About one in five adults living in the United States experiences mental illness in any given year, and more than 380,000 people living in Indiana are living with a serious mental illness, according to the National Alliance on Mental Illness. The organization also notes that 16 million adults had at least one major depressive episode in the past year.
Postpartum depression is defined by The American Psychological Association as a serious mental health problem characterized by a prolonged period of emotional disturbance occurring with the increased responsibilities of caring for a newborn infant. It affects one in seven women. The percentage of African-American women who fall into this ratio is unknown. Lekeisha Sumner, an associate professor and licensed clinical psychologist based in Los Angeles, said she believes there is a need for greater awareness about postpartum depression in the African-American community. In an effort to improve the health of African-Americans, she believes that African-Americans should be encouraged to partake in studies that are culturally sensitive to understand issues relevant to the community.
“People with mental health needs that are not addressed are at heightened risk for a range of chronic medical illnesses and poorer treatment outcomes for physical problems,” Sumner said.
What Sumner can tell us about depression is that upward of 40 percent of African-American women experience depressive symptoms after giving birth. Postpartum depression usually occurs within the first six months after birth. While the percentage of African-American women with postpartum depression is still up in the air, Sumner notes that factors such as pre-pregnancy diabetes or diabetes before childbirth, unplanned pregnancy, environmental and social stressors as well as financial strain can increase the vulnerability among African-Americans. The U.S Department of Health and Human Services of Minority Health reported in 2012 that African-Americans living below the poverty level are three times more likely to report psychological distress than those over twice the poverty level. They are also 20 percent more likely than non-Hispanic whites to report having serious psychological distress. Sumner adds that low-income women of color have almost twice the risk of developing postpartum depression, relative to their white counterparts who have higher incomes.
“Low socio-economic status is a risk factor, as is exposure to environmental toxins, genetic vulnerability, limited social support, infant temperament, stressful life events, biological changes etc.,” said Sumner.
Postpartum distress isn’t only a female issue. Sumner says approximately 4 percent of men experience so-called paternal postpartum depression during the first 12 months after birth. The Centers for Disease Control and Prevention states that by a child’s 12th birthday, 21 percent of fathers will have experienced at least one episode of depression. Young fathers, fathers with a history of depression or with a lower education and income were most likely to experience depression. Sumner said symptoms for men may consist of feelings of intense worthlessness, decreased desire for sex or other pleasurable activities, irritability and anger. It has also been observed that a man’s risk increases during the period before a woman returns to work from maternity leave. Happiness within the relationship plays a role as well.
“If mom has postpartum depression, father is at risk,” notes Sumner. “Also, if he is unhappy in the relationship, he is at risk.”
It doesn’t stop there. Children can be impacted if parents have postpartum depression. There is a chance they may become irritable and withdrawn, and it can be difficult to console the baby. If postpartum depression is left untreated, Sumner says children may be at a heightened risk for behavioral and self-regulation difficulties along with delays in conscious mental activities and being able to function socially. Affected children are also at risk for depression and anxiety during their childhood and adolescence.
So, how is postpartum depression treated? More importantly, how do African-Americans treat it? First, Sumner notes, prenatal care and screening for depression during pregnancy and after birth are important for early detection and treatment. Beyond that, Sumner says it is important that women seek professional help. Women have to reveal that they are feeling intense emotional pain.
“Women often believe that their symptoms will remit without treatment, but that’s not true,” says Sumner. “If the symptoms last for two weeks or longer, it’s imperative to seek professional treatment as the symptoms will likely increase in severity.”
Postpartum depression can also be masked as “baby blues” or stress from the new adjustment. This increases the importance of seeking treatment.
“Between 50 and 80 percent of women experience the baby blues during the first few days and weeks after giving birth, making it difficult to distinguish between the baby blues and clinical depression that requires professional treatment,” Sumner said.
She also states that many women do not get treated for several reasons. Access to care, shame and the “suck it up and deal with it,” or “strong black woman” mentality, as well as mistrust of the medical system and how the information reported to providers could be used against them, are reasons. Some women also fear being perceived as a bad mother.
“There are many misconceptions about postpartum depression, like you are weak or a bad mom,” says Sumner. “However, these misconceptions are untrue. Postpartum depression is caused by a number of factors, many of which a woman has no control over, for example, rapidly changing hormones after birth.”
Besides professional treatment, African-Americans seek help by turning toward spiritual sources, including church members and pastors. Sumner says the exact type of treatment depends on a woman’s history and current medical condition, but it typically involves talk therapy and medication, although, medication is not always a part of treatment. In regards to a woman’s history, Sumner says that if a woman had postpartum depression during a prior pregnancy, her risk of developing it again is increased by nearly 40 percent.
Not treating postpartum depression could have a lasting impact. Sumner says it becomes difficult to bond with the baby and increases the risk of the mom becoming engaged in unhealthy behaviors, such as self-inflicting harm. Children could become more vulnerable to developing emotional and interpersonal difficulties later in life such as with sleeping, excessive crying and even attention deficit hyperactivity disorder. Untreated in mom, depression could last up to two years and recur.
Sumner would like those who have postpartum depression to know that it isn’t their fault.
“Having postpartum depression is not a sign of weakness, nor does it mean that you are not a good or loving mom,” said Sumner. “You did nothing to cause this. It is important to take care of yourself.”