Post Partum Depression?
Q: I had this pretty badly 10 years ago. The biggest help to me came from
someone else who had been through it. She lent me a book: "Ended
Beginnings: Healing Childbearing Losses." This book covers the gamut of
childbirth-related losses, including PPD. When we think of such losses we
typically think of stillbirth or miscarriage. But there are other, less
obvious, losses associated with childbirth -- even if the baby is
perfectly healthy. For women who are predisposed to depression and other
emotional disorders, childbirth can be risky business. I urge you to read
the book to enlighten yourself about what may be going on with your wife
and give her a copy of the book too -- or get a trusted woman friend to
give it to her, if you have reason to think it will be better received
that way.
A:"Much has been written in the lay press about the 'baby blues,' and many
mothers, predominantly primiparas, will admit to a few hours or a day of
incredible emotional seesawing some time in the first week after
delivery. Episodes in which a mother dissolves in tears when she has
'so much to be thankful for' is the usual description. This is a
transient state that has been attributed to the tremendous change in
hormonal levels after the delivery of the placenta, although there are
no studies to confirm this belief. It is usually successfully treated
with reassurance and rest. True post-partum depression does occur,
however, and contrary to popular fantasy, it occurs in women who are
breastfeeding but usually only in women with a problem prior to
pregnancy.
The incidence of psyuchiatric disorders during pregnancy is remarkably
lower than age-adjusted rates in the general population, but rates in
the postpartum period increase dramatically to 1-2 per 1,000, with 50% -
75% involving affective disorders, 10% - 20% schizophrenic illness, 2% -
12% organic psychiatric disorders, and 12% anxiety disorders. Studies
of clinically depressed postpartum women reveal that 2 out of 3 have a
major depression. In an extensive review of postpartum mental illness,
Seager noted that with the introduction and use of antibiotics in the
mid-50's, many symptoms, described as puerperal fever or milk fever,
resulting in toxic-confusional or delirious behavior are no longer
reported.
A growing number of investigators have been unable to demonstrate
significant evidence for a unique pattern of mental illness in puerperal
as compared with nonpuerperal