Perceptions and Attitudes Regarding Postpartum Depression on Reddit: Inductive Content Analysis

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. This can result in a reluctance among women to openly discuss their symptoms with clinicians. However, social media offers supportive communities and unique platforms for individuals to openly share the experiences and opinions that they may be less likely to disclose in person. Despite the availability of new Food and Drug Administration (FDA)-approved medical therapies for PPD over the past 7 years, research investigating comments about perceptions of recommendations for and barriers to treatment has been sparse.

The objective of this study was to evaluate the themes that emerge from comments publicly posted on Reddit discussions regarding PPD to assess perceptions of treatment recommendations and potential treatment barriers.

A qualitative study was conducted of comments made on Reddit responding to eligible posts published in English between August 2019 and August 2024. These posts were retrieved using the following individual keyword searches: "Zulresso," "Zurzuvae," "brexanolone," "zuranolone," "PPD," and "postpartum depression." Eligible posts had to meet the threshold of 5 or more votes and 5 or more comments. All comments that replied to each selected post were retrieved through the keyword search and Reddit's default "Relevance" display setting. Within our 2 overarching categories of interest (treatment recommendations and potential barriers to treatment), comments were selected as our main dataset and assigned to a single theme that best matched their primary focus using inductive content analysis.

Among the eligible 93 identified posts, a total of 3482 comments were evaluated for study inclusion. Percentages represent proportions of coded comments. Of those, 1348 comments were selected for content analysis based on relevance to the 2 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 (450/866, 52%), support for counseling (148/866, 17.1%), recommendation for lifestyle changes (145/866, 16.7%), and support for combination of therapies (123/866, 14.2%). Comments on barriers yielded 4 additional themes: perceived overdiagnosis of PPD and medicalization of situational postpartum distress (187/482, 38.8%), lack of social support and understanding within personal networks (154/482, 32%), insufficient institutional support (97/482, 20.1%), and inadequate health care provider support (44/482, 9.1%).

Our analysis of the Reddit comments revealed that there were significant perceived unmet needs regarding recognition and treatment of PPD, including the optimization of individualized treatment plans, greater public awareness about the condition, and enhanced support from both social and health care networks.