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." This is incredible progress. As a licensed mental health therapist, I understand well the stigma facing mental health and how much awareness and education is needed.
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" normalizes mental health for new mothers experiencing postpartum depression.
In the first two minutes of the episode, we see Andre Johnson Sr., or Dre (played by Anthony Anderson), recognizing the pride a man feels when having a newborn baby. He also honors women for the feat of carrying a human being inside their body, and now holding and nurturing that child for the rest of their lives.
“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.
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.
Dre’s mother, Ruby Johnson (played by Jennifer Lewis) makes the following statement when referring to Bow’s change in behaviors, “This is what new motherhood looks like…she’s just weak.”
There's often a perception 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's not weak. Ruby admits being weak for not being there to help Bow through this experience.
Dre makes the statement that Bow didn't experience the symptoms she's displaying presently after the birth of her other children, and he doesn't understand why this pregnancy is different.
While previous experiences with postpartum depression are a strong indication of present or future indications, they're not the only factor that must be considered. Factors such as previous experience with depression, a family member who's 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 (meaning it was a high-risk pregnancy), and other factors make experiencing postpartum depression very likely.
One of Dre’s co-workers attempts to diagnose Bow as having the “baby blues,” which is used to describe the feelings of unrest, tiredness, worry, and fatigue many women experience after having a baby. It's 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 self-care or that of her family. This affects 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 she or another family member is concerned.
Dre takes the advice of his co-workers and reads through a magazine targeted to women where he discovers his wife may be experiencing postpartum depression. The suggestion from the magazine encourages 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.
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 in race, profession, socioeconomic status, or anything else. A diagnosis of postpartum depression is not an indication of weakness or failure in the new mother; rather, it's an indication of something that affects many women. Luckily, there's help for it.
In one scene, Dre asks Bow over and over if she's okay and tries to engage her in activities. Bow responds, “Please stop trying to fix me.”
It's important to recognize the new mother not as something that has been broken and needs fixing, but as a human being who is experiencing a mood disorder and needs lots of support. This mindset of the mother being "broken" may cause her symptoms to worsen. She may 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 child, or any other self-defeating thought.
Dre’s mother, Ruby, discusses Bow’s ability to parent with Dre, comparing Bow’s present actions with her own experience after giving birth to Dre. She says, “I didn’t go to some quack doctor because I was mentally ill with some made-up disease.”
Dre quickly corrects her and explains that postpartum depression is not made up, stating that many women experience it. The Center for Disease Control estimates 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.
One of Bow’s children asks, “Why isn’t she getting better?”
Sometimes the expectation for the new mother, or her family and friends, is that she 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 her during this time. The best thing family and friends can do is to keep communication open and provide the new mother with what she asks for.
One of the scenes shows Ruby and Bow discussing why Ruby made the decision to give Bow’s child baby formula instead of the breastmilk Bow had pumped. Bow assertively tells Ruby she has crossed a line.
It's 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.
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 tells Ruby to get out of her house, Dre supports his wife, even to the point of asking his own mother to leave their house. Bow needs this support during this time. Ruby also calls Bow crazy and says she is 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 given space to be worked through.
Dre is speaking to his father, played by Lawrence Fishburne, about Bow’s seemingly lack of progress. He states, “I feel powerless.”
It's 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 newborn baby who is crying and solely dependent on the new mother for everything. No pressure at all, right?
There still continues to be a stigma around mental health. 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 the therapeutic homework her therapist assigned to help her through this experience. Bow also expresses initial frustration at her therapist, which is normal for anyone entering therapy. Bow’s continuation with therapy and her medication helps 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.