Why Do Some Women Lose Their Minds After Giving Birth?
CChris Williamson
ParentingPregnancyMental Health
Transcript
00:00:00Is there an adaptive explanation for postpartum depression in women?
00:00:04So I actually think probably not.
00:00:06I think it's more of a sign of an evolutionary cultural mismatch, which is this, going back to this idea that we as humans are cooperative breeders and we evolved to have a lot of support around caregiving.
00:00:22So we evolved to trade off care, to share care with people in the community, with our kin.
00:00:29I think we now place a lot of pressure on individual parents and on the individual nuclear family to serve the roles that dozens of people used to serve when there was a lot more proximity and people helped each other out a lot more with care.
00:00:43So we isolate new parents.
00:00:46We don't value their work.
00:00:48We've already talked about, you know, the incentives of a very late capitalist society where we want people to be ambitious drivers and we want them to move on quickly from this interruption of birth.
00:01:01And so we're not providing the support, you know, in this country, we don't have universal paid maternity leave or paternity leave.
00:01:08So a lot of women go back to work probably before they feel like they're ready.
00:01:13A lot of men do too.
00:01:15We don't give inadequate or we don't give adequate time and protection.
00:01:18Right.
00:01:19And we, you know, we create an uphill battle where parents feel isolated and drained.
00:01:26So is there any evidence of postpartum in hunter-gatherer societies?
00:01:31Not that I know of, but I'm also not sure how well it's been tracked or measured.
00:01:37Yeah.
00:01:37Okay.
00:01:37But I think it's...
00:01:38Trying to see if this mismatch hypothesis kind of can just be split tested across like civilizations.
00:01:44Yeah.
00:01:45I mean, I think there's a really, really interesting question and depression in general, you know, hasn't been observed as much in those populations.
00:01:53So it's a really interesting question.
00:01:55But, you know, in hunter-gatherer societies, when a woman becomes a mother, she becomes, if anything, more socially integrated into the life of the community.
00:02:05In contemporary society, when a woman becomes a mother, she often becomes more isolated.
00:02:10We have all of these public spaces that, you know, don't bring the baby to a wedding.
00:02:17Don't bring the baby to a restaurant.
00:02:19Don't bring the baby to a cafe.
00:02:21People don't want it yet to work, right?
00:02:23Like a hunter-gatherer mom can actually still go to work.
00:02:27She can still be wearing the baby.
00:02:29She can function economically.
00:02:30Swaddle up, grab some berries.
00:02:32Yeah.
00:02:32Had a good day in the office.
00:02:33She can occupy a high status social role.
00:02:36Yeah.
00:02:36And she can be, you know, fully integrated into the community.
00:02:40That's interesting.
00:02:40So what is rewarded socioeconomically at the moment specifically for women is not baby accommodating.
00:02:52We have this kind of sharp divide between work and home, which I think is a legacy of the industrial revolution, right?
00:02:58We, before that work generally happened at home.
00:03:01Dads were around a lot.
00:03:02Moms were around a lot.
00:03:03Kids were raised as workers.
00:03:05They were contributing to the family business, the family economy.
00:03:09Jared, if you brought your kid in here and they were able to write good copy, if your eight month old was able to write good YouTube copy, I'd be down.
00:03:16But I would be, I would be absolutely fine.
00:03:18I mean, you're allowed to come as long as you contribute, but yeah.
00:03:22He's working on it.
00:03:22Yeah.
00:03:22He's trying.
00:03:23Yeah.
00:03:23Good way to hone those skills.
00:03:25What, I'm interested.
00:03:26What do you think's the best advice for dads, like trying to be great father, great husband, still take care of themselves while supporting a mom who's going through postpartum?
00:03:37Give yourself grace.
00:03:39Don't expect that it will be easy.
00:03:41Forewarned is forearmed.
00:03:43So, you know, know that this is going to rock your world and it's going to be transformative, but it's supposed to be transformative.
00:03:49And I would say steer away from the myth that dads don't have any innate wiring to know how to take care of a baby.
00:03:56I think we have this idea that moms are just born knowing what to do when a baby arrives and men are going to be helpless and useless.
00:04:04Does that help moms postpartum?
00:04:06I don't think so, because I will say when I had my kids, I was like, what am I supposed to do with these people?
00:04:10You know, you have to learn and you figure it out.
00:04:13And it's about your motivation and your willingness to practice more than it's about just, you know, having some inborn reflex that's telling you how to care for a child.
