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Down with PPD? MD? PPPD?

Apr27

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Welcome, Wonderers. Alice will be back next week, sparkling words all over this column like yummy little Veuve Cliquot bubbles. This week, Fellow Wonderer Jenn of Breed ‘Em and Weep is reporting once more from Weepland, where she has been pondering the ongoing saga of the forlorn-yet-defiant, mascara-streaked creature that is Britney Spears.
If you haven’t been paying attention to Brit because inhaling lurid, useless details about slutty new life-supporting planets or gobbling up starbirth porn is how you get your cheap thrills, let me fill you in on the U.S.’s greatest natural disaster, now in progress.
I don’t care how much her net worth is. I don’t care if she forgot her panties more than a few times. I don’t care if she beat the crap out of a paparazzi-mobile with an umbrella or shaved her head in public or slid out of a three-story window to flee rehab. Who hasn’t gone commando, shaved the roof, and bitch-slapped a Hummer or two on a bad day?
I can get past all that. But the woman’s got two very young children. And she’s got one other thing that really concerns me: a rumored diagnosis of postpartum depression (PPD).
She’s no Brooke, whose articulate, compassionate voice has been a genuinely welcome (and frequently, wry) one in the PPD arena. No, Britney is a PR disaster for PPD, a disorder I fear is already on the verge of a groaning, eye-rolling backlash. I worry for any illness that, when brought up in polite conversation, can garner slow, faux-serious nods and “ah, yes, of course” without further questions. I worry about PPD because, like most mental illnesses, it fights tooth-and-chewed-off-nails against definition, and it rarely plays by the rules. As much as everyone would like it to.
WebMD.com’s definition of postpartum depression, like many PPD definitions, leaves me with more questions than it answers:

Postpartum depression: Postpartum depression is a complex mix of physical, emotional and behavioral changes that occur in a mother after giving birth. It is a serious condition, affecting about 10% of new mothers. Symptoms range from mild to severe depression and may appear within days of delivery or gradually, perhaps up to a year later. Symptoms may last from a few weeks to a year.

Let’s leave Brit wherever she is (and, like it or not, I still say none of us can say where that poor woman is. Yeah, yeah, sprinkle a little there but for the grace of God in your morning java if you feel a snort coming on, because at least you don’t have one of these selling on eBay with your name on it).
Let’s look elsewhere. Let’s say that another mother, New Mama, wakes up on Day 365 of Her Life as New Mama. Something’s wrong. Much worse than wrong. Maybe she’s been like this for a while; maybe it’s a new, frightening inner shift. Maybe she drags herself to a doctor; maybe someone else manages to get her to one. In the end, the official diagnosis is PPD.
If she’s lucky, the treatment—medication or meditation, herbs or diet, one-on-one counseling or group therapy, exercise or escape, or any combination thereof—works. She gets “better”—whatever better is, she knows it when it arrives on the scene. Everyone in the vicinity breathes a sigh of relief, especially her, her partner (if there is one), and her children. Case closed.
Unless, of course, the case stays open. What happens when the treatment fails? When no amount of meds, no amount of counseling, no amount of time off, time away, or time out can ease a mother’s ongoing suffering? If she’s still weeping in the shower on Day 730, fully two years after the birth of her child, is that still PPD?
Or does the diagnosis evaporate into thin air? If so, where does that leave No-Longer-New-Mama?
I’m no longer a new mama, but my own process of becoming a mother, coupled with the ongoing tightrope act of mothering, seems to have widened a dangerous fault line in my brain. (It’s no accident that I named my blog Breed ‘Em and Weep.) Like other mothers who technically no longer fit the diagnosis of PPD, I wonder if there’s something to the concept of ongoing maternal depression, a concept recently fleshed out by author Tracy Thompson in her book The Ghost in the House: Motherhood, Raising Children, and Struggling with Depression. Thompson suggests that maternal depression may be a lifelong struggle for some women, a chronic illness as life-threatening as diabetes or MS, and her research about the ramifications for children being raised by a depressed mother, although absorbing, is painful to read from the trenches.
In September 2006, Sandra G. Boodman of The Washington Post wrote of Thompson’s Ghost:

Motherhood and depression share a long common border, author Tracy Thompson observes in The Ghost in the House…her exploration of the often-overlooked mental health problem. The book blends memoir with research on the topic. Thompson’s focus is not the more-familiar postpartum form that can follow the birth of a baby, but the longer-term illness that affects an estimated 12 million American women, many of them diagnosed in the prime childbearing years between 25 and 44. In Thompson’s view, unrealistic expectations about motherhood may be increasing the risk of depression in women who feel they can’t measure up.

