by Margaret Sikowitz LAc MFT-i

The New York Times published a story covering the current administration’s FDA recommendations about anti-depressant use and pregnancy, a personal and professional area of tremendous interest. This article has been pinging its way in and out of my inbox with gusto.

Pregnancy and postpartum life are jam packed with physical and emotional changes like no other. The hyper-compressed timeline from conception to labor and delivery intensifies the experience, as anyone who’s gone through this can attest. Between the ACOG (The American College of Gynecologists and Obstetricians) and the APA (American Psychological Association), it’s generally accepted that between 10-20% of pregnant people experience depression in pregnancy in or after pregnancy.
The dichotomy between how media depicts the experience of pregnancy and many people’s lived experiences can feel profoundly dissonant. I recently met with someone who exceeded the minimum criteria for postpartum depression (as scored
on one of the more commonly accepted screening tools, EPDS). When we talked more about her symptoms, she keenly observed “I thought this was supposed to be all butterflies and rainbows, but I can’t stop crying.”

We spent some time focusing on the ‘supposed to’ part of that and came to understand the sticky and pervasive origins of those depictions. Social media, movies, tv, and, even to a degree, unwittingly, some of her friends, portray an often-idealized version of what it’s like to be pregnant, then, to have a baby. The reality was so far from her own that she felt even more isolated in her experience.

We dug deeper, talking about the origins of those ‘supposed to(s)’ and found some relief when we could identify that a marketing department in a corporate conference room is largely responsible for centering those butterfly and rainbow stories. Real humans struggling with sleep deprivation, trying hard to understand newborn cries, quite commonly in a body that just gave birth, have a challenging enough time without those messages.

Similarly, eh hem, (and I’m really trying to stay calm and neutral here), the current administration’s FDA has much too strong a bias to be advising anyone on best health practices, let alone pregnant people’s bodies. (Was that neutral and calm enough??)
So, how do we in the therapy space, either in tandem with a client’s psychiatric and obstetrical care team, or as individual providers, use our tools to help people experiencing these symptoms? Well, above is a good example of how narrative therapy can be helpful. Want to try it on your own?

Consider how and when you find yourself wondering how, or what you ‘should’ be doing, feeling, etc.
Then, think about who defines your ‘should’.
Does that person share your values and experiences? Do they truly understand who and how you are???
If not, examine how you tell your story.

Exploring your own “should”, informed by your unique experiences, may help relieve some of the stress that accompany carrying around other’s expectations.