The Weight of Maternal Postpartum Depression

Authored by: Grace Liu

Art by: Kain Wang

Following an arduous pregnancy, many families eagerly anticipate the birth of their child with expectations of joy and fulfillment. Yet for nearly one in five healthy mothers, this period can become isolating and overshadowed by the sadness and anxiety that result from postpartum depression (PPD). Maternal PPD, formally defined as a long-lasting depressive episode that emerges within the first few weeks after birth or up to a year later, is a leading complication of childbirth [1]. Inadequate childcare, unsupportive work environments, limited paid leave, and the sudden responsibility of caring for a new life further exacerbate the struggles. Previous studies have found that among mothers experiencing PPD, a greater workload, less job flexibility, and insufficient social support were strongly associated with higher depression scores [2].

There are currently several medications to treat PPD, like traditional SSRI antidepressants (e.g., Zoloft) and newer postpartum-specific medications (Brexanolone and Zuranolone). However, researchers are continuing to test the efficacy of these treatments and have reached mixed conclusions. Several studies found that these medications can partially alleviate symptoms, but also noted that they can lead to adverse effects like persistent fatigue and dizziness [3]. Moreover, while medications and psychiatric care alone can help treat symptoms, they still cannot address many of the broader conditions that shape maternal mental health.

Ultimately, women face a significant barrier to care due to stigma and insufficient awareness surrounding the disorder. The commonly held belief that mothers should feel pride and excitement after having a baby can make feelings of sadness seem abnormal and shameful. This directly discourages help-seeking even when symptoms are serious and treatable, especially when mothers internalize societal pressures and worry about being judged as unfit to care for their child [4]. A prior survey found that nearly one in three women refrained from sharing their emotions with healthcare providers out of fear of their baby being taken away [5]. Many mothers worry that expressing their emotions reflects personal shortcomings and leads others to perceive them as weak and undeserving. Far too many downplay their symptoms and suffer in silence as a result, and studies have found that up to half of women with PPD go undiagnosed [6]. Another critical issue leading many to avoid treatment is the persistent lack of awareness surrounding the disorder. Many mothers are simply unaware that their struggles are the result of a clinically recognized condition. Additionally, only 22% of those diagnosed receive mental health treatment for their condition, with much of the discrepancy due to mothers resolving to “get over” their struggles independently [6]​. Several studies have also found that insufficient knowledge among healthcare professionals surrounding PPD and a lack of mother-centered care further delayed successful treatment [5].

History has demonstrated how redefining societal narratives can directly influence how people understand and treat mental health challenges. The “Prozac revolution” of the late 1900s, which involved mass marketing of the new antidepressant Prozac, helped reframe societal views around depression. Mass advertising and medical messaging conveyed that depression was a biological condition caused by a chemical imbalance rather than a personal failing [7]. This shift was particularly relevant to postpartum depression, as it helped reframe maternal distress as a medical condition rather than a reflection of a mother’s competence or emotional strength. While mental health was previously heavily stigmatized, this movement made it more socially acceptable to speak openly about mental health and validated the struggles of many mothers. However, it also shifted the “solution” toward taking medication rather than addressing the social and structural contributors, which continue to pose challenges today [7].

The “Prozac revolution” is sufficient evidence that social narratives play a large role in the experiences of those struggling with mental health. While researchers continue to pursue exciting scientific innovation through drug development, it is becoming increasingly clear that we also need to focus on tackling these issues through social change: reducing stigma, increasing awareness, and expanding structural support through initiatives like expanded workplace protections, paid leave, and accessible childcare. Postpartum depression is not a personal weakness nor something that can be purely solved with medication; it is a public health issue with alarmingly high prevalence that also requires cultural change and awareness to combat.The Weight of Maternal Postpartum Depression

References

1. Egsgaard, Sofie, et al. “Time Trends in Incidence of Postpartum Depression and Depression in Women of Reproductive Age.” Journal of Affective Disorders, vol. 366, Dec. 2024, pp. 91–97, https://doi.org/10.1016/j.jad.2024.08.167.

2. Dagher, Rada K., et al. “Postpartum Depressive Symptoms and the Combined Load of Paid and Unpaid Work: A Longitudinal Analysis.” International Archives of Occupational and Environmental Health, vol. 84, no. 7, 5 Mar. 2011, pp. 735–743, https://doi.org/10.1007/s00420-011-0626-7. Accessed 11 Jan. 2022.

3. Wilson, Claire A, et al. “Brexanolone, Zuranolone and Related Neurosteroid GABAA Receptor Positive Allosteric Modulators for Postnatal Depression.” Cochrane Library, vol. 2025, no. 6, 26 June 2025, https://doi.org/10.1002/14651858.cd014624.pub2. Accessed 18 Aug. 2025.

4. Thorsteinsson, Einar B., et al. “Changes in Stigma and Help-Seeking in Relation to Postpartum Depression: Non-Clinical Parenting Intervention Sample.” PeerJ, vol. 6, no. e5893, 8 Nov. 2018, www.ncbi.nlm.nih.gov/pmc/articles/PMC6230434/, https://doi.org/10.7717/peerj.5893.

5. Sambrook Smith, M., Lawrence, V., Sadler, E., & Easter, A. (2019). Barriers to accessing mental health services for women with perinatal mental illness: systematic review and meta-synthesis of qualitative studies in the UK. BMJ open, 9(1), e024803. https://doi.org/10.1136/bmjopen-2018-024803

6. Nonacs, Ruta. “PPD Screening and Treatment: Is There Room for Improvement? A New Study at Mass General Brigham.” MGH Center for Women’s Mental Health, 14 Sept. 2022, womensmentalhealth.org/posts/steps-for-ppd/.

7. Elliott, Grace K., et al. “The Utilization of Cultural Movements to Overcome Stigma in Narrative of Postnatal Depression.” Frontiers in Psychiatry, vol. 11, no. 11, 30 Oct. 2020, https://doi.org/10.3389/fpsyt.2020.532600.