Depression increases your risk of...depression

Why is it that news about postpartum depression seems so often to fall in the no-shit-sherlock category?

Check out this item: “Psychiatric history affects 'baby blues,' study says.
Mental health issues may increase postpartum suicide risk.” Um—it took researchers with master’s degrees to figure this out?

Then again, read deeper and you find more to undermine conventional wisdom than to reiterate common sense. Midway down the article I see this: Rates of suicide attempts by women after giving birth is much lower than in the general population.

This does make sense; most women, even depressed ones, feel an obligation to their newborns to stay alive. Still, you might think from all the publicity about postpartum depression that women were at high risk of suicide after pregnancy.

Talk about postpartum depression is a strange mixture of the deadly obvious repackaged as profound scientific insight and thoroughly bogus leaps of logic repackaged as unquestionable science. This says to me that we’re thoroughly confused about postpartum depression. And "mental illness" in general, for that matter. My favorite billboard ever, which I used to pass by daily on my way to work, is "Number one cause of suicide: Untreated depression." Can we say tautology, class?

Something in New Mexico's water?

Another crack in the it’s-our-crazy-hormones theory of women’s minds:

As the Our Bodies, Ourselves blog notes, a Center for Disease Control survey has found that postpartum depression is much more commonly experienced by women who also experienced emotional, traumatic, partner-related, and financial stressors during pregnancy, and those who were physically abused during pregnancy were more likely to report symptoms of depression. Women who were younger, less-educated, and who received Medicaid at the time of delivery were also more likely to report symptoms. And rates of reported symptoms of depression varied from 11.7 percent in Maine on up to 20.4 percent in New Mexico. (As I mentioned in an earlier post, poverty also correlates with higher rates of postpartum depression.)

No surprises here, except you should be surprised if you believe the line that postpartum depression just is a hormone imbalance. If postpartum depression is a hormone imbalance, is there something in the water in New Mexico that sends hormones out of whack? And exactly how do receiving Medicaid and not having a Harvard diploma cause hormone imbalances? And if they do, just how relevant is the hormone imbalance to the problem?

To be clear, I’m not arguing that hormones play no role in postpartum depression. I’m sure they do. But I’m not sure which is the cart and which the horse—are whacked-out hormone levels the cause or the effect of being depressed, or some bit actor in the causal drama? I find the theory that our mental lives just are flows of chemistry to be incoherent. Maybe emotions feel like they’re about things in the world at least largely because they are. Like maybe it’s hard to be a mother in this society, and that can get a woman down, even make her crazy.

This just in: being poor is depressing

This oughta put paid to the idea that postpartum depression just is hormones: Researchers at one of my alma maters, the University of Iowa, have found that poor women (in Iowa) are many times more likely to suffer from postpartum depression than better off women. Yeah, no kidding, being poor is depressing.

Another study by the same researchers found that African-American women are more likely than white women to get depressed after birth, while Latinas are less likely to get depressed. The lead researcher suggested that the differences can be traced to differences in social support.

I find the press release darkly amusing in its bureaucratic caution. “Considered together, the results of both studies highlight … the need for early identification programs.” I picture social workers saying to patients, “I think you should be aware that our data suggest there is a high likelihood that you are poor/black.” If you ask me, the results of the studies highlight the need to end poverty and racism and the way our society isolates mothers.

Which is not to dismiss the program the researchers have created to help depressed women postpartum, called “listening visits,” in which mothers get the chance to talk about their difficulties with a caseworker or nurse. But here again there’s something darkly amusing: The visits were modeled on the “health visitor” provided by Britain’s National Health Service for new mothers, and the Iowa researchers imported Brits to do the listening. Eek—the socialists are coming; don’t tell Aetna, Blue Cross, Kaiser, …

Thanks to the Our Bodies, Ourselves blog for noting this research. The blog’s also got other good stuff.