The first time I went through post-partum depression, I spent gloomy months in an emotional soliloquy trying to figure out what was wrong with me and how to get back to normal. When I became depressed again after the birth of my second child, I decided to scathe depression the best way I know how: writing my final academic psychological paper on its causes and therapies. Part of me wanted to thoroughly understand what was affecting me so deeply. But more than that, I felt touchy about the discourse I was hearing on postpartum depression in magazines, birthing classes, fictional TV shows, and right down to my son’s playgroup.
To put it simply, I was getting some feminist heebie-jeebies hearing postpartum depression discussed in language reminiscent of the old diagnosis of “hysteria.” Like a werewolf under the light of a full moon, women with “hysteria” were transformed by the powerful force of their uterus, causing an excess of emotion. Interchange that moon for a baby, and you’ve got postpartum depression — a woman’s disease. A condition a woman can’t control because of her femaleness, the vehicle being her female balance of hormones.
While I sometimes heard sleeplessness and changes in lifestyle mentioned as sideline contributors, a schema prevailed in which a woman with postpartum depression is a victim thrown about by chemical changes in her body and brain. I felt like I was hearing a very old tale: once again, women are the hapless, lone riders on waves of their emotions, while men are left out of the emotional picture. But the woman-as-emotionally-fickle stereotype wasn’t the only problem I saw in the culture surrounding postpartum depression.
First, I will out myself as a believer in family therapy. I feel one-on-one therapy is tricky when the person seeking help returns to a family with an ingrained set of healthy and unhealthy behaviors. Asking one person to change while the rest of the world stays the same is a huge challenge. I am also a believer that families function like an ecosystem, with all the booms and busts, seasons, and natural checks and balances that metaphor implies. So when something as life-altering as the birth of a child enters the family ecosystem, I had a hard time buying the woman’s disease viewpoint. In this perspective, the woman-only perspective was analogous to a highway cut through a rainforest, with everyone insisting only the milled trees were affected.
In the end, research supported my hunch. Several studies looking at the demographics of postpartum depression show high, independent correlations to economic, social, and interpersonal factors. A woman’s relationship to her family, her partner and her peers are all related to her likelihood of becoming depressed and her outcome thereafter. The health of the baby and quality of medical care can be correlated.
Households with a depressed mother often had another depressed or otherwise psychologically suffering member. In one study, family-centered or couple-centered therapy showed greater efficacy than traditional single-patient therapy. All in all, my new vantage of postpartum depression was much more like that rainforest in reality: while some members of the ecosystem are more obviously affected, shockwaves travel throughout.
I even learned that the condition is technically called postpartum onset of depression and not considered a separate diagnosis from major depression in the official psychological manual, the DSM. Those extra two words remove the implied cause-and-effect relationship between postpartum and depression. The term seems to imply a time state of the whole family instead of a physical state highly associated with the mother. Maybe this is mincing words, but as someone labeled by those words, it makes a difference to me.
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Let me be clear: I am not trying to discredit hormones and physical changes as factors in postpartum depression, or even as primary factors in many cases. Instead, I worry that the woman-centric view of postpartum depression has overshadowed other research-supported causes and the subsequent opportunities for a family to understand one another and heal. The woman’s disease perspective undermines the beneficial power of relationships while the stressful aspects continue to exist. To me, these lost opportunities are more important than my feminist ideology or my drive to disseminate false information.
I’m encouraged by recent news coverage of a study declaring an increase in postpartum depression in men. No, I’m not thrilled to hear men are depressed; I am just happy to see a little fracture in the woman’s disease discourse. I’m even happy to hear researchers theorizing a connection between greater involvement of men in parenting and the rise in male postpartum onset of depression. No, not in a “welcome to the club” sort of way.
Instead, as a mother of two sons, I feel hopeful because such a theory could only arise in a society allowing men and women psychological and emotional equality. If we’re going to laud society for gains in equality between men and women, along with gains in equality for same-sex parents, then we have an obligation to recognize and support the struggles of every type of family member during the wonderful but difficult postpartum period.
If you have academic database access, here are relevant studies published in peer-reviewed journals.
Barnes, D.L. (2006). Postpartum depression: Its impact on couples and marital satisfaction. Journal of Systematic Therapies.
Burke, L. (2003, August). The impact of maternal depression on familial relationships. International Review of Psychiatry, 243-255.
