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finalized podcast WHM

finalized podcast WHM

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What comes to mind when you think about what makes a good mother? What goes into that near-sacred bond between mother and child? Is it kindness and caring? Is it every moment that a mother is present for her child? Is it all the ways that a mother provides for her child? Is it selflessness? Is it unconditional love? While it may be hard to define the role of motherhood as a sum of traits or actions, it feels as though we expect mothers to do everything for their children, to do it well and to do it happily. But what about those other mothers, those newsworthy mothers who don't meet these expectations, who violate our cultural ideals of good motherhood and consequently earn our condemnation or, in some cases, our understanding? We must have a critical assessment of our ideals of motherhood and how they are constructed. Media depictions of postpartum mothers provide a site of analysis at the intersection of our cultural norms about mothers and mental illness. Right after giving birth, mothers are in an incredibly vulnerable time of their life. At the same time that a woman's identity experiences a major expansion and she takes on a whole new host of responsibilities and life changes, she may be vulnerable to mental health disorders such as postpartum depression and psychosis. As we will see in our examples, media representations of mothers with postpartum mood disorders are hard to accurately construct as there is no uniform manifestation of depression or psychosis. The quote-unquote correctness of a depiction is not black and white, but we can more easily pick up on sensationalism and melodrama that can make some symptoms of postpartum mood disorders more exciting to the detriment of representing postpartum women in all their complexity. Many of these more widely sensationalized representations can be harmful by constructing narratives that stigmatize the mental health issue, but even more broadly, enshrine our unrealistic and demanding image of good motherhood. Analyzing media representations of postpartum mood disorders is a critical step in the right direction to see how we can better represent postpartum mothers and limit stigmatization of both them as people and their mental illness. Nine months after the birth of her second child, Michael, Angela Thompson had come to believe that her baby was the devil and needed to die. And so, one night, she went into the bathroom and drowned him in the bathtub. She was tried by a judge and found not guilty by reason of insanity. Angela Thompson is just one story of postpartum psychosis that ended in infanticide. If you take a glance at the Internet search results for perinatal mood disorders, you'll quickly get a sense for a repeating trio of discrete postpartum diagnoses that have a hierarchy of severity. Online articles will typically begin by talking about the baby blues. Baby blues include mood swings of feelings of worry, unhappiness, fatigue, bouts of crying, anxiety, etc., in the first few days to two weeks after childbirth. It's said that these things are the normal kinds of emotions that between 70 to 80% of mothers experience after giving birth. No need for the hypochondriac's worry. It's normal. Many women experience the baby blues in the first two weeks after giving birth, and the symptoms are short-lasting. They'll resolve on their own without treatment and don't usually interfere with caretaking ability. Baby blues gets chalked up to the difficulty of new parenthood. It's exhausting. New babies require around-the-clock care. There's a lot of changes that come with stepping into motherhood. There's just a lot of feelings to be had. Of course a new mother may cry a little. That's just part of adjusting. Postpartum depression comes into view when symptoms are more severe and don't seem to go away after those initial few weeks. Postpartum depression affects roughly one in seven new mothers and shows up in the DSM-5 as major depressive disorder with peripartum onset, which means the most recent episode occurred during pregnancy or in the four weeks following delivery. So postpartum depression is not its own formal diagnostic category. It's more like an asterisk for major depressive disorder. So aside from that peripartum onset condition, postpartum depression ends up meaning at least two weeks during which there is either a depressed mood with feelings like sadness, emptiness, and hopelessness, loss of interest or pleasure in nearly all activities, and the persistent presence of at least four symptoms from a list that includes things like changes in appetite or weight, sleep and psychomotor activity, decreased energy, feelings of worthlessness or guilt, difficulty concentrating or making decisions, and recurrent thoughts of death or suicidal ideation, plans, or attempts. Sources other than the DSM comment on postpartum depressive symptoms and more directly address manifestations specific to motherhood, like trouble bonding or forming an emotional attachment with the baby, persistent doubts about the ability to care for the baby, and thoughts of death or harming oneself or the baby or suicide attempts. Postpartum psychosis is the rarest and most severe form of postpartum mental illness. It affects one to two women in every 1,000 and is considered a psychiatric emergency that requires hospitalization. A woman with postpartum psychosis experiences a break in reality, delusions, hallucinations, mania, paranoia, confusion, lack of sleep, agitation. It's warned that there's a potential suicidal and infanticidal risk. So let's take a step back. We've just broken down a hierarchy of postpartum disorders that goes baby blues, depression, psychosis, and gained a picture of what the symptoms for each look like. The information out there on postpartum mood disorders imparts a sense that these are discrete categories on a continuum of severity. They're separate from each other. But there's something more specific happening in the language of all these informative websites to differentiate these conditions from one another, something that exonerated Angela Thompson from being convicted for drowning her child. In the space between the baby blues and postpartum depression, the same feelings of anxiety, exhaustion, and unhappiness become a mental illness, and postpartum psychosis is situated in the realm of insanity. Whereas the baby blues are just that mixed bag of hard new mother feelings that aren't anything to worry about and aren't even surprising if you think about all the hormonal, physical, emotional, and psychological changes throughout pregnancy, when you think about going through