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What No One Wants to Talk About When it Comes to Postpartum Depression

When we think about postpartum depression, we often focus on hormones and brain chemistry. The thinking goes like this: "Well, there are a lot of mind-body changes that take place during pregnancy, and sometimes those changes can lead to postpartum depression." And, yes, it’s absolutely true that hormonal changes play a role in many women’s postpartum depression.

But the full truth is also more complicated.

For some women, their postpartum depression results from their environment. Let’s consider some examples:

If you’ve absorbed a definition of “good mothering” that requires complete self-sacrifice and is literally impossible to meet, that is a risk factor.

If you know what would help you feel more grounded, but you can’t take the time to do it regularly, that’s a risk factor.

If your need to sleep is considered less important than your partner’s, that is a risk factor.

If you practically need an executive order just to get time to take a shower or go on a run, that is a risk factor.

If our partner expects us to take on 100% of night feedings, that’s not just “a bummer.” It’s also risky for our mental and emotional well-being.

When moms aren’t allowed to truly take care of themselves, they are at greater risk for postpartum depression and anxiety.

It’s as simple (and as complicated) as that.

In other words, we need to look closely at how much a woman’s parenting responsibilities are shared with others; whether she feels listened to and supported; how much time she has for rest and play; and whether she feels entitled to fulfill her own wants and needs.

All of these are important contributing factors. So why are we stuck with that old, one-dimensional story about hormones? In short, our patriarchal culture.

It is so much easier to perpetuate this story than to consider that the majority of women who have postpartum mood disorders are on the butt end of people expecting unrealistic things from them.

These problems are deeper than any one pedicure or self-care strategy can fix.


Let’s think about who benefits from “Oh, you know women and their hormones, am I right?!” rather than saying, “Wow, our society is setting mothers up for a task with impossible standards and completely inadequate supports.”

Or that your parents, in-laws or employers have unrealistic expectations of you as a mom. Why can’t you do the things that you know you need and want to doin a way that works for the whole family? Because Mama? YOU are part of the family. And if it doesn’t work for you, it doesn’t work for the family.

It’s the difference between saying, “Oh bless her heart. That must be tough,” and saying, “We need to fundamentally shift the amount of parental leave that is available and culturally acceptable to make use of.”

It’s the difference between saying, “Gosh, that sounds so hard,” and saying, “The expectations we have of moms are out of control and need to be torn down.”

It’s the difference between saying, “You deserve a spa day!” and “You deserve regular, ongoing opportunities and encouragement to connect to yourself, replenish yourself, and nourish your body and spirit!”


Changing the story requires changing our cultural assumption that postpartum depression is an individual issue. At Sage Tree Therapy, we encourage clients to think about what changes they can make to the expectations in their homes and families. With support, you can rework your family’s norms about feeding, cleaning, bedtime, etc., in a way that works for the whole family. Because you are part of the family — so if it doesn’t work for you, it doesn’t work. It may feel overwhelming to get started, but we will be with you throughout the journey. To begin, email info@sagetreetherapy.com or call 314.485.SAGE. We can respond to any questions and get you scheduled for an assessment appointment, which allows us to match you with one of our expert therapists.

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