe there was a reason her doctor wanted her to throw out the birth plan.
Okay, GIANT BITCHSMACK to that asshole of an OB. That is one thing that really needs to be addressed by OB training: appropriately referring women to mental health care.
Yep. And it ties in neatly with Dr. T’s post about Marianne Williamson and her ilk. Women’s mental health should be taken seriously. Women’s pain — all of it, physical and mental — deserves treatment. I sure as hell was terribly depressed after both my kids were born, but everyone told me the baby blues were normal. Two years later and expecting my third, I’m pretty convinced that living in a completely separate reality from everyone else and not being able to sleep for 3 days after watching a mildly unsettling TV show? Not normal.
All my doctors made sure I had a shitload of available resources after my daughter died (including that I had enough meds for the next few months). My hospital has a great perinatal bereavement program. I saw my nurse from when I had a stillbirth and she told me at one time the hospital wanted to get rid of it, she and a few others fought tooth and nail to keep it. I am so appreciative they did.
Ms. Williamson, you are a danger. I tried prayer. I tried meditation. I was deeply loved by my family and friends. I can’t say that I did much with nutrition because I was a graduate student during the worst of it, but I know that wouldn’t have mattered either. Your demonization of psychiatric medications is disgusting. Attitudes like yours prevent people from getting the help that they need. People die because of it. The right medication saved my life. It enables me to be gainfully employed, happily married, and a (reasonably) good parent to my two children. Take it from me – those of us with depression don’t need or want your help.
Looking back, I suffered a severe depressive episode in 4th grade when I was ~10 years old that lasted a year. That episode eventually cleared when I was about 12. I was mildly depressed starting late in my sophomore year (~16 years) after a teacher I had had the year before committed suicide and my grandfather died within a few months of each other.
When I went away to college, I became more depressed and had a bad reaction to the first antidepressant I tried which caused suicidal thoughts. After struggling for a few months with good family and counseling support, I asked to be hospitalized because I wasn’t feeling safe any more.
The hospital and the staff there saved my life. They realized that my current SSRI was making me worse and that I had generalized anxiety disorder to boot. Adding an anti-anxiety medication made me feel sane again and gave me enough energy to keep going until we found a good combination of SSRIs. I found an excellent therapist who I’ve seen for the last 16 years and have taken SSRIs for about 12 of the 16 years.
I used to worry a lot about getting pregnant because I thought there wasn’t a lot of data about the SSRIs and pregnancy. Thanks to Dr. Amy and MotherToBaby.com (tetrologists, I love you!) my fears about staying on an SSRI that I know works for me during pregnancy are gone. I’ve also realized that if I can breastfeed, that would be nice, but I want to enjoy my life and care for my (hypothetical) baby, so if I need SSRIs to stay balanced, I will take them and enjoy feeding the baby bottles of formula.
I was on Zoloft for two pregnancies. It’s not as effective for me as Effexor, but at the time, had a better safety profile. Both of my boys are healthy and thriving.
This crap makes me so angry. It’s hard enough as it is to get women to accept help and not fall prey to the “I must be supermom” stereotype. She disgusts me. Clearly she’s never seen (or felt) the suffering of a women with PPD. Disgusting.