Moms Need to Know PPD is a Disease.
With recent news of the FDA’s approval of Zulessro (brexanolone), a new drug to treat postpartum depression (PPD), there has been a plethora of responses both positive and negative. Zulresso currently comes in the form of an injection through intravenous use and requires 60 hours of inpatient stay at a certified medical center. Although not an ideal form of treatment, it has promising results. As a two time survivor of postpartum depression and anxiety and a maternal mental health advocate in the greater Milwaukee area, I think this is a big win in the world of maternal mental health and here’s why: Zulresso is the FIRST MEDICATION SPECIFICALLY DEVELOPED AND DESIGNED FOR POSTPARTUM DEPRESSION. In all of the years that Moms have been suffering, there has never been any researched treatment that addresses the complexity of this form of depression. So many of us have been fighting an uphill battle to give PPD and its treatment options legitimacy because frankly, much of our culture, community and medical community, do not think it is a legitimate disease.
We know that PPD and other Perinatal Mood and Anxiety Disorders (PMADs) are the number one complication of childbirth (as common as 1 in 7). We also know that suicide accounts for approximately 20 percent of postpartum deaths and is the second most common cause of mortality in postpartum women (Archives of Women’s Mental Health). Unfortunately, many people consciously and unconsciously believe PPD is a defect of character or is simply brought on by mental weakness. Some think it’s purely an emotional response to the stresses of motherhood, particularly in America where our culture fails to truly support mothers or families. I was told by a maternal educator that I should have “gotten a massage” to get over my PPD. Others deal with OB doctors who think PPD symptoms are normal for sleep deprived new mamas (PPD is not normal. It is common, but not normal). Of course, sleep deprivation plays a role in PPD and usually worsens the symptoms, but moderate to severe PPD often isn’t solved by just getting more sleep. One psychiatrist told me she doesn’t really believe in medication as treatment for PPD and that it’s caused by what we eat – the misconceptions around this condition only intensify and exacerbate the problem.
PPD is a real disease that can be complicated or bettered by our emotional state, our environment, our prior traumas, the way we experienced our child’s birth, our life stressors and our community of support. But at its core, it is a disease. A disease that is not a mother’s fault. PPD looks different on each Mom and symptoms range from mild to severe. Stigma around mental illness, particularly in relation to motherhood, prevents Moms from getting the help they need. Hopefully now, Moms with PPD will have more credibility as they advocate for themselves to their employer, to their family and to their medical providers.
When it comes to helping a Mom recover from a PMAD, it will take more than a drug to fully heal her (sometimes she may not need medication) and I believe most perinatal professional providers know this. A Mom is going to need as many options and tools as she can get to feel better and navigate the physical, mental and emotional toll of this disease.
Better prevention strategies and a cultural shift in attitudes and practices around parenthood are needed to combat PPD but we also need more tools to heal. To think that this medication is pathologizing a life threatening disease isn’t accurate because a Mom could have the ideal situation for bringing home a baby and still get PPD – it is not always preventable. My friend said to me once, “What a Mom needs is medication when she needs it.” I couldn’t agree more.
Moms with PPD need us to call PPD what it is, a disease, like diabetes, like cancer, like many other illnesses that are not equated with shame and stigma. A disease that has a promising chance of being treated quickly with this new medication. A disease that needs more research in prevention and treatment.
This drug isn’t right for everyone, not everyone will have easy access to it, not everyone will need it but for those of us who talk everyday with Moms fighting for their health and well-being, this new drug provides more hope and hope is what keeps our fellow mamas alive.
-Written by Sarah Bloomquist