Another unwarranted unwanted voice

Katherine Stone (and her wonderful Postpartum Progress Blog) has called our attention to the words of Tricia Shore , a writer who, when she isn’t stirring up trouble, is a comedian (someone should tell her this isn’t funny) who has declared her comments on PPD for all to see. On behalf of women with postpartum depression, I feel compelled to clarify a few things:

It’s a shame that so many ill-equipped and opinionated writers have such an expansive audience to whom they can further spread their misconceptions. In the past, when someone found a forum to preach misinformation, it could be dismissed as an isolated aberration or an individual’s distorted interpretation or simply unbridled discourse at a cocktail party.

But today, as we continue to seek or be bombarded by Internet-available information we may or may not want or ask for, sometimes something seeps through cracks. We are then forced to spend what little available time we have wondering why someone actually spent the energy and bandwidth to put forth a particular message. The reason we have to respond is because there is now, more than ever, greater access to these unsupervised communications and more lives potentially impacted.

So I reluctantly confess that I spent superfluous time reflecting on the piece written by Tricia Shore that Kathleen so responsibly brought to our attention.

In what might, at first glance, be a not-so-popular posture, I must admit that I agree with her opening opinion which raises a concern of my own: Has our media-soaked attention to a devastating illness, somehow diminished its worthiness in the medical and mental health community? Is there so much hype surrounding postpartum depression that in addition to promoting much needed awareness to this underdiagnosed illness, it might actually dilute the impact and sabotage our own efforts?

I hope not.

Those of us who treat this illness know only too well how excruciatingly painful and potentially deadly it is. Quite frankly, we should not be the least bit influenced by the misguided insights of a bystander who claims to have a worthwhile opinion. But for the sake of those who have been disturbed by this very well-written commentary, and on behalf of women who struggle with postpartum depression, let me do my best to respond to some of her specific points with a few of my own opinions:

–Postpartum depression does not make strong women appear weak. It makes strong women sick.

–Claiming that Brooke is “prostituting”, Oprah is “enabling” and Mary Jo is “victimized” is inflammatory and simply unmerited.

–“Little pills that supposedly cure depression” can save lives and improve the quality of life. This is not a belief, it is evidence-based information that may or may not be significant to Ms. Shore or anyone she loves.

–Breastfeeding may indeed facilitate a pre-pregnant hormonal state. Breastfeeding may also be contraindicated if a woman is sick and unable to adequately care for herself and/or her baby. Breastfeeding can be associated with increased fatigue, depletion of personal resources and guilt that renders a mother virtually frozen with ambivalence. Pressuring a woman to breastfeed when she is in the throes of a major depressive episode and feeling suicidal can have catastrophic consequences.

–If a woman is fortunate enough to be surrounded by family and friends to “help hormones return to normal”, she is likely to feel less isolated, less agitated and far more comforted. The presence of her loving family and friends cannot, however, prevent nor treat a major depressive episode.

–She makes a good point regarding the thyroid and it’s worth repeating by one of the “supposed experts” who understands and treats women with postpartum depression: Before a definitive diagnosis of postpartum depression is made, depression caused by medical conditions such as thyroid dysfunction or anemia must always be ruled out.

–It’s okay for her to be skeptical about our mental health industry. She should be. We all should be. Women who are sick should be especially skeptical about misdiagnoses, mistreatment and misinformation. No one should be prescribed medication if they do not need it. And no one should question the use of medication by someone who does.

–“I even wanted to be a social worker… my plans have changed about becoming a social worker…”

This point, Ms. Shore, is very good news for all of us.

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