I was very pleased to watch television this week and see a mental health focus for an entire episode of the ABC sitcom Black-ish. As a licensed mental health therapist, I understand well the stigma facing mental health and how much awareness and education is needed and see this as incredible progress. In the Black-ish Season 4 Episode 2 – Mother Nature, Bow is feeling overwhelmed after the birth of her son, and learns she is suffering from postpartum depression. Dre urges her to get help and stands by her side while she works through it. Meanwhile, the kids baby-proof the house in an effort to help their parents out.
Here are 14 ways this episode of Black-ish normalized mental health for new mothers experiencing postpartum depression.
1. Honoring mothers is not dishonoring fathers.
In the first 2 minutes of the episode we see Andre Johnson, Sr. (Dre’s) character, played by Anthony Anderson, begins by recognizing the pride a man feels when having a new born baby but he also honored women for the feat of after having carried a human being inside their body and now holding and nurturing that child for the rest of their life. “Mother nature has given women everything they need to sustain life with comfort and ease.” A man honoring and praising a woman for her motherhood does not take away from his honor or manhood, it enhances it.
2. Your family may notice you acting differently but may not understand you are dealing with a mental health issue.
Dr. Rainbow Johnson (Bow), played by Tracee Ellis Ross, is visibly showing signs of depression – easily distracted, lack of motivation, frequent crying, low energy, insomnia, etc. As narrated by Dre, the family is aware that something is “wrong” and take steps to help Bow, but are initially unaware she is struggling with a mood disorder.
3. Having a mental health diagnosis is not a sign of weakness.
Dre’s mother Ruby Johnson, played by Jennifer Lewis, made the following statement when referring to Bow’s change in behaviors, “This is what new motherhood looks like…she’s just weak.” There is often a perception for some people that acknowledging the presence of a mental health diagnosis or even getting help or treatment is a sign of weakness. It is NOT! In the last scenes of the episode Ruby ends up apologizing to Bow and tells Bow she is not weak but states that Ruby was weak for not being there to help Bow through this experience.
4. Having experienced postpartum depression during a previous pregnancy is a risk factor but is not the only indication.
Dre makes a statement that Bow did not experience the symptoms she is displaying presently after the birth of her other children and doesn’t understand why this pregnancy is different. While previous experiences with postpartum depression are a strong indication of present or future indications, it is not the only factor that must be considered. Factors such as previous experience with depression, family member who has been diagnosed with depression or other mental illness, medical complications during childbirth, mixed feelings about the pregnancy, whether it was planned or unplanned, and others. In Bow’s case, the fact that the baby came early, Bow’s age which means a high-risk pregnancy, and many other factors make experiencing postpartum depression very likely in her case.
5. Postpartum depression is NOT the same as having “baby blues.”
One of Dre’s co-workers attempts to diagnose Bow as having “baby blues,” which is used to describe the feelings of unrest, tiredness, worry, and fatigue many women experience after having a baby. It is normal for a mother to experience worry or concern over being able to provide care for the newborn baby, and this is present in approximately 80 percent of mothers. However, postpartum depression is extreme feelings of sadness and anxiety that affect the mother’s individual self-care or that or her family and this is present in approximately 15 percent of births. A new mother should not try to diagnose herself but consider speaking to a mental health professional to get an evaluation if the mother or other family member may be concerned.
6. New mothers may experience postpartum depression and not know it.
Dre took the advice of his co-workers and read through a magazine targeted to women and discovered his wife may be experiencing postpartum depression. The suggestion from the magazine encouraged Dre to be gentle with his approach in discussing this with his wife. While magazine or online questionnaires are no substitute for mental health treatment or assessment, the advice given in this occasion was helpful. Having a discussion with a new mother about the possibility of her having postpartum depression should be done very delicately and in a supportive manner.
7. Mothers should not try to self-diagnose themselves.
Bow makes this statement, “I do not have postpartum depression. I am a doctor and I would know.” While the character of Rainbow Johnson is a medical doctor, she does not specialize in mental health or psychiatry. Postpartum depression doesn’t discriminate on race, profession, socioeconomic status, or any other difference. A diagnosis of postpartum depression is not an indication of weakness or failure in the new mother; rather, it is an indication of something that affects many women and there is help for it.