exhausting and difficult childbirth, when you stack on top of that a bunch of sleepless nights with a newborn and a variety of changes to a new mother's identity and personal life, when it comes to postpartum depression and postpartum psychosis, those aren't about settling in or adjusting. Those are mental illness, legitimate enough to earn the insanity defense against charges of infanticide in legal settings. When we talk about the medicalization of postpartum depression and postpartum psychosis, it means that we think of these experiences in the language of illness and disease and medical intervention. The etiology section of a National Institute of Health article on postpartum depression distinguishes risk factors from causes. Risk factors that are acknowledged to be associated with PPD include psychological things like a history of depression and anxiety or obstetric complications like hospitalizations during pregnancy, social factors like a lack of social support or if the mother is a victim of domestic violence, and lifestyle habits like physical activity and sleeping habits. Yet biological factors like neuroendocrine pathologies and hormonal imbalances take up most of the air in cause sections. The most frequent mention is the rapid drop in hormones like estradiol and progesterone post-delivery as potentially causing the onset of depressive symptoms. Other conjectures mention dysregulation of the cortisol stress response. Without getting too much into the weeds of complicated endocrine and hormonal pathways, suffice it to say that an understanding of postpartum depression as a medical problem shapes treatment options. Treatment sections and articles make medications its own subheading. You'll see mention of SSRIs, Bruxanolone, which is administered through an IV, or most recently in 2023, the all-new FDA-approved, first-ever pill for postpartum depression called Xeranolone. You'll also see different kinds of psychotherapies, such as Xeranolone, which is administered through an IV. You'll also see different kinds of psychotherapy, like EMDR, cognitive behavioral therapy, transcranial magnetic stimulation, and electroconvulsive therapy. A medical outlook also informs what people think the direction of treatment needs to go. There's a call to action for emphasis on prevention, like with better screening and physician follow-up to identify mothers at risk of or experiencing postpartum disorders, and a need for better education on postpartum and treatment options. The woman's body and her experiences have for a long time been wrapped up in the language of illness, disorder, and pathology to be best addressed by medical means. Unspectacular life events like infertility, menopause, menstruation, and childbirth are only a few examples of women's bodily experiences that have moved from the realm of the personal to the realm of the medical to be addressed, suppressed, supported, avoided, monitored, and regulated by reproductive technologies, hormone therapies, pills, and more. Medicalization of postpartum mood disorders goes much farther back than a WebMD article. In the 19th century, the names for postpartum diagnoses were a little different. You had the overarching term, peripheral insanity, that covered a bunch of different insanities that presented differently based on the phase of pregnancy. You had insanity of pregnancy, lactation insanity, and parturition insanity, also called peripheral mania. Except for insanity of lactation, that got rebranded in the 20th century as postpartum depression, peripheral insanity stops being considered a diagnosis different from other forms of general mania, melancholy, and psychosis, and therefore falls out of use as a term by World War I. Peripheral mania, the one after delivery, was considered to be pretty common at the time. Literature from the era on the subject described characteristic symptoms like incessant talking, sometimes coherent and sometimes not, restlessness, inability to sleep, refusal of food or medicine, aversion to the child and or the husband, sometimes expressed in homicidal attempts, and the general meanness towards caretakers and obscenity in language and behavior. In the 1870s, the perspective on the causes of peripheral insanity was physical, a malfunction or disease of the reproductive organs. Accordingly, interventions included medical treatment and surgeries like removal of the ovaries. The physiological basis for peripheral insanity in the discourse ran parallel to how doctors recorded and translated women's embodiment of illness in patient reports, imbuing them with sexual ideology of normative motherhood and femininity. Doctors' elaboration of peripherally insane women was saturated with commentary on motherhood defiled by insanity. One Dr. R. M. Wigginson wrote, the loving and affectionate mother who has so recently had charge of her household has suddenly been deprived of her reason, and instead of being able to throw around to her family that halo of former love, she is now a violent maniac and feared by all. Peripherally insane women were startling in physicians' minds for behaviors violating maternal and wifely devotion. Patients exhibited aversion towards husband and child, neglected their personal appearance and household duties, and spoke and acted obscenely. Naming and building up this behavior as emblematic of peripheral insanity created an illness state symptomatically defined by breaching cultural ideas of the mother and woman. But what about the patients themselves? What did their illness mean for them? A woman's perspective can only be gleaned through doctors' case studies and the information those doctors filtered as important enough to record. So case studies aren't really a complete or objective picture of the meaning of the postpartum insanity for the patients. Nonetheless, some situational components shine through that can be seen as great enough cause for insane behavior. Things like traumatic birth experiences, a stillborn infant, intimate partner violence, abandonment by a husband during pregnancy, or having many children in very few years shine through case studies as circumstances unbearable to women and setting off insane behavior. But more than this, women suffering from peripheral insanity were rebelling against gender norms. Women refused to act motherly. They refused to acknowledge their infants. Women refused to act wifely. They claimed not to know their husbands, feared that their husbands wanted to hurt them, or struck out at them. Women with peripheral insanity didn't act like women at all. They were apathetic, irritable, violent, and melancholy. They required the care of others rather than being oriented to the needs of those around them. They acted immodestly. Peripherally