Welcome to my blog, which speaks to parents, professionals who work with children, and policy makers. I aim to show how contemporary developmental science points us on a path to effective prevention, intervention, and treatment, with the aim of promoting healthy development and wellbeing of all children and families.

Sunday, May 5, 2019

Addressing Postpartum Depression in Honor of Mother's Day and Mental Health Month


Soon we will we celebrate mothers for a day- bringing breakfast in bed, going out to dinner, buying flowers. In my personal experience, one of the greatest pleasures of Mother's Day is to take joy in my children as they grow and develop and make their way out into the world.

D. W. Winnicott, pediatrician turned psychoanalyst, famously said, "There is no such thing as a baby." He meant that one cannot fully understand a baby without considering the relationship with the mother. Equally true is that without a child, there is no such thing as a mother. In order to understand a mother's experience, it important to consider the child and what he or she brings to the relationship. 

Winnicott coined the phrase 'the holding environment" to describe the way in which a mother, by being present both physically and emotionally with her baby, helps him to manage and contain intense feelings.  He wrote:

"It will be observed that though at first we were talking about very simple things, we were also talking about matters that have vital importance, matters that concern the laying down of the foundations for mental health."

 A number of years ago I had the privilege of participating in the important work of The Ellen Story Commission on Postpartum Depression. Now retired, Rep. Story (D-Amherst) originally filed a bill that mandated universal PPD screening in multiple settings (OB and pediatric), but it was amended to a law that calls on the Department of Public Health to issue regulations on best practices for PPD screening. The law also created the Commission, whose  job is to help DPH in its work to develop plans for the state of Massachusetts to address PPD. 

Rep Story will be speaking in Dalton,MA on the evening of June 19th at the first quarterly dinner/educational event of the Hello It's Me Project, whose primary aim is to build a community "holding environment" to promote healthy parent-infant relationships. 

What makes postpartum depression different from other forms of depression is that it occurs in the setting of responsibility for a new life-with a person who is completely dependent- who brings his or her unique qualities to the relationship.  To fully hold the mother's experience, it is important to recognize the baby's contribution. 

For example,  a baby who has difficulties settling to sleep, or is not naturally cuddly will have significant impact on a mother's emotional experience. For a mother, sleep deprivation and feelings of inadequacy may compound an existing depression. In turn, the mother's state of mind, particularly if she is preoccupied with her own distress, may impair her ability to help the baby to contain and manage his experience. One study showed that mothers struggling with anxiety and depression often wake their babies at night, offering an example of how mother and baby interact to impact emotional development of one another. 

How fitting that Mother's Day occurs in the middle of Mental Health Awareness Month. The work of Representative Story and the PPD commission is a tribute to both.  When we as a society attend to the emotional needs of new mothers (and fathers- who get their own day in June) we help them to emerge from pain and suffering to take joy in their children.  This not only promotes their children's healthy development, but it also makes for a really great Mother's Day!!