Originally posted March 4, 2013.
Stigma and Fear Around Perinatal Mental Illness
The mentally ill are dealing with public and self-shame. Research consistently shows that we stereotype people with mental illness as 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.”
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 her own 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.
You think there is 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? Gee, you don’t know?
Why does World Mental Health Day (World Health Organization sponsors this on October 10th) come and go so quietly?
Did you know that depression in Women is More Common than Breast Cancer or Stroke
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 in the 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’ve also published information about the stigma of mental illness in my book, BirthTouch Pocket Guide to Perinatal Mental Illness for Childbirth Professionals and in the Lamaze blog Science & Sensibility.
Corrigan, P.W., Morris, S., Larson, Jon; Rafacz, J., Wassel, A., Michaels, P., Wilkniss, S., Batia, K., & Rüsch, 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
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.womensmentalhealth.org/specialty-clinics/psychiatric-disorders-during-pregnancy/ from http://www.who.int/mental_health/management/depression/definition/en/