Clark, R., Tluczek, A., Brown, R. (2008, September-October). A mother-infant therapy group model for Postpartum depression. Infant Mental Health Journal.
Johnson, S., Jacob, T. (1997, February). Marital interactions of depressed men and women. Journal of Consulting and Clinical Psychology, 15-23.
Misri, S., Kostaras, X., Fox, D., Kostaras, D. (2000, August). The impact of partner support in the treatment of postpartum depression. The Canadian Journal of Psychiatry, 554, 556-557
Page, M. (2008, September). Postpartum daily stress, relationship quality, and depressive symptoms. International Journal of Family Therapy. Retrieved from
Shlulz, M., Cowan, C., Cowan P. (2006, February). Promoting Healthy beginnings: A Randomized Controlled Trial of a Preventative Intervention to Preserve Marital Quality During the Transition to Parenthood. Journal of Consulting and Clinical Psychology, 12-15.
My husband had (and is still dealing with, to some extent) some post-partum (onset of) depression. He was let go from his job when our son was 1 week old, which was lovely during maternity leave (although tremendously shitty timing for our financial situation), but when I went back to work, I think he felt pretty lonely.
Add the loss of employment to a new baby all day and then factor in some REALLY closed-off, not terribly welcoming “new mom groups” that made him feel like an outsider for a year and a half before he just gave up in frustration despite months and months of volunteering and really PUTTING HIMSELF OUT THERE and it was a recipe for disaster. There’s such a growing abundance of support systems available for new mamas – at home and employed-outside-the-home and everything in between, but there’s very little for dads experiencing many of the same issues as moms. Although moms’ groups can be inclusive of dads, there are similar but at the same time DRASTICALLY different issues that come up for papas that just aren’t being taken care of in a meaningful way.
This is a great article – I hope that papas start being able to find and USE the help that they so often need when transitioning to parenthood whether for the first or tenth time. It’s rough out there.
Thanks for writing this. My sister in law had to be temporarily hospitalized due to postpartum depression and I was taking care of her children. He husband called to talk to them and I ended up sort of counseling him. Basically I told him that while my sister in law might be hospitalized that he needed therapy too. She wasn’t the only one depressed, the only one having problems. Her problems just made her suicidal. His made him ignore her and their children and cut himself off from his family because he was depressed and in turn made her issues worse. He’s getting therapy now, and she’s got her kids back with her, and they are both doing much better. But the breakdown of their family unit at a time when they should have been celebrating and tired instead of broken and suicidal really shook me. I understand in theory how it happened. But the actual works of it boggled my mind.
Family is a team game, and I like the ecological metaphor. I like metaphors anyway, and the ecological one is one that I’ve come across elsewhere. It’s a good one.
The ‘women’s disease’ nonsense is one of several crank handles in the machine that churns out media narrative, and it’s right to challenge this discourse and post articles like this. Delving into the comments, I can tell similar stories of men being excluded from postnatal groups and getting quite strongly challenged for being outside a day nursery having dropped a daughter off. Like I say, parenting is a team game, whoever you might have in your team, and my feeling is that as a man, apart from actual breastfeeding, there’s nothing I can’t do, shouldn’t be able to do, or shouldn’t be expected to do.
I’m looking forward to being challenged outside the school gate when I drop my son off, but then I’m a subversive git. What still bothers me, though, is that whenever I do anything with my son, I get hailed as being “so good, oh you’re SO GOOD!”. Rubbish! I’m more or less as good as my wife, but no-one ever tells her that she’s so good.
Except me, of course. Team game. It’s good for morale.
Thank you so much for this; I’m a psych major who had begun to question this aspect of depression in my Abnormal Psych class, only to be told that there is (as far as the majority of psychologists are concerned) no real difference for treatment. It’s heartening to see that family therapy is being seen as far more effective – and is proving to be so – than solitary CBT or just the addition of anti-depressants. Not to minimize medication; it can make a huge difference and be a major component of treatment – but I don’t think that medication should be the ultimate answer, either. Thank you as well for the links, I’m going to enjoy reading them!
