16 Time March 30, 2020
depression. “Any general pediatrician
and obstetrician could tell you that it’s
way more common for mothers to be anx-
ious about their babies and themselves
after delivery than it is for them to be de-
pressed,” Paul told me. “Clearly they’re
two distinct sort of sets of behaviors.”
But Dr. Samantha Meltzer-Brody, who
established the international consortium
Postpartum Depression: Action Towards
Causes and Treatment (PACT) and who di-
rects the UNC Center for Women’s Mood
Disorders, resists the idea of anx-
iety as a distinct category of dis-
order. She explained to me that
depression manifests differently
in different people and insisted
that some moms have strong anx-
iety with no mood symptoms but
still have PPD. She also thinks
the DSM should more clearly
emphasize anxiety in its char-
acterization of PPD. I find her
explanations compelling, but as
someone who felt no overwhelm-
ing sadness, suicidal ideation or
anhedonia (the inability to feel
pleasure), I chafe at the sugges-
tion that I was depressed.
This could be my misunder-
standing of depression, but it
echoes a long history of women
being told they don’t understand
what they’re feeling. It also raises
the question of how far language
can be stretched until it obscures
rather than illuminates.
It is time to recognize anxiety as a seri-
ous problem in American motherhood. It
is time to start paying as much attention to
the health of new mothers as to the health
of their babies. “It is normal for new moth-
ers to worry,” one mom I interviewed was
told over and over, even as she hid all her
knives in her basement. It should not be
normal for mothers to worry the way they
do. It is our society’s responsibility to sup-
port women as they become mothers with
medical and mental-health care, paid leave
and quality childcare, instead of leaving
them floundering in isolation and worry.
Otherwise, with a culture that rewards ob-
sessive anxiety as proper vigilance, moth-
ers are bound to drown in fear.Menkedick is the author of Ordinary
Insanity: Fear and the Silent Crisis
of Motherhood in AmericaPostpartum anxiety
goes undiagnosed
By Sarah Menkedick
TheView Health
17%
Approximate
percentage of
new mothers in
a 2013 study
who experienced
postpartum anxiety6%
Approximate
percentage of new
mothers in the study
who experienced
postpartum
depressionAs A new moTher, i worried AbouT mouse poop in The
small cabin where I lived. About fracking chemicals in the
water. About glyphosate in the oatmeal. About flame retar-
dants in pajamas. About phthalates in toys. Although it con-
stantly overwhelmed me, I thought my anxiety was normal,
even necessary. After all, it was my job to protect my child.
When I mentioned my fear at my six-week
follow-up appointment after birth—the sole
instance of medical care many new moms
receive in the entire year postpartum—the
midwife shrugged and chided me that anx-
ious mothers make anxious children.
For more than two years, I worried as
a full-time job, all the while telling my-
self I was a good mother, an extra-vigilant
mother, a mother who wouldn’t make a
critical mistake that would harm her child.
I Googled, I read scientific studies, I could
recite the latest American Academy of Pedi-
atrics recommendations about screen time.
Meanwhile I boxed myself into a narrow,
miserable life, full of ritual acts of preven-
tion and desperate information-seeking.
Our notion of mental illness in the post-
partum period is limited to the image of
the depressed woman, crying, unable to
get out of bed, uninterested in her baby.
But, like me, many women who struggle
with mental health in the perinatal period
experience anxiety and intrusive thoughts
as their most intense symptoms. Only when
I began to talk openly with other women about what I had
gone through did I finally recognize my anxiety as an illness,
and not simply good mothering.
Anxiety is a silent epidemic among American mothers.
It is debilitating, but normalized and even socially sanctioned.
We’ve come to confuse fear with love, and the pursuit of zero
risk with responsible parenting. There is no established defi-
nition of post partum anxiety, and no category for it in the
Diagnostic and Statistical Manual of Mental Disorders (DSM).
In most medical literature, it either does not exist or is a mere
symptom of postpartum depression (PPD).
This lack of medical aTTenTion to postpartum anxiety
persists in spite of compelling evidence of its prevalence.
A 2013 study led by Dr. Ian Paul, a pediatrics professor at Penn
State College of Medicine, found postpartum anxiety rates
around 17% among new moms and depression rates around 6%.
A 2016 study by University of British Columbia assistant pro-
fessor Nichole Fairbrother had similar results: 17% of women
surveyed during the first three months postpartum struggled
with anxiety and related disorders, whereas 4.8% experienced