Apple health app features: How to track your mental health on your iPhone
It’s important to keep track of how you’re doing. Here’s how to easily track your mental health with your iPhone.
Problem Solved
Krysten Alvarez was seven and a half months pregnant with her first child when she fell down the stairs, breaking four bones in her foot.
Hours later, her baby boy was delivered via an emergency C-section. She spent five days in the hospital, during which her son was in the neonatal intensive care unit (NICU). But upon returning home, Alvarez was stuck in a cast and couldn’t even bathe her newborn baby, much less herself. The feelings of postpartum depression — despair, guilt, shame and worthlessness — began creeping in.
“I wasn’t enough,” she thought. “I wasn’t a good mom, because I couldn’t support my baby. I couldn’t do anything, and it just kept getting worse.”
She looked to her mom, sister and husband and told them they would be better off if they could “find somebody that would take care of everybody.”
“I told them, ‘I’m ready to go. I need to leave… you’re taking care of a newborn and you’re taking care of me,'” Alvarez says, reflecting on the 2023 incident. She packed a backpack with the intention of going to a homeless shelter.
“I don’t really like saying it out loud. It hurts my heart because it was never the person that I was,” she says.
Alvarez comes from a Latina family, where she says it’s ingrained in the culture to be “tough and strong.” Despite her struggles with postpartum depression, she felt like she couldn’t speak up. Her mother and grandmother had gotten through the pitfalls of motherhood without medication or other forms of support; her mom worked a full-time job while raising three kids. Alvarez took maternity leave and struggled with just one kid. Her mind raced, “Why can’t I do it?”
The data on postpartum depression rates in the United States is vague. According to a 2016 study in the Journal of Racial and Health Disparities, the risk of postpartum depression is nearly 40% higher in Latina women than in the general population in small towns and rural communities in the U.S. A 2013 report published in the Journal of Affective Disorders found that roughly 13% of women experience postpartum depression, but that percentage jumps up to 54% for Latina immigrants. However, Latina women are less likely to access mental health treatment. 35.1% of Hispanic/Latinx adults with mental illness receive treatment each year compared to the U.S. average of 46.2%, according to the National Alliance on Mental Illness.
Dr. Ingrid Paredes, an OB-GYN and postpartum depression expert, says cultural stigma and attitudes deter new mothers from seeking help.
“As providers, it’s really challenging detective work that we have to do to detect it,” she says, as patients will often downplay their symptoms. As a Latina provider herself, she says the hardest part is getting them to accept help when it’s offered.
Alvarez grappled with accepting help: ‘I thought struggle was weakness’
Alaverez had seen a therapist for anxiety and ADHD at the beginning of her pregnancy, but stopped her medication cold turkey as she worried it would affect the baby, and even stopped talking to the therapist. She says her family was unaware that she was struggling.
But following her pregnancy, Alvarez was pained by how much her symptoms were affecting her family. When she said she would be better off gone, she saw the hurt on their faces.
“That’s when it clicked. I was like, ‘I need to be OK for them, not even so much myself,'” she says.
Alvarez went to a postpartum depression group, but after hearing other mothers share their experiences, she felt her problems weren’t “bad enough.”
Other group members expressed anger and resentment toward their baby (studies show “postpartum anger” can coincide with postpartum depression), feelings Alvarez couldn’t relate to. She told herself she didn’t really have postpartum depression — that she was “going crazy” and just couldn’t handle motherhood — and left group therapy.
On social media, her friends shared their milestones: marriages, pregnancies, joyful glimpses of parenthood. Alaverez felt like she was the only person in her circle suffering.
She pushed it down until her second pregnancy, which also ended in an early delivery due to preeclampsia. According to Paredes, one of the main risk factors for postpartum depression is having had it in the past. When Alaverez’s second baby, who is now 6 months old, had to go to the NICU, she felt like she couldn’t do anything right.
Her doctors would ask her how she was doing, and she would respond, “Everything’s great.”
“I don’t like to show struggle, because for a long time, I thought struggle was weakness,” she says. “I felt like it was on me again, and it was a lot easier to blame myself than it was something that I can’t see or control.”
Her husband finally intervened. “My husband looked at the doctor and said, ‘This isn’t true. She’s here with you with a smile, but she goes home and cries all day,'” she recalls.
New medication treats postpartum depression in two weeks
In August 2023, the U.S. Food and Drug Administration approved Zurzuvae (zuranolone), the first oral medication indicated to treat postpartum depression in adults.
Zurzuvae is a synthetic form of allopregnanolone, a naturally occurring neurosteroid that derives from the hormone progesterone. After pregnancy, allopregnanolone levels drop dramatically. In women at risk of postpartum depression, changes in peripartum levels of the neurosteroid have been associated with depressive symptoms.
Alverez was extremely reluctant to take her doctors’ recommendations to try Zurzuvae after her second pregnancy. It took her two weeks to even open the box to try it. When she mentioned it to her abuelitas and tias, they begged her not to take it: “You’re crazy. Why would you start that? You don’t know what it’s going to do to you?”
But Alverez knew she needed to take the next step, because she couldn’t continue “suffering in silence.”
“That’s what my family did. Generationally, I think they just suffered silently, and I couldn’t suffer silently anymore, because it was killing me, like genuinely destroying my way of living,” she says.
Paredes says that among her patients, stigma around medications and postpartum depression is present across all cultures. But what she notices in Latina populations is that family members are more often involved in the decision-making process.
“When I think back of my patients, I can picture several of them and how they have all had different reasons why they either didn’t get care or didn’t do the medication, or why they got worse,” Paredes says. “Either the husband doesn’t really believe in it, or the mom tries to normalize it.”
Alvarez says it took a lot to understand that struggling did not make her weak, and finally accepting care helped her make sense of her symptoms.
She compares it to putting your oxygen mask on first.
“Growing up, I always thought that was selfish,” she says. “Now I realize that in saving myself, I can save more people. It’s not selfish to put my mask on first. It actually helped my family.”
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