In short
The episode is a “bummer” public-service discussion of postpartum depression and related maternal mental health conditions (including postpartum anxiety, postpartum OCD, postpartum psychosis, and postpartum mood/anxiety disorder). It argues stigma and lack of screening lead to underdiagnosis, while treatment is effective. It also covers risk factors, racial disparities, effects on babies, and that postpartum depression can affect fathers too.
Guest backgrounds
No episode guests are interviewed. The hosts are Josh, Chuck, and Jerry (Stuff You Should Know).
Key claims
About 10–15% (or ~1 in 8) of women experience postpartum depression; stigma prevents help-seeking; ~half of cases go undiagnosed. CDC data cited: postpartum depression rates were 7x higher in 2015 vs 2000; suicide/drug overdose are leading causes of postpartum maternal death (22%). Postpartum psychosis is rare (1/1,000) but an ER emergency.
Notable examples
Undiagnosed symptoms like irritability, insomnia, fatigue; intrusive sexual thoughts in postpartum OCD (not desire, just intrusive thoughts). Racial disparities: up to 40% of Black and Latina moms; Black moms 6x more likely; less treatment initiation. Treatment examples: CBT, SSRIs (sertraline/paroxetine preferred for nursing), and brexanolone/allopregnanolone-targeted therapy.
Written by AI. May contain mistakes. Listen to the episode to check what was said.
Chapters
Tap a time to open that second in VOIntroduction to Postpartum Depression
1:29 to 2:41
Discussion on the significance of addressing postpartum depression.
“Welcome to Stuff You Should Know, a production of iHeartRadio.”
Understanding the Stigma
2:41 to 4:34
Exploring the stigma surrounding postpartum depression and maternal health.
“that women go through because there are, you know, several subcategories that they kind of place under postpartum depression.”
Statistics on Postpartum Depression
4:34 to 6:37
Review of statistics and alarming trends in postpartum depression rates.
“And now it's supposed to be the best thing ever.”
Symptoms and Misconceptions
6:37 to 8:06
Discussion on symptoms of postpartum depression and common misconceptions.
“There was a CDC study that found that rates of postpartum depression were seven times higher in 2015 than they were in 2000.”
Postpartum Psychosis Overview
8:06 to 9:27
Introduction to postpartum psychosis and its distinguishing features.
“In part because even doctors sometimes are like, you'll be fine.”
Risk Factors for Postpartum Issues
9:27 to 13:12
Exploring risk factors associated with postpartum depression and psychosis.
“But the overlap is so great that a lot of times I think people are like, well, it'll pass.”
Further Discussion on Other Disorders
13:12 to 14:00
Brief overview of other maternal mental health disorders.
“And that's probably what kicks the whole thing off is that loss of sleep.”
Understanding Risk Factors for PPD
14:00 to 15:02
Learn about various risk factors associated with postpartum depression.
“But, you know, some similar risk factors for regular PPD, if you have a history of depression or anxiety, you're more likely.”
Exploring Perinatal OCD and Intrusive Thoughts
15:02 to 17:38
Discuss the challenges of perinatal OCD and intrusive thoughts new parents may experience.
“So POCD, this to me sounds like the hardest to deal with because I think you're probably the least likely to step forward and say, I need some help, everybody.”
The Importance of Support Systems
17:38 to 19:47
Understand the significance of support systems for new parents dealing with intrusive thoughts.
“So if you're having thoughts like this, you're not alone.”
Show all 25 chapters
Resources for New Parents
19:47 to 20:10
Recommendations for podcasts and resources that support new parents.
“You think you're the worst and you're really the best.”
Racial Disparities in PPD Treatment
20:33 to 24:12
Examine the stark racial disparities in the incidence and treatment of postpartum depression.
“30 years ago, an island off Manhattan almost brought down New York City.”
Biological and Environmental Causes of PPD
24:12 to 26:51
Learn about the biological and environmental factors contributing to postpartum depression.
“There's also reasons why they're more likely to suffer from PPD in the first place, and those seem to center on social determinants of health.”
Hormonal Changes After Birth
26:51 to 28:56
Discover the hormonal changes that occur after birth and their effects on new parents.
“They could have been like, well, let's just tap these down very slowly over the course of six months.”
Environmental Stressors for New Mothers
28:56 to 30:58
Explore the environmental challenges new mothers face, including sleep disruption.
“And having a new baby comes along with all of a sudden you have to stay at home with your new baby and can't do anything.”
Sleep Disruption and Support from Partners
30:59 to 31:39
Learn about the importance of partner support during sleepless nights.
“You might think that your baby is just a walking sickness bomb waiting to happen if they go and breathe the world's air.”
The Role of Allopregnanolone in PPD
31:40 to 33:52
Discover how the hormone allopregnanolone impacts postpartum depression.
“They've gotten even more granular if you're like a C-suite type and have figured out that there's this one hormone in particular that really seems to be largely responsible.”
Understanding Bonding and PPD
33:53 to 35:39
Examine how postpartum depression affects a mother's ability to bond with her baby.
“Um, pregnant women with, uh, PPD are far more likely to, to deliver a preterm baby or a baby with low birth weight.”
Treatment Options for PPD
35:52 to 40:14
Learn about effective treatment options available for postpartum depression.
“30 years ago, an island off Manhattan almost brought down New York City.”
Postpartum Depression in Fathers
40:15 to 42:02
Understand that fathers can also experience postpartum depression and its causes.
“And those are the generic terms for them.”
Understanding Postpartum Depression in Parents
42:02 to 43:30
Learn about the unique risk factors for postpartum depression in both mothers and fathers.
“And there's also additional risk factors that dads customarily have that new moms don't necessarily.”
Economic Pressures and Childcare Costs
43:30 to 45:24
Explore the financial strains new parents face regarding childcare and parental leave.
“leave, both parents have to go to work very soon after the birth, they will have to put their kid in child care.”
Hormonal Changes in New Fathers
45:24 to 46:46
Discover how hormonal shifts in men during their partner's pregnancy affect family dynamics.
“And people think, you know, researchers think that that's basically to keep tuk-tuk at bay and to reduce aggressive tendencies while, you know, father-infant bonding is happening.”
Humor in Parenting Dynamics
46:46 to 47:26
Hear a lighthearted discussion about using humor to navigate parenting challenges.
