The word matrescence is not in most clinical training. It probably should be. The closest concept that does appear is postpartum depression, and the two are routinely treated as overlapping categories in conversations where they should not be.
This is a short post because the distinction is short. I am writing it down mostly so I have a paragraph I can hand to people instead of trying to explain it from scratch every time.
The actual distinction
Matrescence is a developmental process. The framing comes from anthropologist Dana Raphael in the 1970s and was extended into clinical psychology by Aurélie Athan and Alexandra Sacks. It describes the psychological, hormonal, social, and identity-level transition into motherhood, modeled as a developmental stage analogous to adolescence. It is not pathological. It can be turbulent. It is supposed to be.
Postpartum depression is a clinical diagnosis. It has DSM-5 criteria, established prevalence data, and well-validated screening instruments (the Edinburgh Postnatal Depression Scale being the most common). It is a mood disorder with a perinatal onset specifier. It is treatable, and not treating it is dangerous.
The difference matters because they get confused, and the confusion runs in both directions.
Both directions of the confusion
Underdiagnosis. A person experiencing actual postpartum depression sometimes gets told, by family or by a clinician, that what they’re feeling is “just” matrescence — a normal developmental transition — and given a wait-and-see response. This is harmful when the person actually meets criteria for a clinical mood disorder. The normalization framing, applied to the wrong patient, delays treatment.
Pathologization. A person going through the developmental transition that matrescence describes — restructuring identity, grieving a previous self, experiencing intense ambivalence — sometimes gets told that what they’re feeling is depression, when the experience is uncomfortable but developmentally normative. This isn’t harmless either. It produces unnecessary medication, unnecessary self-doubt, and the message that an already-isolating experience is also a sign of something wrong with them.
Why I think this is a counseling-training problem
In training programs that focus on perinatal care, matrescence is increasingly part of the curriculum. In general counseling training it isn’t. So a clinician without perinatal specialization, faced with a parent in distress in the first year postpartum, has only one well-trained category — postpartum depression — and tends to fit the patient to it.
The fix isn’t elaborate. It’s a single half-day of training and a screening protocol that doesn’t collapse the two. The Sacks and Athan framework is the place to start.
References
- Athan, A. M. (2020). Reproductive identity: An emerging concept. American Psychologist.
- Sacks, A. (2017). A new way to think about the transition to motherhood. TED.
- Raphael, D. (1973). Being female: Reproduction, power, and change.
This post will probably get expanded into something longer once the BRCA project is further along.