Stigma & Prevalence of Perinatal Mental Illness

Part One of this series of posts discusses the experience of public stigma and self-shame around perinatal mental illness. Part Two talks about risk factors and types of perinatal mental illnesses. Part Three about what you can do, Words & Actions that Heal and some resources. I hope you find this a useful addition to your knowledge base as a birth professional.

Woman to Woman Support

As a childbirth professional, how do you help women & families? Lamaze has a wonderfully constructive focus on birth as a normal and healthy process. Lamaze Six Healthy Birth Practices promotes positive empowerment of families. And, it is useful to be aware that the time around birth, pregnancy and postpartum is the time that a woman is most likely to (re) develop a mental illness (Nonacs, 2006).

Childbirth professionals are often the first point of woman-to-woman contact for new moms. Becoming educated about perinatal mood/anxiety disorders and having a list of resources available in your community and online is an effective way to be of help without overstepping your personal, certification or licensure boundaries.

You may be the first person she calls. You can help out by being positively aware, using Words that Heal, and providing a list of contacts in the community and online.

Fear and stigma around 'postpartum mental illness'

The mentally ill are dealing with public and self-shame. In the observer, the stereotype of someone who has a mental illness is someone low-functioning, someone who can't hold a job (Corrigan et al, 2010). Feelings of uneasiness and fear, rather than feelings of compassion bubble up (Corrigan et al, 2010). Think about your own reactions to the words 'mental illness.'

So be aware that a mother who is feeling depressed, anxious or fearful is probably experiencing deep self-shame. She probably feels more shame than is expected and associated with a physical illness. She probably has erroneous beliefs about the nature of mental illness.

Some mothers believe they are weak, and 'should' be able to control their feelings. Other moms might believe they are bad mothers because they are in such pain, like they are belittling the miracle of their new baby. Others might be afraid to admit the scary thoughts they are having. Yet others believe there is no effective treatment; they think they just can't get better.

Postpartum mental illness exists on a spectrum. Postpartum mental illness conjures up images of a mom who hurts her children, of courtrooms, of a person who is hearing voices, a home that gets visited by Child Protective Services and a mom who ends up institutionalized (Puryear, 2007). This stereotype is extreme and erroneous, as there are different types of postpartum mental illnesses.

No public stigma? No self-shame? Take a look at these statistics.

The World Health Organization lists depression as one of the top two to four causes of disability (defined as the loss of productive life) worldwide today. Mental illness is more prevalent than many other more publicized illnesses, but as a society we are very quiet about it.

No public stigma? No self-shame? I wonder why is there no nationwide Walk for Depression? What color is the depression ribbon? Why does World Mental Health Day (World Health Organization sponsors this on October 10th ) come and go so quietly? (Well, PsychCentral did have a blog party that day...)

Depression in Women is More Common than Breast Cancer or Stroke (saaay what?)

One in four women suffers depression at some point in her life, and women are more likely to suffer depression during and shortly after pregnancy than at any other time (Nonacs, 2006). Ruta Nonacs, MD (2011), editor-in-chief of Massachusetts General Hospital's Center of Women's Mental Health's website estimates annually in the US, there are about 4 million births, and about 950,000 to 1,000,000 mothers suffer from depression either during or after childbirth every year.

The good news is there are effective treatments for depression and postpartum depression. But the sad fact is less than 25 % of persons affected by depression receive any treatment at all (WHO, 2012). The top barriers to receiving proper treatment are the social stigma associated with mental illness (shame), lack of personal resources and the lack of trained clinicians (WHO, 2012).

So, think about that, only about 25% of those moms actually seek and receive help for perinatal depression. So many women cope all alone, managing their very real emotional pain while at the same time coping with an infant.

According to Postpartum Progress, there are more occurrences of perinatal depression annually than there are breast cancer diagnoses, occurrences of stroke in women, or diagnoses of diabetes. Postpartum Support International says that postnatal depression is the most common complication in childbirth today. Dr. Nonacs (2012) adds there are more occurrences of perinatal depression than pre-term labor or pre-eclampsia.

Pretty surprising statistics, no?

Any thoughts about why we are mum about maternal mental illness? I'd love to hear your comments.

Do you believe you can be a positive influence regarding maternal mental health? Or do you believe it is too specialized an area in which childbirth professionals to be knowledgeable?

Please share your views below. I love to hear from you!

References

Corrigan, P.W., Morris, S., Larson,J., Rafacz, J., Wassel, A., Michaels, P., Wilkniss, S., Batia,. K., & Rusch, N. (2010). Self stigma and coming out about one's mental illness. Journal of Community Psychology, 38(3), 259-275.

Kleiman, K. (2009). Therapy and the postpartum woman. New York: Routledge Press.

Massachusetts General Hospital (2012). Psychiatric disorders during pregnancy. Retrieved March 27, 2012 from http://www.womensmentalhealth.org/specialty-clinics/psychiatric-disorders-during-pregnancy/

Nonacs, R. (2006). A deeper shade of blue. New York: Simon and Schuster.

Postpartum Support International (PSI, 2009). Components of care. Seattle: PSI

Puryear, L. J. (2007). Understanding your moods when you're expecting. New York: Houghton Mifflin Company.

World Health Organization (WHO, 2012). Depression. Retrieved March 31, 2012 from http://www.who.int/mental_health/management/depression/definition/en/

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