insane women, whether intentionally or unintentionally, were rebelling against the characteristics of womanhood and motherhood. And the biological basis and aura of medicalization attached to peripheral illness permitted those women to express themselves in these ways under the label of disorder. The current medicalization of postpartum depression psychosis has a similar validating effect. Jocelyn Fenton Stitt argues that while the medicalization of women's biological experiences has been understood in feminist theory as oppressive, the contemporary medicalization of negative reactions to early motherhood as postpartum depression has served to let women defend themselves against accusations of being bad and uncaring mothers. The difference between women with peripheral insanity in the 19th century and today's postpartum women is that in the case of peripheral insanity, women were medicalized as case studies for doctors' interpretation. Women participated in the construction of peripheral insanity as a category of illness as far as how they presented themselves, but it was ultimately the doctors' translation of their symptoms that built up what it meant to have peripheral insanity. Medicalization was top-down from doctors on to these women. What Jocelyn Fenton Stitt observes is that women today are active participants in the biomedicalization of postpartum disorders, advancing a biological view as a rhetorical tool to de-stigmatize the lived experiences of mothers that don't match our cultural idea of motherhood as a time of complete fulfillment and joy and mothers as natural caregivers. Postpartum mothers embody a contradiction of all of our expectations of mothers and motherhood. They come to embody bad mothers. Murderous mothers are only the most extreme perversion of the maternal role, but it reduces to, if postpartum depression is a disease, then women with postpartum depression or psychosis are not guilty of being bad mothers. Jacqueline Goodman is the attorney for Sonia Hermosillo, a California mother of three accused of throwing her seven-month-old infant from the fourth floor of a hospital parking garage. In 2021, Sonia Hermosillo was found guilty of one count of first-degree murder and one count of felony assault of a child causing death. Hermosillo pleaded not guilty by reason of insanity. Orange County District Attorney Todd Spitzer said during the 2021 sentencing, the most basic job of a parent is to keep their children safe from harm. This child didn't even have the chance to take his first steps, say his first word, or even celebrate his first birthday before he was murdered by the very person whose job was supposed to keep him safe. But Jacqueline Goodman has a different perspective. And I don't look at Ms. Hermosillo like a lot of people do, but postpartum it's somehow her fault, that somehow she shouldn't be doing it. She's a bad mom if she feels this way. She really has a mental illness. As of February 2024, an appeals court ruled that the original sentencing failed to adequately consider mental illness. The murder conviction was upheld, but the case was sent back to the original judge to factor in arguments for mental illness when determining a new sentence that could give Sonia a probation sentence as opposed to life in prison. So here we have the cultural extreme of bad mothering, infanticide. And postpartum psychosis' medicalization as a mental illness makes this condition translatable into the legal realm under the insanity defense with enough legitimacy to amend a sentence of life in jail. It prevents us from uncritically demonizing mothers who kill their children. It's not as simple as saying, like District Attorney Todd Spitzer, that Sonia failed at the most basic job of a parent to keep their child safe from harm. It's not that simple because she was suffering from postpartum psychosis. But what about the words of postpartum mothers themselves? Mother Naomi Knowles talks about her daughter Anna. And I thought to myself, I never want Anna to feel this kind of pain. And it wasn't just emotional pain. It was like physical pain and just exhaustion. And I thought if life is hopeless, then I'm just going to save her from it. I'm just going to have her go to a place where there's no sadness and no pain. And I always believed that babies go to heaven. And so I really wanted to just save her from a life of pain. And so I remember the next morning when I woke up going into her room and I put a pillow over her face and just held it there until she stopped struggling. What does Naomi Knowles think about this moment in her life now? My parents came to visit me and they said, we think we know what happened to you. And I said, what are you talking about? And they're like, well, we've been doing some reading and we've been talking to people and we think that you had an episode of postpartum psychosis. Everything made sense. All the pieces came together and I understood that I really was ill at the time. The state of Arizona didn't recognize it. They still don't. But I don't really care what the state thinks about me. I don't really care what anybody thinks about me except for God and my family. And they know who I am. They know my heart. And they know that I would never hurt her in my right mind. The medicalization of postpartum psychosis as mental illness demands a humanization and destigmatization of mothers who do not live up to our cultural idea of the perfect mother or even just the capable and happy mother. But there's a great irony here that we haven't looked at yet. In seeking to sympathetically portray infanticidal mothers, advocates for these women and the women themselves affirm a true motherly nature that makes their actions just incomprehensible and illogical. Of course it could have only been a medical psychotic break that could have pushed these women to do what they did. Jacqueline Goodman on Sonia Hermosillo says, Her other two children, from beginning until this happened, she was a perfect mother. She was fastidious. She was a wonderful homemaker. She cooked three meals a day. She sewed their clothing. She loved her children very, very much. She was a wonderful, wonderful mother and a wonderful wife. And the testament to that is how much her husband, who has suffered this enormous, incomprehensible loss, has stood by her side from the very beginning. Because he knows. He knows better than you and I know that something happened to Sonia when she got pregnant this time. Something went terribly wrong. You can't see a mother who was everything she was in the beginning who commits this horrible act and think anything other than that she was psychotic. But let's go back to Angela Thompson, the mother who drowned her seven-month-old Michael during a