“I'm waiting for Ruby to be like, what's a beta cuck?”
Listener Feedback and Engagement
47:26 to 48:56
The hosts discuss listener reactions and the importance of feedback for improvement.
“Yeah, if you're a new mom or an old mom or even never had kids, it doesn't matter.”
Transcript
Automatic transcript. May contain errors.0:00Josh Clark:This is an iHeart Podcast. Guaranteed Human.
0:04Chuck Bryant:With no fees or minimums on checking accounts, it's no wonder that Capital One Bank Guy is so passionate about banking with Capital One. If he were here, he wouldn't just tell you about no fees or minimums. He'd also tell you about how Capital One cafes are open seven days a week to assist with your banking needs. Yep, even on weekends. It's pretty much all he talks about. In a good way. What's in your wallet? Terms apply. See CapitalOne.com slash Bank Guy. Capital One N-A, member FDIC. This is Jacob Goldstein from What's Your Problem? When you think about discovering small brands, what store pops into your mind?
0:40Chuck Bryant:Well, it should be Walmart. Seriously. Walmart has thousands of small brands, and they're all in one place. Just go online or in-store, discover, and shop. It could not be easier. Every one of these brands has a real story and real people behind it. They're true American success stories, and you can find them all at Walmart. Discover thousands of small brands at walmart.com today. 30 years ago, an island off Manhattan almost brought down New York City.
1:12Josh Clark:Who will you trust? Your friends and neighbors? Or will you trust the people five miles overseas?
1:17Chuck Bryant:This is a story about neighbors turning on each other, and what happens when a forgotten place decides it's had enough.
1:24Josh Clark:But we're not stopping, are we?
1:29Chuck Bryant:Listen to Revisionist History, The Staten Island Problem, on the iHeartRadio app, Apple Podcasts, or wherever you get your podcasts.
1:38Josh Clark:Welcome to Stuff You Should Know, a production of iHeartRadio.
1:48Chuck Bryant:Hey, and welcome to the podcast. I'm Josh, and there's Chuck, and Jerry's here too, and this is Stuff You Should Know. the kind of bummer edition. Yeah. So we're hoping to shine a light on something to help people out.
2:03Josh Clark:That's right. You know how we do these playlists once a quarter now, which by the way, I hope people are enjoying those sort of collecting things in groups and releasing them once a quarter in groups of 10 or 12. Right. I thought it was kind of a fun idea and we've been enjoying it, but maybe one day something we can bucket is just really sad, joke-free episodes that we feel like are almost like a public service announcement.
2:28Chuck Bryant:For sure.
2:29Josh Clark:We just call them bummer episodes you need to hear.
2:31Chuck Bryant:Right. I think that's a great title. Let's do that. I mean, we have enough for sure.
2:37Josh Clark:Yeah. I mean, this would definitely be one of them because we're talking about postpartum depression and sort of the general bucket of post and even prenatal and during natal troubles. that women go through because there are, you know, several subcategories that they kind of place under postpartum depression. But it is a real serious thing that affects, you know, I saw 10 to 15%. I think Dave helped us with this and he said one in eight, which is about 12 % of women experience this. And it's one of those things that is not talked about enough to where it seems like the numbers could be higher because people are still ashamed to admit this kind of thing happens.
3:25Chuck Bryant:Yeah, there is a definite stigma on this to varying degrees, depending on your culture or ethnic group. Yeah. But basically across the board, you're going to find a stigma against a new mother who can't get it together for her baby. That's kind of like what people sometimes look at it as. And if you are basically being looked at like that and you're already down on yourself because you're not performing perfectly to your own standards or whatever. That heaped on top of it, you're probably not going to be like, everybody, I need help. You're going to just kind of dig in and just keep trying to go.
4:05Chuck Bryant:And that is the exact opposite of what you're supposed to do with any of what are called maternal mental health issues. There's a whole umbrella term. It's not just postpartum depression or perinatal depression. There's a bunch of other ones we'll talk about a little bit, too. but all of them add up to you got to ask for help. You also have to be on the lookout for needing to offer help to the new mother, too, if you're the father or a family member or a friend or something.
4:35Josh Clark:Yeah, it's a brutal situation where, I mean, giving birth is a, you know, it can be a very wonderful, joyous thing, but no matter how you slice it, But it's a very big sort of, and traumatic doesn't always necessarily mean something awful, but just such a big life event that then you're then expected. And now it's supposed to be the best thing ever. And you're going to be the happiest you've ever been immediately despite these huge hormonal swings. And you're going to be a perfect mom. You're going to be such a great mom. You're going to be a perfect mom. It's just so much pressure. And so, yeah, this is a bit of a PSA for sure.
5:17Chuck Bryant:For sure. And you hit something on the nose, being perfect immediately. I mean, being perfect is too high an expectation anyway. Nobody's perfect. But the idea that you're just supposed to immediately click with your kid and just now you're a perfect mom or a great mom, like that is not how it plays out very often. I would guess most of the time it doesn't play out. It's a process. Exactly. So, like I said, postpartum depression or perinatal, I'm just going to call it postpartum. I basically don't know anybody who's ever called it perinatal depression.
5:51Josh Clark:Yeah.
5:52Chuck Bryant:So, we're just going to call it postpartum depression with the caveat that it doesn't just happen after birth. It can happen while during the pregnancy as well, right?
6:01Josh Clark:Yeah, and up to a year following birth as well.
6:04Chuck Bryant:For sure. So, again, this falls under the umbrella term of maternal mental health. There's also some others, postpartum anxiety, postpartum obsessive compulsive disorder. We'll talk about those a little bit later. But when you put all of these things together, you get a really bleak picture of mothers in the United States, whereas the rest of the world is doing better and better with maternal mental health. The U.S. keeps getting worse and worse. And I mean, like, a lot worse. Yeah.
6:38Josh Clark:There was a CDC study that found that rates of postpartum depression were seven times higher in 2015 than they were in 2000. And between 2016 and 2023, new moms reported nearly 65 percent increase of fair to poor mental health. It is. Oh, man. It is the leading cause of death among new mothers now in the United States with suicide and drug overdose, accounting for 22 % of all postpartum maternal deaths in the United States. That's crazy. So, you know, maternal death rates, you usually look at it as like, you know, something tragic happened in the birth, like physically or biologically. Right. And in the United States, the leading cause of death is suicide and drug overdoses.
