Understanding perinatal RELATIONAL DISTRESS

From post-partum depression to relationship woes – the importance of mental health after giving birth

- THOMAS DELAWARDE-SAÏAS

Post-partum depression” has been discussed as an identifiable, measurable, treatable disorder for 50 years. Thresholds, scales, prevalence rates: everything seems clear, even reassuring.

But this binary model — it’s either depression or not depression — obscures a more subtle reality: new parenthood is disruptive, makes us vulnerable and places us all on a spectrum of distress.

The notion of postpartum depression was established in 1968, primarily because it responded to dual academic and medical requirements: to lend scientific legitimacy to the suffering of new mothers and to provide a clear and specific diagnostic framework for a particular period of life.

At the time, emphasis was placed on the atypical nature of this depression, which resembled an anxiety disorder. Its specificity was considered to be solely related to its symptoms, and the challenge lay more in its detection than management.

Minimizing lived experiences

Furthermore, this specific characterization made it possible to distinguish postnatal depression from the “baby blues” (sometimes called “chemical depression”) that occur in the form of brief depressive episodes linked to biological factors, particularly postpartum hormonal changes.

Since then, the debate has been confined to psychiatric classifications and screening tools. But that’s reduced a lived experience to a simple diagnostic category.

In a recent article published in the journal Neuropsychiatrie de l'enfance et de l'adolescence, we proposed, together with child psychiatrist Romain Dugravier, talking about perinatal relational distress rather than postpartum depression.

Far from being unanimously accepted within the scientific community, our approach, which questions diagnoses and labels, attempts to view adjustments to parenthood beyond the sole prism of individual disorders.

A crisis of maturity