postpartum psychotic break. About six years later, Angela became pregnant unexpectedly. She talks about the profound differences this time. It was like going from darkness into light. When I gave birth to Tommy, I felt my whole world had changed. I was so happy. I was delighted. I couldn't believe I had another child, another baby, a little boy. And I felt, I really felt like this was an opportunity to show that I had, I was a good mom. Angela's own children today, Tommy and Allison, can't reconcile the loving mother they know from the mother in the headlines. I mean, it was shocking, because to hear that story and then compare that to who I know, it's the polar opposite. That's not even possible from the mother that I know. But it's also a testament to the strength of character that my mom has. You know, she's such a strong person that even though it's part of her history, it doesn't define her. Medicalization, in the case of postpartum psychosis and depression, is a strategy of humanization. It's a way to validate the otherwise unutterable, dark emotions of mothers struggling to be mothers because what they are going through is a mental illness. It's a hormonal imbalance. It's a physical thing over which they have no control. It's not them. It's this last part that feels off. It's not them. Rather than critiquing the demands and expectations of mothers and how they should feel about their children, rather than continuing the conversation in a way that maybe says that all the aspects of new motherhood, all the responsibilities, the context in which a mother lives, could combine and be difficult enough where depressive or psychotic symptoms aren't all that surprising. These stories, Angela's and Sonia's, don't make that challenge. In fact, to support the medicalized view of postpartum disorders, to make people understand and care kindly about what they went through, the postpartum mother is othered as an unimaginable medical phenomenon that just doesn't make sense to reveal the true core of deep mothering in these women. Instead of making postpartum disorders an entry into untangling our cultural attitudes on motherhood, postpartum narratives often invoke the same image of motherhood they are violating to only more convincingly argue that postpartum depression and psychosis are unnatural illnesses. The various depictions of postpartum disorders, including postpartum depression in media, have also impacted societal connotations of these ailments. In particular, we have found that both historical and modern news media have leaned on the side of sensationalizing postpartum disorders such as postpartum depression and psychosis, which has increased societal stigma surrounding such disorders. In order to properly analyze news media's place in the stigmatization of postpartum disorders today, we must look at historical depictions. A prime example of this is the mid-20th century case in Cook County, Illinois, People v. Skiatch, in which a young mother, Dorothy Skiatch, killed her 6-day-old daughter. In a Streeter, Illinois, The Times article reporting on the case, it was said that Dorothy, quote, killed her 6-day-old baby because she feared a life of poverty, end quote. It was further reported that the judge presiding over the case, Julius H. Minor, called the slaying a merciless killing for personal convenience and that he told Dorothy, you will begin to realize that the curse of life is not poverty but to be alone and unloved. The sensationalization of this case and Dorothy's condition is evident through multiple quotes in the article and particularly with the word choice of slaying and merciless killing for personal convenience. This violent, unsympathetic language demonizes Dorothy and her experience with what is now called postpartum psychosis, or as it was used in her defense at the time, corporal insanity. Furthermore, we must consider Sabrina's earlier point of how much postpartum symptoms can be sensically connected to contextual and situational pressures. As is reported in the article, Dorothy's husband was unemployed and her pleas to her mother for financial support were outright refused. Considering what we know now of the significant health consequences of childhood poverty, it is important that in our condemnation of Dorothy's act, we apply the appropriate amount of nuance. According to Shickendance, et al., 2015, conditions related to childhood poverty include obesity, asthma, developmental delay, failure to thrive, accidents, and many more. Thus, was Dorothy killing her child a, quote, merciless killing for personal convenience, as Judge Mildred described it, or was it potentially the only action Dorothy could think of in the thick of the postpartum psychosis that undoubtedly clouded her judgment that would prevent her daughter from living the life she herself was already struggling tremendously with? In any case, we must acknowledge that such language used in the article as slaying and merciless killing for personal convenience demonized Dorothy and her experience with postpartum disorders, and in the process demonized countless other mothers who go through similar struggles or thoughts. In looking for a more modern case, we can point to the case of Anna Englund and her two-month-old baby Miles. In a 2023 video published by CBS Colorado, the killing of Miles by Anna was described as a, quote, The video describes Anna's psychotic break after dealing with postpartum depression and her subsequent killing of her child Miles. The video features a friend of Anna's who was the godmother to Miles in an interview. The friend stated that we thought she was doing better, and then all of a sudden she just took off, and that she randomly left with the baby. This clip of quotes in the video creates a sensationalist lens in that it emphasizes the seeming impulsivity of Anna's actions, despite acknowledging that Anna had been knowingly struggling with postpartum depression. A layer of stigmatization is furthered with the later quote attributed to the same friend, that when she does come to her senses, I know she's going to hate herself and feel guilty. This continued framing of Anna's actions and mental state as impulsive and wholly morally offensive contributes to the stigmatization of postpartum disorders and that it focuses on Anna's actions and not the failings of her community and various support systems, including medical, that led to such a mental state two months following the birth in the first place. This encourages a lack of nuance in the discussion of mothers who deal with postpartum disorders and leads to the demonization of these afflictions as a whole by society. In particular, the depiction of Anna's actions as impulsive and a failure on her own part, through these quotes