Nina In New York: Postpartum Depression Screening Recommendations Better Late Than Never
A lighthearted look at news, events, culture and everyday life in New York. The opinions expressed are solely those of the writer.
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By Nina Pajak
This week, a government-appointed panel gave the recommendation that all pregnant and postpartum women should be screened for depression. As it turns out, the panel says, this is an issue that affects more women than the medical profession has understood—around one in seven. At least, that's how many are reported. And what's more, they say, the mental health of a new mother can also have a significant impact on her child. The recommendation also states that this service be fully covered under the Affordable Care Act, and that all relevant physicians should comply regardless of whether they have specifically dedicated psych staff.
Sloooow. Clap.
I don't mean to diminish the importance of this: it's huge. The panel's findings are likely to influence policy and genuinely affect change in the way doctors operate all over the country. It's just that . . . well . . . duh? And also, welcome. Where've ya been? We've been waiting for you, for generations, just sitting around and feeling pretty darn terrible and alone. You didn't have to go to all this trouble. All you have to do to come to this conclusion is walk into any playground on any sunny day and talk to the moms pushing their kids on the swings.
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In the weeks following the birth of my daughter, I cried. A lot. And when I wasn't crying, I was sitting in a chair, despondent, exhausted, cripplingly anxious, enduring the excruciating pain of early nursing while wondering what in god's name I'd done to my life. I didn't want to socialize. I only ate when prevailed upon by family members. I took slow, uncomfortable walks around the neighborhood in an effort not to feel like a person who had just been ripped in half and then unceremoniously cast out of the joyful part of the world. No matter how many loving people surrounded me, I felt alone. In the quiet moments, when the baby was asleep, I was plagued with horrifying, intrusive thoughts of various natures which I still find difficult to revisit.
In fact, that was the one, defining characteristic of my experience: I didn't want to talk about it. With anyone. I felt I couldn't. After a woman has a baby, quite understandably, people inquire after you in this manner:
"Aren't you just so happy?"
"Is it bliss?"
"Are you absolutely over the moon?"
Of course you should be. You've just been given a gift whose value is incalculable. A gift which many people have given up everything to pursue. It's silly and selfish and embarrassing to feel anything but grateful. And so on a rational level, I was "happy." I had what I always wanted. My baby was healthy and beautiful, and it would have been insane to wish for anything more. Ever the proficient test taker, I told my OB that I was doing fine at my six-week postpartum checkup. It was a quick inquiry, and I wasn't lying—I wasn't in danger of hurting myself or my child. I was managing. I wasn't drinking or doing drugs or unable to perform my maternal duties. Was I okay? Sure, I guess I was okay, whatever that meant.
But I wasn't, obviously. There is very little about PPD that aligns with rational thought. And mine lasted for a solid few months, which is well past the fictional six-week milestone agreed upon by all the glib internet articles about those pesky "baby blues." It wasn't until months (even years) later, when I felt able to discuss it with other mom friends, that I realized that I had been so very far from alone. My story is a dime a dozen. And I'd had it much easier than many other women.
I don't know if I ever would have felt comfortable enough to open up at the time of my PPD, but if there'd been less shame and secrecy associated with the problem, perhaps I would have been able to find the solace and support I needed. Instead, I trudged through like a good soldier until I slowly began to see the light on the other side. And once I came through it, I felt so much regret that I hadn't been more patient with myself, that I hadn't known better than to beat myself when I was down. Now, I feel a strong responsibility to be forthright about what I went through. The more of us who do this, the easier it will be for future sufferers.
Recently, more celebrities and writers have come out and spoken honestly about their experiences with postpartum depression. And while this is a terrific trend, it doesn't go very far in terms of how it changes the conversation among the general population. Here's what will: doctors who all ask probing questions and open up the dialogue from an early stage in the pregnancy process, so that women (and their partners and family members) are genuinely prepared for what may come. A government and healthcare system that recognize this condition as being very real and very common. More legitimate and helpful information, made more readily available. And hey, here's a repulsive fact which still isn't being addressed: there is no institutionalized standard for mental health screenings for patients who have experienced pregnancy or infant loss.
Let that one sink in for a moment. Now resume your slow clap.
Nina Pajak is a writer living with her husband, daughter and dog in Queens. Connect with Nina on Twitter!