7:24Chuck Bryant:Yeah. I mean, and this is the highest in the developed world by far. And that increases the highest in the developed world, right? So it's a crisis in the United States. It's a crisis worldwide, but in the United States, it's like a five-alarm fire, apparently. I'd be really interested to know what the problem is. Yeah. Like, what's behind those figures or underneath those figures? Same. You think it's the United States transition toward becoming the society from A Handmaid's Tale?
8:01Josh Clark:Yeah. That might have something to do with it.
8:04Chuck Bryant:So, one of the other things about postpartum depression, too, that's really problematic is, and you kind of touched on this early on, I think something like half of cases just go undiagnosed. In part because even doctors sometimes are like, you'll be fine. Just get over it. Just get back in there, you know, give it the old college try. And families, too. And I think that self-inflicted stigma, too, that new mothers have.
8:32Josh Clark:Yeah. Yeah. And, you know, it's it's one of the reasons is because and, you know, they have screening tools now. There's one called the Edinburgh Postnatal Depression Scale to determine like when that line is crossed, because the the baby blues or the postpartum blues are something that happens a lot. Like maybe even most pregnancies, you end up for, you know, up to like a week or two having these hormonal swings where there's like overlapping symptoms with what ends up being PPD. So that's why a lot of reason it becomes undiagnosed is because people think like, well, this is just the baby blues.
9:09Josh Clark:I'm suffering from some sadness and crying and feeling overwhelmed, certainly, because this is maybe my first time, although I should point out that postpartum is not limited to first birth at all. It can happen with any, like their third birth, the third kid, fourth kid, whatever. But the overlap is so great that a lot of times I think people are like, well, it'll pass. It'll pass. It's just the baby blues. But if it goes on for more than a week or two, you're probably in PPD territory.
9:38Chuck Bryant:Yeah, it's not that the postpartum depression is a like a different thing than the baby blues. It's the severity of the symptoms, the same symptoms and the duration of those same symptoms that really differentiate it and make it something that like you need help for. like you need to get professional help, it's not just going to go away on its own. Or if it does, it's going to you're going to grind through years of it. Yeah. Totally unnecessarily. Because we didn't say this yet. It's very highly treatable.
10:10Josh Clark:Yeah, for sure. That's the good news. And we'll get to that. But, you know, some of those symptoms we should list are loss of appetite, difficulty sleeping, feeling worthlessness or maybe even guilt or shame, anxiety, panic. irritability, anger, big-time mood swings, difficulty with bonding with your baby. And again, these can be the baby blues, or if they're super severe and go on long enough, like you said, it develops into PPD. And it's the kind of thing that can also start several weeks to a month later. So you've got to keep an eye out. Like if those first couple of weeks are like, you're like, oh, man, I managed to dodge this.
10:50Josh Clark:It also might start later, and that's okay. You just need to be aware. Right.
10:57Chuck Bryant:I said that there's other disorders under the umbrella of maternal mental health issues, and another one is postpartum psychosis. And it's essentially what it sounds like. The mental health disorder can become so pronounced after birth that you may suffer from delusions. You may become paranoid. You may be disoriented. You may feel disassociated from the people around you or the world itself or reality. And that is considered – so postpartum depression is something you need to seek help for. Postpartum psychosis is considered a, you immediately take a trip to the ER when you or the people around you figure out that you are suffering from postpartum psychosis.
11:44Chuck Bryant:It's like, get in the car, maybe you can throw on a robe and just go to the ER.
11:49Josh Clark:Yeah, and it's very rare, we should say. It's one out of every 1 ,000 births. But they say that because, very sadly, about 4.5 % of the cases of that psychosis result in harm to the baby. and 5 % result in suicide. And if you've ever seen some terrible news report about like a mom that said, God told me to drown my baby, that's what we're talking about here because delusions of grandeur, a lot of times religious in nature, obsessive thoughts about harming you or harming your baby, extreme paranoia, like that kind of thing. That's what falls under the postpartum psychosis banner. Yeah.
12:32Chuck Bryant:And from researching postpartum psychosis, they found that there are some additional risk factors. Seems like the number one risk factor for developing it is if you have a history, whether personal or familial, of bipolar disorder. and that if you start having sleep loss that triggers bouts of mania, that is a really big red flag that you are at a great risk of going on to develop postpartum psychosis. Meaning, so sleep loss, which you already are getting from just having a new baby, but if that triggers mania, that's a big red flag. And that's probably what kicks the whole thing off is that loss of sleep.
13:16Chuck Bryant:It's like crazy important. And it's nuts that evolution didn't take that into account. Like, oh, yeah, we need to make sure everybody sleeps after this, not stays awake for the next two years because it'll drive people crazy. That can trigger that all of these maternal mental health issues.
13:35Josh Clark:Yeah, I mean, that can be rough on a family. We got very, very lucky with Ruby in that she was a pretty good sleeper from early on. But I've heard some nightmare stories, and it's really tough. Sleep is so, so important. I think another thing we didn't point out was for the postpartum psychosis, it's almost always a first-time pregnancy, too, which differentiates it from general postpartum depression. But, you know, some similar risk factors for regular PPD, if you have a history of depression or anxiety, you're more likely. If you had a childhood trauma that you experienced, if you underwent infertility treatment, you may be more likely to.
14:19Josh Clark:If it's an unplanned pregnancy or if you're a low-income mother, especially if you're like literally living in poverty, they experience PPD at twice the rate of higher income moms. And there are also a couple of biological factors if you suffer from anemia or hypothyroidism. And then it can be genetic. I think depending on what study you've seen, I've seen anywhere from 14 to 30 percent have like potentially a genetic factor, like inheritable.
14:48Chuck Bryant:Oh, really? I hadn't seen that at all. Well, let's talk about postpartum or perinatal OCD and perinatal mood and anxiety disorder real quick, too, okay?
15:01Josh Clark:Yeah.
