Housekeeper Needed

A grateful husband wrote to Family First thanking them for his wife's recovery.  He says they have four children, the last three born one after another.  After the last one, his wife could not get back to herself for a long time and constantly had a feeling of drowning, everything was too much for her.  She spent a lot of time crying and it was hard for everyone.      (sorry, I can't fix the size of this paragraph)

Then his wife read the magazine's article on postpartum depression and found that it described her feelings and symptoms.  The article described Nitza, an organization that helps women with PPD and it was wonderful for her.  "Now, as my wife has finished her medication and is, baruch Hashem, completely back to herself," he wanted to thank the publication.

With four children, and three born one after another, it's no wonder that she felt that it was too much for her.  The husband doesn't tell us whether she was working too. 

My question is, what if she had full-time help, would she feel like she was drowning? What if she had part-time help? Whether the help was to clean and do laundry and food preparation, and/or help with the babies, would she then need medication? I think it's highly unlikely.  Why is there a psychiatric diagnosis and medical treatment for women who need physical help?

see previous post here and here

Another thought, more controversial -

When we're feeling down, we often look to the future and dread what may happen.  The woman who had three children, one after another, could very well have thought - and what if I have another child again soon? If I'm not managing now, yet another child will put me over the edge!

Perhaps this is why getting a medical diagnosis was helpful to her.  It enabled her to tell a rav that she is on medication and cannot have another child again soon.  Do women have to be desperate, spend a lot of time crying, and end up at a psychiatrist, in order to prove their inability to have another child?

I'm not saying that she was playacting or that her behavior was premeditated.  I think her feeling overwhelmed was normal and justified. But that third child's birth wasn't a surprise.  It took nine months for it to be born.  Was she thinking she'll just go back to work after three months (maternity leave in Israel) and life would go on as before with the addition of a newborn? Was she looking around her and seeing other women with even more children who work and thinking she should be able to manage just like them? The only way for her to "prove" that she is different than "everybody else," was to become "sick," get a diagnosis and medication. 

There has to be a better way.

The Hospital Under the Bridge Syndrome

In a recent issue of Mishpacha magazine there was an Amitz story called "Advance Notice" which irked me because the message was the wrong message.  In short, a woman is left to handle 5 children under the age of six, the youngest of whom is a newborn.  She had no help whatsoever and had to care for the children (including the toddler who became ill), do the cooking, cleaning, and laundry, and all shopping herself.  Then, rather than reading that she finally got the help she needed, we read that she got a medical diagnosis instead and the subsequent treatment. 

This is reminiscent of the Chelm story in which the wise people of the town build a hospital under the bridge because of the many accidents that take place there rather than fixing the bridge.  This woman did not need a doctor, a diagnosis, or treatment.  She needed help in the house! We are fed article after article to convince us that PPD is nothing to be embarrassed about and urging people to be aware of the symptoms and to seek help.  Are we in Chelm?! It is obvious that if a woman has to deal with everything this woman had to deal with, that she is more likely than not to break! Rather than work on teaching us to "recognize the signs" and convincing us to get medical help, how about urging women to get the physical household help they need! If a woman is having her fifth child under age six, she and her husband must be urged to get household help.  The articles should be directed at women to insist they not be martyrs and at men to insist that they do not allow their wives to be martyrs.  No more hospitals under the bridge!

a related post:

http://bikores.blogspot.com/search/label/PPD

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.