Tuesday, August 30, 2011

Breaking Down Mainstream Stigma

Postpartum Depression Misrepresented in the News

If you read the news regularly, then last week you probably read the devastating news about Sonia Hermosillo, a mother in California who has been charged with murder for throwing her 7-month-old son from a parking garage. If you have your finger on the pulse of Postpartum Mental Illness in the news, then you know that infanticide, though rare, happens.

Sometimes it appears that an understanding of Postpartum Mental Illness is expanding to all corners of society. Today, PPD awareness organizations and blogs are sprouting up across the web at a rapid pace. Information is becoming much more available, and yet---news like this reminds me that widespread misconceptions about PPD remain strong in the conscience of society. For example, this article suggests that Hermosillo was simply suffering from "Post-partum Blues."

The prosecutor maintains that regardless of her mental health condition, Hermosillo consciously intended to kill her son. He is quoted in the article as saying: "It's not like she's in a foetal position when the police arrived [...] She picks a specific location, drives to the top of the building (and) takes the helmet off. I'm sure she's depressed, the post-partum blues, I'm sure she had some of that."

While I can't speak with certainty about what drove Hermosillo to kill her son, I can't help but notice the red flags in the articles: She was hospitalized in June for Postpartum Depression. She was having trouble bonding with her son, and didn't want him. Her son had a mild congenital disorder she perceived as being very serious. According to friends and family, she was normal prior to the birth of her son, and after he was born she changed completely---responding to questions with simple "Yes" and "No" responses and rarely smiling.

Without knowing Hermosillo, it wouldn't be either fair or ethical to jump to conclusions about what disorder she may have had. Sadly, Mothers can take the lives of their children for many reasons, including sociopathy or psychosis. But based on information gathered from the article it is very possible that she had Postpartum Psychosis.

What's the Difference between Postpartum Depression & Postpartum Psychosis?

First and foremost, while Postpartum Depression afflicts roughly 20% percent of new mothers (almost 1 in 4), Postpartum Psychosis is incredibly rare. According to Postpartum Support International only .1% of women end up with Postpartum Psychosis (that's about 1 in 1000 women). Furthermore, only 5% of the .1% of women who get Postpartum Psychosis will go on to commit suicide or infanticide.

It is important to know that Postpartum Depression and Postpartum Psychosis are two completely different disorders. Contrary to popular belief, Postpartum Psychosis is not a more severe form of Postpartum Depression. Having Postpartum Depression does not mean you will eventually develop Postpartum Psychosis.

So, if Psychosis is so rare, and infanticide is even more rare than that, why is it that cases of Postpartum Psychosis resulting infanticide are the most likely cases of Postpartum Mental Illness to be publicized? How is it that the average person wrongly believes that there is a direct link between Postpartum Depression and infanticide, yet most people do not know that Postpartum Depression is the #1 complication of childbirth?

Hermosillo did not kill her son because of Postpartum Depression or Baby Blues. Although many women with Perinatal Mood and Anxiety Disorders have obsessive thoughts about harming themselves or others (even thoughts of dropping or throwing baby out the window), it is highly unlikely that any harm will ever come to their children.

In fact, according to Karen Kleiman, author of Dropping the Baby and Other Scary Thoughts: Breaking the Cycle of Unwanted Thoughts in Motherhood, a 2006 study (Abramowitz, Khandker, Nelson, Deacon & Rygwal) showed that 91 percent of ALL new mothers and 88 percent of ALL new fathers experience obsessive thoughts about their babies following the child's birth, and another study showed that 41 to 57 percent of women with PPD report having aggressive thoughts of harming their baby.

Kleiman writes that unwanted scary thoughts by themselves are not necessarily clinically significant, but the way the mother feels about the thoughts are. Kleiman states that scary thoughts can be broken down into two categories:

Obsessive Thoughts: A mother with Postpartum Obsessive Compulsive Disorder may have a recurrent thought of harming her child that provokes intense anxiety within her, and she might distance herself from her child as a result. Her anxiety and distancing suggests that the thought is ego-dystonic, which is a fancy way of saying that it goes against her conscious sense of right and wrong. Kleiman writes:

"If you are having scary thoughts about harming your baby, you may be frantically wondering if your thoughts are psychotic in nature. The mere fact that you are frightened and concerned about your thoughts suggests that they are obsessive thoughts, not psychotic thoughts."

Psychotic Thoughts: In complete contrast, a woman with Postpartum Psychosis might experience the thought as being relieving or in alignment with her distorted sense of right and wrong: ego-syntonic. She may show no emotion or reaction to her thoughts of harming her child. She might even believe she is being directed by a higher power to harm her child, or in the instance of a child with a disorder, she might believe it to be an act of mercy. Kleiman writes:

"[With Postpartum Psychosis] others will notice that your behavior is much different than your usual behavior and may have difficulty holding a coherent conversation with you. The presence of psychotic thoughts is an emergency that needs to be treated aggressively and always requires hospitalization."

What does this all Mean?

The purpose of making these clarifications is twofold:

First, my hope is that the general public might develop a better sense of the the vast difference between Postpartum Depression and Postpartum Psychosis. If this information is all new to you, please ask yourself the following questions: If 1 in 4 women suffer from Postpartum Depression, why is it not being discussed more sensitively in the news? Why does a rare but devastating condition such as Postpartum Psychosis receive more attention than PPD? How does the public's distorted understanding of Postpartum Depression keep women in the shadows, and what can we do about it? Second, I wanted to make sure that this message reaches women currently suffering from Postpartum Depression or other Perinatal Mood Disorders. I want them to be reassured that despite mainstream news' messages, PPD does not put them at increased risk of committing violent acts towards their children. You don't deserve to suffer in silence, and help is available!

I sincerely hope some day soon journalists become aware that linking infanticide with PPD perpetuates a dangerous ignorance and stigma that keeps many women suffering from Perinatal Mood and Anxiety Disorders in silence.

(Note: If you are struggling with Postpartum Depression or any other Perinatal Mood Disorder, please get help! You should know that there are promising and effective treatments available to you. Visit http://www.hascares.org/ or http://www.postpartum.net/ for more information.)

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