Read the full transcript
15:02Chuck Bryant:So POCD, this to me sounds like the hardest to deal with because I think you're probably the least likely to step forward and say, I need some help, everybody. But it's obsessive compulsive disorder that develops way more quickly than typical obsessive compulsive disorder, usually very shortly after birth or after the baby's born. And it's, you know, like ritual behaviors, like checking on the baby incessantly, worrying that the baby's going to get contaminated with germs, and lots of intrusive thoughts that can be super disturbing.
15:41Josh Clark:Yeah, for sure. I mean, I think it's a natural tendency if you've, especially for a first time parent to have this new, seemingly very fragile tender thing that you're in charge of keeping alive. It's a pretty natural instinct, I think, to maybe think like they're so small and so fragile. aisle. So my dumb advice, just as a parent, is like, they're more robust than you think, and they're made to survive, and they're made to live, generally speaking. So you have that on your side. But I can see how it's pretty easy for maybe someone to go down this road of worrying about germs or checking on the baby every like 10 minutes in the middle of the night And to become sort of obsessive, this, the POCD can cross the line into some even unwanted sexual obsessions.
16:36Josh Clark:Like a mother apparently can have sexualized images flashing through their mind while they're changing a diaper, which is just sort of creates a cycle of you thinking like, what's wrong with me? What's going on? I'm having this weird thing flash through my head. Right. And in reality, that's all it is, is just like a sleep or your hormones or something just really unusual that flash through your head. And as an intrusive thought, it does not mean that that's who you are or what or you're leading to some awful outcome.
17:10Chuck Bryant:Right. And I think that's kind of worth saying again, Chuck, because this is the kind of thing that you would not. Who are you going to tell that to? I know. I'm having sexualized thoughts about our baby.
17:20Josh Clark:Yeah. Yeah, right.
17:21Chuck Bryant:You're not going to tell that to anybody. It's going to be so tough to admit that. So you have to know that is not you. It is your hormones. It is not you. You do. You have not suddenly developed a sexual attraction to infants or children. Like it's not you. So if you're having thoughts like this, you're not alone. It's actually more common than you would think. and like you can get treatment for this and you should get treatment for it because you're probably really being hard on yourself right now.
17:51Josh Clark:Yeah, and you know, and if you give into that thought, then that's when you're maybe avoiding bathing your baby or avoiding caring and holding for your baby. So it's a tough thing to come forward and talk to people. So that's why it's really great to have a great support system of other moms, friends and families to people to lean on Because I guarantee you, if you say the weirdest thought you've had out loud in a group of moms, there will be a couple of them that are like, I had the same thoughts. It's okay.
18:22Chuck Bryant:Right. Yeah. Yeah. Hopefully you have a group like that or can find one, you know?
18:26Josh Clark:Yeah.
18:27Chuck Bryant:Then there's postnatal mood and anxiety disorder, which essentially is a really terrible positive feedback loop to where you feel like you're not bonding with your baby well enough or fast enough. And so you start to become anxious, which the baby picks up on and the baby becomes distressed or less likely to connect with you or pay attention to you, which makes it harder for you to read the baby, which makes it less likely for you to bond in any kind of quick fashion. And it just keeps going in this cycle.
19:01Josh Clark:Yeah, for sure. And you know what? I want to recommend a podcast because if you maybe are a little more isolated and you don't feel like you have this or if you just don't have this sort of support system around you, our old buddy Jesse Thorne, who runs the Maximum Fun Network and co-hosts with Judge John Hodgman with our pal, his wonderful wife, Teresa, is she's just the best. And I don't think they do it anymore. But Teresa and Biz Ellis had a show called One Bad Mother. Oh, yeah, I remember that. For a long time. And I'm pretty sure they stopped doing it, but they did it for many, many years.
19:39Josh Clark:And One Bad Mother was just a great outlet and support system for just this kind of stuff. You know, the message was always like, you're doing just fine. You're doing okay. You think you're the worst and you're really the best. And like, you know, if you're having a hard time and you're you feel like you're alone in this, like turn on that podcast, like do something like that to know that you're not alone out there.
20:03Chuck Bryant:Right. And pour yourself a mega pint of wine and treat yourself to the bad moms trilogy in one sitting.
20:11Josh Clark:That's right.
20:13Chuck Bryant:So you want to take a break?
20:15Josh Clark:Yeah, let's take a break and we'll get into some statistics about other communities and how they deal with this.
20:33Chuck Bryant:30 years ago, an island off Manhattan almost brought down New York City.
20:38Josh Clark:Who will you trust? Your friends and neighbors? Or will you trust the people five miles overseas?
20:44Chuck Bryant:This is a story about neighbors turning on each other. And what happens when a forgotten place decides it's had enough.
20:53Josh Clark:We reached for a feeling that exists in this city, but we're not stopping, are we?
21:03Chuck Bryant:I'm Ben Nadeff-Haffrey, and for my new series on revisionist history, I took a deep dive into Staten Island's attempt to secede from New York City in the 1990s, and what it all has to do with the politics of resentment that dominate America today. Listen to Revisionist History, The Staten Island Problem on the iHeartRadio app, Apple Podcasts, or wherever you get your podcasts.
21:41Josh Clark:All right, everyone, we're back. We promised talk about statistics. And in this case, there are some pretty stark racial disparities when it comes to PPD. as far as the incidence of occurrence and, very sadly, treatment. Up to 40 % of Black and Latina moms suffer from PPD, which is about twice the rate of non-Hispanic white moms. And single Black mothers are six times more likely than the general population to experience it. Really sadly, Latina women and Black women are 57 % and 41%, respectively less likely to start treatment for PPD than white women.
22:25Chuck Bryant:Right. And there's a lot of reasons for why they're less likely to start treatment. In part, there's a stigma, just like with any culture. I think in Latino culture, that stigma can be even stronger than white or black culture. But for, say, black women in particular, it can often go undiagnosed because it doesn't present as the classic symptoms that the Embra scale is designed to detect. Rather than depressive symptoms, a black mom might have irritability, self-criticism, deep fatigue, insomnia. These are not all necessarily shared by all new mothers. And so it just, the doctor just might miss it.
23:07Chuck Bryant:They might be like, hey, you're just aggro. Stop being aggro.
23:11Josh Clark:Right. You know? Yeah. Yeah, I think they came up with a different scale just for black mothers, right?
23:18Chuck Bryant:Yeah, the Jackson-Hogue-Phillips contextualized stress measure, which next time you have a party, give that out as a party favor for guests.
