“Post-Abortion Syndrome” is a Major Logic Fail

In 2009, Priscilla Coleman of Bowling State University and her colleagues published an analysis of the National Comorbidity Study and concluded that women who reported having had an abortion were at higher risk for anxiety, mood disorders and substance abuse than women who did not report having an abortion. Julia Steinberg of the University of California, San Francisco, and Lawrence Finer of the Guttmacher Institute recently reviewed the data (read their report) and reject Coleman’s finding.

After analyzing the same data from the National Comorbidity Study, Steinberg and Finer refute the causal link between abortion and mental health issues.  From the Washington Post:

“We were unable to reproduce the most basic tabulations of Coleman and colleagues,” Steinberg said in a statement released with the paper. “Moreover, their findings were logically inconsistent with other published research — for example, they found higher rates of depression in the last month than other studies found during respondents’ entire lifetimes. This suggests that the results were substantially inflated.”

What they did find was a that women who had multiple abortions were more likely to have pre-existing mental health disorders and to have experienced sexual or physical violence before the abortion, compared with women who had had one or no abortions. Taking that into consideration, researchers found no significant link between abortion history and substance abuse or mood and anxiety disorders. Not only does that finding dispute Coleman’s bogus claims, it reminds us that when thinking about supposed “mental health risks of abortion,” to use our common sense.

The reality is that most women who get abortions do not choose to do so for so-called “frivolous” reasons, as the Pro-Lifers would like us to believe. Often times there are a lot of overlapping factors that go into that decision. While plenty of women DO NOT experience depression after having an abortion, some certainly do. But suggesting that this link is causal – that abortion causes depression – is ignoring a whole piece of the puzzle and just bad logic.  Mental health is inextricably linked to situational circumstances, and the same kinds of circumstances that could lead to one needing an abortion are also ones that could affect mental health. Post hoc ergo propter hoc: correlation, not causation.

Let’s say a woman is raped and becomes pregnant from that assault. Or let’s say she becomes pregnant because her partner refuses to use contraception and she cannot afford to support or care for any more children. Or maybe she had a health condition that makes it really dangerous to continue the pregnancy. Or maybe she’s 16 and her parents will kick her out on the streets if they found out she was pregnant. So she gets an abortion, and she is also depressed.

Saying that she has “post-abortion syndrome” is kind of like saying that a woman who has to leave home to escape from an abusive partner and goes to a hotel is depressed because she’s suffering from “post-hotel syndrome.” Or that a victim of a vicious bear mauling is depressed because she is suffering from “post-reconstructive-surgery syndrome.”  She’s not depressed because she went to a hotel or had a medical procedure. She’s depressed because of the circumstances surrounding it.

And yes, often times the circumstances surrounding the decision to abort are depressing. If Pro-Lifers were actually concerned with women’s mental health, they would be working to improve those conditions (poverty, homelessness, rape, misogyny, sex education, healthcare) instead of working to take away access to a procedure that is most often chosen in order to prevent and alleviate further strain.

This study is just another example of how Pro-Lifers value the *airquotes* life of the fetus over the actual, real-life LIVES of women, and how they are ready to manipulate the truth in order to get what they want.

“Emotional Eating” is more than just emotional

In addition to working full time, I study health communication. You know, how people communicate about their health, how we can better bridge the communication between healthcare providers and everyone else, and how we can use communications to educate and motivate people to live healthier lives. For a class assignment, I was given the charge of making a “lifestyle transformation challenge.” I had to pick a behavior I wanted to change and track my progress towards making it a long-term lifestyle change. The point of this was to gain a full understanding of just how hard making a lifestyle transformation really is – an important thing to know if you are trying to convince others to do it.

So what behavior did I decide to change?  I’m a snacker. A big one. I feel most comfortable when I am eating something. My favorite foods are ones that you can eat over a long period of time – foods like artichokes or tacos that are more of a hobby kit than an actual meal.  I don’t have much of a sweet tooth, but I certainly have a salt tooth. Anything I can munch mindlessly while watching tv, writing or studying is a-okay by me. Anything with cheese is even better.

My lifestyle transformation challenge was to try to cut back on snacking, especially at night.  I came up with what I thought was a really creative way to do it – nothing like any diet plan I had ever seen.  I would give myself an hour-long window to eat dinner, and that would be it for the night.  I would not count calories or stress about what I ate for dinner, as long as I ate it within the hour window and didn’t nosh afterwards. I thought this would be easy.

Long story short: I failed to transform my lifestyle and stop snacking in the evening. But the good news, I suppose, is in what I learned along the way. During this challenge, I read Perfect Girls, Starving Daughters, a powerful book about my generation’s relationship to achievement, perfectionism, and food, by Courtney Martin. I had of course heard of “emotional eating” prior to reading the book, but had never realized what it really meant or considered my snacking habits to fall under that category.

I have come to really hate the term “emotional eating” and all that it conjures up. The idea that millions of women are crying into a bowls of ice cream or “eating their feelings” is a myth. It’s a myth with plenty of moral stigma attached – weakness, gluttony, failure, loneliness. (Cat ladies? Cathy comics?) The reality is that when stressed, depressed, tired, etc., one is more likely to consume more calories for a number of reasons that are much more complicated than just “eating your feelings.”

