Rant Alert: How Doctors are Still Getting it Wrong …

I truly believe most doctors really do care about their patients. I sincerely hope this is, at least in part, the reason they made the decision to go into medical school.

I also believe, or hope to believe, that most doctors are  continuing to educate themselves about prenatal and postpartum depression.

Why is it, then, that so many doctors continue to misunderstand this illness?

I didn’t have postpartum depression after giving birth to my children, some twenty hundred years ago. But had I felt overwhelmed with anxiety or paralyzed by fear or stymied by guilt or hopelessly hopeless, I can’t imagine not telling my doctor.

So we tell women to tell their doctors. Disclose your feelings. Expose your vulnerability. Ask for help.

And many do.

Hopefully, most get the help they need.

Some, however, still get this:

“I told my doctor how bad I was feeling. I told him I couldn’t breathe, sometimes, and that I didn’t think I should be a mother; that I made a mistake and that my son deserved someone who loved being a mother. I told him that I didn’t think anything was wrong, really, because my son was healthy and my husband was amazing but still, I couldn’t shake this feeling that something was terribly wrong and that I would never feel like myself again. I told him I stayed up at night worrying that something terrible would happen and that I couldn’t stand how I was feeling. He sat writing some notes in my chart and barely looked at me. When I started crying, he looked up for a quick glance, of course I felt judged, but I don’t think he was really judging me. I think I was judging myself because I felt so fragile and so emotional, so unlike me.  But since he didn’t offer any kind words of support, I took a deep breath and tried to keep it together. I felt like I was going to jump out of my skin.  Then, he put down his pen and took off his glasses to look directly at me, the way that professors do when they have something serious to say. That was nice. I felt listened to. I felt cared for. I didn’t feel rushed. I think he really cared. But then, he said the wrong thing.”

“What did he say?” I asked.

“He said, ‘just be grateful.'”

Collective sigh.

“I AM GRATEFUL!!! UGH. That’s not the solution. That’s part of the problem! If I weren’t so grateful for my gorgeous son and my fabulous family, I would have killed myself by now. Just be grateful? Are you kidding me? Oh please. I am so in the wrong place.”

Yes, she was, in that moment, anyway.

To be sure, being grateful has enormous healing powers. Gratitude and a host of other positive emotions can sprinkle bits of magic into an aching soul. Make no mistake about it, being truly grateful from deep within your heart, can be a life-altering and amazing experience.

But it is not, in and of itself, an antidote to depression.

Women who are depressed cannot (yet) turn it around by inserting a corrective emotion.  Although this is clearly where we hope she can go, fairly soon, it is not likely that she can do that simply when instructed by her healthcare provider. It feels dismissive, though I will give him the benefit of the doubt and presume he meant it supportively.

It was too soon.

Rather than tell postpartum women who are depressed that they should be grateful when they are acutely symptomatic, they should be comforted with reassurance and expertise, then referred for treatment. That’s all. I know doctors are busy and incredibly overloaded. But please, if a postpartum woman has the courage to tell you how bad she is feeling, please do not tell her to be grateful.

Tell her you will help her feel better.

 

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