Rock-A-Bye Baby Blues

By Carrie Myers Smith

"I thought I was going to die. [My] emotions and moods, thoughts and reactions were all inappropriate and exaggerated. I cried when I should have simply frowned, trembled when I should have slumbered, and numbed up when I should have been high on love for my baby. I didn't think I'd ever feel normal again."

After the birth of her first child, Christine Gonzales expected to recover very quickly both physically and emotionally. Instead, postpartum depression (PPD) hit her like a storm.

"I just remember sitting in a rocking chair, rocking my baby with tears rolling down my face," says Gonzales. "When anyone would ask what was wrong, I would just repeat, 'I don't know, I don't know,' over and over."

But Gonzales is not alone. Ten to 15 percent of new mothers will experience PPD within six months of giving birth.

While most people think PPD is directly related to hormonal swings in the postpartum period, researchers point to a variety of causes including: a traumatic or disappointing pregnancy or birth, a lack of social support, stressful life events, a history of depression, hormonal imbalances, sleep deprivation or nutritional imbalances.

But, the causes of PPD are one thing; the effects are another story.

In her book, Sleepless Days, Susan Kushner Resnick recounts her desperate feelings.

"I thought I was going to die," writes Resnick. "[My] emotions and moods, thoughts and reactions were all inappropriate and exaggerated. I cried when I should have simply frowned, trembled when I should have slumbered, and numbed up when I should have been high on love for my baby. I didn't think I'd ever feel normal again."

What's worse is that the symptoms differ from woman to woman.

Crysty, mother of two, explains, "I was unable to concentrate. I didn't have the ability to be close to my kids ... I didn't even want to get out of bed. I could have gone to sleep at any time."

Just like Resnick, Crysty never thought these feelings would end. "I would cry because I didn't know what was happening to me. I thought I was going crazy."

Although many women experience PPD, not many cases are diagnosed. According to Jo Borrill, a biomedical research manager at the Mental Health Foundation in London, only about a quarter of postnatal depression cases are identified. Many researchers attribute this to the difficulties in distinguishing between PPD and the stresses of early motherhood.

But there is a difference. The "baby blues" are the emotional ups and downs that strike new mothers in the first few days following birth. Almost 75 percent of new mothers will experience tearfulness and mood swings.

"The difference with PPD," says Resnick, "is the fear of being alone with the baby, the thoughts of hurting the baby, or the obsession that the baby will get hurt somehow. And the physical changes rapid weight loss, insomnia, and anxiety attacks."

Nada Stotland, M.D., M.P.H., Chair of the department of psychiatry at Illinois Masonic Medical Center and professor in psychiatry and obstetrics at Rush Medical College, echoes these thoughts. "Psychiatric disorders are stigmatized and under-diagnosed in general," says Dr. Stotland. "Plus, women are supposed to be happy if they deliver normal babies, and they and their families often think they are unappreciative if they are depressed."

Like Christine Gonzales, most women create a picture-perfect image of motherhood in their minds — happiness, contentment, joy — a real feeling of accomplishment. When it turns out to be nothing like they expected, the image is shattered and so are their spirits.

And then there is the pressure from the outside. In our society, motherhood is considered a normal experience. Women are expected to continue on in their lives as usual after the birth of a baby. Researchers compare this to many other cultures where new mothers are pampered after birth.

The first thing to remember is that PPD is very real and that there is no need to suffer in silence anymore.

"Don't let anyone tell you it's all in your head, or that you need a vacation," says Resnick. "Find a qualified therapist who specializes in PPD."

There are myriad treatments available.

"Postpartum depression responds to the same treatments that work for depression that occurs at other phases of life," says Stotland.

These treatments include therapy and antidepressant medications. In the past women may have been hesitant to take antidepressants fearing that they would pass into their breastmilk. But, a new study in the February 2000 issue of the American Journal of Psychiatry showed that breastfed infants of mothers taking the antidepressant Paxil, had no detectable traces of the medication in their blood.

If medication is too frightening, there are natural alternatives for treating PPD including: herbal remedies, homeopathy, nutrition, bodywork and massage, exercise and rest. Like many alternative treatments, there are few clinical studies showing their effectiveness, but time is always a good test. Susan Roberts, N.D., president of the American College of Naturopathic Obstetricians, explains, "Many of these treatments have been proven over time to be safe and effective." But, Roberts cautions, mothers should seek experienced, credible practitioners to work with.

So, it seems, with the right steps, PPD is treatable and, perhaps, even avoidable. Most importantly, Resnick reminds us, it is temporary.

"I've accepted what happened to me," she says. "I lost my mind, for a little while. Postpartum depression will be temporary for you too, or your wife, or sister, or daughter, or best friend. But know this: you are not alone."

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