In Perfect Girls, Starving Daughters, Courtney Martin described a “perfect girl/starving daughter” dichotomy in each of us, and while I’m sure her book resonated more with some than others, it was so true to my own experience that I now consider it gospel. You see, girls of my generation were raised by feminist moms– moms that told us that girls could be or do anything. These were also moms that managed (somehow) to work and raise us and take care of the home at the same time. They were “supermoms” and we grew up observing their busy schedules and overachiever lifestyles. And we became overachievers. We are breaking barriers in the sciences, outnumbering men in colleges, playing competitive sports, and we still look beautiful and feminine and thin. We don’t sleep much because all of this takes time.  We are Martin’s “perfect girls.”

But we are also “starving daughters” – weak, needy girls who are tired and lonely and just want to be cuddled, looked after, and loved. There is a hole in our center – you could call it spiritual, you could call it psychological – that wants to be filled with love and comfort.  Every now and then the break-neck pace of overachieverdom overwhelms us and the “starving daughter” comes out. I can literally hear mine repeating the phrase “I am just so tired” or “I am NOT okay” over and over in my head. These are the days we spend on the couch, watching TV and feeling weepy. And for many of us, these are the days we eat – consciously or not – in an attempt to fill that hole.  Thanks to Courtney Martin, I am now able to recognize my starving daughter self for what she is – my own body telling me I’m putting too much pressure on myself. She’s telling me that I don’t need another resume-builder; I need comfort, rest and love.

But there are other ways to look at the issue of “emotional eating.”  From a more medicalized perspective, there is a strong correlation between obesity and stress, depression, and sleep deprivation.  And let’s remember that according to medicine, stress and depression and sleep deprivation are legitimate medical ailments with diagnoses, treatments – the whole shebang. Overeating is a symptom of these diseases. Eating is soothing, and therefore a quick and dirty method for coping with anxiety or stress. Not to mention the fact that busy (and often stressed) people don’t have a lot of time for grocery shopping or meal prep, and often grab less-healthy foods on the fly. Sometimes their only option is a vending machine. And when you need energy NOW, your choices will reflect that with sugar, caffeine, and carbs. With depression comes apathy and the need to self-soothe. Again, these symptoms make it more likely that one will eat to soothe, and will care less about what they are eating so long as it is satisfying (warm, filling, sweet, salty, etc).

And finally, sleep deprivation is a huge factor in so-called “emotional” eating.  For one, if you’re awake for 19 hours a day, you’re likely to consume more calories than someone who is only awake for 16.  Also, sleep has a big effect on your metabolism and the way you process food. Sleep deprivation can actually cause you to gain weight, or make it harder to lose weight. Also, sleep deprivation makes us tired – and contributes to anxiety and depression, for which we often use food to cope.  I am not going to lie.  The more I learn, the more I realize sleep deprivation is a big part of my problem.

I now understand that the reason my lifestyle transformation failed was that I was trying to treat a symptom instead of the disease. I was trying to stop snacking when I should have been addressing the reasons why I snack. Working full time and being a full time student was just too much for me. I was stressed out and living with more anxiety than usual. And I had physical symptoms too – particularly a sore neck that some days hurt so badly I couldn’t turn my head.  I wasn’t sleeping much, and homework kept me from spending as much time with my friends – the people who give me love.  I also gave up exercise (the great stress-reducer) partly because I didn’t have the time, but also because I didn’t have the energy. I also didn’t have time or energy to go grocery shopping or cook. All of these things were factors in my snacking. There were physical factors, mental factors, and environmental factors contributing to my low level of health, for which snacking was a coping mechanism. Taking away my coping mechanism without making any other changes simply wasn’t going to work.

The irony in all of this is that I have been studying health all semester.  I began this semester as a “perfect girl,” pushing myself to do it all because working full time while I was in school was a smart career move and the financially responsible thing to do. I made it about halfway through the semester before the “starving daughter” took over. But during this difficult time, I managed to learn some things.

There are a lot of messages out there that tell us that success and achievement are more important than happiness, or even one’s health. Those are the messages I pretty much bought into, and despite my new-found perspective, I still have trouble challenging them. After all, we are a nation of workaholics that tends to view illness as weakness, and obesity as failure.  Even though we often view medicalization as a bad thing, this is one of those times that medicalizing an issue can actually be helpful in overcoming the moral stigma attached to it.  And as Courtney Martin showed us, sociology – looking at “emotional eating” on a society-wide level – can also be a tool for overcoming stigma.

Now that the semester is finally coming to a close, I am committed to making a real lifestyle transformation: the decision to drop to working part-time. While my “perfect girl” cringes at my laziness and self-indulgence, my “starving daughter” is hopeful. With the extra 16 hours a week, I will be able to sleep more, exercise more, and get to the grocery store before it closes. I will be able to see my friends on weekends. Surely it will be a financial hit and probably not the smartest career move, but it is a real step towards reaching balance and achieving mind/body health. It is my hope that by treating the real problem, some of the symptoms – like snacking – will clear up on their own.