23:29Josh Clark:Yeah, for sure. But that's great that they were like, hey, we have a hole in our treatment plan here as far as even diagnosing this in black women. So they came up with their own scale, which is awesome. basically everybody, the American College of Obstetricians and Gynecologists, the AMA, the American Academy of Pediatrics, everyone recommends that everybody should be screened for perinatal depression. But very sadly, less than 20 % of all women are screened for these mental health disorders, and those numbers are a lot lower for women of color. Right.
24:05Chuck Bryant:So those are reasons why they might not actually go seek out treatment for PPD. There's also reasons why they're more likely to suffer from PPD in the first place, and those seem to center on social determinants of health. Yeah. Which is like your your environment, your income level, the amount of free time you might even have to go see the doctor. All of these things tend to be less than what a white mother would experience. And all of them help increase the likelihood of experiencing postpartum depression.
24:41Josh Clark:Yeah, for sure.
24:43Chuck Bryant:So regardless, Chuck, of whatever your ethnic or racial group, there are essentially the same causes. I mean, PPD, even though it might manifest itself differently, even though access to help for PPD is different, those are all human-made obstacles.
25:01Josh Clark:Yeah.
25:01Chuck Bryant:The biological basis for it is the same in every case. And essentially, it's a combination of hormones and the stark raving horror that is becoming a new parent.
25:16Josh Clark:Yeah, for sure. Like we were saying, you're thrown into this brand new thing where your first charge is like, all right, keep this baby alive.
25:24Chuck Bryant:I mean, I cannot imagine.
25:27Josh Clark:I mean, I remember, and this is like, I imagine it's the same with adoption as with just, you know, a regular birth. But, you know, all of a sudden someone just hands you a baby and the nurses see the look on your face. And hopefully the nurses are all as great as ours were. They're just like, you're doing fine. They told us what I said. It was like, hey, these babies are meant to stay alive. You're going to be just fine. Just feed them this way. And you're on the right track by just getting food into their body. And so, you know, like I said, you know, evolution has happened in such a way where they want these babies to live.
26:09Josh Clark:So you've already got a bit of a head start. But being bombarded by hormones and a change in hormones is definitely something that's hard to deal with because your body's bombarded with hormones because you're pregnant to help you be successfully pregnant and to stay pregnant. And then immediately after, within like 72 hours, most of these hormones go back to their previous state. And that's just a big break to throw on.
26:38Chuck Bryant:Yeah. It's pretty mean of evolution, really, to just be like, here's all the stuff that you need to have a baby. Now you don't have a baby anymore. Who cares about you? And your baby's like, thanks for the ride, lady.
26:51Josh Clark:Right. They could have been like, well, let's just tap these down very slowly over the course of six months.
26:55Chuck Bryant:Yeah. What the hey? You know? I know. I'm a childless man. Sis even. And I am offended by that. I'm mad at natural selection for that. It's just totally unfair. It's just unfair.
27:10Josh Clark:Well, what are some of these hormones? Let's talk about them.
27:13Chuck Bryant:Well, you got good old progesterone. Everybody knows that one. That one won the Super Bowl last year.
27:19Josh Clark:That's right.
27:20Chuck Bryant:It helps you create your placenta that the baby's going to, I guess, attach to. I remember if I remember my health class from eighth grade correctly.
27:30Josh Clark:OK.
27:30Chuck Bryant:It also stimulates blood vessel growth, which helps get nutrients and oxygen to the womb. Progesterone, like any hormone, it's actually quite clever. We have a finite number of hormones. Not that many, actually. I'm not sure how many. But they do so many different things. And they do so many different things in combinations. It's just elegant and beautiful the human body can be, except when the hormone levels drop too quickly.
27:55Josh Clark:Yeah, for sure. There's also, of course, estrogen that's going to help the uterus grow, contribute to fetal development as far as organs and things go. It's going to stimulate that milk duct development. Relaxin is another one. That's the most chill of all. That's going to inhibit uterine contractions until you need them. to avoid premature birth. And then it's going to do double duty and relax and soften the pelvic joints when you're preparing for birth. And then finally, we have oxytocin. They really shoot through the roof at the beginning of labor to stimulate uterine contractions. And then, again, like we said, within about 72 hours of birth, at least estrogen and progesterone that had increased tenfold just goes back to normal.
28:43Josh Clark:Yeah. And these huge hormonal swings are just tough to deal with. You know, it's tough to know which way is up.
28:50Chuck Bryant:Okay. That's just the hormonal, the biological aspect of it. There's also the environmental aspect of it, the nurture version. That was nature. This is the nurture part. And having a new baby comes along with all of a sudden you have to stay at home with your new baby and can't do anything. You aren't sleeping. I think that that is like kind of overlooked by people who've never had kids or underestimated, I think, maybe, or who haven't had kids that don't sleep very well. And then you also have to nurse. You have been physically gone through the ringer, taken through the ringer. Like there's all sorts of different things that come that are specific exclusively to just having had a baby that combined with the hormones, they just come together.
29:42Chuck Bryant:and at the very least give almost all new mothers the baby blues and then some moms postpartum depression, postpartum mood and anxiety disorder, postpartum psychosis, postpartum OCD.
29:56Josh Clark:Yeah. And, you know, as far as the sleeping goes, even if you have like a great sleeper like we did, you're still going to have disrupted sleep for a while because you have to get up and feed that baby in the middle of the night. And some people have a really hard time going back to bed. So this is when partners need to really, really, really, really, really step up. If you have a partner when you're having a baby, I can't imagine how tough this is on your own. But, yeah, step up. Take middle-of-the-night feedings. Let that mom get as much sleep as possible. And then they also say sleep when the baby sleeps.
30:32Josh Clark:So embrace those naps all day long. If, like, your baby has a great nap in the afternoon, so should you.
30:38Chuck Bryant:Right. Don't like your mother-in-law? Well, if she's willing to come over and watch the baby overnight, fake it.
30:45Josh Clark:Yeah. Oh, man. And we had a lot of help. So, like, because, you know, my mom and Emily's mom were both living here at the time. And so I just really feel for people that don't have that kind of help and feel like they're trapped at home. So my other advice as a sis dad is to get out in the world. You might think that your baby is just a walking sickness bomb waiting to happen if they go and breathe the world's air.
