Pssst, Post-Natal Depression Is Just Depression

A story on the BBC, entitled "Why fathers have post-natal depression" got me thinking this morning. It begins, "A Gloucester man has been acquitted of murdering his six-month-old daughter, after saying he had had post-natal depression. The case of Mark Bruton-Young has put the issue of men who struggle to cope with becoming fathers in the headlines."

For sure, parents become depressed after the birth of a child. And not just mothers. Fathers too.

Hearing about murder trial after an infant dies certainly gets your attention. But this is not the first time I've seen post-natal depression discussed as a unique syndrome that deserves a unique name. Does it?

I think not.

The truth is depression has many different precipitants--from job loss to divorce to a cancer diagnosis. But there's little pull for recognizing post-employment depression, post-marriage depression, or post-cancer depression as separate syndromes. Until proven otherwise, we should regard these presentations as just depression, with the same symptoms, and with the same biology and cognitive features.

It should not be a surprise that some fathers and mothers get depressed after the birth of a child. The truth is that depression is exceedingly common in young adults, whatever their circumstances. I've never seen data that shows that the birth of a child is a more robust precipitant of depression than other stressors like financial or marital distress. And it should also be bourne in mind that many who suffer from post-natal depression had previous episodes (by the way, most episodes of depression in adults are recurrences). The antecedents of the earlier episodes rarely get so much attention.

Descriptively and clinically, we lose something when we don't see the essential communality behind different surface presentations of the same syndrome. You can recognize that it would be absurd to have separate syndromes for drinkers of Jack Daniels and drinkers of Jose Cuervo. It's an alcohol use disorder; whatever the poison, it doesn't really matter.

I think the pull to label post-partum depression as a distinct form of depression is ultimately social. The birth of a baby is supposed to bring joy. So depression in the parent stands out, and conflicts violently with our script of how things ought to be. Bourne of our unease, we feel licensed to give this depression a special name, separate from other depressions where feeling down is more easily understood.

The claims for post-natal depression as a specific form of depression don't have strong scientific merit. Post-natal depression is real and it's important simply because it's depression, a common, burdensome, increasingly prevalent form of psychopathology, and not because it comes after the arrival of a baby.