This article appears in our 2015 Summer issue, Blue. Subscribe today!
By Hannah Moulton Belec
In 2005, Brooke Shields released Down Came the Rain, a book that detailed her emotional downward spiral after giving birth to her daughter. Shields admitted that she had visions of her baby being thrown against the wall, thought about driving her car into a freeway barrier with her daughter in the backseat, and felt like she wasn’t bonded to her child. Though postpartum depression (PPD) has been documented for millennia, for many people, public awareness began with Shields’s story. Her story made huge waves—and not just because it laid bare a brutal reality of parenting that’s anathema to our cultural understanding of new-mom bliss. Shields writes in her book that she received mostly negative reactions when she started talking more about her experience. (Famously, Tom Cruise went on Today to censure Shields for “promoting” antidepressants.) She describes wishing that people were more open and says that media portrayals of PPD actually made her believe she didn’t have the disorder and didn’t need help: “Postpartum depression was a crazy person’s affliction, and I associated it only with those people who harmed their kids by doing things like driving the car into a lake,” she wrote. “It only hit those people you read about in the news.”
Ten years later, although the media landscape is wildly different, the understanding of PPD is much the same. We know now that one in seven mothers experiences PPD (and one in four low-income mothers), but, according to the nonprofit Postpartum Progress, most never seek help. Founder Katherine Stone is deeply concerned that media depictions teach women that mothers with PPD are dangers to society, even though the illness is easily treatable. “It’s extremely disconcerting, because it prevents women from asking for help. If you’re afraid to ask for help or even tell someone you love that something is wrong, and then you see one of these shows, why would you tell?” says Stone.
For how common PPD is (and it’s just one of a group of disorders that can happen during and after pregnancy or adoption), it’s not represented a whole lot in pop culture. But what’s out there paints a pretty uniform stigma: Women with PPD are out of control, likely to kill themselves or their kids, and need to be hospitalized or have their babies taken away from them. The majority of representations of postpartum issues seem to be in horror and docudrama news, which tend to emphasize the taboo of mothers killing their children. These genres are pretty well understood to be sensational at their core. Perhaps more telling are the earnest depictions of PPD and what messages they send to anyone who has had or will have PPD.
One of the only films I’ve seen that uses the diagnosis by name is 1988’s For Keeps. Molly Ringwald plays Darcy, a high school senior who hopes to study journalism in college but gets pregnant. After she and her boyfriend Stan decide to keep the baby, the couple struggles. The birth scene is pretty realistic, showing a miserable Darcy begging for painkillers and complaining about her vagina ripping and burning. When the doctor asks whether Darcy wants to hold her baby daughter, Darcy looks dazed and delirious and can only mutter, “She’s nice. I want my mother.” Darcy doesn’t want to hold or breastfeed her baby, and Stan doesn’t understand her indifference. The doctor says it’s just a phase, and friends say that her mothering instinct will kick in. The friends are right: When Darcy sees an intruder lurking around their apartment, she rushes to the defense, saying, “Nobody is gonna hurt my baby.”
While she’s holding the little one, who must be about five or six weeks old since she can smile, the baby latches onto Darcy’s breast and starts feeding immediately (an absurdity if you know anything about nursing). Darcy becomes the doting mother everyone always knew she was. Before this moment, the only thing that animated Darcy was writing an essay. “I felt like, when she was being ripped out from inside of me, everything I loved about being young was being ripped out at the same time,” she wrote. She finishes her essay later, but Darcy’s depression ends up being little more than a joke. At one point, Stan’s grade-school-age sister takes one look at the zoned-out Darcy, heaves a sigh, and delivers the diagnosis, “Hmmm, postpartum depression,” as if it were a kids-say-the-darndest things punch line.
Postpartum disorders are addressed more often on the small screen, but the messages tend toward the sensational and stigmatizing. In season four of Homeland, which aired in 2014, Claire Danes’s character, Carrie, struggles with the grief of losing her baby’s father while also dealing with what appears to be depression and anxiety. Carrie spends most of the season out of the country, avoiding her baby. She says that she’s tried to be happy about having a child but that ultimately she’s a terrible mom. Carrie resolves to give motherhood a real try, but only after months of depression that include a moment when she seems to think about drowning her baby in the bathtub. Carrie gently lets the baby slip underwater; you see the water submerging the baby’s face from the baby’s point of view. Carrie hesitates for a stomach-turning beat before quickly grabbing her baby out of the water. They both dissolve into sobs.