31:12Chuck Bryant:Yeah.
31:13Josh Clark:But there's nothing better than you can do for yourself and your baby than to get out in the world as much as possible as soon as possible.
31:19Chuck Bryant:Yeah.
31:20Josh Clark:They'll be just fine.
31:21Chuck Bryant:Great advice, Chuck. You are just rolling with it today.
31:24Josh Clark:Well, I hope I've learned something.
31:26Chuck Bryant:I think you've learned a lot.
31:28Josh Clark:Yeah.
31:29Chuck Bryant:So, yes, you have your hormone levels plummeting. That seems like a pretty good answer to where postpartum depression comes from, right? Yeah. But it turns out that they've zoomed in. They've gotten even more granular if you're like a C-suite type and have figured out that there's this one hormone in particular that really seems to be largely responsible. It's not the only one responsible for it, but it's a pretty – it got caught red-handed with like a bag with the dollar sign on it, wearing a black mask kind of skulking away.
32:03Josh Clark:That's right.
32:04Chuck Bryant:So what is it, Chuck?
32:05Josh Clark:It is allopregnanolone. It's funny. Dave wrote this, and he was like, good luck pronouncing that. And Dave, buddy, that one's pretty easy compared to a lot of the stuff that we see.
32:14Chuck Bryant:For sure.
32:15Josh Clark:But that is a steroid.
32:16Chuck Bryant:Just try saying deletrius.
32:18Josh Clark:That's a steroid naturally produced in the brain. And it plays a couple of key roles during pregnancy in that it inhibits the release of oxytocin, which we already talked about, to avoid premature labor, which you don't want. It also protects the developing fetal brain from all those stress hormones that mom has.
32:36Chuck Bryant:Right. Okay, so this is pretty great stuff. Unfortunately, just like all the other hormones, it says so long I've done my thing, like within, you know, a couple of days of having given birth. So all of a sudden, not only is this a hormonal change, this natural antidepressant has suddenly just vanished on you. And this can really seem to trigger postpartum depression in a lot of women.
33:05Josh Clark:Yeah, for sure. So it's going to lower their anxiety for a while while they're pregnant and boost a mother's mood. And then after that baby is born, when it crashes out, it's it's probably feels akin to like going off an SSRI or something.
33:23Chuck Bryant:But quickly, like, I mean, whenever you go off a medication like that, you're supposed to step it down slowly. Yeah. Keeper it off. This is like, again, nature just being a total bee. ripping that stuff away from you, and all of a sudden you're just going cold turkey off of this antidepressant you got used to over nine months.
33:45Josh Clark:Yeah, for sure.
33:46Chuck Bryant:So, Chuck, one thing that we've really been focusing on is the mom, and the mom definitely suffers from post-partum depression, but so can the baby as well.
33:56Josh Clark:Yeah, for sure. Um, pregnant women with, uh, PPD are far more likely to, to deliver a preterm baby or a baby with low birth weight. So there can be a literal, like, um, like a physical outcome of postpartum depression for the baby. And we talked earlier about, uh, black and Latina women experiencing PPD at higher rates. So that also is going to correlate over to birth outcomes because black Black women are 50 percent more likely to give birth preterm than white women and more than twice as likely to have a baby with a low birth weight.
34:30Chuck Bryant:Right. This, of course, makes it even more pressure laden for you to get it just right. Right. So that also can affect your ability to bond with your baby. And again, as we saw with postpartum mood and anxiety disorder, that can create a feedback cycle where you get more and more anxious about it, more and more depressed about it. And that that affects your bonding even further, which you get more and more depressed and anxious about. And that affects your baby as well.
35:00Josh Clark:Yeah, for sure. Should we take a break?
35:03Chuck Bryant:Yeah, there is one other thing, I think, before we break to point out. And that is that if you have postpartum depression, it doesn't mean that you don't want to bond with your baby. Like you are incapable of bonding with your baby in the healthiest possible way. It's not you. It's your biology and your environment
35:23Josh Clark:Yeah, I thought you were about to say It's not you, it's them, it's the baby It's the baby's fault, yeah He's just not that into you Alright, I'm glad we could make a sort of a light joke I hope it came across that way And we will be back right after this With treatment options Because there's great news on the horizon
35:52Chuck Bryant:30 years ago, an island off Manhattan almost brought down New York City.
35:57Josh Clark:Who will you trust? Your friends and neighbors? Or will you trust the people five miles overseas?
36:03Chuck Bryant:This is a story about neighbors turning on each other. And what happens when a forgotten place decides it's had enough.
36:12Josh Clark:We reached for a feeling that exists in this city. But we're not stopping, are we?
36:22Chuck Bryant:I'm Ben Nadeff-Haffrey. And for my new series on revisionist history, I took a deep dive into Staten Island's attempt to secede from New York City in the 1990s. And what it all has to do with the politics of resentment that dominate America today. Listen to Revisionist History, The Staten Island Problem, on the iHeartRadio app, Apple Podcasts, or wherever you get your podcasts.
37:01Chuck Bryant:Okay, Chuck, so you said there's great news on the horizon, and we're about to lay it on them. All the moms who are bawling and yelling and doing all the things while they're listening to this episode, treatment is quite viable.
37:16Josh Clark:That's right. Standard treatment is what you might think. It's therapy, perhaps antidepressant medication, certainly CBT, cognitive behavioral therapy, we've talked about a lot.
37:29Chuck Bryant:Yeah.
37:29Josh Clark:That has been proven to be pretty effective for PPD and postpartum anxiety. And everything. Yeah, and everything in general. But in the case of CBT, you know, you're identifying these triggers that seem very automatic, these thought patterns that you think you can't help. And, you know, coach you through that and how to develop a healthier way of responding to those things when they do happen.
37:53Chuck Bryant:Right. God bless Dr. Aaron T. Beck, the creator of CBT.
37:58Josh Clark:Yeah, for sure.
37:59Chuck Bryant:There's also medication. We talked about allopregnanolone being discovered as like a main culprit for postpartum depression. That led to some drugs being expressly targeted to basically help that transition. So you don't just go cold turkey. You kind of taper off of that stuff. And then there's also long been SSRIs prescribed for it, like a standard antidepressant. And that, of course, gives moms pause like any kind of medication can give a lot of moms pause. because they're like, I'm nursing, so what's that going to do to the baby?
