Dec 1, 2009

Alarmist and Unhelpful Approach to Postpartum Depression

The frum world is doing its best to publicize more and more articles about mental illnesses and disorders.  One topic that is quite popular is post-partum depression.  In an ad for a new book published for frum people on this topic, it is claimed that PPD affects 80% of women after childbirth.  Nitza - The Jerusalem Postpartum Support Network claims 85% of women have some PPD reactions for a few weeks.

What doesn't come across clearly, is that they are referring to feelings of mild depression, crying spells, anxiety, irritability, and mood swings which, if the truth be told, women occasionally feel even without giving birth.  It is quite normal when experiencing hormonal changes and sleep deprivation to feel this way.  This is not postpartum depression.

This is a letter that I wrote to a frum publication about their handling of this topic:

In your about postpartum depression a doctor is quoted as comparing postpartum depression to diabetes and says that just as a diabetic must take medication, a woman experiencing postpartum depression must take medication.

Yet later in the article, Michal Finkelstein RN CNM says, “A loving friend, neighbor, relative, or spouse can intervene with kindness and empathy … this along with some physical support (childcare, meal preparation, and housework assistance) may even be enough to help her overcome her postpartum depression.” In other words, the comparison to diabetes is fallacious, for even if a diabetic is offered the optimum in moral and physical support, this will not help their insulin problem!

I’ve noticed that lately, the diabetes analogy is used quite regularly for conditions that bear no resemblance to diabetes. For reasons peculiar to our culture today, people prefer hearing that their condition is medical and requiring medication, rather than something they can overcome with the proper emotional, physical, spiritual help and Torah guidance.

I feel for the woman in the article who was recommended hospitalization and Prozac and I believe her when she says, “I’m not sick. You don’t understand what I’m feeling. I don’t need that. I just want someone to talk to and hold my hand.”

I think that providing listening ears and physical help will go a long way towards alleviating and eliminating most postpartum depression.

Unfortunately, frum sources tend to push medication and even when they mention nipping the problem in the bud with proper physical and moral support, the latter is drowned out by the medical model.

The way I'd like to see it written is:

Postpartum depression may or may not require medical intervention. As a first resort, women should be strongly encouraged by their spouse, doctor, and anybody who is concerned for their welfare, to take it easy, accept help, not be a martyr, to value their health over their independently taking care of everything, and to postpone commitments to the community and to their family that jeopardize their state of well-being. If women have been given the moral and physical help they need and still experience depression, then they should seek out medical intervention, but in the vast majority of cases, moral support, physical help, and reduced demands, are what a woman needs.


  1. B'h
    I happen to very much agree with your perspective on this.

    Pills, shmills makes makes one over the hill imho.

    There is a time and place for them, but only as a last resort!!

  2. I volunteer to make meals in our community for new mothers via shifra and puah committee. Many women who have nearby relatives cannot expect help from them after the birth of a baby. Often grandmothers work and are still paying tuitions, marrying off kids, and other expenses. Sisters are often overwhelmed with their own broods and cannot lend much of a hand. BY chessed girls come to help but beyond that, some new mothers have nowhere to turn for help. Where I live there is no kimpeturin heim. I truly understand why mothers go there but they are expensive and one young mother in my daughter's building got homesick after one hour there and had to leave.