Postpartum Depression is not a Pacifier

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Recently, Sage Biotech, a company which has an experimental treatment for Postpartum Depression (PPD), posted their team at the ACOG conference in May posing beside their new ad campaign. While there is hope that this new drug may show promise for moms like me suffering from PPD, I am about to tell you why this is just another tone-deaf response to what PPD really means for the women who suffer from it.

I have been open and honest about my own struggles with my mood disorder and PPD to boot. I ran the gamut from pre-natal to post-natal depression on top of my issues with anxiety and OCD. It’s been hard. I don’t think I’ve ever been this blue, to be frank. So, to some degree, I feel any attention brought to bear on this issue is important.

Still, I can’t help but fundamentally disagree with the imagery Sage is using. At first, I couldn’t get why any of this would bother people until I saw the ad. I was like, “Great! Maybe this will help women and maybe 10 years down the road we will find it is safe for breastfeeding moms!” After all, SSRI’s don’t work for me. That is what led me to not be able to choose to breastfeed in the first place. All the drugs I was left with weren’t safe. My hope was that if this wasn’t an SSRI, it may open new doors for women. The ad, though, oof. What a doozy!

A woman looks blankly into the camera with a pacifier in her mouth. The ad reads “Silence Sucks”. The whole thing seems creepy. The mom is now a child. She is forced to be silent by PPD. The problem is, that isn’t how the disease works at all.

First of all, let’s remind ourselves that Sage is not a charity. This is an ad campaign which is meant to attract the viewership of medical professionals and investors. It is not out of benevolence anymore than those Dove commercials that are supposed to bring about #realbeauty but end up just making you fear your own hideously rough armpits. I mean, I never knew I had an armpit issue until Dove informed me I did.  So, Sage is using this imagery that infantilizes women and puts the silence largely on our shoulders to sell their wares. This is the first strike and an important contextual point.

Secondly, PPD isn’t what forces me to be silent. It isn’t what other women who have had PPD or who I have talked to in online support groups say is the cause for “silence”. PPD makes you want to cry and scream and feel everything sometimes all at once. It does not produce silence. However, you learn to be disciplined and silent because everyone around you is saying “sush”.

No one wants to hear the sad mom. No one wants to know that you harmed yourself that morning or that when your baby starts screaming during a sleep regression, you can’t cope and start having intrusive thoughts about killing yourself. No one wants to know that daily you have to pull yourself up and keep going even though everything in your head is telling you “if you died tomorrow, no one would care” or “your baby would be better off without you”. None of these thoughts are true, of course. Your baby absolutely would not be better off without you. People would care.

I’ve had conversations in which I share what I am going through openly. If you ever want to see people run out of a room quickly, say “yeah, I actually have postpartum depression and x isn’t helping”. People will either file out silently, fall silent and just stare at you, or find a reason to be anywhere else immediately after. If someone does stay and continue engaging, in my experience, they are about to say one of two things. One, “I’ve been there”, is the best case scenario. The other is “well, just remember you have a beautiful baby and you should focus on the positive”. These are people who just don’t get it. And, unfortunately, you begin to find that almost no one gets it.

I have had frequent conversations with family members who want to blame me setting important boundaries on my mental illness. If I don’t want someone to visit because it will be too stressful, suddenly, I’m “crazy”. If I just want to hear that I am worth investing in or that someone loves me because, honestly, that day, one person’s love and care may be enough to sustain me and push some of those intrusive thoughts down, I often get a “stop feeling sorry for yourself” or “you don’t get a medal as a parent”. These are my family. Invalidation abounds.

If you need something, don’t ask for it. That’s what I’ve learned these days. My therapist often says “validation is free” and it is. Still, it’s not something many people know how to give. We try to practice in our house acts of validation. It was something I didn’t get a lot growing up and struggle to comprehend in parenting. Still, I have practiced and practiced with friends and can now listen to someone’s struggles – even if I don’t agree with them – and say “I am so sorry to hear that. That sounds really tough” and either offer advice if they asked or ask them what they need from me if they didn’t. Anyone can do this. Anyone. The problem with having PPD is that you become intimately aware that it makes most people uncomfortable.

Antidepressants will not make you magically open up about everything in your life. They aren’t truth serum. In order for those suffering with this disease to open up, the public perception and social stigma must be addressed. Putting the burden on those trying to survive is appalling. I get what Sage was trying to do but it makes me wonder if they even talked to a single one of the people in their trial or any of the psychiatrists participating? Heck, did they even read anything on Postpartum Progress?

And, honestly, they should have known better regardless of the specific subject knowledge. Almost anyone could understand the serious stigma surrounding mental illness. I have likely had a mental illness as long as I could remember. My parents like to deny that I did because I had pretty good coping skills – I was social, I was a good student, I had friends – but I have a family history that, according to a past provider is “loaded” with mood disorders. I have always felt that – even to my family – I needed to cover up and ignore what I was really struggling with. My life unraveled only days after my daughter’s birth when a family member made me feel so low that I had to enforce a boundary to keep my family safe. It was the right thing to do, of course, but when I was open about how badly I felt, people seemed stunned and combative. “I didn’t know you were like that…”

But I am. I am someone who has always had a mental illness. I always will. Unlike many who suffer from PPD, this will not go away. I will get stable again hopefully within a year or so but I will always be in treatment. It’s just that without any more strength to keep it all in, I had to let it all out. It really made people uncomfortable but I was unable to be silent. The lesson I learned was that asking for help made it worse. That’s the same thing I’d known as a person with OCD and a mood disorder but it was really deafening now.

Women with PPD don’t stay silent because the disease makes us into subordinate, ineffectual people. We want connection, help, and to be supported. We want to ask for it. But after the 10th or so person tells you to “just stay positive” or refuses to tell you that you matter to them because you want to just “feel sorry for yourself” and then vents to you about their problems, you are bound to feel like no one is going to care. Why bother? So, you fall silent. This is the worst outcome for progress, perhaps, but it seems your only option… the only way to stay safe.

Sage’s drug isn’t going to change that. This campaign won’t change that. It just feels like a cheap shot at the women suffering from PPD.

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