13 October 2011

What's the big deal about PostPartum Depression?

I've heard people ask "What's the big deal about PostPartum Depression?" and while part of me thinks "How can anyone say that?", part of me knows that that question comes from a place of ignorance. I speak from experience when I say that it can be hard to understand and hard to be sympathetic when you've never dealt with PPD or a loved one with PPD. Prior to my own experience with it I would hear the stories about the extreme cases (think Andrea Yates) and think "That's just an excuse". Maybe it is an excuse for some people but for far too many, it's not. PostPartum Mood Disorders don't have to cause someone to kill or try to kill, but they most certainly are something to be taken seriously.

PostPartum Depression is not a "bad mood". It's not a matter of "choosing to wallow". It's not indicative of someone who "Needs to pray harder" or "Should go to church more often". PostPartum Depression is a legitimate medical condition that must be treated by a qualified medical professional. In a blog entry titled How Many Women Get Postpartum Depression? The Statistics of PPD , Katherine Stone of Postpartum Progress addresses the sobering statistics.

Quick, guess which number is higher: the number of people who sprain an ankle each year, the number of people who have a stroke, or the number of women who experience postpartum depression?
PPD. Surprised?
In so many books, articles and news programs, you hear the statistic — approximately 10 to 15% of women suffer from postpartum mood disorders (PPMDs), including postpartum depression (PPD), postpartum anxiety/OCD and postpartum psychosis. What bothers me about that statistic is that it holds no meaning for most people, and because of that I think these illnesses get much less funding and attention than so many of the other prevalent illnesses that strike Americans. As a result, I decided to do a bit of quick, non-scientific research to look at the real numbers and to help people understand the real impact that postpartum depression is having on the women of our country.
There were approximately 4.3 million live births in the United States in 2007. This statistic does not include fetal losses, including miscarriages and stillbirths. The National Vital Statistics Report indicates that the total number of clinically recognized pregnancies is around 6.4 million. This is important to know, because all postpartum women are susceptible to postpartum depression, regardless of the pregnancy’s outcome.
So let’s split the difference between the high (20%) and low estimates of PPD (11%) and say that an average of 15% of all postpartum women in the US suffer, as the CDC reported in its 2008 PRAMS research. And let’s use the number of clinically recognized pregnancies and not live births. This would mean that each year approximately 950,000 women are suffering postpartum depression.
BUT, did you know the CDC’s research only reflected self-reported cases of postpartum depression? How many women do you think did not mention they had PPD out of fear or shame? Should we increase the estimate of sufferers to 17% or 20%?
ALSO, these numbers don’t take into account women who may have suffered other perinatal mood and anxiety disorders like PPOCD or postpartum psychosis. Should that make the numbers go even higher?
I’d argue that the average number of new mothers who experience perinatal mood and anxiety disorders is more likely in the 20% range, which would mean around 1.3 million annually.
How does that compare with the incidence among women of other major diseases in America?
In fact, more mothers will suffer from postpartum depression and related illnesses this year than the combined number of new cases for both sexes of tuberculosis, leukemia, multiple sclerosis, Parkinson’s disease, Alzheimer’s disease and epilepsy. This is not to minimize these other terrible diseases, of course. I simply want to illustrate just how prevalent postpartum mood & anxiety disorders are.
Dr. Ruta Nonacs of Massachusetts General Hospital and Harvard Medical School adds, “Postpartum depression is far more common than gestational diabetes. All women receiving prenatal care are screened for diabetes, but how many pregnant and postpartum women are screened for depression? PPD is also more common than preterm labor, low birth weight, pre-eclampsia and high blood pressure; in other words, PPD is the most common complication associated with pregnancy and childbirth.”
Let me leave you with one last thought: More moms will suffer from PPD than men will be diagnosed with new cases of impotence (approx. 600,000) this year. Yet you wouldn’t know it, considering the overabundance of erectile dysfunction (ED) ads and people falling all over themselves to discuss ED openly. Why doesn’t PPD get the same attention from pharmaceutical companies?
Why doesn’t society work as hard to eliminate the stigma of PPD? Why aren’t more corporations and foundations concerned about PPD and supporting awareness campaigns?
This really is a big problem, and deserves much more attention than it’s getting.

If ever there were chilling statistics, I think this makes the cut with no problem. Making it worse, an additional statistic is that only an estimated 15% of those women will receive professional treatment. That means that (going by the numbers laid out above) a estimated 1,133,334 women will suffer n silence, will go without help. Still wondering why all the fuss? 

My experience with PPD was that it made me a totally different person and not in a good way. I spent my days sitting in a rocking chair holding my baby and staring off into the distance. I cried for no reason all the time. I had horrible mood swings. I felt like nobody cared. I couldn't sleep. I felt like I was falling into a dark pit that was totally devoid of light. I felt like life wasn't worth living. I didn't want to go anywhere or do anything or see anyone. I got incredibly angry and frustrated and felt so overwhelmed. This was supposed to be the happiest time in my life and I was wishing I had never been born and that I could just go to sleep and never wake up. The feelings were both intense and lifeless. I don't know how better to describe the fact that I felt such intense emotion and yet felt at the same time that I wasn't feeling anything. 

1.3 million women are feeling like this and their family and friends are dealing with the stress and frustration of it.1,133,334 women and their families are suffering in silence at what should be the happiest  time of their lives and not getting the help they deserve, the help that is out there for them. More than a million women going without help and afraid to say anything. More than a million families struggling to make sense of it. More than a million women wondering "Why bother living? What's the point? Nobody gets it." and some of those women actually will act on it and kill themselves, all for a lack of public awareness and education. More than a million women at risk of committing suicide because they think there's no help for them. Are you still asking what the big deal is?

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