ABC’s “Black-ish” is no stranger to tackling tough topics in ways that manage to be creative and impactful, while somehow remaining funny and tremendously accessible. The most recent episode featured a powerful story line centered around Rainbow “Bow” Johnson’s struggles with postpartum depression (PPD) after giving birth to her son Devante. Reportedly, the idea for the story came from one of the writer’s own experiences with PPD. Perhaps this personal connection is why they did such a meticulous job of accurately portraying postpartum depression and depicting several of the challenges that come along with it.  To that end, I want to highlight 10 things they got right about postpartum depression

  • It Impacts Black Families: As I’ve written about previously, women of color are at greater risk for developing postpartum depression, are less likely to be properly screened for the disorder, and are less likely to receive treatment. There is a serious lack of conversation around this which contributes to the silencing around this issue. Representation is a key way to combat stigma and improve access to proper screening and care

 

  • It’s not always obvious: There are numerous ways postpartum depression can manifest. I see many women in my practice who think they don’t have postpartum depression because their symptoms don’t match up with what they’ve read about, because they don’t always feel badly, or because they have been assured that what they are feeling is normal for new moms. PPD can be sneaky, many moms who have it may seem ok or look well to outsiders, but struggle intensely on the inside.

 

  • Every Pregnancy is Different: Bow did not experience any postpartum challenges with her previous four children and was surprised to experience depression after the birth of her fifth child. While you are more likely to experience postpartum depression if you’ve had it previously, that is not always the case. Often this is related to the presence of additional risk factors.

 

  • Additional Risk Factors: Baby Devante’s preterm delivery was referenced in this episode. Additionally, the finale of the last season showed that Bow has some medical complications with the birth, an early delivery, and that Devante had to go to the NICU. These are all risk factors for PPD which could be why Bow experienced it with this baby, and not with her other children.

 

  • Anxiety: There is a line in the episode where Bow describes herself as full of anxiety. There are also moments which depict her worry over Devante’s breathing and the temperature of his room. Anxiety is a common symptom of postpartum depression. Many of the women I see with PPD describe a sense of agitation and state of heightened alert as one of their core complaints. In addition, some women (approximately 10%) experience postpartum anxiety disorder which is a distinct perinatal mental health condition that is less commonly discussed.

 

  • Bonding is Hard: One symptom of postpartum depression is a lack of interest in one’s baby or difficulty bonding with the baby. Some women also describe feeling like they don’t want to be alone with their babies. While this is an entirely normal symptom of PPD, it is highly stigmatized and many women feel deep shame about it. For that reason, it was so important to hear Bow talking about it.

 

  • It Impacts the Whole Family: Black-ish is narrated through the voice of Dre, Bow’s husband. Through the voice over we heard about Dre’s fears and feelings of helplessness around Bow’s condition. We also got to see the anxiety and confusion playing out amongst her four older children as they tried to understand what was happening to their mom. Postpartum depression can impact family members who also benefit from support, and sometimes their own mental health treatment.

 

  • Medication and Nursing: During the episode, Bow and Dre meet with a psychiatrist to discuss her symptoms. During that meeting, Bow decides to take a medication (presumably an antidepressant) to help with her symptoms and raises the question of medication safety during breastfeeding. While I didn’t love that medication was presented as the first line treatment, it was so great to see this concern addressed. There are numerous medications that are deemed safe to take while breastfeeding (or during pregnancy for that matter) but many women are reluctant to take much needed medication because of misinformation about its safety, and stigma around its use.

 

  • Stigma: Speaking of stigma, this show addressed so many aspects of stigma that surround postpartum depression. Whether it be about taking medication, writing off symptoms as “just new mom problems,” or seeking professional help, this episode called out stigma head on. This was exemplified in the interaction between Bow and her mother-in-law Ruby which touched on how cultural and generational beliefs around mental health are shaming and can impact recovery.

 

  • Therapy Helps: While postpartum depression can feel frightening and overwhelming, it is treatable with professional help. Towards the end of the show, Bow references her therapist, is depicted doing the therapy “homework” of journaling, and notes that is helping her to feel better. This was such a great message around the importance and efficacy of treatment, and a wonderful marker of hope that women can and do get better.