Post-Partum Depression ?

Q: Post-partum depression is a severe form of "baby blues," mild sadness and anxiety that some two-thirds of new mothers experience. A few new moms -- one in 1000 -- suffer a complete break with reality, post-partum psychosis. That's what happened in 1984 to Nancy Berchtold, of Morrisville, Pa., after the birth of her daughter, Alison. Seventeen days post-partum, she became delusional, and had to be hospitalized.

A:Post-partum depression has been recognized since ancient times. In 460 B.C., Hippocrates described it. Other descriptions have turned up from time to time since then. But the condition has become widely publicized only within the past 15 years. The cause of all the post-partum emotional reactions remains unclear, but scientists cite several contributing factors. One is stress. "As a new mother, I felt overwhelmed," recalls Jane Honikman, founder of Post-Partum Support International (see Resources at the end of this article). "The first year with each of my three children was very hard. I was exhausted and sleep-deprived. Add a colicky baby, or a lack of emotional support, and you have a one-way ticket to the blues." Motherhood is most disorienting for first-time moms. Not surprisingly, they are at unusually high risk of post-partum emotional problems. Hormones also play a role. High levels of female sex hormones circulate in expectant mothers' blood, but drop precipitously within hours of delivery, contributing to biochemical depression. Pregnancy also increases levels of endorphins, the body's feel-good chemicals. Endorphin levels fall abruptly after delivery, adding to risk of depression. Finally, a history of depression increases risk. One-third of women with previous depression experience it post-partum, Dr. Parry says, and half of women who become depressed after one delivery relapse after subsequent births. To treat mild baby blues and more severe depression, Honikman recommends joining a mothers' group. Renshoe attended a new-mothers' support group three times a month for six months. "It was so reassuring to know that other women were experiencing what I was going through." After Nancy Berchtold overcame her post-partum psychosis, she couldn't find a support group. She placed a newspaper ad,

hoping to start one. Her group has since blossomed into Depression After Delivery, with 55 chapters nationwide (see Resources). Sometimes post-partum depression is caused by a thyroid disorder. Like sex hormones, thyroid hormones may fall precipitously after delivery and may not return to normal. Any medical workup for post-partum depression should include a thyroid function test. Thyroid abnormalities respond to replacement-hormone medication. Another reason to seek help is research suggesting that children of mothers with post-partum depression are unusually prone to insecurity, sleep disturbances, impaired cognitive development, and frequent temper tantrums.