Claire Danes as Carrie Mathis in Homeland (Showtime)
Drowning babies in the bathtub is a common theme. A similar situation is featured in a 2009 episode of Private Practice, a spin-off of Grey’s Anatomy that focuses on a small doctor’s office. A crossover episode follows a mother, Rachel, who brings her baby in because the baby slipped in the bathtub while Rachel left to answer the phone. Her ramblings and fatigue are a red flag to the doctors, who worry that she has PPD and needs to sleep. Doctors watch the baby and offer Rachel acupuncture for her stress. Rachel panics and complains to the doctors, with long needles hanging out of her wild-eyed face, that she can never sleep and the crying never stops. Rachel admits that there was no phone call; she held the baby underwater before coming back to her senses. Rachel is hospitalized, and the doctors debate whether she should get her baby back. The men defend Rachel and say that she’s a good mom who is suffering from postpartum psychosis, which is very rare. A psychiatrist, Violet, doesn’t think Rachel should get her baby back, saying that she could snap the baby’s neck. Ultimately, the family is reunited. Rachel’s illness will now be treated, and Violet assures her that “it’s gonna get better.”
Hospitalization and potential loss of custody are also huge issues in the web series Susanna, which is produced by YouTube channel WIGS. The series debuted to accolades in 2013 for “shedding light” on postpartum depression. Writer Jon Avnet, who produced Black Swan and directed Fried Green Tomatoes, told CBS that he was inspired to write Susanna after hearing about a colleague’s experience. “I wanted to create a fictional narrative that would allow people to have a conversation,” he said. “I don’t want women to suffer in shame or in silence.” Although the episodes all end with information on how to get help from Postpartum Support International, the secondhand interpretation of what it’s like to have postpartum depression is problematic.
The title character, played by Maggie Grace, is not the one with PPD. Instead, her life is upended because her unreliable sister, Katie (Anna Paquin), has PPD. Katie isn’t adjusting well to motherhood. She obsessively disinfects everything, she has trouble breastfeeding, and she can’t get her baby to sleep or stop crying. The series begins with Katie calling her sister in a panic. Financier Susanna tries to talk Katie through an emotional tailspin in which Katie admits that she’s afraid of what she might do. Eventually, Susanna decides to take her sister to the emergency room, where Katie is—whether voluntarily or involuntarily is debatable—admitted and sedated.
What do all of these depictions add up to? First of all, a lot of medical misinformation and conflation of what is really a range of illnesses. PPD is one of several mood disorders that take the form of anxiety, obsessive-compulsive disorder, or post-traumatic stress. But the disorder that gets the most attention onscreen is postpartum psychosis, which is an extremely rare condition (affecting 0.1 percent of mothers, or one in a thousand) that sometimes leads to violence. Symptoms of the more common disorders can include feeling disconnected from your baby, insomnia, crying all the time, feeling worthless, worrying about whether your baby is eating enough, feeling like you need to constantly check whether your baby is breathing, and having what are called “intrusive thoughts”—scary and often violent thoughts about harming your baby or yourself. The symptoms of postpartum psychosis are more severe and can include hallucinations, hearing voices, and being suspicious of your loved ones. (The psychosis has an infanticide rate: 4 percent of the 0.1 percent of mothers affected will kill their babies.)
All of these disorders are curable with treatment, and violence is extremely rare. So why are women with PPD usually portrayed as potential murderers? Much of what we know about postpartum disorders flies in the face of what we see onscreen. As Postpartum Progress founder Katherine Stone says, women with PPD don’t hurt anyone, except maybe themselves, and most women with postpartum psychosis don’t hurt anyone either. The former condition affects about 15 percent of mothers; the latter affects 0.1 percent of mothers. Pop culture depictions wildly overrepresent and sensationalize postpartum psychosis, conflate psychosis with much more prevalent depression, and send the dangerous message that if you ask for help, you’ll be treated like the monster you fear you are.
“Every time the media—whether entertainment or news—chooses to cover perinatal mood and anxiety disorders, the portrayal is always of some out-of-control woman committing or attempting to commit infanticide,” says Stone. The Private Practice episode earned the ire of Stone because it was “yet another story about a murderous mommy rather than the truth,” once again conflating postpartum psychosis with postpartum depression.
Susanna also seems to confuse the two disorders, especially when it comes to intrusive thoughts. When Katie admits to having troubling thoughts about what she might do, everyone around her reacts as if she’s about to do those horrifying things. But intrusive thoughts are not desires or intentions; they’re manifestations of fears. “It’s a reflection of the deepest anxieties you have in your role as a mom,” Stone says. Women with postpartum depression tend to think that if they can think these things, they must be capable of doing them. But Stone says that intrusive thoughts “are not indicative in any way of danger. In fact, women who have these thoughts are the safest out there, because they avoid contact with their babies.” In the book Dropping the Baby and Other Scary Thoughts, authors Karen Kleiman and Amy Wenzel say that women being alarmed is actually a good sign: “It is understandable that you are frightened by these thoughts…. However, this distress, as disturbing as it feels to you, provides reassurance that these thoughts are anxiety driven and not psychotic.”
