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America Changed the Terms.

Washington changed the rules at the G20. Canada retaliated. London warned the market. The real story is who loses leverage when America stops following the old system.
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There Is No Such Thing as Postpartum Depression​

How a Label Became a Diagnosis, a Market, a Legal Defense and a Narrative: THE MACHINE SERIES​

Vivify Mariposa
Sep 08, 2026


Many people are going to read that title and get angry before they read another word, but if you are actually a critical thinker you will continue, because being offended by a title does not make the title false, and repeating something for decades through medicine, academia, government, television, social media and now artificial intelligence does not magically turn it into truth either.

I come from a large family. My grandmother had thirteen children. Her first daughter had eight. Aunts and uncles and cousins did the same, and I grew up around other families who lived the same way, and I still have friends raising large families now. We love children. That is not a slogan in my world, it is the ordinary condition of the house you grow up in, and it is the reason I could not read what I was reading this month without writing something.

What I was reading was the defense of a nurse who shared a house with a husband who worked from home, and who waited for him to be out of it to kill her children.

And thousands of women went online to explain why she is the one who was failed. They raised more than a million dollars for her family, and the morning after a jury could not convict her they raised the fundraising target to three million. They know the name of her hospital and her husband and her medications. Most of them cannot tell you the names of the three children.

Then there are the other videos, which are their own answer to the question of whether any of this is really about a medical condition. Women filming themselves mistreating their own babies for an audience. A mother recording her small son running behind her car on a road because she made him get out and walk, because he made a joke about her arms and her feelings were hurt. A trend of women acting out the Duxbury killings for the camera, waiting for the laugh.

I spent hours arguing with an artificial intelligence about all of it, asking it for logic and truth and getting documents back, and I am going to come back to what that showed me because it turned out to be part of the same story.

I already wrote about the mind, about the foundations that built the profession and how ordinary human experience was converted into billable conditions, in The Mind They Built to Run It. And I wrote about the labels themselves, the ones that get attached to people to end the conversation before it starts, in Trump Is Dismantling a Machine Most People Still Don’t Know Exists and Part Two. This is the next part of the same trail, and it starts with a word most people have never questioned in their lives.
 

Two Labels, Two Populations
​

I already wrote about Drapetomania, the disorder Samuel Cartwright published in 1851 for enslaved people who ran. The symptoms were dissatisfaction, sullenness and refusal to work. The cure was whipping them back into the submissive condition Cartwright believed enslaved people were supposed to occupy. A man wanting his freedom was the signal, and the signal was named a disease of the man producing it.



The label for women was older and it lasted longer. Hysteria, from hystera, the Greek word for womb. The illness was named after the organ, and for roughly two thousand years the explanation for whatever was wrong with a woman was that the organ had caused it. It covered almost everything a living body does, including crying, laughing, yawning and stretching. Women were confined to bed for months with reading forbidden, and some had their reproductive organs removed to treat their minds, because the diagnosis said the organ was the problem.

One was written for people who would not stay enslaved. The other was written for women. Neither one described a disease. Each one described what the people holding the pen needed the behavior to mean, and once the behavior had a medical name, the person producing it no longer had an argument, only a condition.

Nobody defends Drapetomania now. Hysteria was still in the American manual in 1968 and stayed until 1980. But now people are defending child murder under the name postpartum depression. Nice way to get rid of what bothers you, then say your hormones made you do it and you are free.

The Claim of Ancient Lineage
​

Something I found writing about the mind, about labels, and about autism keeps repeating, and it repeated again here. When you question one of these categories, the first defense is never evidence that the category is correct. It is age. You are told the condition has always existed, that physicians described it centuries ago, that the ancients knew it, and the implication is that you are the ignorant one for asking about something so long established. Then you go and look at what those older physicians actually wrote, and it is not the same thing. Somebody in the last hundred and fifty years built a new category, attached it to an old description, and collected the credit for discovering something that already had a name and a different meaning. Because it came out of academia, almost nobody checked.



Here it happened in front of me. When I pushed for historical proof that postpartum depression is ancient, what came back was Louis-Victor Marcé, a French physician who published a treatise in Paris in 1858 based on 310 cases. The book exists, it sits in university archives, and the citation is real. The citation was never about postpartum depression, no matter how many people claim that it was.

The title translates as Treatise on the Madness of Pregnant Women, New Mothers, and Nursing Women. La folie. Madness. What Marcé documented was puerperal insanity, a rare and severe psychotic condition with hallucination, mania and delusion, the category Esquirol had been describing decades before him.

That is not what is diagnosed today. One is a rare psychotic break. The other is a mood score on a questionnaire, applied to roughly one in six new mothers. The old book is being used to give the new category a lineage it does not have, and when I said so, the search moved forward in time and came back with something else.
 

1968
​

Brice Pitt, a British psychiatrist, published a paper in the British Journal of Psychiatry in 1968 titled “Atypical Depression Following Childbirth,” under the Royal College of Psychiatrists. In it he separated three things: the blues, ordinary tearfulness in the days after birth which he described as commonplace and self-resolving; puerperal psychosis, the severe old category; and a third thing, a non-psychotic depressive illness following childbirth that did not fit either.

That third category is the direct ancestor of what is diagnosed today. It is British, not American. It came twenty-six years before the American Psychiatric Association wrote anything into its manual.

The AI presented this to me as though it had settled the argument. I was looking at the date and thinking the opposite, because 1968 is not antiquity, it is the second half of the twentieth century, and what the paper actually establishes is that by 1968 a psychiatrist was constructing new language around what women experienced after childbirth and deciding which parts of ordinary sadness, exhaustion and disappointment would be reclassified as something else.

