Why We Don’t Talk About Miscarriage

teddy bear in empty child room

Miscarriage and stillbirth are emotionally intense and very unique forms of grief and trauma, ones that often occur in privacy and silence. For parents eagerly anticipating the arrival of a new family member, fetal death — whether it occurs early or late in pregnancy — can be devastating. The shroud of secrecy that hangs over these topics may make it challenging to talk about, but it’s critical to bring these conversations into the light.

I talked with two experts, Boston-based psychologist Aline Zoldbrod and Doctor Elizabeth Fitelson of Columbia University’s Department of Psychiatry, about the emotional and cultural issues surrounding miscarriage and stillbirth — and how to approach this very distinctive life experience. Continue reading Why We Don’t Talk About Miscarriage

Finding Help for Complicated Grief

sad woman looking into sunset

Grief is one of the most intensely personal emotions we experience, and also one of the most public; not for nothing does every culture on Earth have rituals associated with grieving. Many of those rituals unfold over a series of days or months — Shiva in Jewish tradition, prayers in Buddhism — reflecting the fact that grief takes time. In a fast-paced society, there can be tremendous pressure to “get over it” as quickly as possible, and those who take more time than others may be viewed as suspect.

When does mourning cross the tipping point between a natural and healthy response to an intense life event and into something more dangerous? That’s a question that challenges researchers interested in a phenomenon called “complicated grief” or “difficult grief,” in which people become “stuck,” as Talkspace therapist Cynthia Stocker terms it. Whether an adjustment is related to the death of a loved one, the loss of a job, or another dramatic change like something that affects someone’s sense of identity, some people have difficulty processing and moving through their grief. It can become overwhelming, and that’s when grief may transition into something harmful. Continue reading Finding Help for Complicated Grief

Why Aren’t We Talking About Postoperative Depression?

woman in hospital bed hands over face after surgery

Surgery can be a life-changing event, whether you’re treating an emergency medical condition or finally getting a procedure that changes the way you look and feel about yourself. In the whirlwind of presurgical paperwork and meetings and consultations, though, there’s one issue a care team may skip over: postoperative depression.

It’s a strange problem for people to forget to mention, because it’s not uncommon. In a 2000 feature for Harvard Magazine, surgeons described it as an “understandable complication.”

So why aren’t we talking about it? The answer is complex, and it involves a number of stops along a rabbit hole of twists and turns that leave patients unprepared for the emotional aftermath of surgery. While depression may be “understandable,” that doesn’t mean it should be ignored; and refusing to acknowledge that it’s a risk doesn’t resolve the problem.

It’s also very treatable. Prepared patients, particularly those with underlying mental health conditions, can be more proactive about managing it if they’re forewarned.

Clinical Health Psychologist Steven Tovian, who works at Northwestern University in Chicago in addition to maintaining a private practice, told Talkspace one reason postoperative depression falls by the wayside is limited research into the subject. Theories about what causes it may abound, but they aren’t backed by detailed, substantial research that explores the phenomenon and delves into ways to treat it.

Without that information, it’s both harder to treat and more difficult to convince surgical care teams that advising patients could be advantageous for recovery. Cultural attitudes within the medical profession also create a barrier to frank discussions about mental health for surgical patients, which is bad news for those at risk. Continue reading Why Aren’t We Talking About Postoperative Depression?