Yet when Katie admits that she still has unwelcome thoughts, even though she’s sure she’d never carry them out, she’s treated as dangerous and sequestered from her baby. The mere fact that Katie is immediately hospitalized is also confusing: Unless it’s severe, which Katie’s case doesn’t seem to be, it’s rare to be hospitalized for PPD. This conflation of psychosis and depression, of intrusive thoughts and intention to harm, isn’t just semantics: Worrying that you’ll drop your baby down the stairs, stab him with a kitchen knife, or throw him against the wall are horrifying experiences for a new parent. If the cultural consensus is that intrusive thoughts equal infanticide or suicide, women will continue to be petrified to seek help. Women need to know that “we’re not all out-of-control, bedraggled murderers,” Stone says. “We’re just not.”
Yet shows like Private Practice and Susanna send the message that if you have PPD and someone finds out what’s going on, they’ll put you in the hospital and maybe take your baby away long-term, because you’re a killer on the verge of snapping. Perhaps not as graphic but still damaging, the other depictions also discourage seeking help. For Keeps tells us that you can just wait postpartum depression out until your true maternal instinct kicks in. In Homeland, Carrie gets over what seems to be paralyzing postpartum depression and anxiety simply and without help, even though her treatment and medication for a different mental illness, bipolar disorder, is acknowledged earlier in the series as absolutely crucial.
Women are credited as cowriters on For Keeps and Private Practice, but the tone of these depictions leads me to assume that no one in those writers’ rooms has gone through PPD. I assume the opposite for the writers of Scrubs, the comedy sitcom about a hospital staff, who managed to talk about PPD with depth and humor. When nurse Carla has a baby in season six, we see her trying to pull herself out of a tailspin of frustration and despair. She hides it at first, but her husband, Turk, realizes something is very wrong when Carla can’t stop crying and says, “I can’t do this. We have to take her back.” Carla insists that she doesn’t have PPD—she has “the weepies,” and she can handle it.
Over the course of the season, the idea of watching out for and identifying PPD is treated with gravitas—even amid jokes, Carla’s experience isn’t trivialized. The male doctors make clear that it’s a serious condition, and when Turk can’t get through to Carla, he enlists a woman who’s been through it, Jordan, to intervene. Jordan admits that she didn’t feel cut out to be a mother when she had her son and that she thought about throwing him out the window when he wouldn’t stop crying. Relief rushes over Carla as she admits having similar thoughts. Jordan’s advice is a thing of beauty: “Listen, you can’t get rid of this by sheer force of will or positive thinking or taking advice from a big Hollywood movie star and the dead science-fiction writer he worships,” Jordan says. “You need to get some help.” The episode closes with Carla, now on antidepressants, nuzzling her baby and making fun of Turk’s baldness.
Carla’s symptoms don’t encompass all postpartum disorders, but the depiction is by far the most true-to-life one I’ve seen onscreen. She realizes that there’s a problem, gets help, and gets better quickly. Onscreen depictions are clearly lagging when it comes to fighting the cultural misunderstanding of PPD, but blogs, memoirs, and podcasts are publishing strong counternarratives. On One Bad Mother, a comedy podcast about parenting, Biz Ellis and Theresa Thorn talk candidly about how menial and frustrating parenting can be; they dedicated an episode to postpartum depression in 2014. The media has led us to believe that PPD is one-size-fits-all, Ellis says. “If you aren’t about to murder your family, then you don’t really need help and you should just toughen up. That is exactly how I felt.” To fight back, she says, “Let’s share and overshare, especially the super-boring, not-good-for-TV experiences we’ve had with PPD.”
Stone’s blog, PostpartumProgress.com, publishes a growing number of women doing just that. More celebrities have spoken out about their experiences since Shields did, including Lisa Rinna, Bryce Dallas Howard, and Gwyneth Paltrow. Stories are surfacing where before there was silence. The confessions spill over with shame, fear, anxiety, utter desperation, and hopelessness. But also bravery. And survival.
A few weeks after a complicated birth, my husband, Eric, walked in on a by-then familiar scene. I was wailing and rocking back and forth on the edge of our bed, painfully trying to breastfeed my son, Oscar, who wasn’t gaining enough weight and cried ceaselessly. Eric wanted me to stop nursing and seemed to think that I was only as miserable as I had decided to be. Eric admitted recently that he’d resisted the idea that I had PPD leading up to my diagnosis, because he had equated the illness with suicide and murder—that was the education that media had given him on the topic.
I’ve never told Eric the full truth about my dread and regret in those first few months (and vice versa—men get PPD too). I desperately wanted to take it all back, thought I’d never sleep again, and fantasized about driving over a cliff into the Atlantic. I couldn’t see a way out of the darkness that had enveloped me. But after months of therapy, I learned that the worst version of myself wasn’t me; it was depression. Oscar will be 2 in November, and he’s a babbling, giggling, sweet little man. I hope he doesn’t think any less of me when he reads this someday. His mama backed away from the ledge to love him. I hope that more parents can get the help they need to do the same.