Why Do So Many Moms Stay Silent About Their PPD?

A new study from North Carolina State University found that 1 in 5 moms who exhibit signs of postpartum mood disorders (PPMDs) don’t share this information with their health care providers and end up suffering in silence.

This is absolutely heartbreaking. No mother should have to suffer from PPMD without help and support. And if left untreated, we know that severe cases of PPMD can lead to tragic outcomes for mothers and their families.

The researchers surveyed a group of 211 mothers who had given birth in the past three years and ascertained whether they showed signs of PPMD, including depression or anxiety. Then they asked the mothers whether or not they had relayed this information to their health care providers.

A startling 51% of the moms surveyed showed signs of a postpartum mood disorder, but only 21% shared this with their health care team (which could have been anyone from their doctors, midwives, nurses, lactation consultants, or doulas).

“Our study finds that many women who would benefit from treatment are not receiving it, because they don’t tell anyone that they’re dealing with any challenges,” explains Betty-Shannon Prevatt, a clinical psychologist at North Carolina State and lead author of the study.

These statistics are very disconcerting, to say the least. And it should be noted that the mothers’ health care providers did ask these mothers the required questions about their mental health state, but the mothers chose not to disclose this information.

“To place this in context, there are national guidelines in place telling health care providers to ask women about PPMD symptoms after childbirth,” said Sarah Desmarais, associate professor of psychology at North Carolina State and another co-author of the study. “With so many women in our study not disclosing PPMDs to their providers, it strongly suggests that a significant percentage of these women did not disclose their symptoms even when asked.”

So what exactly is going on here? Why are so many mothers reluctant to share?

The study doesn’t offer any concrete answers to these questions. But as someone who suffered in silence with postpartum anxiety after the birth of my first son, I completely understand why PPMDs are so underreported. It is terrifying to admit that something is wrong — and the anxiety or depression you are experiencing makes it that much more difficult. Not only that, but mental health issues are cloaked in shame for so many of us.

In my experience, the anxiety I experienced was crippling at times, but I was pretty functional for the most part, which made me think I was probably fine. Except for the times that my heart was racing at top speed inside my chest for no discernible reason, and I couldn’t sleep for fear that my son would stop breathing, I was a loving, attentive mom.

In fact, I needed see myself in that positive light. It was hard to admit that I had any sort of issue because I thought that would somehow signal that I was imperfect. So I rationalized it, saying I was just an anxious mother, and that was normal. When my midwife asked about my mental health state at my six-week checkup, I decided there wasn’t anything serious to report.

So, like many mothers, I just let it slide and ended up suffering for many months in silence. It wasn’t until my son was 2 1/2 and I had a bit of a nervous breakdown that I went into psychotherapy to address the severe anxiety I had developed surrounding motherhood.

Interestingly, in the study out of North Carolina State University, it was the mothers who were experiencing the highest level of stress who did report their symptoms to their doctors. The researchers also found that women with the strongest support networks were also more likely to report any mental health issues they were having, which only reinforces the idea of how important these support systems are for new mothers.

“This work highlights the importance of support networks and the need to normalize the wide variety of reactions women have after childbirth,” Prevatt explains. “We need to make it OK for women to talk about their mental health, so that they can have better access to care. Working with the people around new mothers may be key.”

Yes. This is definitely part of how we need to address this issue. Having the support available for new moms is the first step, but that the support also needs to directly address the mental health issues that women suffer from — to make them feel heard, nurtured, and accepted.

It’s one thing for a new mom to go to a mommy-and-me-type class or to make new mom friends on the playground, but where is the place that a new mom can go where she will be assured that having a baby is pretty much the freaking ridiculously hardest thing on earth, and that if she can’t handle it, there is nothing wrong with her?

Where can she go where all the darkest, most confusing feelings she is having about motherhood will be taken with utmost seriousness, and where she will not be shamed or judged for how she is feeling?

Of course, there are new mom support groups (online and in real life) that strive to provide that space, but it can take time (sometimes a long time) for a new mom to find the right fit group for her, and there needs to be other ways and places where new moms can express themselves and feel supported.

And in general, we all need to do our part to make our fellow moms feel less alone, to raise each other up, and to get the message out there that when motherhood feels too hard to handle, help is available. Every single mother needs to know that she deserves time and support to tend to her mental health — and that doing so is one of the strongest, most powerful things she can do as a mom.