00:04:24And dads have that capacity to care and to build those empathetic, responsive, caregiving brains.
00:04:31I've got two potential hypotheses in my mind.
00:04:34The first one is like postpartum contagion.
00:04:38I have to assume that if the mom is dealing with it, it's more likely that the dad's going to deal with it.
00:04:44But I wonder if level of paternal child caring decreases the likelihood of female postpartum depression.
00:04:58Do we know what levels of household setup can increase or decrease the likelihood?
00:05:07So there is some research on this and it corroborates both of your hunches.
00:05:11Dude, don't test me.
00:05:13Don't test me on this shit.
00:05:14So you can keep the pro science hat off.
00:05:17Yeah, you don't need it.
00:05:18Yeah, good.
00:05:19Good instincts.
00:05:20But there's research that depressive symptoms are correlated within moms and dads.
00:05:26So if mom is more depressed, dad's more likely to be depressed.
00:05:29If dad's depressed, mom's more likely to be depressed.
00:05:31And if one partner is well and can support the other partner, that's also a huge resilience factor.
00:05:36That's a buffer.
00:05:37So they track together.
00:05:40And there's also evidence that when dads are more involved, moms benefit.
00:05:44So one really cool study tested a paternity leave reform program in Sweden where they were expanding flexibility of paternity leave for dads.
00:05:53They found that if you look at babies born right before and right after that policy intervention, you actually see lower rates of anti-anxiety medication.
00:06:02Prescriptions were filled less often by the new moms.
00:06:06So if dads have more access to leave, moms actually show this population level mental health benefit.
00:06:12And my lab has done similar work.
00:06:14And we found that if you look at prenatal to postpartum trajectories of depressive symptoms, when dads get access to paid paternity leave, moms are less likely to get depressed after the birth of a baby.
00:06:25So it seems like for postpartum depression, maybe for dads as well as moms, one of the key drivers is social integration, level of social integration.
00:06:39Does that mean that if you're struggling with postpartum depression, you should try and turn on the socialization taps a little bit, do mommy, daddy daycare, meetup things?
00:06:51Yeah.
00:06:51That seems like an intervention that might work.
00:06:53Exactly.
00:06:54And that goes back to the evolutionary mismatch idea, right?
00:06:57We're supposed to be embedded in social networks that help us care for our kids.
00:07:00We're not supposed to do it alone.
00:07:02Is postpartum basically like, fuck, this is a lot and I'm overwhelmed?
00:07:07Yeah.
00:07:07I mean, that's part of it.
00:07:09Yeah.
00:07:10Compounded with sleep loss, identity challenges, relationship strain, money and life worries, and your brain and hormones getting totally disrupted.
00:07:22Does that mean that there is a socioeconomic predictor for postpartum depression because people who are more wealthy are more likely to have childcare, which means that they have more assistance, less pressure and better sleep?
00:07:41Yes.
00:07:42Dude.
00:07:42Yes.
00:07:43Yes.
00:07:43So there is a socioeconomic link between postpartum depression risk.
00:07:48And part of it is, you know, there are moms in the U.S. who go back to work less than two weeks after the birth of a baby.
00:07:56So if you're a shift worker, if you're a gig worker, if you're at Walmart, you are probably not getting time to rest, recover and bond.
00:08:04And that's really stressful and really taxing to your ability to adjust to parenthood.
00:08:10So that's part of it.
00:08:11It's also like, what are the community resources that are available to you?
00:08:14Can you afford support and childcare?
00:08:17But some of the best interventions for postpartum depression are around shoring up your social support networks.
00:08:23So helping get people to be more proactive about asking for help, helping to invest in your relationships.
00:08:30And you can even do preventive intervention before a baby is born to say, and we actually do this.
00:08:36My lab leads psychoeducation workshops with a big hospital system that serves low-income new parents.
00:08:44We say we have them make a social support map.
00:08:46So we say, who are you going to be able to ask for help in different domains after the baby comes?
00:08:51You know, maybe your older brother isn't going to be that helpful when it comes to taking the baby for a nap,
00:08:59but he can help with your lawn care.
00:09:03You know, so how do you plug different people in your life into different roles
00:09:06to make sure that your social support needs are met?
00:09:10And we try to coach people to be more assertive about asking for help
00:09:14because I think we're conditioned in our society to be very reluctant.
00:09:18Independence, agency, sovereignty.
00:09:20Individualism.
00:09:20Yeah, yeah, yeah.
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