Postpartum Depression Not an Illness

by Phil on April 24, 2013

BACKGROUND

The primary purpose of the bio-psychiatric-pharma faction is to expand turf and sell more drugs.  This is a multi-faceted endeavor, one component of which is disease mongering.  This consists of using marketing techniques to persuade large numbers of people that they have an illness which needs to be treated with drugs.

With regards to postpartum depression, it is an obvious fact that some mothers do indeed experience a measure of depression in the period after giving birth.  The term postpartum depression has in the past been generally understood to mean that the problem had something to do with hormones.  Today brain chemicals are blamed.

HISTORY

In the old days (pre-1950) postpartum depression was rare.  But perhaps back then things weren’t so difficult.  Most women were in stable relationships and did not work outside the home.  Extended families were usually close by, and for the most part, babies were born at home.

Today it’s very different.  Many women react negatively to the loss of autonomy they experience in a hospital setting.  And when they come home, they are often overwhelmed by the extra work, the sense of isolation, and by the lack of sleep.  In this context, it’s very easy to start doubting oneself, and young women in particular can become very susceptible to the psychiatric-pharma pitch.

Over the years, I’ve worked with a good number of postpartum women who were depressed.  In my view their major needs were: someone supportive to talk to (not necessarily a mental health worker), some practical help with childcare and chores, and sympathetic, non-judgmental encouragement.

DISEASE MONGERING

The disease mongering for postpartum depression is a truly well-organized psychiatry/pharma marketing machine.  Take a look at Postpartum Support International and Postpartum Progress.

UNIVERSAL SCREENING

For years psychiatry/pharma has been promoting the idea of universal screening for postpartum depression, i.e. that all postpartum women should be screened for depression.  They’ve made a great deal of progress in this area, and in the US we may be fairly close to universal screening already.

Screening, however, is a very insidious concept.  It sounds so benign.  “We just want to check to see if you’re sick.”  Who can argue with that?  But the reality is that the thresholds are set ridiculously low, and the “screen” is simply a “patient” recruiting tool.

The new mother is vulnerable and perhaps lacking in confidence, and is an easy sell.  Any resistance on her part is countered by the assurance that getting “treatment” is the best thing she can do “for the baby.”

The marketing pitch doesn’t stop with depression.  Postpartum Progress lists the other “illnesses” that the postpartum mother needs to be aware of (link here):

  • Antenatal Depression
  • Postpartum Anxiety
  • Postpartum OCD
  • Postpartum Panic Disorder
  • Postpartum Post-Traumatic Stress Disorder
  • Postpartum Psychosis

Nor does it stop with the mother.  Check out Postpartum Men!  And why not?  An untapped market is like money going down the drain.  Perhaps next we should have postpartum screening for the baby’s siblings, so we can get big brother and big sister on drugs too.  It makes sense.  The arrival of a new baby inevitably precipitates some negative feelings.  Left untreated, who knows where this could lead?  And what about the baby him/herself?  Enough.

CONTRARY VOICES

Fortunately there are some sane voices out there also.  Evelyn Pringle has written some great critiques of the postpartum marketing.  Dyan Neary (here) addresses the issue of pregnant women being prescribed psychotropic drugs.  Paula Caplan weighs in energetically here.  All good reading.

QUESTIONABLE RESEARCH

Last month (March 2013) an article by Katherine Wisner MD et al appeared in JAMA.  It was titled Onset Timing, Thoughts of Self-harm, and Diagnoses in Postpartum Women With Screen-Positive Depression Findings.  You can see the abstract here.

In the study, 10,000 women who had recently given birth were screened for depression using a 10 item questionnaire.  Fourteen percent screened positive for depression, and of those, 98% were found on interview to have a DSM “diagnosis.”

The study is methodologically flawed.  James Coyne PhD has written an excellent critique titled Time to screen postpartum women for depression and suicidality to save lives?  (From the title you might get the impression that Dr. Coyne is advocating screening – but note the question mark.  It’s a critique.)

By the way, Dr. Wisner has ties to Eli Lilly.  Stephen Wisniewski PhD, one of the other authors of the JAMA article, consults for a number of pharmaceutical companies.