8. A woman experiencing postpartum depression is not someone who needs to be fixed.
In one scene Dre is seen asking Bow over and over if she is okay and trying to engage her in activities. Bow responds with, “Please stop trying to fix me.” Recognizing the new mother is not glass that has been broken that needs to be fixed, but is a human being who is experiencing a mood disorder who needs lots of support during this time. This mindset of her being “broken” will cause the mother’s symptoms to worsen and she may even feel like her body is failing if she can’t breastfeed, or her skills as a mother are failing if she is unable to console her mother, or any other self-defeating thought.
9. Just because someone else did NOT seek treatment after giving birth does not mean this is healthy for everyone.
Dre’s mother Ruby has a discussion with Dre about Bow’s ability to parent and compares Bow’s present actions to how she was after giving birth to Dre by saying, “I didn’t go to some quack doctor because I was mentally ill with some made-up disease.” Dre quickly corrected her and explained to her that postpartum depression is not made up and mentions how many women experience it. The Centers for Disease Control estimate 11 to 20 percent of new mothers experience postpartum depression. Just because your mother, sister, grandmother, aunt, best friend, or whomever didn’t receive treatment for postpartum depression doesn’t mean that is the best course of action for you.
10. Recovery from postpartum depression is not instantaneous; it takes time.
One of Bow’s children ask, “Why isn’t she getting better.” Sometimes the expectation for the new mother, or her family and friends, is that the new mother will get better quickly. This process takes time and can be incredibly frustrating for the new mother. Support, encouragement, and space will be vital to the new mother during this time. The best thing family and friends can do to the mother and keep open communication with the new mother and provide her with what she asks for.
11. Experiencing postpartum depression is not a reason to allow people to walk over you; establish and reinforce boundaries.
One of the scenes with Ruby and Bow discussing Ruby making a decision to give Bow’s child baby formula instead the breastmilk Bow had pumped. Bow assertively told Ruby she had crossed the line when she did this to Bow’s child. It is important to seek the counsel of a mental health professional regarding healthy behaviors and practices, but at the end of the day you are a mother and it is your child…no one should ever make you feel bad for wanting to raise a healthy baby and no one should violate your wishes as the child’s mother. This may mean setting boundaries with your family, in-laws, friends, significant other, or other people.
12. The new mother needs support and unconditional love from her significant other.
If the new mother is fortunate to have the support of a significant other that person should be prepared to fully support and love the new mother unconditionally. In the scene when Bow instructed Ruby to get out of her house, Dre supported his wife, even to the point of asking his own mother to leave their house. Bow needed this support during this time. Ruby also called Bow crazy and said she was overreacting. Name-calling and unrealistic expectations will only backfire and make things harder for the new mother. The feelings the new mother is experiencing are real and they should be honored and be given space to be worked through.
13. Everyone around the new mother will feel powerless to help, and that’s okay…because it’s not about them.
Dre is speaking to his father, played by Lawrence Fishburne, about Bow’s seemingly lack of progress and he states, “I feel powerless.” It is not uncommon for men to feel like the woman needs fixing and it’s their job to fix her, but the new mother just needs time, support, and unconditional love to help her during this time. Let’s us not forget this woman just carried a human being inside her body and now that human being is a new born baby who is crying and is solely dependent on the new mother for everything. No pressure at all right?
14. Counseling/Therapy and medication management are proven treatments for postpartum depression.
There still continues to be a stigma around mental health and it is everyone’s responsibility to become informed and to inform others so we can break the stigma. In the last few scenes of the episode Bow talks about therapeutic homework her therapist gave her to help her through this experience. Bow also expressed initial frustration at her therapist, which is normal for anyone entering therapy. Bow’s continuation with therapy and her medication helped her eventually work through and improve her mood.
If you or a loved one may be experiencing postpartum depression please contact a mental health professional for an evaluation.