The Historical Context of Postpartum Depression Treatment
Throughout the late 1800s, isolation was seen as a normal treatment to “cure” women suffering from postpartum depression. This treatment was known as the “rest cure,” which consisted of isolating the patient completely to avoid any mental activity and provide rest. At the time, a well-known feminist writer, Charlotte Perkins Gilman, was prescribed this isolation treatment after the birth of her daughter that left her with a crippling depression (“Charlotte Perkins Gilman”379). “The Yellow Wallpaper” was then written by Gilman to share her experience with the “treatment” that was being prescribed not only to her, but also to several other women, driving them near the borderline of utter mental ruin. In the short story “The Yellow Wallpaper,” Gilman’s prescribed “rest cure” after giving birth took a big part in her descent into madness. While in today’s world, with so many medical advancements, Gilman’s treatment can be seen as a punishment more than anything else.
Depression, also referred to as melancholy, has been a common illness that has been dealt with for several of decades, although there had never been a stable cure until today. Throughout the early parts of American history, physicians back in the late 1800’s could not distinguish between the different types of mental disorder their patients were experiencing, therefore, they treated all of their mentally ill patients with the same rest cure. This then led to people suffering from mental illnesses to be diagnosed equally, and their treatment consisted of being held captive in buildings that were very similar to the types of structures a prison would have and being chained to their beds with conditions that were terrifying (“History of Mental Health Treatment”). These so called, health facilities were structured as if the mentally ill patients were murderous inmates, and equipped with barred windows, each door was latched separately, and had the entire building secured in case if any incident were to occur. Even though the confined patients were not threatening at all, these facilities treated them like savages, beating them in ways that were “unspeakably cruel” (“History of Mental Health Treatment”).
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The Grim Reality of Mental Health Facilities in the 1800s
The method that people used back then to treat these mental illnesses was the total opposite of what a health facility would perform nowadays and seemed a lot more like a prison environment. In addition, this treatment that was applied and recommended only worsened the patient’s condition even more, resulting to what Gilman had described herself that her treatment “drove her so near the borderline of utter mental ruin” (“Charlotte Perkins Gilman”379). When Gilman was diagnosed with postpartum depression, her physician had advised her a “rest cure” that consisted of complete bed rest and mental inactivity (“Charlotte Perkins Gilman”379). Luckily, and thanks to Gilman’s story, a handful of critics were able to realize how this gruesome situation was and highlighted how the prescribed “treatment” had negatively affected the narrator’s overall psychological health. In an article by John Bak, the author reveals that the narrator’s prescribed treatment in this case scenario was the act of imprisonment that led the narrator to go insane. The author points out that Gilman’s environment in “The Yellow Wallpaper” is awfully similar to the environment in a panopticon system. The panopticon system was seen as a room that is “morally reformed and health preserved,” which would be the description of Gilman’s prescribed treatment or the “rest cure” for her illness which isolated her in a nursery three miles away from town (Bak41).
However, the actual use of this panopticon system was more as a “laboratory than a corrective institute” which was the exact reason why the narrator started to distinguish certain vivid objects that were not there as a “perfunctory dismissal of the paper’s “optic horror” (Bak41). Bak also showed how the narrator’s personality slowly unraveled “through the stages from concern to paranoia and, finally, to madness” throughout the time she had been forbidden to do any activities throughout her “rest cure” (Bak42), which had then gradually developed into a paranoia that Foucault says is inevitable with unabated surveillance” (Bak41). In addition to the rooms’ intriguing terror, the method physicians used to treat their mentally ill patients was as unbelievable as their environment, noting that highly qualified physicians should be devoting their full potential to help their helpless patients. Instead, these so-called “physicians” back then would torment their patients making the cure worse than the disease.
Furthermore, already considering that medical treatments and therapy were as bad as they were, it was especially worse with female patients. During this time in history, women were seen as inferior to men, thus giving men the superiority in society to treat women as they wished. Elaine Hedges had precisely pointed out in her article that Gilman’s role was to be “a rest and comfort” to her husband while she was obviously the one in need of that companionship throughout her illness (Hedges106). Within this article, the author also shows how Gilman was being treated in a less superior range; the physician also being her husband would dismiss every word the patient had to say and treated her as an inferior, distinguishing the narrator as if she were an infant speaking to her with sayings like, “blessed little goose” and his “little girl” (Hedges106). Just as the physician refers to the narrator as a “little girl,” he also places her in a room that is specifically child proof as the room was intended to “prevent small children from falling out”.
The Role of Gender in Mental Health Treatment
As the narrator had examined the wallpaper within the room, she viewed what seemed to be a pattern, but before she could even distinguish it the author mentions that “it slaps you in the face, knocks you down, and tramples upon you” (Hedges 106). The author used this personification to compare the wallpaper to the narrator’s relationship with her physician. This phrase boldly emphasizes how it is that the physician reacts when the narrator expresses her mixed emotions while he also laughs at her because she does not know any better, for she is just a “little girl”. As a result, patients during this time would go insane because their prescribed physicians would not fully assist them and their disorder.