This is another example of spurious research being used as a marketing tool.

Postpartum depression is not an illness.  Nor is it a function of hormones or brain chemicals.  It stems from the fact that some new mothers feel isolated, vulnerable, unsure of themselves, and overwhelmed.  In some cases, they have had a difficult or unpleasant birthing experience.  These problems can only be addressed through human contact, reliable support, sympathetic encouragement, and practical help.

 

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  • Tina

    Was this post written by a man named Phil? That would explain the lack of intelligence expressed in this piece. Do you know what it feels like to be so depressed you can’t even change the diaper of your newborn or to feel so low that you want to kill yourself? Do you have any idea what it feels like to be in the throes of postpartum psychosis and to lose touch with reality…to be a danger to yourself and your family? I have suffered a number of the postpartum illnesses first hand and can tell you with certainty that they do in fact exist. You don’t have a clue. Your piece is a slap in the face to the many of us who are SURVIVORS of these ILLNESSES. Don’t write about things you know nothing about.

  • Alena @ Simply Complicated Lif

    OH MY HEAVENS! It would only have taken a cup of tea for me to stop self-harming? My rage could have been controlled if someone would have helped with the chores. ARE YOU A JOKE? (don’t answer that, I know you must be.)

    Please, if you are a mother who finds this article by searching for answers for your depression, please click on the links to Postpartum Progress or PSI. Please do not let this whack make you think that PPD isn’t an illness, and please get help. I lost out on enjoying nearly a year of my childs life because I was sick, you know with an ILLNESS.

  • Tina

    It has taken me nearly three years to recover from postpartum psychosis and depression. Tea and help with chores? It is so laughable.

  • http://twitter.com/jennamariebee Mrs. Jenna

    Please. Tell me MORE about how it feels to be a woman who has given birth. Your male perspective clearly outweighs my own personal experience of having human contact, reliable support, sympathetic encouragement and practical help months after having my daughter and still wanting to shut myself in the garage with the car running, or turn my car into oncoming traffic. TELL ME MORE.

  • Tina

    Exactly! I had the MOST supportive family and husband plus tons of herbal tea and still wanted to do the same thing. UNREAL.

  • Nadia

    This is incredibly insulting and ignorant. People suffer and die from postpartum depression. I wish you could feel the way we have felt for just one day… you would not survive, sir, because you are clearly a coward.

  • PPD survivor

    If postpartum depression isn’t about hormones, brain chemicals and other contributing factors making it “not an illness” then erectile dysfunction is all in your.. uh head. I love it when people who have never experienced clinical depression write about it like it was just a bad day. May you be blessed with first hand experience, sir.

  • PPD survivor

    And btw, there’s an explanation for why not much was heard about PPD prior to.. late last century. James A. Hamilton, MD, PhD wrote about it in the forward to the book, The New Mother Syndrome, by Carol Dix. As he points out, “Psychiatric illness following childbearing was acknowledged by the ancient world: Hippocrates described it in the 4thC, B.C. During the 19thC scores of very able physicians, led by L. V. Marce’ in France, desxcribed postpartum symptoms and illness with great accuracy.” He goes on to say that because psychiatry was still fairly young in the early 20th C and the physical medical world was focused on finding specific causes (germs etc.) –”advances in pathology and bacteriology had led to the positive identification of the causes of many diseases.” Anyway, go read it for yourself, sir. It basically boils down to it was inconvenient and made the mental health world look less than the physical health world when using “postpartum” or “perinatal” because there was no organism to point to as being the cause. It wasn’t until the 1970s when somehow the UK, Europe, Japan all saw a consistent and unique phenomenon related to the perinatal period. The US, however, was not enthusiastic about a conference that was set to discuss these observations. There. Schooled.

  • Phil_Hickey

    PPD Survivor,

    Thanks for your interesting comments. Can you provide me with definitive proof that hormones and brain chemicals cause post-partum women to be depressed? If not, then it seems more reasonable to me to conceptualize depression in the post-partum period as essentially similar to depression at any other time of life, and caused by the kinds of factors that make people feel
    depressed.

    If you have proof of your position, please send me the
    references, and we can discuss.

    Best wishes.

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