I was honored when Katie Contrera, a graduate student in the Science/Medical Writing program at Johns Hopkins University, reached out to me for a therapist’s perspective on Postpartum Depression. Chatting on the phone with her, I loved hearing her passion for reducing stigma around peripartum mental health through her writing. Like me, she was interested in the role of social media and it’s ability to connect us yet make us less social. Katie sent me a copy of her article after turning it in for class. It’s good. And I’m honored that she let me publish it here.
Reframing Motherhood: The photo that doesn’t get posted
By Katie Contrera
It’s Mother’s Day—and you can tell just by looking at Facebook. Pictures of and tributes to moms pepper your newsfeed. A new mother holds her baby close and they both smile. She is beaming. She looks beautiful. She looks happy.
You might be surprised to hear that the woman smiling back at you is anything but. And it’s more than just sleepless nights and “mommy blues.” It’s a silent agony. She is paralyzed by fear and anxiety and she feels guilty for having fear and anxiety. It’s an isolation that’s wholly rooted in shame. Shame because mothers are only supposed to feel happiness when they hold their squirming bundles of joy.
This is how Carrie Martin,* a litigator in Denver, Colorado, describes her postpartum depression (PPD) survival story.
And she isn’t alone.
In 2013, the Center for Disease Control stated that 950,000 women in the U.S. reported suffering from perinatal mood disorder, the most common of which is postpartum depression. This is the largest group of Americans with depression, according to the American College of Obstetrics and Gynecology. Suicide is the second leading cause of death in postpartum women.Tweet
Even more concerning, the incidence is considered to be underreported because of the devastating stigma attached to depression—maternal depression especially.
Martin knows this stigma well. She suffered from PPD after delivering her son, Reed, in May 2013. Nothing was easy after that. She was anxious all the time and had a crippling fear she would harm her child. It was, at times, debilitating.
On her way to work one morning she reached her breaking point. She pulled over to the side of the road, called her husband, and through uncontrollable sobs pleaded, “I can’t do this anymore.”
Abigail Burd, LCSW, a San Diego-based therapist whose practice covers maternal mental health, explains that this is an absolutely common experience in women suffering from PPD.
“Not only is there a stigma around depression but, culturally, there is this expectation that motherhood is this wonderful, magical experience.”
This veneer makes suffering that much more isolating as mothers wrestle with gnawing thoughts of “‘I’m not good enough. I’m not a good mom,’” says Burd, “and the stakes are life and death.”
This isolation is intensified by the influence of social media. A study recently published by the American Psychological Association provides context for the role social media may play in the world of PPD patients. The study reports that the greater exposure a user has to “successful others,” the greater the opportunity for negative social evaluation.
And the “successful other” abounds—Pinterest inspired birthday parties and sepia-filtered naps on Instagram make it that much harder.
“No one ever posts ‘I am depressed,’ or, you know, ‘I feel defective for not being hardwired with a mom gene.’” Martin laughs a little, “I mean, it even sucks to not drink coffee or have a beer when you’re breastfeeding. But no one ever talks about it!”
Perhaps this lack of dialogue stems from a lack of understanding.
Jennifer Payne M.D., associate professor of psychiatry and director of the Women’s Mood Disorder Center at Johns Hopkins, notes, “Mood disorders in women are understudied, to put it mildly.” This is especially true in the case of PPD.
“There are anxieties tied to studying women with perinatal mood disorders that stem from a fear of harming the child,” she remarks. As a result, researchers and pharmaceutical companies aren’t as inclined to move the needle on this work. And that’s troubling.
Research will shed light on medication management and interventional therapies for women who face higher risk factors for developing PPD. In the long run, Payne says, this will create more positive outcomes for both the mother and child.
A lack of research can also be harmful from an awareness perspective, perpetuating maternal mental health stigmas. This is why Burd argues that more dialogue in the public sphere can create an honest narrative about motherhood and mood disorders.
“And, social media can be an appropriate platform for that,” she notes.
Despite its drawbacks, connecting virtually is a low-commitment way to engage with other women who are going through the same thing.
Martin says online support groups can be an effective tool in combination with medication and psychotherapy, but she admits recovery is still a work in progress.
“It’s kind of like a shadow that follows you,” she explains.
There are still triggers, still pangs of guilt, still feelings of resentment for not having this ethereal experience society tells women they should have with their newborns.
As professionals and advocates continue to lead research, therapy and outreach initiatives, there is hope that reframing the cultural narrative about motherhood will allow women to share their survival stories openly, just as Martin has begun to do.
From time-to-time, she comes across that photo she posted to Facebook on Mother’s Day. The one that told a story of a content, new mother. Of course, she knows the photo is concealing a much different story, one of a dark, emotionally depleting time.
A reminder to her, and a lesson for many, one never truly knows the battle being fought by others—whatever they might post.
*some details have been changed to protect anonymity
Katie is a science/medicine writer in Baltimore, Maryland. She is an advocate of women’s health issues, particularly those surrounding mood disorders. She can be reached at firstname.lastname@example.org.
Images: Breakfast in Bed (1897) by Mary Cassatt, oil on canvas, Huntington Library; Dorothea Lange, Farm Security Administration/Office of War Information/Office of Emergency Management/Resettlement Administration. (Both public domain via Wikimedia Commons.)