JMIR Publications

ABSTRACT

Background:

Over the past decade, postpartum depression (PPD) diagnoses have significantly risen across all ethnic and racial groups. However, PPD remains underdiagnosed due, in part, to stigmatization and misunderstanding by the public, which can result in a reluctance among women to openly discuss their symptoms with clinicians. However, social media offers supportive communities and unique platforms to share their unfiltered experiences and opinions that they may not disclose in-person. Despite the availability of new FDA-approved medical therapies for PDD over the past seven years, research investigating women’s comments about their perceptions of recommendations for and barriers to treatment of PDD have been sparse.

Objective:

The objective of this study is to evaluate the themes that emerged from the comments of those who responded to posts regarding PPD on Reddit to assess women’s perceptions of treatment recommendations and potential treatment barriers.

Methods:

A qualitative study was conducted of comments made responding to eligible Reddit posts published in English between August 2019 to August 2024, which were retrieved using the keywords “Zulresso,” “Zurzuvae,” “brexanolone,” “zuranolone,” “PPD,” and “postpartum depression.” Eligible posts had to meet the threshold of at least ≥ 5 votes and ≥ 5 comments. All comments that replied to each selected post were retrieved through the keyword search and Reddit’s default “relevance” filter. Each comment was assigned to a single theme that matched its primary focus, and these comments formed the main dataset for our thematic analysis. With our two overarching categories of interest, treatment recommendations and potential barriers to treatment, multiple specific themes were developed using inductive content analysis.

Results:

Of the eligible 93 identified posts, a total of 3,482 comments were evaluated for study inclusion. Of those, 1,348 comments were selected for thematic analysis based on relevance to the two topic categories of interest; 866 comments discussed treatment recommendations and 482 comments discussed perceived potential treatment barriers. In the category of treatment recommendations, the following themes were identified: support of medication use (52.0%), support for counseling (17.1%), recommendation for lifestyle changes (16.7%), and support for combination of therapies (14.2%). Comments on barriers yielded four additional themes: perceived overdiagnosis of PPD (38.8%), lack of social support and understanding within personal networks (32.0%), inadequate healthcare provider support (20.1%), and insufficient institutional support (9.1%).

Conclusions:

Our analysis of the Reddit comments revealed that women perceive significant unmet needs regarding PPD. Specifically, they emphasized critical areas for improvement, including the optimization of individualized treatment plans, greater public awareness about the condition, and enhanced support from both social and healthcare networks.