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PPD–It’s Not Just the Hormones!!

In our book A Womb of Her Own (Routledge, 2017) author Kristin Reale writes as follows: Furthering this view and pointing to more current literature, Blum (2007) comments that women feel incredibly isolated due to the pressure coming from years of infant focused research that the infant and growing child’s mental health rests squarely on the idealized mother’s shoulders. The need for women to perform as the idealized mother has minimized the role that of the father, the need for extended family, social community and how cultural institutions play a huge and dynamic role in a child’s development. To feel this immense pressure to be the everything to and for their children can trigger woman to become depressed, especially those who were already at risk. (Plaskin, 2000)

Never “Good Enough”

The withstanding unaltered popular belief of the mother ideal has left very little room for women to truly experience their true self as “good enough” mothers (Winnicott, 1965). It has induced more guilt, repressed anger, and created an ingrained disapproving environment, both societally and within families, making it very difficult for women to seek and receive help. (Plaskin, 2000) Women may find themselves very much in physical need, having endured a long labor birthing a baby, or experienced a major abdominal surgery having a C-section – both serious somatic undertakings — leaving the new mother in need of being mothered herself. Plaskin (2000) comments on this experience of birth, in that most often mothers are told that whatever outcome birth took, no matter how traumatic, or seemingly violent toward their bodies (noting long excruciating labors, extensive episiotomies, or emergency C-sections) that the mother should automatically be pleased that the baby was “healthy” and “we needed to do what was needed to be done.” This, unfortunately, as noted by Plaskin (2000) and others in postpartum literature, leaves zero room for the mother’s experiences and negates the importance of her birth story. Here, within the mother’s very first experiences becoming a mother, we experience the first glimpse of the need to idealize motherhood with the narrative being “selfless”.

Not Just the Hormones

It has been widely accepted and disseminated in many psychiatric and medical circles that the majority of PPD is caused by the major hormonal shifts that occur during pregnancy and especially with birth. And as the image of the idealized mother persists, neglecting the traumatic intergenerational histories of motherhood often reported, not surprisingly, after reviewing the current literature, I have found that it seems it has been more culturally palatable to focus on the more biological side of motherhood. Focusing on the biological foundations of mental illness seems to be an enduring and appealing place for the American culture when considering mental illness, regrettably overlooking the deep and complex psychological keystones. But while a portion of this biological research may be applicable, Blum (2007) calls into question the need to focus more psychodynamically, stating that “numerous studies have examined the potential roles of estrogen, progesterone, testosterone, prolactin, oxytocin, cortisol, biogenic amines, and other physiological agents in relation to postpartum depression (Zonana & Gorman, 2005) and despite extensive investigations, there has been no major study demonstrating a direct association between these [hormonal] changes and subsequent major depression” (Harris, 2002, p. 407). Blum (2007) goes on to interestingly state, “Similarly, ‘studies of various neurotransmitter systems and other neuroregulators have not provided evidence that any one distinguishes women with postpartum depression from women without postpartum depression. (Llewellyn, Stowe, & Nemeroff, 1997).


Blum, Lawrence D. Psychodynamics of postpartum depression. Psychoanalytic     Psychology, Vol 24(1), Jan 2007, 45-62.

D.W. Winnicott: Maturational Processes and the Faciliating Enviornment: Studies in the Theory of Emotional Development (London: Hogarth Press, 1965)

Harris, B. (2002). Postpartum depression. Psychiatric Annals, 32, 405– 415

Llewellyn, A. M., Stowe, A. N., & Nemeroff, C. B. (1997). Depression during pregnancy and the puerperium. Journal of Clinical Psychiatry, 58, 26 –32.

Placksin, Sally. 2000, Mothering the New Mother: Women’s feelings and needs after childbirth. William Morrow Paperbacks.

Zonana, J. E., & Gorman, J. M. (2005). The neurobiology of postpartum depression. CNS Spectrums, 10, 792–799.




















PPD–It’s Not Just the Hormones!!

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). PPD–It’s Not Just the Hormones!!. Psych Central. Retrieved on February 26, 2020, from


Last updated: 26 Sep 2019
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