Mental Health- The subject of the CRAZY: Mental Health-Postpartum Depression and the cultural pressure to keep quiet.
Have you ever felt that you had to silence your emotions? Silence your fears? Silence your pain?
Maybe it was because you were raised to be strong, maybe because you were raised to get over it. It is no surprise that our environment plays a role on how we behave, and even who we become. This may be a conscious action, or it may be something that has been embedded in the fabric of our being. Culturally speaking, most of us can place ourselves in some sort of category, or group. I am Latina, but I am also Mexican. I am a WOMAN who became a MOTHER. But that was not my PURPOSE in life. At least I do not think it was my only purpose; but I was raised to believe that it WAS, and NEEDED to be. This pressure surprisingly did not come so much from my parents, but from my culture as a whole. This of course played a major role on my decision to keep my postpartum depression suppressed and hidden.
In this blog I want to touch the subject of postpartum depression through the lens of culture. That is, I want to explore a very important facet of mental health, which may be shaped by our culture’s standards of behavior and thought patterns regarding mental health. For example, you may find that in some cultures it may more difficult to talk about mental health. In some cultures, the idea of mental health may have become synonymous with words like “crazy” “psycho” “abnormal,” or even in some religious realms as “not Godly,” or even “possessed.” These ideas may in fact account for the silence regarding mental health; in this case postpartum depression. Let’s explore why.
Mental health and Culture
If you consider yourself as part of a minority group then you may find this post a little more relatable. If you or someone you know has gone through mental health problems; you may find some of this as an (“AH!”) moment. This is not because I discovered something new or all of a sudden came up with a new theory, but because I have found credible research suggesting that many who do not seek help with their mental health may feel the pressure from their culture or environment to keep it HUSH HUSH. Here is some research:
*Let us first explore how postpartum depression is diagnosed or screened for.
Screening for Postpartum depression
The Edinburgh postpartum depression scale, or EPDS, has been the screening tool of choice and may be administered any time postpartum. This measure includes a ten-point scale that measures the symptoms associated with PPD and allows the physician to evaluate whether the patient needs further treatment or evaluations (Blum, 2007, Krantz et al., 2008). As Blum (2007) explains, women who suffer from PPD may exhibit emotional problems such as sadness, depression, anxiety, guilt and conflicting feelings associated with being a mother. This tool however does not always account for several factors or variables such as:
- Cultural background or religious beliefs of the patient (Mother).
- Accuracy of self-reporting. Since women without a previous history of depression may not recognize what depression looks or feels like, they may not accurately report symptomology (Kopelman & Stuart, 2005).
- Cultural differences and problems in translation-That is, some mothers pertaining to minority groups in which English is not their first language, may in fact not understand the questions being asked in the screening (Fuggle et al., 2002).
So how does culture or environmental factors play a role in self-reports pertaining to postpartum depression (PPD)?
Previous research regarding variables affecting PPD has yielded important information concerning cultural, socioeconomic, and ethnic differences in reports. Studies exploring the prevalence of PPD suggest that PPD may be greatly related to factors such as economic status, family structure, previous history of mental health problems, and cultural variables (Ghosh & Goswami, 2011). Some researchers also suggest that while some cultures may welcome the sharing of feelings, some cultures may actually scorn or judge mothers who complain or report symptoms of depression (Kopelman & Stuart, 2005). They suggest that because of these cultural differences, some mothers may become discouraged to share their true feelings after birth and may lie in their self-reports (Kopelman & Stuart, 2005).
My thoughts: What Elena Thinks
I have never heard my mother complain about being a mother. She had nine children and has raised us wonderfully (I do think!). She would never say motherhood was a burden, and never talked about her emotional journey. I just assumed that she was always happy. No one around me spoke to me about being sad before, or after having a child. Sure I learned it in school, I wrote papers about it… but it was never real until it was MY reality. I did not recognize it at first, but it was there. This is what I think made me hide it for so long. This is why I kept it my secret. My culture made me do it!! Well not MADE me, but definitely colored my perception about postpartum depression and influenced my silence. This is what I now realized my world was filled with. It was filled with these ideas and conversations.
-People will tell you that everything will be worth it in the end and will discourage you from feeling otherwise.
-Everyone is so concerned with your newborn child that they forget that you went through something too.
– My culture cherishes mothers; they cherish big families… so I felt abnormal when I knew I did not feel that way. I was not like them.
-It is not common to see people in my culture seek professional mental health. When I told my parents I wanted to become a psychologist they laughed and said “I wanted to become a doctor for crazy people.”
-I learned to excuse my feelings and I just assumed as some told me “My hormones” were to blame and that I needed to get over it. So I kept quiet and agreed.
Bottom line friends: Mental health is not for the crazy; it is not for the weird, it is not for the week… Mental health and mental health problems are human, and they are more common than we think. You are never the first person to go through something… you may just be the first brave one to speak up!
Thanks again for taking the time to read my blog. As always please leave your comments or suggestions and I would be happy to respond. Much of the information was taken directly from my Master’s thesis paper that I would be more than happy to share!
Blum, L. D. (2007). Psychodynamics of postpartum depression. Psychoanalytic Psychology, 24(1), 45-62. doi:10.1037/0736-97188.8.131.52
Fuggle, P., Glover, L., Khan, F., & Haydon, K. (2002). Screening for postnatal depression in Bengali women: preliminary observations from using a translated version of the Edinburgh Postnatal Depression Scale (EPDS). Journal Of Reproductive & Infant Psychology, 20(2), 71-82 12p.
Ghosh, A., & Goswami, S. (2011). Evaluation of post partum depression in a tertiary hospital. The Journal of Obstetrics and Gynecology of India, 61(5), 528-530. doi:10.1007/s13224-011-0077-9
Kopelman, Robin,M.D., M.P.H., & Stuart, S., M.D. (2005). Psychological treatments for postpartum depression. Psychiatric Annals, 35(7), 556-566. Retrieved from http://ezproxy.snhu.edu/login?url=http://search.proquest.com/docview/217057035?accountid=3783
Krantz, I., Eriksson, B., Lundquist-Persson, C., Ahlberg, B. M., Nilstun, T., Medicinska och farmaceutiska vetenskapsområdet, . . . Uppsala universitet. (2008). Screening for postpartum depression with the edinburgh postnatal depression scale (EPDS): An ethical analysis. Scandinavian Journal of Public Health, 36(2), 211-216. doi:10.1177/1403494807085392
Ramsay, R. (1993). Postnatal depression. The Lancet, 342(8883), 1358-1358. doi:10.1016/0140-6736(93)92263-S