included in the interview with her friend, ignores the existing medical literature that points to impulsivity as a symptom of postpartum disorders, such as one published in 2019 by Wilson et al. in BMC Psychiatry. The tone of blame in she just randomly left with the baby and when she does come to her senses, I know she's going to hate herself, neglects this fact and encourages the sensationalization of her tragedy. Furthermore, the conclusion of the video being the reporter telling the friend the news of the baby's death on camera, and the cameras rolling for her reaction of the previously unheard news, encourages a ton of dramatization in the overall video that objectifies the devastating reality of Anna and Miles's case and the reality of Anna's that so many other mothers experience postpartum. Through these two examples, we can see that the sensationalization of postpartum disorders in news media is nothing new. It is vital that we acknowledge the societal biases and misconceptions surrounding the depiction of postpartum disorders in order to properly support postpartum-affected mothers and eliminate the stigma, as well as help the mothers experiencing such afflictions get the help they need. There's another dimension to how medicalization of postpartum disorders takes a critical view of the politics of mothering out of the conversation. When we think of something as a medical problem, our solutions are medical solutions. TV show representations of postpartum depression illustrate the effect that medicalization has on how we approach postpartum depression to the detriment of making a larger statement on what it means to struggle with motherhood. The CW show Jane the Virgin includes a plot point where one character, Petra Solano, develops postpartum depression after giving birth to twins. Jane is one of the first people to pick up a sense that Petra is having a hard time. When she talks with Petra about it, here's what she says. Just mom to mom, I wanted to see how you were doing. Because Rafael and I are a little concerned. I mean, yes, we talked about it. I know you don't like to be handled. I don't really know what I'm doing with him. That is totally normal. It is. Have you ever been to one of those new moms groups? No, please. Seriously. I went when I was feeling overwhelmed, and it helped. Because then you see that everyone's going through the same thing. So they go to this new moms group. Jane talks about how when her own son was a newborn, the group was really helpful in terms of not feeling so alone, and that her friend Petra is going through at times too with the twins. Here's what the other mothers have to say. You're in the right place. We're all feeling alone and overwhelmed here. This is my second kid. I thought I was prepared. Nope. That newborn bubble is intense. And the hormones. There are days when I wonder why I did it. Are there any days you don't wonder? Petra laughs along with these women, and when she's comfortable enough, she begins to talk. And I feel at a loss, I guess. I mean, I look at them, and I know they're my daughters, but I just can't connect with them. I don't know. I just feel like maybe they would be better off with someone else taking care of them. But what Petra says catches the attention of the women in the room. The woman leading the moms group jumps in to say, it definitely sounds like you're veering into postpartum territory. When Petra's flustered by this and doesn't believe it, the woman presses to ask how Petra's sleep is. Petra goes on the defensive when Jane brings up that she saw Petra walking the halls in the middle of the night. What is this, some kind of intervention? You told me to come here and talk about how I was feeling. I know, I'm hearing you, and I'm a little concerned. I'm fine. Excuse me, I need to use the restroom. Ow! Petra leaves the mom group frustrated by the sense of being judged. Jane follows her, telling her that they were all just concerned. And during a heart-to-heart with Petra, Jane gives Petra the number for a doctor that one of the women in the new moms group saw for postpartum. In this series of scenes lies one shortcoming of a view of postpartum depression that emphasizes biological pathology above all else. It's that tone shift when the mom's group leader says that Petra's veering into postpartum territory. It's the reaction that seems to suggest that what Petra needs is bigger than this circle of social support. How's your sleep? What are your symptoms? Here's a doctor's number. What Petra has to say about motherhood isn't judged to be the same as what the other mothers express. It begins to look like something like pathology, and this pathologization pushes Petra out of the room. It pushes her experiences out of the room. When we medicalize something, we assert the concrete, valid, serious existence of illness or disease. To the extent that medicalization legitimizes an issue and spurs on efforts for diagnoses, screening, consultations, and certain kinds of services and resources is a powerful thing and a powerful difference from dismissing and stigmatizing postpartum mood disorders. But by medicalizing, we can also end up alienating social forms of treatment. The mom's group helped Petra look around and see that other mothers weren't happy. She laughed with them and felt the beginnings of community and connection and support. She found comfort by recognizing her same feelings and the different experiences of others. But medicalizing postpartum depression can make it seem like treating it is beyond social support. Petra doesn't go back to the mom's group, and maybe that's because she's a side character, and this is only a subplot in the episode. But because of all that we don't see, it ends up being implicitly communicated that the ultimate space for her feelings was with the doctor who she ends up calling. What's even more interesting to think about is how by making postpartum depression feel different because it's a medical condition, we take the feelings of postpartum mothers out of those conversations on general motherhood, of feeling overwhelmed and alone. Postpartum depression no longer impinges on a problematic concept of motherhood in the way that the support group mothers were critiquing the disconnect between their ideas of motherhood and their lived experiences. What the postpartum mother feels isn't about struggling with an identity and its responsibilities. Now what the mother feels are the symptoms of an illness. So then we abstract the manifestations of postpartum from a critique on the politics of motherhood. Now what the mother feels are the symptoms of an illness. So then we abstract the manifestations of postpartum from a critique on the politics of mothering. As much as