New Guidelines Recommend All Pregnant and Postpartum Women Should Be Screened for Depression

Image Source: Thinkstock
Image Source: Thinkstock

Remember back to when you first had a baby: Did your doctor ever ask you how you were feeling?

Perhaps they did at your six-week checkup, asking about your physical health — how your body had recovered post-birth and if you were struggling with breastfeeding. But did they ask about your mental health — if you were feeling down or if you felt tired and unmotivated? What about in the long months after that, when you were maybe alone with a baby 24/7 while your partner went back to work. Did anyone ask if you had been feeling down at all, or how you were coping? I’m guessing for many women, the answer is no.

But the U.S. Preventative Services Task Force is hoping to change that. In an update to their 2009 guidelines, they’re recommending that all women who are pregnant or within a year of having given birth be screened for perinatal depression. This is in addition to their broader recommendation that all adults over 18 be screened for depression.

Ellen L. Poleshuck, associate professor of psychiatry and obstetrics and gynecology at the University of Rochester Medical Center, added, “One of the things that I think is exciting about these new recommendations is the decision to specify that it includes pregnant and postpartum women because we know that untreated depression in (these) women can affect the baby as well as the mother.”

This topic is very close to my heart for several reasons, not least because there is such a stigma in admitting to any kind of mental health issue. Yet 1 in 5 adults in the U.S. will experience mental health issues in a given year, and nearly 60 percent of those won’t receive the mental health services they need.

1 in 5 adults in the U.S. will experience mental health issues in a given year, and nearly 60 percent of those won’t receive the mental health services they need.
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I’m not ashamed to admit that twice in my life — after both births of my children — I ended up taking antidepressants. On both occasions, I didn’t become depressed in the immediate aftermath of birth, but nine months to a year later. Depression wasn’t something I woke up with one day; it slowly crept up on me until I was a shadow of my former gregarious self.

During that time, I felt utterly numb. Like I was being dragged down the abyss, unable to get air, unable to see anything further than the apparent tragic waste of my life. I wanted to curl up, hibernate, and never wake up. Sleep was the only pleasure I enjoyed, a temporary respite from an otherwise anxious state. Depression, you see, clouds all judgment. It stops rationality, the ability to accept sympathy, the ability to empathize.

Eventually I reached out, thanks to my patient mom who could tell something was wrong, and got help. With the right medication, I felt better — less anxious, like a hole inside me had been filled. In short, I felt like I could cope. I coped with my husband losing his job — twice. I coped with going back to work full-time with two kids and a writing job on the side. No one who bumped into me at the park or saw me at work would have ever known that I was suffering — because the medicine was working.

So to hear that in the U.S., depression screenings will become obligatory for women at one of the most vulnerable times in their lives, is great news. If only the U.K. would follow suit. The screenings will likely include a nine-question test called the Patient Health Questionnaire, which asks about mood, fatigue, concentration, appetite, whether they’ve been interested in activities, and whether they’ve thought about hurting themselves in the last two weeks. The only failing is that it requires people to answer honestly, and those who want to avoid diagnosis may well lie in their responses.

We need realistic portrayals of women acknowledging their issues, getting help, and surviving. Hopefully these new required screenings will help that happen.
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So why is there such a stigma surrounding mental health? Perhaps the imagery we see in popular culture of depressed women only strengthens the preconceived notion of what it means to be depressed.

Writer, director, and actress Lena Dunham (who has taken antidepressants since she was a teenager) recently posted on Instagram, “Lately I’ve been noticing that nearly every pop cultural image we see of a woman on psychiatric medication is that of an out-of-control, exhausting and exhausted girl who needs help, but guess what? Most women on meds are women who have been brave enough to help themselves.”

The 29-year-old went on to stress how women on medication for their mental health should not be made to feel inadequate or ashamed.

“It’s important that we see normalizing portrayals of people, women, choosing to take action when it comes to their mental health. Meds didn’t make me a hollowed out version of my former self or a messy bar patron with a bad bleach job. They allowed to really meet myself. I wish that for every lady who has ever struggled. There’s really no shame.”

It is time we talked more openly about being depressed and other mental health issues without fear of judgment, pity, or shame. Often the loudest, happiest sunniest people are the ones with the darkest thoughts, the demons in their heads. Having been the life and soul of the party, the cheery workmate, the calm earth mom — all the while on meds — I can verify this. Want to see what a woman on meds is like? Look around you. The stigmatized, ridiculed, unstable wreck is not representative of who we are.

We need realistic portrayals of women acknowledging their issues, getting help, and surviving. Hopefully these new required screenings will help that happen. Then maybe the shame of depression will finally fade away.

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