Recently, I worked on a project examining postpartum depression in developing countries, particularly in South Asia. We soon realized that before such a sensitive topic could be addressed, many cultural barriers had to be overcome, including the fact that there isn’t even a word for depression in many South Asian languages! However, for all of our Western advancements and openness in dialogue, mental health is still relatively a taboo here too.
Postpartum depression is characterized by symptoms such as depressed mood, weight changes, sleep disturbances, excessive anxiety, and possibly even negative feelings towards the baby. If ignored, mothers may progress to more severe depression and greater suicidal tendencies.
It’s hard to know exactly how many women in the United States suffer from postpartum depression—estimates range anywhere from 10-20%. The challenge is that there is currently no widely used blood test or other objective test for diagnosing postpartum depression. Physicians typically use tools like the Edinburgh Postnatal Depression Scale (EPDS) to identify whether a mother’s self-reported symptoms are significant enough to be labeled as postpartum depression. But, sometimes, when women are told that the birth of a baby is supposed to be a joyous occasion, they don’t always feel comfortable sharing that something is amiss.
Concerted efforts are underway to change the national dialogue on postpartum depression with celebrities like Chrissy Teigen and Hayden Panettiere speaking out about their experiences. As [future] physicians, regardless of specialty, we too need to normalize such conversations. And a little technology doesn’t hurt either.
The Glow Nurture app, named one 10 Best iPhone Apps, is a pregnancy and postpartum companion app that allows women to check-in with themselves and connect with a supportive community of other new moms. The app tracks the user’s daily emotions and provides additional insights based on how the user is feeling. By also noting the number of other users who feel the same way, it ensures that a mother doesn’t feel alone.
MGHPDS, an app developed by Massachusetts General Hospital, combines elements of EPDS with other symptoms specific to postpartum depression to help bring screening directly to women. If a user screens positive, she is presented with referral sources and additional guidance. The developers plan to couple the app with a digital treatment tool in a future version.
Of course, nothing beats human support and medications when needed. But first, we have to start talking about it.
Aleesha Shaik DUCOM 2019