Maybe Don’t Depict Postpartum Depression This Way

Sage Therapeutics, a biopharmaceutical company that develops medicines to treat central nervous disorders, has been in the news lately for two very different reasons.

The company's working on an experimental treatment for postpartum depression, and announced Monday that the drug, brexanolone, had positive results in a clinical trial. That good news pushed up the company's stock price. But—and there's always a but—the company's efforts to raise awareness about postpartum depression have hit a nerve, reports STAT News.

The Silence Sucks campaign features close-up photos of upset women with pacifiers stuck in their mouths, alongside the slogan, "when it comes to postpartum depression (PPD), silence sucks." The ads don't specifically mention the new drug—they can't, as it still needs further testing before getting Food and Drug Administration approval. Rather, they urge women to speak "openly and honestly" to their doctor about postpartum depression, according to STAT. Sage has put the images on buses and bus stops, in conference booths, and on the campaign's site.

Postpartum depression is a condition that can go unnoticed, so the campaign has garnered support from women who've experienced it and as well as some therapists. About one in nine women develop postpartum depression in the US, according to the most recent statistics from the Centers for Disease Control and Prevention. The symptoms are similar to those of major depression, but can also include feeling disconnected from or worrying about hurting the baby, and can occur during pregnancy as well as up to a year after giving birth.

But others aren't on board with the ad's imagery, saying it infantilizes women with the illness. We recognize that communicating postpartum depression in an advertisement is hard unless you show women holding babies, but perhaps tearful women could have held pacifiers instead of being metaphorically gagged with them.

Psychotherapist Mara Acel-Green, who specializes in treating postpartum depression, told STAT that the campaign is a missed opportunity: Instead of just nudging women to speak up, she believes providers, specifically pediatricians, need to be coaxed out of silence to screen women for symptoms and help normalize the condition. This is not a one-way street. "'Silence Sucks' places the onus on women [to speak up]," Acel-Green said. "I think providers are silent. It's not the women. Nobody is asking them."

Sage's chief medical officer Steve Kane told STAT that the company hopes the campaign will encourage new moms to talk about their mental health, which underscores Acel-Green's criticism. "During an episode of postpartum depression, feelings of guilt, shame, or fear can be significant barriers that prevent women from speaking up about their symptoms," Kane said.

As for the company's experimental drug, it's designed to restore the equilibrium of the neurotransmitters in the brain when they become imbalanced, according to STAT. And apparently it works fast—the most recent clinical trial showed 70 percent of participants who received the drug saw remission of their postpartum depression symptoms within 60 hours of treatment, and they were still symptom-free after 30 days. Traditional antidepressants, on the other hand, can take weeks to start working. Though the study was small—just 21 women total—there were also few side effects.

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