This week, the United States Preventive Services Task Force recommended that women should be screened for depression during pregnancy and after giving birth. It's the first time screening has been recommended for maternal mental illness, and most see it as a breakthrough.
The need for early intervention has also been highlighted by recent Australian research, which found that women with a history of mental health problems are overwhelmingly more likely to suffer postnatal depression than other women.
Given the number of women affected by perinatal mental health issues – in Australia, it's estimated that antenatal depression and anxiety affects one in 10, and postnatal depression affects one in seven – this recommendation should be reason to celebrate. How wonderful that early, accurate diagnoses will mean more women won't need to suffer in silence, and will receive the treatment and support needed for a full recovery.
And yet, in a post to her Facebook page, New York Times best-selling author Marianne Williamson criticised the move, suggesting it was a ploy by "big pharma" to sell more medication.
"Follow the money on this one," she wrote. Williamson went on to suggest that "hormonal changes during and after pregnancy are NORMAL. Meditation helps. Prayer helps. Nutritional support helps. Love helps."
When challenged by her followers, Williamson posted once again:
"Postpartum depression, for example, is often a result of a woman's heartbreak over having to go back to work sooner than her body, mind and heart are ready to. She knows in her gut that her baby needs her home longer, and she needs to be with the baby longer. Nature is screaming out to her from every cell of her being. Now if we give that woman an antidepressant and basically numb her pain, that totally supports the status quo … In many such instances, the disease is not inside the woman; the disease is inside a system so based on greed that it does not honor parents' need to remain with their children long enough after birth."
As someone who suffered a severe psychotic depression after the birth of my son, an illness for which I was hospitalised twice, Williamson's ill-informed, deeply stigmatising comments left me trembling with anger. Medication didn't "numb my pain" – it helped keep me alive. As for prayer and meditation? If only it were that simple. Nutritional support? At my lowest I could hardly eat. And as loved and supported as I was by my husband, my baby, my family and my friends, all the love in the world wasn't enough to get me well.
What I needed was psychiatric help and evidence-based treatment, something I was extremely fortunate to have access to. There's a big difference between the "baby blues", the teariness, anxiety or irritability many women experience post-birth, and severe mental illness that leaves one barely able to function. That's not "normal". And it's downright dangerous to suggest that it is.
I'm not the only one incensed by Williamson's comments. CEO of Postpartum Progress Katherine Stone took to Twitter to discuss the Facebook post. She tweeted: "As long as there are mothers suffering in silence, as long as there is stigma, we will not be quiet."
Using the hashtag #meditateonthis mothers have joined Stone (who also suffered from PND) in sharing their own stories of illness and recovery, and of the painful struggle that is being so desperately unwell when common lore suggests it should be "the happiest time of your life". Many have spoken out about taking psychiatric medication and their desire to keep fighting the stigma that continues, even now, to surround mental illness and its treatment.
My case wasn't one of "heartbreak over having to go back to work" - I was home with my baby. Mothers need help, not stigma. #meditateonthis— Whitney Meade (@whitneymeade) January 28, 2016
What Williamson is missing, and what the voices of #meditateonthis highlight, is the simple fact that perinatal mental illness is multifaceted. Not all women will require medication, but many will. And there isn't and shouldn't be any shame in that.
If you need assistance you can call the PANDA helpline on 1300 726 306. Fact sheets about perinatal anxiety and depression and its treatment can be found on their website.