38:35Josh Clark:Yeah, for sure. They've studied this. The current sort of wisdom on this is that they have been detected in very, very low levels, sometimes even undetectable levels in breast milk. There are rare reports of adverse effects on infants or in infants. So that's where the science currently stands.
38:57Chuck Bryant:Yes, I also saw that paroxetine and sertraline, which is soroxet and Zoloft, they seem to be the preferred antidepressants for nursing mothers because they have a shorter half-life than other SSRIs. And they pass to breast milk in smaller amounts than other SSRIs. So, if SSRIs in general are okay, these two are super okay, according to the medical establishment. Not me, because I'm not a doctor.
39:26Josh Clark:That's right. And by the way, we did, I think, two pretty good episodes on breastfeeding back in the day. That was a two-parter, right?
39:34Chuck Bryant:We did one on bottle feeding and one on breastfeeding.
39:37Josh Clark:Right. Yeah, so feeding your baby. And, you know, I recommend you do those. And we got, you know, it's always when it's two dudes podcasting about this stuff, about lady stuff, we're always a little nervous. And we always get really good feedback from women that say, like, you guys did a really good job, and it's good that you guys are out there sort of not feeling like it has to come from a woman's perspective. So I hope we're doing this all justice, you know.
40:05Chuck Bryant:God, I hope so, too.
40:07Josh Clark:I think you're doing fine.
40:08Chuck Bryant:I think you're doing great.
40:10Josh Clark:But I'm just another cis dude.
40:12Chuck Bryant:So if you want to target allopregnanolone, there is a drug called brexanolone. Yeah. Yeah. There's another one called Zeranolone. Yeah. Zeranolone. And those are the generic terms for them. The problem is, is as it stands right now, if you're paying out of pocket with zero insurance, you're going to pay$34 ,000 for one. In the United States, I'm sure it's like$10 in Canada.
40:40Josh Clark:Yeah.
40:41Chuck Bryant:Or$15 ,000 for the other.
40:44Josh Clark:Shame, shame, shame.
40:45Chuck Bryant:Yeah, hopefully if you have even passingly decent insurance in the United States, like you're not going to pay anything even remotely like that. But yes, I think you should say it again, Chuck.
40:58Josh Clark:Yeah, still, even if insurance is covering it, shame, shame, shame, shame, capital S-H-A-M-E.
41:03Chuck Bryant:Good for you, buddy. And now here's an ad for Saranolone.
41:10Josh Clark:Oh, man, you're managing to squeeze in some jokes. I like that.
41:13Chuck Bryant:I like you.
41:18Josh Clark:So can men get postpartum depression? The answer is yes, that can happen. Apparently between 8 % and 10 % of new dads suffer from some kind of anxiety or depression after the birth of a job. And it also may be connected to hormones in some cases. It's usually later than women might experience it, between three and six months later, maybe up to a year later. But a lot of the same, you know, issues, sleep issues, loss of appetite, feeling overwhelmed, tired, sad, anxious, and also the same people at risk. If you're a younger dad, if you have a history of depression, if you are struggling financially, or if you're just having trouble in your marriage or relationship, you know, you don't have to be married to have a baby.
42:01Josh Clark:We all know that. All right. All of those same kind of risk factors.
42:06Chuck Bryant:Right. And there's also additional risk factors that dads customarily have that new moms don't necessarily. And that's like the new mom is expected to be a great mom and raise a great, healthy, well-adjusted baby right out of the box. The dad is expected to really step it up and provide for his new family. And that can often mean like, well, you're stuck here in this job and you're now beholden to this employer. and like you may, that might not be the greatest feeling in the world for you right then. And at the very least, it's additional pressure. So that can also kick off postpartum depression in dads, which was, I think, best expressed in the Wham song, Everything She Wants.
42:50Josh Clark:That's right. And I hope this is clear, but to be clear, we're not obviously talking about the old days where like the man's got the job and the woman doesn't work and isn't expected to. But, you know, in two income families, a lot of times when a mom has a baby, they at the very least hopefully have a great maternity leave kind of situation. If not, sometimes they have to leave like whatever job and just not get paid for a while. So there may be more pressure on the second income earner to, you know, kind of make up for that loss or at least keep the ship afloat till mom can get back to work.
43:26Yeah.
43:27Chuck Bryant:And one of the, I guess, quirks of the United States economy, I guess, is that especially if you have a two-income house and there is not great maternal leave or paternal leave, both parents have to go to work very soon after the birth, they will have to put their kid in child care. The United States, unlike some other countries, does not have free child care. It is a paid private business industry. And some couples figure out that the cost of daycare is more than, say, the mom or the dad would actually bring home. And so in that sense, it makes sense to just for the mom or the dad to stay home, whoever has the lower income that daycare would exceed.
44:21Chuck Bryant:That's nuts that that happens to anybody. And it happens to a decent amount, at least anecdotally.
44:28Josh Clark:Yeah, for sure. Daycare is really, really expensive. And it's a real shame because that helps the family. That helps for outcomes for the kid and their development. So my recommendation is to use your voice at the voting booth. And if there are candidates in your local city or state or nationwide that believe in the idea of free child care, then speak with your vote. That's all I'm going to say on that.
44:56Chuck Bryant:Okay. One other thing too, Chuck, it's not just environment. Just like with postpartum depression in women, postpartum depression in men also seems to have to do with hormones because men's hormones or the balance of hormones change during pregnancy as well, which is pretty neat.
45:15Josh Clark:Yeah, for sure. Your testosterone is going to probably drop during the pregnancy and continues to get lower after the birth happens. And people think, you know, researchers think that that's basically to keep tuk-tuk at bay and to reduce aggressive tendencies while, you know, father-infant bonding is happening. Like, chill out, dad. You need to be gentler right now. So we're going to lower your T.
45:42Chuck Bryant:Right. And also stick around and help raise the kid rather than go look for your next conquest.
45:49Josh Clark:Yeah. Man, I wonder if I should say this on the air.
45:51Chuck Bryant:We can edit it out. All right.