And 1968 is the same year hysteria came back into the American manual. For twelve years, from 1968 to 1980, the womb disease and the childbirth category existed in the field at the same time. Hysteria came out in 1980. The postpartum specifier went into DSM-IV in 1994, limited to four weeks after birth. DSM-5 widened it again in 2013, renaming it peripartum onset and extending it to include depression beginning during pregnancy, and advocacy organizations pushed unsuccessfully for a six-month window.
 

The Committee and Its Funders
​

Lisa Cosgrove and Sheldon Krimsky published an analysis in PLOS Medicine comparing the financial relationships of DSM-IV and DSM-5 panel members with the pharmaceutical industry.

Sixty-nine percent of the DSM-5 task force reported industry ties, up from fifty-seven percent under DSM-IV, an increase that occurred after the association introduced disclosure requirements intended to reduce it. On the Mood Disorders work group specifically, the group responsible for the category the postpartum specifier sits inside, sixty-seven percent, twelve members, had financial relationships with companies manufacturing treatments for the conditions they were classifying. The panels with the highest concentrations were the ones where medication is the primary intervention. Psychotic Disorders reached eighty-three percent. Sleep and Wake Disorders reached one hundred.



The disclosure rules were introduced to fix this and the numbers went up afterward, so all disclosure did was put the payments on paper while they grew.

And understand what the DSM actually is. It is a book with a list, and the list tells you which category you fall under. That is the whole product. Many of the people deciding what goes on the list, and how wide those categories become, had financial relationships with companies selling treatments for the conditions they were classifying.

Who Paid to Make the Word Everywhere
​

I do not accept a stack of papers as proof, and the reason is not that I dislike academia. It is that I worked inside it. During my college years I worked in a research foundation department and my job was allocating the funds that were donated to studies. I saw how it actually happens. A donor decides the subject. The money is placed against that subject. Then a student looking for a project sees one with funding attached, materials covered, a supervisor who wants it finished and a clear path to completion, sitting next to a question nobody is paying anything for. They take the funded one, because they need to finish. Nobody has to falsify a result. The donor’s question gets asked over and over, and the question nobody funded never becomes a study, never becomes a paper, and never enters the record for anybody to cite later. Peer review then checks whether the funded study was done competently. It does not ask why that question was funded and the other one was not, and it cannot, because the unfunded question is invisible to it.



So when somebody hands me a pile of literature, what I am looking at is the accumulated output of whoever paid for the field, and the silence in that pile is not proof that nothing is there. It is proof that nobody paid to look.

At some point I stopped asking only who created the diagnosis and started asking a much simpler question, who is paying to make sure everybody knows the word, because if repetition is supposed to be evidence that something is true, then it matters whether the repetition happened naturally or whether somebody spent millions of dollars building the machinery that produces it.

What I found was not hidden, because the organizations themselves describe exactly what they are doing. Perigee Fund says maternal mental health needs a robust, connected and coordinated advocacy field, and its own plan calls for coordinated federal strategy, more postpartum depression screening and treatment, an advocacy network focused on federal funding, media scans, narrative change, communication plans and better use of social media. Those are their words. The same fund has financed organizations including the Maternal Mental Health Leadership Alliance, the Policy Center for Maternal Mental Health and Shades of Blue, and Perigee itself says those organizations have worked together to advance federal maternal mental health policy.

Then follow that one step further and the money becomes impossible to ignore. The Maternal Mental Health Leadership Alliance states that since 2019 it has helped secure $125.5 million in federal funding that directly supports maternal mental health research and programs. It helped establish the National Maternal Mental Health Hotline in 2022, reports that the hotline has fielded almost 100,000 contacts, and is currently asking Congress for ten million dollars a year to expand it along with fourteen and a half million for a psychiatry access program. It led the advocacy that produced the MOMS Act, which became law in December 2024 and requires the Department of Defense to implement maternal mental health programs.

The Policy Center for Maternal Mental Health names its own funders in its 2024 annual impact report, and lists what each one paid for. Perigee Fund, federal policy work. ZOMA Foundation, insurance and payment reform. California Health Care Foundation, Cigna Foundation, the Esther A. and Joseph Klingenstein Fund and Flourish Impact Fund, all financing the same Ob/Gyn and community health worker screening capacity pilot. W.K. Kellogg Foundation, the Mom Congress initiative that brings mothers to Washington. And Sage Therapeutics, funding fellows programs and reporting activities.

Sage Therapeutics, with Biogen, manufactures Zurzuvae, zuranolone, the first and only oral medication approved by the FDA specifically for postpartum depression. It was approved in August 2023 and priced at $15,900 for a fourteen-day course. The Maternal Mental Health Leadership Alliance published an article welcoming its arrival, titled “The First Oral Treatment for Postpartum Depression is Finally Here.”

So the company that sells the drug funds the policy center that runs the screening pilots. The alliance that lobbies Congress for screening money and hotline money publishes material promoting the product. And the committee that widened the diagnostic criteria in the first place was two-thirds financed by the industry that manufactures the treatment.

Then there is the part that connects to everything I had already been watching happen in the media, because the California Health Care Foundation openly calls one part of its work narrative change. It funded the USC Norman Lear Center to study how narrative change functions and funded Hollywood, Health & Society to supply material to screenwriters portraying maternity care in television and entertainment. Perigee’s own strategy calls for scanning media coverage, changing the narrative, building communication plans and making better use of social media.

None of that proves a diagnosis true or false, and that is exactly the point. Funding proves funding. Coordination proves coordination. A media strategy proves there was a media strategy. Federal lobbying proves people were lobbying the federal government. What it does mean is that when a person tells me everybody knows about postpartum depression because the condition is simply so obviously real that society naturally became aware of it, I now have a different question, which is how much of what people believe they discovered independently was actually repeated to them through a funded network that describes its own coordination in its own annual reports.
 
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