postpartum is locked into a battle against accusations of bad mothering, what medicalized postpartum feels like doesn't get to make a statement on mothering. So where do we go from here? How can we approach postpartum mood disorders in a way that has the strength to compellingly validate and destigmatize at the same time that it brings this form of deviant mothering into conversation with our standards of what motherhood is and looks and feels like? Erin Bagwell's YouTube documentary, Year One, following her first year of motherhood, provides us a vision of a non-medicalized affirmation of postpartum motherhood experiences. It's about the change and hardship and growth she went through. It's about postpartum depression. But it's ultimately a story about her evolving relationship with motherhood. Erin talks about the fear she felt at having to take care of her daughter Ginny all by herself after her partner's paternity leave was up. She didn't know if she had the energy to do it alone. Erin says, This wasn't something we shared together anymore. This was my job. We see Erin change Ginny's diapers, dress her, play with her, breastfeed her, and take her on walks. But there are feelings that cut sharply through these everyday moments. I can't stop crying. And I feel so much guilt. Like somehow I should be stronger or more grateful. I feel claustrophobic walking the same streets over and over again. And I know I need more support. But it seems like Sal is giving everything that he can too. So we're just like in this really tight place. And I think maybe that's the hardest. So you just have to sit with this discomfort of not being sure. I hate that. When Erin accepts that she has postpartum depression, she begins going to therapy and joins a mother's circle just like Petra. But this mother's circle was specifically for other women dealing with postpartum depression and anxiety. And for the first time, Erin felt like she wasn't alone. Surrounded by a group of struggling moms, they carried their stories together. Here's an excerpt from one mother's circle get-together. I just think that we don't ever... The people that have the experiences that we had don't talk about it. Because there's a myriad of experiences for everything. But somehow we've like decided that becoming a mother is a one-way thing. That's the only way to talk about it. It's beautiful. It's amazing. I've never felt so much purpose in my life. I've never felt conflicted before. The sun is shining. The angels are singing. And I'm like, oh my god. Erin's mother's circle allowed her to find a sense of community, support, and understanding. But in her conversations with her therapist, Erin still doesn't know what to make of her early motherhood experiences. A question I did want to kind of talk to you about is I feel like as I'm moving kind of through and with kind of... I don't want to say like a resolution of my postpartum depression, but definitely feeling like I'm on the lighter side of of having those days. How do I feel okay about that period of my motherhood journey that was like so hard? You know, like I'm having a lot of trouble forgiving myself for feeling all of these intense feelings and thoughts when like now I'm in a good place. You know what I mean? And that was like the start of my whole like journey. And I like resent it. I am like jealous of other mothers who have not had to experience that. And I just feel I don't know, like it scares me a little bit that like now I have to kind of reckon with what feels like a real intense period of my life. Erin's therapist answer is compassion for yourself. The answer to having so much grief over an early motherhood experience marked by so many dark or intense emotions as opposed to what we think we should have, what we see in other mothers who don't have that struggle, is compassion for yourself. Erin also talks about the place she's at now. I also learned that even on my darkest days, I am not my thoughts. I am not the whispering voice inside of me that wants me to hurt myself. That is not my truth. My truth is complicated and beautiful and powerful and grounded in love. Asking for help was the first step towards choosing myself. And in doing so, it gave me permission to redefine my relationship to motherhood. I'm not a bad mom because I have depression. I'm a great mom and I have depression. Year One isn't only about postpartum depression. It's about motherhood, and postpartum depression is part of that motherhood experience. Now, in critiquing the effect of medicalizing postpartum disorders, I don't want to come across as anti-medicine. That's not what this podcast is about. Postpartum depression and postpartum psychosis are real, and if medical treatments work, then that is what works. But Erin's Year One provides a view of how we can talk about postpartum and how we can destigmatize it in a way that doesn't rely on a medical narrative that can validate postpartum mothers, but only validate them as ill, not mothers. For Erin, destigmatization came from bonding with other postpartum mothers over their shared experiences. It came from the insight that we only talk about mothers in one way, but there are many other different realities out there. And it didn't come from some biological mechanism we can point to to take the blame off of mothers. And for Erin, her postpartum was an integral part to coming into her identity as a person and a mother. It's not an othered version of herself that she rejects or doesn't recognize in contrast to where she is now. Erin says that even though having postpartum depression was the hardest thing she's ever experienced, it was also a gift. In her words, it allowed her to burn down everything she knew and start over, to be more present, to be more vulnerable, to be more resilient, and most of all, to learn how to take care of herself while she learned how to take care of her little girl. So what if we could accept postpartum depression into motherhood like Erin? What if we could elevate postpartum mothers' voices in a way that dismantled our enshrined ideal of motherhood? And what if we could conceive of the despair that postpartum mothers feel as more meaningful than medical illness or insanity? For Keeps is an American dramedy from the 80s that follows the story of a young couple, Darcy and Stan, who are on the cusp of graduating high school when they discover they're expecting a child. After some debate, they ultimately decide the baby is, quote, and to live a new married life in their own apartment. Darcy later enters a gruesome birth process that is emotionally charged with issues between her and her own mother, along with the fact that she is losing her childhood. After bringing home her baby, Darcy is struck with postpartum