How our culture is setting this generation of mums up for mental illness
This article was written by family doctor [GP] based on Vancouver Island, Canada – Phillippa Houghton.
It is well known that becoming a new mom is no easy feat, but what we don’t talk about enough is how commonly millennial women struggle with perinatal mood and anxiety disorders, often battling these mental health conditions alone.
How common are perinatal mood and anxiety disorders?
Millennial moms, those born between 1981 and 1996, are experiencing perinatal mood and anxiety disorders at higher rates than the generations before them. Some data suggests perinatal depression is about 51% more common in millennial mothers than it was in their own mothers’ generation 25 years ago (1).
Certainly, a component of this increase is due to better awareness, screening and diagnosis; millennials in general are more apt to speak openly about their mental health and come forward than generations previous. However, there are some specific cultural factors that impact new mothers today which increases their risk of perinatal distress and mental illness.
Prior to the COVID19 pandemic, perinatal depression impacted about 20% of expectant/new mothers and perinatal anxiety was comparable. Since the onset of the pandemic, initial data has shown that around 40% of expectant and new mothers are struggling with clinically significant depression and as many as 50% are dealing with clinically significant anxiety (2).
What exactly is perinatal depression and anxiety?
Perinatal depression and anxiety are mental health disorders that onset within the period surrounding conception, pregnancy or one year postpartum. While the symptoms are comparable and overlap with these disorders outside of pregnancy, there are some unique features that impact this population that may be overlooked, even by healthcare providers, as they are not openly discussed.
It can be easy to miss a mother in distress, because she is probably keeping it together on the outside. We have strong biological drivers that force us to keep putting one foot in front of the other for the benefit of our babies, so while a new mom might be suffering on the inside, to everyone else looking in, she may be doing a great job. She may appear put together, with a clean home and a well-dressed baby – but when no one is watching she may be riddled with anxiety and self-doubt, exhausted from staying up all night checking that the baby is breathing or distressed by intrusive thoughts or images.
What are the symptoms of perinatal depression and anxiety?
Perinatal depression and anxiety have many overlapping symptoms, and often occur together. A mother suffering from one or both of these disorders may experience self-doubt, guilt, constant feelings of overwhelm, fatigue, lack of motivation, irritability, anger or rage. She may find herself thinking “I just don’t feel like myself anymore”. She may feel constantly resentful towards her partner, as if the smallest infraction could make her lose her temper. She may feel like she doesn’t belong in motherhood, like she made a mistake or her family would be better off without her. In the most severe forms, she may consider suicide or self-harm.
What contributes to perinatal depression and anxiety?
There are many risk factors that contribute to a woman developing perinatal depression; just because you have one or some of these factors does not mean development of mental illness is written in stone. A few of the known risk factors include prior mental health disorder (in or out of pregnancy), pregnancy loss or stillbirth, previous birth trauma, breastfeeding complications and external stressors such as financial strain, relationship problems or separation from social supports.
Millennial motherhood amplifies some of these risk factors, predominantly because of the culture teachings we received growing up. Many women in this age category were raised to believe that motherhood was not the only thing they would do with their lives. They were taught to have strong personal identities, pursue their own careers and be independent in their finances before settling down with children. They were taught not to rely on anyone but themselves, to be their own boss, to have their own money, their own goals, their own lives. Millennial women were raised to push themselves and achieve in academics and career, to do their best and do it on their own, to stand up for women everywhere and shatter the glass ceiling.
They have been raised in a culture that prides itself on independence, self-reliance and preservation of public-image. Not to mention preservation of social identity with the constant influence of social media impacting every waking moment.
These traits can certainly be desirable in the workplace, universities, boardrooms, courtrooms and legislative assemblies. Everywhere we turn, women are pushing the envelope and taking the lead in industries previously run by men. Where these traits do not help, however, is in motherhood.
We were never meant to raise babies in isolation; we need to lean on the experience of other mothers. We need to be able to ask for help and recognize that we cannot achieve the task of motherhood alone.
Millennial women are coming into motherhood later than their own mothers did (3). In many cases this generation of women has had much more time than the women who came before us to hone our identities around personal achievements, hobbies and careers. This can create a profound sense of identity shift or loss when baby arrives; as the aspects of the woman’s life that made her feel whole are no longer as accessible. Becoming a mother leads to a complete shakedown of everything that once felt familiar. The early newborn season can feel like a sleep deprived blur, the days can feel incredibly long while at the same time incredibly busy, leaving a new mama wondering when she last showered or ate, let alone took a moment to cultivate her own interests or connect with friends. Suddenly pieces of her life may feel foreign and connecting with friends who are not in the same season may feel impossible.
These identity shifts, in combination with hormonal changes, sleep deprivation and general lifestyle changes all collide at once, and for many women this can be extremely difficult to process. Social media often portrays motherhood as this magical experience, where everyone else seems to have it together. The insta-mom appears to be owning motherhood, doing it on her own with perfectly styled hair and a gleaming white kitchen. This reinforces the narrative that millennial women have been constantly subject to; that individual achievement, pursuit of perfection and doing it on their own is the ultimate goal. While this belief may help in some professional circumstances, new motherhood is not the place.
In chasing academics, careers and life experiences, we have become geographically displaced from the maternal wisdom of mothers who came before us. We no longer have our own mothers, aunties and grandmothers down the street to help walk us through the challenging moments of motherhood and reassure us that our experience is normal. Millennial women are forced to build these villages out of nothing. They have to create a mom tribe to access the same level of support – but when you’re raised in a culture that values autonomy, it can feel like a pretty big deal to reach out and say, “hey – I need some help here”.
Perinatal distress, mood and anxiety disorders are common. Struggling with transition to motherhood and identity shift is common. If you think you may be suffering from clinically significant depression or anxiety, there is help available – please talk to your GP. If you are a millennial woman preparing for motherhood, there are steps you can take to prepare yourself for this transition. Be on the lookout for my next piece on preparing for millennial motherhood and safeguarding your mental health as a mom.
References
- Pearson RM, Carnegie RE, Cree C, Rollings C, Rena-Jones L, Evans J, et al. Prevalence of prenatal depression symptoms among 2 generations of pregnant mothers. JAMA Network Open. 2018;1(3).
- Lebel C, MacKinnon A, Bagshawe M, Tomfohr-Madsen L, Giesbrecht G. Elevated depression and anxiety symptoms among PREGNANT individuals during the COVID-19 pandemic. Journal of Affective Disorders. 2020;277:5–13.
- Nitsche N, Brückner H. Late, but not too late? Postponement of first birth among highly educated us women. European Journal of Population. 2020;37(2):371–403.