Postpartum Depression May Not Wait for the Delivery


At 6 and a half months pregnant, Mary Guest jumped to her death off the 16th floor of her parent’s apartment building.

Mary was a lively, accomplished woman. She worked at an elementary school in Portland, Oregon, helping children with behavioral problems. Her co-workers described her as compassionate, driven, and supportive. Her supervisor said he had never seen a teacher that was more gifted at attending to students’ needs.

When Mary found out she was pregnant, she was ecstatic. She had been struggling with severe depression all her life, but decided to discontinue her medication because her doctor told her there was a risk of harm to the fetus. She was under the close care of a psychiatric nurse throughout the duration of her pregnancy, who told her that she could call any time for a prescription.

However, the months went on, Mary became worried about the health of her fetus, despite reassurances from her doctor that her baby was completely healthy. Despite genetic testing and multiple ultrasounds that confirmed the health of the baby, Mary would spend hours online researching everything that could possibly go wrong. This obsession started out small, but soon began to torment her as her pregnancy progressed.

During the fifth month of her pregnancy, Mary resumed her antidepressants. However, she saw little improvement in her mood, and the medication didn’t seem to help with her irrational thoughts anymore. She became convinced that she was doing her child a disservice by living in this world, and this led to her demise.

Mary’s mother, Kristin, spoke openly about Mary’s depression and suicide. “We are totally convinced that in Mary’s mind, what she did was an act of love,” Kristin said in a statement to the New York Times. “That’s the only place from which Mary ever came. She was tormented that the child was going to have some serious problem, and felt it would be better not to bring this child into the world than to birth her and not be able to take care of her. We feel, rightly or wrongly, that if Mary had stayed on her medications, or even gone back on them sooner, it’s possible she would have survived.”

In the last two decades, postpartum depression has become increasingly recognized, and many states have established programs for screening and treatment. However, antenatal depression, the form of depression Mary was experiencing, is a far less recognized issue, despite the fact that this form of depression affects up to 15 percent of expectant women.

Much of the lack of attention regarding maternal depression is due to societal stigma. Many of the misconceptions surrounding these mental illnesses focus on questioning how pregnant women can possibly fail to be joyful. How can pregnant women be sad when they are about to bring a child into the world? Pregnant women are often portrayed to be extremely optimistic, disregarding the physical discomfort they are in because of the fact that they are nurturing a new life.

As a society, we have not done enough to acknowledge the anxiety-ridden aspects of pregnancy. We have not addressed the trauma that can also be associated with all of the change that comes with motherhood. This, combined with the notion that taking antidepressants while pregnant is selfish due to the potential harm to the fetus, often deter pregnant women from seeking help. Wendy Isnardi, who struggled with severe depression during and after her pregnancy, described her battle with the illness: “I thought people who took medication were nuts, until I began to feel like I was really going crazy,” she said. “I had constant thoughts of harm to the baby. I knew that I was not capable of doing the things that were going on in my head, but I needed to make sure that I was not a danger.”

Many women like Wendy and Mary are extremely unsure of how to handle their depression, and this is in large part due to the ambiguity regarding antidepressants and their effects on the fetus. A large number of women, just like Mary, are afraid to go on antidepressants during their pregnancy due to studies that have shown harmful effects on the fetus. However, the reality is that these studies have only come out with preliminary evidence that was not validated properly, and these results have been made into widely universal statistics even though they are not properly supported by evidence.

Because of the possible risks surrounding antidepressants, many women turn to therapy and support groups, such as the ones at the Postpartum Resource Center of New York. However, despite the existence of these support groups, the stigma around depression during pregnancy is stronger than ever, with many women ashamed and afraid to come to these groups in case their husband or families find out. Pregnant women are often not made aware of the wealth of treatment options available to them that don’t involve medication: cognitive behavioral therapy, light therapy, and even electroshock treatment can all reduce depressive symptoms.

In addition to making more women aware of their treatment options, we need to do more research into postpartum and antenatal depression. There is so little known about both of these illnesses. Examining their complexities to better understand the diseases could literally save the lives of both the mother and child.

 

References

Belluck, P. (2016, January 26). Short answers to hard questions about postpartum depression. The New York Times. Retrieved from https://www.nytimes.com/interactive/2016/01/26/health/what-is-postpartum-depression-test.html

Belluck, P. (n.d.). ‘Thinking of ways to harm her’: New findings on timing and range of maternal mental illness. The New York Times. Retrieved from https://www.nytimes.com/2014/06/16/health/thinking-of-ways-to-harm-her.html?

Solomon, A. (2015, May 28). The secret sadness of pregnancy with depression. The New York Times. Retrieved from https://www.nytimes.com/2015/05/31/magazine/the-secret-sadness-of-pregnancy-with-depression.html

 

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