Although this type of treatment seemed ordinary back then, it is very different in today’s modern lifestyle. This type of treatment was later seen more as a bitter way for physicians to treat their patients, which is why today’s standing medical field has risen to improve the treatment for postpartum depression. In contrast to the past, physicians can now identify what class of disorder a patient is dealing with, prescribing all their ill patients with the correct treatment that will rehabilitate them back to their usual state of mind. Postpartum depression may now be taken care of with several types of treatments, all depending on the mother’s severity of the condition. Patients with mild symptoms are most commonly to be treated with medications such as anti-depressants and therapy altogether (Johnson). The psychotherapy consists of a one to one conversation with a specialized therapist that assists the patient with emotional support, while also advising realistic goals for the patient to achieve throughout this difficult time they are experiencing (“Postpartum Depression Therapy”). The patient is also allowed to select which type of therapy they would like to attend out of the five available to that specific condition. The therapies consist of the following: cognitive behavioral, interpersonal, eye movement desensitization, reprocessing, group, and couples’ therapy. These postpartum therapies will all help the patient cope with their disorder and above all, the patient recognizes that this disorder is not their fault and realize that many people are battling throughout the same condition they are experiencing (“Postpartum Depression Therapy”). Doctors also suggest that patients should make a few adjustments to their current lifestyle, such as giving some time for themselves, where they can enter a happy and positive environment that friends and family can support them each step of the way. There are various ways that patients can accomplish this goal - eating nourishing meals, getting good rest, and especially getting a good workout that can help brighten up the patients’ day as they relieve their stress and get their mind off things while also lifting up their psyches (Johnson).
Modern Approaches to Postpartum Depression Treatment
In different circumstances, if the severity of the mother’s condition were to get out of hand, possibly experiencing symptoms of suicidal thoughts or psychosis, she will then need to be admitted into a mental hospital. There she would be prescribed a treatment plan by a psychiatrist that could involve a variety of other mental health professionals that would assist the patient with both psychiatric therapies and medications (Schimelpfening). Unlike the environment patients were placed in during Gilman’s time, today’s hospital staff gives their ill patients a healthy environment with respect. While hospitalized, patients now have the right to know what medications are being prescribed to them as well have the authority to deny any treatments they presume are unnecessary. Nevertheless, they could be placed in a room, although they would typically be roomed with a roommate and are allowed to freely interact with one another. They would also have an arranged schedule to follow throughout their stay, being able to attend on going activities and therapies, which would avoid the patients from being in an isolated environment, and instead, it allows them to surround themselves in a profound environment (Schimelpfening).
Although isolation was considered as a treatment for postpartum depression back then, in today’s modern world, it is seen and used as a form of punishment to discipline those who rebelliously disobey rules. As a matter of fact, isolation is most commonly used in federal prisons as a solitary confinement to discipline rebellious inmates. Prison itself is not the inmates’ sole punishment, but rather the confinement that defeats them all such as the hot box, hole, and lock down confinements where the prisoners are isolated in a small structured room for days until their time is up just as Breslow had stated “it is a prison within a prison”(Bennett). Several prisons determine how long the prisoner will go from being both socially and physically cut off ranging from “low, moderate, high, and greatest” using how critical of a crime the inmate had committed (Breslow). Prisoners who are charged with serious crimes ranging from both high and greatest would endure an isolation that would last for about thirty to sixty days being in a confined room that is smaller than a closet. In today’s society, it is seen more as a normality for prisoners to be dreadfully punished by being locked up in an isolated room for numerous days, and contrastingly abnormal for them to be outdoors getting any form of exercise (Breslow). Prisoners are isolated in atrocious confinements for the “sake” of their health and others; however, this “disciplinary” confinement has done the opposite. Research has shown that isolation has greatly impacted a person’s psychological health. It has been proven that a third of prisoners that have been isolated have ended up critically insane with suicidal urges that engages them towards self - mutilation (Breslow). The federal prison system showed that the prisoners that were being isolated in a special housing status or psychiatrist seclusion cells had approximately sixty-three percent suicidal death rate. However, suicide is not the only effect prisoners are left with; they can also end up with a psychiatric syndrome which leads them to having hallucinations, panic attacks, overt paranoia, impulse control; hypersensitivity to external stimuli; trouble processing, concentration and memory loss (Breslow). One example of isolation affecting a person’s psychological health was an inmate that had stated himself “the hole and segregation cells are depressing enough to drive many men to take their lives in order to escape” (Breslow). The psychological effects that inmates are left with due to isolation only makes them even more dangerous than they already were previously.
Isolation as a Disciplinary Measure in Today's Society
It has been proven that isolation is not a treatment, but rather a disciplinary punishment that is used upon rebellious individuals. Throughout history, isolation had been used as a treatment for women. As it was used upon Gilman, she wrote “The Yellow Wallpaper” to inform the world of what it is that isolation actually does to a person. Society has slowly evolved making significant changes in order to be able to provide the correct treatment for women with postpartum depression and now uses isolation as a disciplinary punishment in the prison system.
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