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Postpartum Depression-A Well-Kept Secret

In our book A Womb of Her Own (Routledge, 2017) author and therapist, Kristin Reale writes about her own postpartum depression. She writes as follows:

As all crises are, being struck by postpartum depression was an incredible life changing experience. It was a turning point not only in my personal life, but also professionally as a clinician. The Greek root of the word crisis means “to sift”. And sifting I have done. To come eye to eye with your own insanity is both completely terrifying and a true gift as a clinician. What we do not yet know about ourselves, what we have not yet experienced and processed in our own psychology, is where our biggest clinical blocks lie. These are the possible pitfalls of being in clinical practice and mistakenly feeling settled in your self. I feel honored and humbled — and a little trepidatious — to share my experience. But I truly believe it is vitally important as clinicians to honor our experience as vulnerable and visceral as it can be. We owe it to ourselves, our patients, our profession to stay authentic and low to the ground, avoiding the hazards of grandiosity as we practice. We can all drift into feeling like we are protected from things our patients experience: confusing painful relationships, anger and rage, the difficulties of parenting, divorce, violent acts, trauma, mental illness. We have an illusion that we are somehow much more prepared for life’s difficulties, or will somehow be able to take a pass and avoid them; that because we have “done our work” and may intellectually and emotionally understand more about the mental sphere than a non-clinician, that we then are more in control of our lives, our psyches. We, of course, are not aware when we are in this protected illusion, and so whenever we sense that we have entered an illusion, what a useful time to stop and look inward.

The Facts:

A few facts…postpartum mood disorders will effect 25% of new mothers. That is one in four (Stone 2014).  It is thought that women will get “depressed” within the first few weeks after giving birth, but the truth is a woman can be effected by postpartum mood disorders for the entire first year after giving birth, possibly two years. Postpartum mood disorders go quite far beyond postpartum depression. In fact, most women do not feel depressed, but instead feel overwhelming anxiety, panic, agoraphobic and obsessive compulsive symptoms, and psychosis. They may look to be over achieving at motherhood–not lying in bed. They may be so anxious about motherhood and relating to the infant and the world that they present as perfectionistic, not removed. They may be overcompensating with control, not avoiding responsibility. This is not to say that there are not many women that experience crippling depressive symptoms, including a lack of desire to attach and care for their infants (Stone, 2014).

Of approximately 4.3 million live births, about 1.3 million women will suffer from postpartum depression and postpartum mood disorders every year. What do these numbers mean? Let me put some perspective on those statistics: each year roughly 300,000 women suffer a stroke, 800,000 are diagnosed with diabetes, 230,000 women are diagnosed with breast cancer. 1.3 million women suffered postpartum mood disorders. In fact, more women will suffer from postpartum depression and related mood disorders this year than the combined number of new cases for both men and women of tuberculosis, leukemia, multiple sclerosis, Parkinson’s disease and epilepsy –combined (Stone, 2014). Yet, there is an overwhelming shroud of shame that still blankets women in society about seeking help, being wholly honest and talking through their painful experience postpartum.

The Shroud of Shame

I have to think that this secrecy is due in large part related to the well-worn idealization of the good mother. Good mothers do not lose their mind. And to talk of a therapist having postpartum depression? This feels even more secret. Good therapists do not lose their mind. It feels sinful to talk about. This is due of course, I believe, to the link between the idealization of good mothers and the good therapist. There is an overwhelming expectation of selflessness from a mother — and “good therapist” — and not much room for the acceptance of the full force of one’s own complicated emotional response. How do we then come to understand the real experience of motherhood when we look to the affective responses provoked in us in the face of overwhelming demands? How do we reconcile the idealization of being selfless with the reality of one’s own subjective experience of holding?


Stone, Katherine. (2014, June) Retrieved from


Postpartum Depression-A Well-Kept Secret

Ellen Toronto, Ph.D.

Dr. Ellen Toronto is a licensed clinical psychologist/psychoanalyst in the state of Michigan.

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APA Reference
Toronto, E. (2019). Postpartum Depression-A Well-Kept Secret. Psych Central. Retrieved on July 11, 2020, from


Last updated: 24 Sep 2019
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