Postpartum Depression ?

Q: I've heard a lot about postpartum depression in light of the five children who were killed by their mother. Just exactly what is it and what can be done to prevent the kind of tragedy inflicted on these children and their family?

A:I read an interesting study a few weeks ago about maternal guilt. It seems that no matter how well one's children turn out, almost all women experience some degree of repetitive and recurring guilt regarding their behavior as mothers. I worry then that many women will wrongly identify in some unhealthy way with the conduct of this mother and the suffering she inflicted on her children and family. If she was suffering from postpartum depression, it was of a unique nature unlike that experienced by the vast majority of women so afflicted. Some published reports indicated that she was taking anti-psychotic medications that would imply that she might have been suffering from postpartum psychosis, an altogether different kind of mental illness. There are varying degrees of emotional distress encountered by women after the birth of a child. The most common is called the "postpartum blues". This is an emotional let down experienced by 50-60% of all women that may be due to persistent pain, fatigue, concerns about the responsibilities of motherhood, and self-image. This typically lasts from a few days to a few weeks and will usually resolve with the establishment of a new schedule in the context of a supportive environment. Postpartum depression can occur in about 25% of all women and is characterized by: A depressed mood and loss of interest in most activities A significant change in appetite or weight Excessive sleep or insomnia Agitated behavior or excessively withdrawn Feelings of worthlessness or inappropriate guilt Difficulty concentrating Recurrent thoughts of death or suicide Women with a history of depression or psychosis before pregnancy are at a much higher risk of developing postpartum depression and severe mental illness and should be treated before, during, and after the pregnancy. Major marital or relational problems and an unwanted pregnancy will also increase one's risk. Keep in mind as well that women are under tremendous pressure to perform as mothers in a society that offers less and less support for motherhood. Anyone close to a woman after the birth of a child has a responsibility to look for the signs of postpartum depression. This is especially true for physicians and other health care professionals coming into contact with the new mother and her children after the birth. Antidepressants are helpful in the context of ongoing therapy and organized assistance at home will make a difference. Isolation and an unhealthy sense of self-sufficiency may make the situation worse. Postpartum depression may not be avoidable, but if identified early and treated, its effects can be minimized and the health and safety of the new mother and child protected.

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