Postpartum depression can prove devastating

Imagine this: You’ve just had a baby, a baby you wanted very much. You’re exhausted after your labor; you don’t feel that instant love everyone told you would be there.

But it doesn’t feel any better after you get some sleep, such as it is at the hospital, with nurses and friends constantly stopping in. And it doesn’t feel any better when you go home. You feel overwhelmed with this new creature, and panic because they forgot to send you home with the instruction manual, or to tell you where the volume switch is.

Your partner helps, your mother helps, and things get better for a while. But Mom goes home and your partner goes back to work and you can’t figure out how to get out of your bathrobe.

As the weeks wear on, you can only just muster the strength to take care of your baby. You begin to dread her insistent cries, her endless needs.

Then one day you’re driving the two of you to the doctor, and you give serious consideration to wrapping your car, yourself and your baby around a tree, and you feel frightened and guilty and a certain bizarre sense of relief when you think of it.

If you’re lucky, your obstetrician, family practitioner or pediatrician will gently question you, looking for signs of postpartum depression, because that is what you have. And if you are doubly lucky, you won’t have heard Tom Cruise on one of his tirades about Brooke Shields, her new book about her postpartum depression, and the very devil in its two incarnations – psychiatry and psychiatric medications.

I think Ms. Shields said it best in her Op-Ed piece for the New York Times: “I’m going to take a wild guess and say that Mr. Cruise has never suffered from postpartum depression.” Nor, I might add, has he ever lived with a woman who did, since his two children are adopted.

Post-partum depression is dead serious, not vitamins and exercise serious. It is not the “baby blues” that affect 70 to 80 percent of new moms for a week or two. PPD affects 10 percent of moms, can occur any time within the first six months of giving birth, and can last a year or longer if left untreated.

Symptoms are just like those for a major depression with any or all of the following: low mood, irritability, anxiety, tearfulness, insomnia, fatigue, lack of appetite, suicidal thoughts and recurrent thoughts of death. The depression may be so severe that a mother cannot manage to care for herself or her baby.

Not only can PPD have a devastating affect on a woman’s self image and confidence in herself as a mother, her depression can affect the social, emotional and cognitive development of her infant.

Given the devastating effects that PPD can have on both mother and baby, treatment is imperative. While we don’t know the exact cause of PPD, it most likely has something to do with the enormous shifts in hormones that take place at the time of delivery and the effect that shift has on brain chemistry.

While hormone therapy is not currently recommended for the treatment of PPD, the National Institute of Mental Health is currently conducting a clinical trial on the use of estrogen for treating PPD. A particular form of psychotherapy, called interpersonal therapy, has proven enormously helpful, as has the addition of antidepressants, particularly the SSRIs such as Paxil and Prozac. (These are safe for breast-feeding moms.)

Treatment can literally make the difference between the gloom of night and the hope and light of day.

“If any good can come of Mr. Cruise’s ridiculous rant,” Ms. Shields wrote, “let’s hope that it gives much-needed attention to a serious disease.”

I couldn’t agree more.

Women are often too scared, ashamed or embarrassed to seek help. But there’s help out there.

Let your health-care provider know that you need it.