In 2001, Andrew Solomon published The Noonday Demon: An Atlas of Depression.  As somebody who has long suffered from depression, Mr. Solomon brings to this book a nuanced understanding of depression — looking at it from many different angles:  personal, cultural, scientific, and political.  An updated version of his book will be released next week and will include a chapter on depression emerging in the context of pregnancy.

This chapter is excerpted in the May 31st issue of the New York Times Magazine.  Mr. Solomon writes eloquently of the suffering and shame women face when they find themselves struggling with depression when pregnant or as a new mother.  He particularly focuses on how, as a society, we have unrealistically high expectations of all mothers, expecting them to sacrifice their own mental health as they pursue “what is best for the baby.”  From the article:

Though antenatal and postpartum depression are linked, antenatal depression has remained underground. Much of the stigma around maternal depression — antenatal and postpartum — seems to focus on women who fail at joy, often suggesting that such women are heartless. How can anyone not be swept up by the momentousness of producing a child who will give her life purpose? The myth of the pregnant mother who is high on hormones has had considerable staying power. Something sentimental in us likes the notion that the physical discomfort of pregnancy is outweighed by the thrill of nurturing a new life within your own body. At a time of opening social mores, when mental illness is more readily acknowledged, when feminism has won women a wider range of career options, when some women’s choice not to have children is validated, when the right of gay men and lesbians to be parents has pushed the frontiers of fatherhood and motherhood, this monolithic perception of pregnancy persists. We have not acknowledged how appropriately anxiety-ridden pregnancy is, how traumatic the change in identity that accompanies prospective motherhood can be.

This is a polarizing topic.  I am writing this article a mere 9 hours after Solomon’s  article was posted online, and already there are 132 comments.  Mr. Solomon explores both sides of the debate, highlighting the incomplete data we have regarding the safety of antidepressant medications taken during pregnancy but at the same time clearly stating that depression itself can be life-threatening for the mother and her child and may have significant and life-altering  long-term consequences.  Most importantly, his goal is to make women aware of this issue and urges them to get the help they need.

Listen to interview with Andrew Solomon on Fresh Air with Terry Gross

Ruta Nonacs, MD PhD

Depression During Pregnancy is a Double-Edged Sword (Interview with Andrew Solomon)

The Secret Sadness of Depression with Pregnancy

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