depression. Shortly after beginning their lives as new parents, the two are blindsided by the harsh financial reality of living on their own and paying for postnatal health care, and Stan is forced to reconcile their disheartening financial situation as a stereotypical breadwinner. Darcy's experience of postpartum depression is brief. It's depicted as a passing cloud of gloom that easily fits our common cultural notions of the baby blues. She doesn't receive any medical or psychological assistance, only familial support. Conceptual research on familial support of mothers, specifically intergenerational support, has demonstrated better outcomes for mothers, especially those who are managing life with rocky financial conditions or as a single mother. Darcy's depiction of postpartum depression has some positives and some negatives. While it's a good thing that communal support Darcy needed from both her mother and her friend are normalized, Darcy's psychological needs are otherwise ignored. It's played off as a passing phase. This demedicalization of Darcy in the movie, for Keats, is an intriguing aspect to note. Instead of writing off her problem as a medical condition affecting her functioning, Darcy's depiction of postpartum depression Darcy's depiction of postpartum depression Darcy's depiction of postpartum depression Darcy's depiction of postpartum depression Darcy's depiction of postpartum depression Darcy's depiction of postpartum depression Darcy's depiction of postpartum depression Darcy's depiction of postpartum depression Darcy's depiction of postpartum depression Darcy's depiction of postpartum depression Darcy's depiction of postpartum depression Darcy's depiction of postpartum depression Darcy's depiction of postpartum depression Darcy's depiction of postpartum depression Darcy's depiction of postpartum depression Let's welcome Jocelyn Bartlett! Is she breastfeeding? She doesn't even want to hold the baby. The doctor says it's just a phase. Her age, all the changes... Hey, don't worry. The natural tendency of the mother will kick in. It means genetic animal instinct. What? You mean a squawking? It doesn't even mean a squawking. I don't know, man. Maybe she's been giving enough oxygen to her brain during the delivery. Maybe she wants a boy. It's true! This is a complex manifestation of jealousy. You're paying too much attention to the other woman. I didn't know you could pay too much attention to a baby. Freud's work was known for advocating for essentialist gender roles from a considerably misogynistic standpoint, so I don't think he's particularly the shining advocate of advice for motherhood. When talking about motherhood in any medical context, it's important to actually listen to mothers. Time and time again, we will see others speaking for mothers' experiences of mental health. This theme of explaining mothers' experiences from an outside point of view aligns with the common clinical theme of defining postpartum depression as a pathological disruption of natural motherhood, which further stigmatizes the illness. Supporting mothers can even just be hearing from different women postpartum depression and hearing new perspectives. For Keats, it partially hits this mark by allowing Darcy to have her own voice to a degree, but fails to fully capture the postpartum experience. Furthermore, this demedicalization of Darcy's postpartum experience in the film allows other people to speak for her experience and fills an important time that could be filled with more scenes that give Darcy's character and emotional development, removing her voice and replacing possibly positive education about treatment of postpartum depression or even supportive of postpartum depression with plain-out, disjointed, second-hand explanations of her experience. This discourse surrounding Darcy is not unlike the culture of mother-blaming that was pervasive throughout late 20th century America. A 2011 article from Held and Rutherford at York University called Can't a Mother Sing the Blues? describes the neoconservative culture of the 1980s as a nostalgic revival of traditional 1950s family values. Furthermore, this article describes that contemporary pop psychology was a popular way of explaining failures in motherhood, including postpartum depression. This culture described in the York University article is echoed in a swirling speculation surrounding Darcy and her mental health, making this piece of film a timely representation of mothers in the 80s. In today's context, Darcy's postpartum period is an odd depiction amongst many of the examples we described, since her postpartum depression strikes her only for a brief period until her mother steps in and supports this couple financially and through child care. After that, it's like the clouds have cleared for her. She gets her high school degree, and her tumultuous relationship with Stan is succinctly re-established when they make up after a fight. For other women who deal with postpartum issues, fighting through postpartum mood disorders might not be so easy. A Mouthful of Air is a 2021 film directed by writer Amy Kopelman that highlights new mother Julie Davis' struggle with postpartum depression and anxiety. The film is an adaptation of Kopelman's 2003 novel published under the same name. Starring acclaimed actress Amanda Seyfried in the role of Julie, Julie Davis is a children's author who, after giving birth to her first child, Teddy, attempts suicide in the presence of her child and is hospitalized. Her unexpected pregnancy that was discovered soon after sets her and her husband Ethan Davis, played by Finn Wittrock, on a journey to deal with her condition, alongside battling memories of past childhood traumas of Julie's that arise around the same time. Kopelman's depiction of the outside reaction to Julie's mental state emphasizes the tendency to depict postpartum-affected mothers as selfish. Julie's thoughts of inadequacy, insecurity, and worry plague the film. She struggles with the thought that no one seemingly understands her feelings, especially right after her hospitalization. Not her husband, nor her doctor, nor other family like her sister and brother-in-law. In fact, it is her sister-in-law that says some of the harshest things surrounding Julie's mental state. At the bar one night, when Julie tries to get her mind off of things by joining her husband, his sister, and his sister's partner to watch a game, the table begins discussing the prospect of Julie and Ethan moving to a bigger home outside the city to accommodate their growing family, and Julie is hesitant about the idea. Sorry. Can you say that? You're a happy man. I'm very confused. I'm very confused. I'm sorry. It's always about you, Julie. It's never about him. Have you