Down with PPD? MD? PPPD?

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.