I would have thought that, as I recall from medical school, the big issue around perinatal depression is that there is a societal expectation that people are happy. The husband, or whoever the father is, thinks that the mother should be happy. The siblings figure they should be happy. Their parents think they should be happy, and they're not. I would have thought it's part and parcel of the whole problem that there is this expectation. You're supposed to be happy, and perhaps there's some shame and unwillingness to talk about it because you're supposed to be happy.
With that, I have two questions. One is, why? How much of it is hormonal? I'm sure there are a large number of cases, because there's pre-existing depression, but how much of it is other things, like the situation the woman is in, if she is unhappy in the relationship or there's loss of freedom or lack of support? How much of it is situational? How much is hormonal? That's one question as to why. Then the second part of the question is, how much is that part and parcel of the whole problem of recognition and treatment, the fact that there is this expectation that you're supposed to be happy?