ever even asked him what it was like for him? Ask him. Ask him when he did every night while you were in the hospital. Tell her. Why didn't you? I think a move might be good for us. That's all. He would come home after work, after visiting you in the hospital, after bringing your son to bed, and you know what he would do? He would scrub the carpet. That's the thing about blood, Julie. Your blood, it won't come out of the carpet. I'm going to pee. I have to pee. Are you happy? Really. Really? Yes. The line, it's always about you, Julie, encapsulates an all-too-common idea that women with postpartum depression are selfish or faking it, that their emotions are not a genuine consequence of going through the changes of motherhood, and that they should be happy, stable, and just like they were before coming moms. This line sets the tone for the rest of the film as it relates to how others interact with and react to Julie's emotional state. Even with those like your husband, the emotional disconnect is incredibly clear. They do not recognize the true depths of pain Julie is experiencing. Their responses are surface level. They do not see what she is trying to communicate regarding her pains and uncertainties surrounding parenting. This is taken to new depths when Julie discovers that she is pregnant once again, this time with a daughter. She expresses worries such as, what if she doesn't like my hair? And what if she cringes at the sound of my voice? Showing how much her anxieties and depressive thoughts have amplified with this second pregnancy. However, her husband's lack of sensitivity and compassion regarding her concerns, initially responding with anger, increasingly isolates and upsets Julie. This comes to a head when the baby arrives and she refuses to take her depression medication since it would mean she can't breastfeed. Julie expresses thoughts such as, I feel like I'm failing her, and how many prices is she going to have to pay for me being her mom? Due to not being allowed to breastfeed because of her medication. When Julie raises her desire to postpone taking her depression medication for six weeks in order to be able to initially breastfeed, the following interaction ensues. Did you take your medicine? No, it's my overnight pack. But I'm not going to take them. Just six weeks, that's all I need. I mean, I did it for nine months, so like what's six more weeks, right? I promise I'm going to take them. I'm going to. I know, put the cabin pressure mask on yourself, I get it. No, I get that. And if I'm taking a nose up, if I feel like I'm losing it, it will be right there. It will be right there and I'll take them. I promise, I know it's not okay, but okay? No, no, it's not okay. I'm not going down this road with you again. And your promise doesn't mean anything. I mean, you left our kid alone in a fucking extra saucer. You're going to bring this up now. Don't make me an asshole here, okay? For the last year I've been walking on eggshells around you because I know how to keep my end of a deal. It's not fair that you're bringing this up now. Don't talk about fair, okay? This isn't about you. It's not actually about you. It's about them. This remark from Ethan reinforces the false idea that Julie is being intentionally selfish, when this mindset is actually just a byproduct of her postpartum depression. Her insistence to breastfeed is just a continuation of Julie not feeling adequate enough in her depressive state to be a good enough mother. Feeling like she's failing her daughter, that her daughter is already paying a price for being born to her, successfully breastfeeding is one thing that Julie hopes she can do as a last resort of sorts to be a quote-unquote good mom. Her husband doesn't see this and just thinks she is being selfish and irrational, insensitive to his needs and what he has been through taking care of her. Unfortunately, this lack of understanding and emotional disconnect from Ethan and others around her is ultimately what leads her to being distressed and isolated enough that Julie kills herself, unexpectedly to the rest of her family at the end of the film. As we can see, Kopelman's depictions of moments such as the scene at the bar with Julie and her sister-in-law and the scene in the recovery room at the hospital with Julie and her husband show how reactions to postpartum depression in media often include assertions or conceptions that the mother is selfish, that her expressed needs are being exaggerated. The recognition of this pattern is key in beginning to properly address and dismantle the societal stigma surrounding postpartum depression. As we conclude our exploration into how postpartum mood disorders implicate our cultural values, images, and discussions related to motherhood and how they appear in media representations, it's vital that we acquire a critical literacy to assess the implicit argumentation of the narratives presented to us and to be cognizant of how they shape our perceptions to either foster normalization and understanding or apprehension. Across various representations of postpartum mothers, we have come to see that the message isn't always as reductive as postpartum mothers are bad or that postpartum mothers are above reproach. Rather, each media representation provides varying levels of complexity to each woman's experience navigating immense pressures to provide for another. These navigations are, on one hand, about plot-contingent personal factors and, on the other hand, about our dominant cultural narratives on mental health and what it means to be a mother. Moving forward, it's necessary to first always carry an inquisitive mindset towards the media we digest, challenge stereotypes, and to keep our eyes open for media that elevates diverse points of view of motherhood. By advocating for representations of mothers that we may typically not see in the media, we can help shift the cultural discourse towards better understanding and supporting all mothers. Ultimately, let us remember that the postpartum period is as much a part of motherhood as it is caring and growing a fetus, giving birth, and raising a child. Postpartum depression and psychosis are more than diagnoses and probabilistic after-effects of giving birth. When we speak of postpartum depression and psychosis, we are speaking of people. By fostering a critical eye towards depiction of postpartum mood disorders, we are trying to make sense of how people's lived experience challenge and fit into our norms on medicalization, mental health, and motherhood. Ultimately, we have much to learn about our society and our own beliefs from these transgressive mothers. Thank you for joining us on this important conversation.

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