45:54Josh Clark:We'll see. One of the funny things that Emily has done lately is, you know, all the in the stupid manosphere world, like, you know, low T beta male soy. That's another one. Like your soy, like because you eat soy instead of meat. like a man does, she will anytime I'm like, I don't know, just being wishy-washy about something or if she feels like she just wants to kind of poke fun at me, she'll call me like a beta cuck or ask me if I have low tea or like, hey, soy, come over here and help me with this thing. Oh, my gosh. It's very, I mean, it always just brings the house down between the two of us because it's just such a dumb thing anyway.
46:36Josh Clark:I like that she's taken something from the manosphere and kind of twisted it to use it in our own marriage as a comedy.
46:41Chuck Bryant:I would love to be sitting on the couch someday and her do that to you because, yes, I would lose it to you. So funny.
46:47Josh Clark:Yeah. I'm waiting for Ruby to be like, what's a beta cuck? Right.
46:53Chuck Bryant:Let's see. Oh, yeah. Postpartum depression is also treatable in dad. So if you think you have it, seek help because it's very treatable, too.
47:01Josh Clark:That's right.
47:03Chuck Bryant:You got anything else?
47:04Josh Clark:I got nothing else, man. I always feel like we're on ice skates with these episodes.
47:08Chuck Bryant:I didn't feel like that about this one.
47:10Josh Clark:I always get a little nervous in how I speak about this stuff, so I hope we did okay.
47:13Chuck Bryant:You did great, man. You did great.
47:15Josh Clark:You did great.
47:15Chuck Bryant:Well, then it sounds like we both did great.
47:18Josh Clark:But I want moms to write in and say you did great. I don't care what I think about you and what you think about me anymore. We know we love each other.
47:25Chuck Bryant:All right. Fair enough. Okay. Yeah, if you're a new mom or an old mom or even never had kids, it doesn't matter. We would love to hear from you about this episode.
47:36Josh Clark:Yeah, and not just saying we're great. Like, if we fell short, let us know, and we'll try and do better and correct it.
47:41Chuck Bryant:Well put, man. I'm glad you said that, too. Yeah. Yeah. We sounded like a couple of... I know. Like, please make us feel better. Right. A couple of cucks. Beta cucks. Yeah. Since Chuck just laughed about beta cucks again. So funny. That means it's time for listener mail.
48:01Josh Clark:Soy is the one that really gets me.
48:03Chuck Bryant:Well, you know what's crazy is soy actually does raise your estrogen levels and can give men mini boobs.
48:09Josh Clark:Oh, well, great. Give it to me. I love it. All right, this is from Adam in Michigan. Hey, guys, I'm a little more than disappointed that in the Three Mile Island episode, you failed to mention professional wrestler Adam Baum. He was a popular wrestler in the 1980s in the WWF. He was billed as being from Three Mile Island and was an imposing 6 '6", 290. Wow. He had yellow contact lenses. And his finishing move was called the Adam Smasher. This is so great. He was a rather imposing figure with a very creepy theme song, and he made quite an impact. His real name is Brian Clark, and he's still alive and looks almost like he did in the 1980s.
48:49Josh Clark:Adam from Michigan.
48:51Chuck Bryant:Nice. I have never heard of him, so thank you for letting us know, Adam.
48:55Josh Clark:Yeah, that's fun.
48:56Chuck Bryant:You hadn't heard of him?
48:58Josh Clark:No, I mean, I didn't keep up with wrestling much.
49:00Chuck Bryant:No, I didn't either. But it sounds like we were missing out on a lot. but you know
49:05Josh Clark:we're just soy loving beta cucks so what do we know
49:09Chuck Bryant:if you want to be like Adam and let us know wait is this from Adam Bomb himself
49:13Josh Clark:no this is A-D-A-M
49:16Chuck Bryant:oh okay well there was an Adam Bomb who was a DJ at album 88 for a while he had like the soul something show
49:25Josh Clark:oh wow I bet I listened to it
49:27Chuck Bryant:it was really good well anyway thanks a lot Adam from Michigan for letting us know about Adam Bomb we love that And if you want to get in touch with us like Adam did, you can send us an email too. Send it off to stuffpodcast at iheartradio.com.
49:45Josh Clark:Stuff You Should Know is a production of iHeart Radio. For more podcasts from iHeart Radio, visit the iHeart Radio app. Apple Podcasts are wherever you listen to your favorite shows.
50:01Josh Clark:This is Mandy Woodruff-Santos from Brown Ambition. When you think about discovering small brands, what store pops into your mind? Well, it should be Walmart. Seriously, Walmart has thousands of small brands, and they're all in one place. Just go online or in-store, discover, and shop. It could not be easier. Every one of these brands has a real story and real people behind it. They're true American success stories. And you can find them all at Walmart. Discover thousands of small brands at walmart.com today. He's dribbling the ball with everything on the line. He's driving down the pitch. He's facing price hikes and cuts past him.
50:37Josh Clark:Carrier Contracts tries to block him. Oh, he leaves him in the dust. He's at the edge of the box. He cuts past the nonstop group chat trash talk. He clears on goal. He shoots. No! Unlimited data for$25 a month forever. Visit your local Boost Mobile store today to get unlimited data with a price that never changes. Boost Mobile. After 30 GB, customers may experience lower speeds. Its customers will pay$25 a month as long as they remain active on the Boost$25 Unlimited plan.
51:03Chuck Bryant:30 years ago, an island off Manhattan almost brought down New York City.
51:08Josh Clark:Who will you trust? Your friends and neighbors? Or will you trust the people five miles overseas?
51:13Chuck Bryant:This is a story about neighbors turning on each other. And what happens when a forgotten place decides it's had enough.
51:20Josh Clark:But we're not stopping, are we?
51:25Chuck Bryant:Listen to Revisionist History, the Staten Island Problem on the iHeartRadio app, Apple Podcasts, or wherever you get your podcasts.
51:33Josh Clark:This is an iHeart Podcast. Guaranteed human.
From the publisher
Most new moms get the baby blues soon after giving birth. Postpartum depression is something much different - the symptoms are similar, but their intensity can have sweeping effects on mom, baby, and the whole family. Fortunately, it’s highly treatable but the catch is moms usually have to ask for help.
See omnystudio.com/listener for privacy information.


