Targeting Postpartum Depression:  An  Issue Critical to the Wellness of Military Mothers and Families

by Susan Dowd Stone

The last decade has brought increased attention to the issue of postpartum depression. Thought to affect up to 20 percent of American mothers (and those statistics do not include women whose babies are stillborn or who miscarry, who are also susceptible to the illness), untreated maternal depression can have devastating long-term consequences for the mother, infant, and family, including family disintegration and loss of life.

Through public service announcement campaigns promoting awareness of postpartum depression (such as CBS Cares) legislative initiatives such as the Melanie Blocker Stokes MOTHERS Act, and other programs designed to enhance the early detection and treatment of this disorder, our nation has become more aware of perinatal mental health issues. But the gap between suffering mothers and access to effective treatment remains unbridged, and preliminary studies indicate this gap may be wider still among military mothers.

The stigma of acknowledging mental health issues related to childbirth remains the most prominent barrier to treatment, causing great shame in mothers whose childbirth experience results in depression and anxiety or thoughts of not wanting the child. Such women, possibly the majority, attempt to “tough it out” alone, greatly compromising their well-being and that of their infant.

In addition, the lack of mental health providers specifically trained in this specialty may discourage a woman’s healthcare team from the assessment process as the team lacks a reliable referral network if the illness is detected. These factors have led to undertreatment or no treatment of sufferers with devastating and prolonged consequences to mothers, infants, and families. Such consequences can range from long-term learning and behavioral disabilities in the child to chronic depression in the mother and even death.

Among military mothers, the incidence of postpartum (and antenatal) depression can be higher owing to the presence of psychosocial stressors known to increase risk for development of these disorders especially during times of war and active duty. Such stressors may include prolonged family separations resulting from deployment (for either the partner or the new mother who has recently given birth), less consistent healthcare, marital issues, financial difficulties, and disrupted sleeping or eating patterns. 

Fear of child removal may discourage a new mother from reaching out for help. In addition, for a mother who is also a soldier, an admission of mental illness may be perceived as a disqualifying factor for promotion or even deployment of herself or her military spouse. The Motherhood Myth—that childbirth and delivery should be among the happiest time in a woman’s life—can increase a mother’s sense of isolation when her experience differs from this expected norm. Increased suicidality has also been associated with military mothers’ suffering from postpartum depression. Further studies are urgently needed to clarify the multiple factors contributing to this increased risk among military mothers.

Give an Hour™ and Postpartum Support International are developing a program to target the issue of postpartum depression among military families in three critical ways:  first, by bringing awareness to military mothers and families of the frequency, risks, and symptoms of these highly treatable disorders; second by recruiting more mental health professionals to GAH™’s programs who are specifically trained to treat this illness; and third, by offering training and informational resources to both military families and GAH volunteers in an attempt to comprehensively reduce or eliminate all barriers to treatment. 

This collaboration could have a major impact on how perinatal issues are perceived and identified among military families and healthcare professionals and facilitate reduction of stigma and increased utilization of services. As Postpartum Support International has long proclaimed to new mothers who may find themselves in an unexpectedly sad reaction to new motherhood, “You are not alone, you are not to blame, and with help, you will be well.”

Symptoms of postpartum depression include the following, but it is important to note that symptoms of maternal depression may begin during pregnancy.
• Tearfulness and mood swings
• Feeling unlike oneself, a sense that “something is wrong”
• Lethargy, inability to go about daily life/tasks
• Insomnia, agitation, irritability
• Lack of bonding with the baby, indifference or wishing to give the baby away
• Obsessive thoughts, i.e., fear that something is wrong with the baby (despite pediatric    reassurance)
• Thoughts of harming the baby or oneself
• Withdrawal from family and friends
• Perception of being unsupported

As. Dr. Barbara Van Dalen, president of Give an Hour™, observes, “The issue of postpartum depression is actually one we know a great deal about and have the resources to address. There is no reason for families and the youngest members of our military communities, their infants, to deal with perinatal difficulties in isolation or without professional help.”

I could not agree more. Through this new collaboration, Give an Hour™’s profound and sustained commitment to offer free mental health services to military families and PSI’s expertise in helping mothers suffering from postpartum depression will reach our military’s most vulnerable dyad of mother and child.

If you or a loved one is experiencing these symptoms, please contact your healthcare provider immediately. Do not wait. Recovery cannot start until treatment begins. Symptomatic relief can be expeditiously resolved in the majority of cases. You can begin by calling PSI at 1-800-944-4773, visiting our Web site at www.postpartum.net, or joining a free weekly and anonymous chat with an expert to respond to your questions about these issues.

Susan Dowd Stone, MSW, LCSW, is chair of the President’s Advisory Council of Postpartum Support International.