As a non-mama who was diagnosed with depression 10+ years ago, it’s encouraging to see these links as well. I stopped therapy due to a horrible counseling center on campus (notorious for expelling depressed and suicidal students, or otherwise getting them to leave), but this has left a bad taste in my partner’s mouth regarding therapy. I would love love love for him to go to therapy sessions with me (as soon as I find a good counselor I can afford) because even though it’s technically my disease, it affects every aspect of our life together; we’re both suffering through it and fighting against the next break down.
I’ll certainly be reading all these links and hopefully using some as references once I get around to having the “family therapy” discussion.
Thank you. Those two words, “onset of”, mean the world to me. As someone who has suffered from depression in the past, and who has seen the effects of untreated depression on her family, I am so afraid of this when it’s my time to be a mother. But if it’s just depression, if it is just the same old depression just it just happens to occur after the flipping huge life change that is OMG BABY, then I think it’s a lot less scary.
I think it gets spoken about more in physical terms (in relation to hormonal changes, etc.) because it makes women feel like it’s not their fault. I think we, as women and especially as mothers, put a lot of pressure on ourselves to ‘handle’ everything and I think it’s easier to blame the physical causes than the phsycological ones when we can’t cope… it makes us feel LESS weak. You make a lot of great points on the family unit and how we all affect each other and I really thought this was a great article. I’m just trying to provide another view point. Perhaps it is not being spoken about as a ‘women’s disease’ to perpetuate the “woman-as-emotionally-fickle stereotype”, but rather to make women feel like there are concrete reasons for the on-set of their depression.
Diffusing blame is an element I definitely thought of and recognized when I started to research. I absolutely think this is why women have used the “Oh these hormones” thing so extensively; it sure is easier than saying “My marriage is not how I imagined it would be” or “I don’t feel connected to my family or my baby.” But that is also exactly the reason why we should break down those walls and make those relational/emotional aspects as accessible to talk about as the physical changes after childbirth. So I guess I should clarify that I don’t look down on anyone who faults their hormones; but I hope it becomes more commonplace to examine and exploit the other factors, too.
Oh, I didn’t think you were looking down on anyone. It is obviously a well thought out and well researched article. What I was really trying to get at is that if blaming it on hormones helps women to acknowledge their depression in the fist place and seek help, then maybe is not a bad thing… at least it is being talked about more openly now. I think you are right that we need to “examine and exploit the other factors” and “break down those walls”! I just think that you’re a little ahead of the rest of society… but PLEASE keep pushing the rest of us to catch up 🙂
THANK YOU for writing this. That was enormously interesting and helpful.
More articles like this, please!! It’s hard to criticize being “offbeat” if us offbeat-ers(?) can prove we KNOW what the eff we’re talking about.
hey! I did my MA medical anthropology thesis on postnatal depression…
THANK YOU. This article sums up so much of what I’ve been thinking and feeling about my experiences with postpartum depression. I totally think that physicality/hormones plays a part in the onset, and maybe the continuation of the actual depression. I mean, I get very valid PMS every month that I totally blame on hormones, and it’s real. However, at 10 months postpartum, I was still depressed… and everybody just kept saying, “It can take years for you hormones to go back to normal.” But when women are still depressed months and months after birth, it’s not just a crazy woman hormones issue. There are definitely other factors, but it’s easier for us as women, and for the medical professionals to just say, “It’s hormones. You’re a woman and your hormones make you crazy,” than it is to actually examine the other factors for being depressed. You can’t do anything to change your hormones, but you can change the way you approach an actual disease, or problems with your view of yourself and your relationships, or whatever. i totally believe that blaming hormones is just like blaming vapors. It’s just some mysterious thing that happens to women. Anyway! Yes. Thank you, I agree.
So right on!
Thank you.
Thank you! This article was in the back of my mind today when I met with the OB. I reminded her of my significant history of depression and asked her if she would be willing to let me leave the hospital with a script for an antidepressant. It’s a while out but it’s better to be prepared than not
So amazing. Thank you! I’m applying to grad programs in psych right now…as in right at this moment! (reading this does not count as procrastination because you cited your sources ahaha!) My partner and I are discussing having a baby within the course of my time at grad school, and I found your writing to be empowering and refreshingly family-oriented. Like some of the other ladies above me, I too have suffered with depression in the past, and the idea of struggling with that at a time when I want to be celebrating is very frightening. Thank you for reminding me that I am a part of an amazing, loving, and unstoppable family unit, and that we can get through anything together.