Is that a mother thing, this sense of not measuring up? A woman thing? A human thing? I know few people who feel confident they’re doing their best on a regular basis, and the mothers I know seem to be the least likely to rate themselves as champs…if you can get them talking, really talking. Soul-crushing emotions like despair and worthlessness are not always welcome visitors to casual playdates, or half-hour coffee chitchats—which may explain the profound appeal of bold mama blogs like Dooce that dare to tread where real-life friends and acquaintances may not. Thompson herself has a blog, Maternally Challenged, and this post, “Balm”, addresses the ruthless anxiety that often accompanies depression. (Another bonus.)
But is it all “just” depression? Is it better to divvy depression up into pie slices like PPD and maternal depression? Maybe you missed this one: paternal postpartum depression is a new slice of the pie (cue more eye-rolling from some, hearty nodding from others—only you know who you are).
I didn’t say I had the answers. It’s called Wonderland over here—free-range Wonderers, knock yourself out! The only undisputed fact I can offer up is that it’s far more difficult for a mother to care for herself when there are little ones who require round-the-clock care at the same time. And anytime a mother doubts her ability to care for her kids, there’s going to be shame—a killer downward spiral in its own right.
As for Britney, well, all I can say is, girl had better get crackin. Because this is crummy news for writer/mothers, particularly those of us who usually keep our panties on and don’t get a lot of press to start with.
Excuse me. I’m going to download some astronomy porn now.

About the author

Alice Bradley

http://www.finslippy.com
Alice Bradley was a regular contributor to Alpha Mom, writing about current events as they related to parenting. You can read about her daily life at her personal blog, Finslippy.


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9 Responses to “Down with PPD? MD? PPPD?”

  1. Maggie Apr 27 at 4:11 pm Reply Reply

    I can honestly say I’m almost jealous of Britney. I don’t envy anyone with depression or anxiety of any kind, but at least she can get the best help possible. She can go to the best doc in the world if she wants to. My boat — and it’s one I think a whole lotta moms are in — is the one where you don’t have insurance but make too much money for any assistance but you just can’t afford to go to a good psychiatrist or therapist. The most I can afford — without forgoing food, or something — is the cheapo walk in clinic. I’m sure they’d be glad to give me some pills, but I doubt that I could pay for the prescription. And, besides, I think I need more than that. This is tough stuff, and some days I wonder if it will ever end. I just want to feel good and enjoy my family. This is one reason I started blog reading — it is some comfort to know that I’m very much not alone.

  2. BOSSY Apr 27 at 6:32 pm Reply Reply

    Bossy thinks when you have a baby it’s natural to mourn the loss of self. And like mourning an actual death the grief strikes in degrees: For some people there is a wash of unspecified sadness, and for some it hits hard and sucks away logic, morals, and the will to live.

  3. Jenn Apr 27 at 7:44 pm Reply Reply

    Maggie: I’m jealous AND I want to hold her tightly against my matronly bosom and croon, “Shhhhh, shhhhhh,” into her ears.
    (I think that’s what many blogs do for me, sort of. A virtual rocking and hush-it’s-going-to-be-all-right.)

  4. ozma Apr 28 at 1:22 am Reply Reply

    OK, this is weird but after I had my child I developed a strong desire to shave my head. I still have it! Why? Is there something about having a baby that makes baldness desirable? I think this is pretty much the only thing Britney Spears and I could conceivably have in common.

  5. Cheri Apr 28 at 2:18 pm Reply Reply

    Personally, I’m glad they are talking PPD for Britney. It’s what I have been wondering for a while. Every new sensationalist article fills me with such sadness for her and her boys. I, too, want to find her and hug her and tell her it will be okay. She’s been through a major life change – a divorce – right on the heels of giving birth and all in the glaring spotlight. The real shame would be if everyone around continued to watch and attempt to profit from her pain and potential illness without doing anything to help her.
    Not that I have a tremendous amount of sympathy for many of Anna Nicole Smith’s life choices, but I do wonder if that wasn’t what happened to her. And it leaves me incredibly sad. For both of these women, their children, and all of us. If these superstars, loved by so many, surrounded by people, suffered or are sufferig from PPD and can’t get anyone to recognize it and step in to help, then what hope is there for all of us “regular” mommies who just struggle to get by with a little help from our spouses (if we’re lucky)?

  6. Well said, Jenn.
    What the eye-rolling public fails to take into account is she’s definitely suffering in a profound way and she has two babies who need their mama. I’m afraid for this young woman, and when I hear these stories about her I don’t find them titillating. These are the acts of someone lost and desperate, and I pray she finds her way out.

  7. Jill Apr 29 at 11:30 pm Reply Reply

    Hmmm, I never really thought of PPD. I always figured she was finally cracking under the pressure of trying to maintain the gaze of that fickle limelight. Hey, anything for a tabloid cover I guess. *shrug*
    I feel for her. I think I’d have gone crazy too if I were her. But you’d think that with all the eyes of the world on her, she’d at least try to make some better parenting decisions (neverending carseat debacle, anyone?). She needs to cash in her chips, take her kids, and go to her mom’s house and just hide out for a long, long time. Rest and recuperate. Get to know her children and spend time with them. GET OUT of the public eye, and get her sanity back.

  8. Rachel May 05 at 1:31 am Reply Reply

    In a discussion on a message board I frequent it came up that her behavior lends to the theory that she may be bipolar, in addition to PPD. I’d say her behavior is pretty darn extreme, and the bipolar theory did ring likely to me.
    I admit, I’ve rolled my eyes at the idea of PPD, but reading this article, and that maternally challenged link makes me think that perhaps my parenting struggles might be a result of a mild case of it.
    Thanks for the thought provoking read.

  9. A May 09 at 7:29 pm Reply Reply

    I worry about Britney & I worry about Angelina and Katie. Mostly I worry about myself. My baby is almost a year now, I’m dosed to the eyelids and I’m drowning most days.
    I have to believe that with time will come sanity.

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