Teen moms face plenty of challenges, from dealing with the shame and stigma of an unplanned pregnancy to finishing school and finding employment. But many must also deal with the challenges of mental illness. Researchers have found that twice as many teen moms are at risk of developing postpartum depression (PPD) as their older counterparts. And nearly three times as many teens with mental illness get pregnant as adolescents without a disorder.
The high rate of PPD among teen mothers
According to a survey of 6,400 Canadian women published in the journal Pediatrics in May 2012, the highest incidence of postpartum depression occurred among girls age 15 to 19 – at a rate twice as high as PPD in moms older than 25.
Although research on the incidence and causes of PPD in teens is scant, a study published in the August 2014 issue of Maternal and Child Health Journal found a correlation in teen moms between increased stress from parenting and the risk of postpartum depression.
That connection makes sense to Gloria Malone, who gave birth to her daughter four days shy of her 16th birthday. "I was so busy taking care of my baby, packing her diaper bag and my backpack in the morning so she could go to daycare and I could go to school," says Malone, now 24 and a teen mom advocate in New York City. "There was no time for myself, and no one stopped to ask me,'how are you feeling?' Mental health was not on my radar."
The stigma of teen pregnancy is a barrier to recognition and treatment
"You made your bed, now lie in it." That was the kind of response Christina Martinez, 35, of Sacramento, California, heard when she shared her feelings of overwhelming sadness after giving birth to her first child while still in high school. She now realizes that she was suffering from postpartum depression, but no one even acknowledged her emotional challenges, let alone talked to her about the possibility that she might be suffering from PPD.
"At 17, 'postpartum depression' wasn't really in my vocabulary," says Martinez. When she gave birth to her fourth child at age 30, she experienced PPD again. But this time, she had a husband and a career as an early childhood educator, and people reacted with more empathy.
Parenting teens face "constant shaming and stigma," says Malone, cofounder (with Martinez and six other women) of #NoTeenShame, a social media campaign to raise awareness of the shame and stigma faced by teen mothers. "According to society, pregnant and parenting teens must be punished and used for political prevention campaigns, instead of being treated as the fully human individuals that we are."
The connection between mental health and getting pregnant in your teens
Girls age 15 to 19 with a diagnosis of a major mental illness, such as bipolar disorder, depression and schizophrenia, are almost three times as likely to give birth as adolescents without mental health issues, according to a study of more than 70,000 teen girls in Ontario. The reasons why girls with mental illness are more likely to become teen moms needs further research, but it may be linked to impulsive behavior, according to study author Simone Vigod, MD, a psychiatrist and researcher at Women's College Hospital in Toronto.
"Wanting to be close to someone may lead to risky sexual behavior," points out Consuela Greene, another cofounder of #NoTeenShame and a social entrepreneur in Boston who has worked with teen moms.
Greene, now 38, was a teen mom herself (at 15 and 19) and was diagnosed with clinical depression in her 20s. She says she experienced symptoms before her second child was born and recalls feeling "an overall melancholy." But no one asked how she was doing emotionally or offered any help.
Mood disorders make teen parenting even harder
"There were times I called my mom to come over because my son was crying, and it was like the noise of scratching a chalkboard," says Shiloh (who asked that we only use her first name), a 28-year-old mom to two children, who lives in northwest Missouri. Shiloh was diagnosed with cyclothymia – often considered a precursor to bipolar disorder – just after high school before she became pregnant with her first child, who was born when she was 19.
When teens with mental illness become moms, they may find it "very, very difficult to parent a child in a healthy way," especially if there's a history of trauma or abuse, says Candice Jarvis, LCSW-R, assistant executive director for teen family services at Inwood House in New York City, which offers programs in pregnancy prevention, youth development, and family services to teenagers living in poverty.
They may have problems with bonding and nurturing, she explains. "Breastfeeding [may] feel inappropriate and too intimate to a victim of sexual abuse."
"Untreated mental health issues in parenting leave so much guilt," says Greene. "You're not doing your best work."
The opportunity to prevent unplanned pregnancy and help parenting teens
Supporting teens with mental health issues will bring "opportunities for prevention," says Vigod. "We need to make sure there's good reproductive counseling available." And a pilot study at Women & Infants Hospital of Rhode Island found that an intervention program cut the incidence of postpartum depression in teen moms by half.
The highly structured program is called REACH (Relax, Encourage, Appreciate, Communicate and Help), and it's tailored to adolescents through individual sessions, videos, role-playing exercises, and homework. Pregnant teens learn about their expectations of motherhood, stress management, support systems, communication skills, healthy relationships, interpersonal conflict, goal setting, and psychosocial resources. The program also helps teens differentiate between the "baby blues" and depression.
That approach offers a significant break from most programs targeted to teen moms, which usually focus on goals like finishing school, learning parenting skills, and finding employment but fail to address mental health concerns, says Jarvis.
Prioritizing the mental health of teen moms is a mission for Malone. "You can only be as good to your baby as you are to yourself."
If you are in Greater New York City, you may be interested in attending the Seleni Institute's Young Parent Series offered bimonthly to pregnant and new parents under age 24.