Guess What's Here, TXReject! ?

Q: Seriously, I did read about this and it's heartbreaking. Apparently she was suffering from postpartum depression, which can really mess up some women. (A relative of mine just left her family for a few months after the birth of her youngest.) She called her husband at work and all she said was "You'd better come home." That poor bastard.

A:On this subject, here's a bit of pure speculation on my part: the woman has 5 children in pretty rapid succession, and she homeschools too. Perhaps there is an element of religious fanaticism thrown into the mix? I am going to be very curious to see if we hear about voices from God, or something to that effect. Having the blues after giving birth isn't all that unusual. As many as 50 percent to 80 percent of women experience the "baby blues": feelings of anxiety, sadness or crying spells, irritability, disturbed sleep (apart from baby interruptions) or change in appetite. Women and their families may be distressed by the experience, but it doesn't last long. The baby blues usually arrive two to three days after delivery. And with lots of loving support, new moms are pretty much back to normal within two weeks. But not all feelings of sadness after the birth of a child are the baby blues. They may be symptomatic of a postpartum depression. What's postpartum depression? "Postpartum depression is a common, but frequently unrecognized, devastating mood disorder," says Kathryn Leopold, M.D., assistant professor of obstetrics at Albany Medical Center in New York. Most women who develop postpartum depression experience symptoms within six weeks of delivery, but not within the first two weeks. While similar to the baby blues, postpartum depression is more severe and longer-lasting. As with other types of depression, the cause of postpartum depression is unknown. However, research suggests a probable combination of factors may be responsible, says Leopold. A woman experiences a dramatic change in her body chemistry after giving birth as a result of the sudden drop in estrogen and progesterone. She also experiences increased stress with an equally sudden change in role and responsibility. Add a biological or genetic predisposition to depression and/or a psychological predisposition (such as pessimism or low self-esteem), and you may have the basis for a postpartum depression. How successful is treatment? Most women make a full recovery, says Marlene Casiano, M.D., a Chicago-based psychiatrist with a subspecialty in postpartum depression. But they are at risk of recurrent episodes of depression with subsequent pregnancies, at menopause, or during times of high stress. The treatment for postpartum depression is the same as for other major depressions: antidepressant medication, often in conjunction with psychotherapy. As with any other medication, special attention must be paid if a woman is breast-feeding -- it may limit the choice of antidepressant medication, but it doesn't rule it out. Electroconvulsive

therapy may be used in situations when the depression is resistant to medication. "With psychotherapy," continues Casiano, "instead of just individual therapy, we try to involve the husband and/or other support people in a woman's life -- those who can give her some help. And we encourage the woman to take time to take care of her own needs." Support groups for postpartum depression are also beneficial. Belonging to a group lets a woman know that she isn't alone in her experience, and that she will recover. But first it's necessary to get treatment. Women experiencing symptoms of postpartum depression should talk with their obstetrician or a mental-health practitioner.