The
soft gauzy wonder of being a new mother can be torn apart by a silent
invader that stalks women from pregnancy through as much as two years
after delivery.
This invader is known as postpartum
depression, or PPD, although it can have symptoms that are not commonly
thought of as depression at all, such as anxiety or compulsive
behavior. Some medical experts estimate one in five mothers will suffer
some postpartum mood disorder.
Heidi Koss-Nobel has a lovely Sammamish home and two delightful
daughters, but she knows the icy grip of this disorder on her psyche.
She is helping with a statewide awareness campaign that is just getting
off the ground.
Koss-Nobel's dedication comes from her own personal devastation and
recovery. Besides volunteering with the Washington state chapter of
Postpartum Support International (PSI), Koss-Nobel also works as a
postpartum doula, assisting women who already know they are at risk for
this disorder.
Potential symptoms are these:
- Difficulty sleeping, even when the baby sleeps.
- Excessive fatigue
- Inability to relax; can't sit still
- Irritability, crying, sadness
- Anxiety, scary or intrusive thoughts
- Less enjoyment of daily life than before the birth
- Physical symptoms, such as headaches, shortness of breath, numbness or tingling, heart racing
As Koss-Nobel explains, awareness can save lives. She had worried about
mood and asked her obstetrician about it, because she suffered fairly
severe premenstrual symptoms. This is a known risk factor for
postpartum mood disorders.
After her first daughter was born, she was hyper vigilant, had scary
thoughts and other symptoms. Her doctor said she could not be treated
with medications, and just needed to "get out more." She attempted
suicide three times before finally contacting a volunteer support
group. They helped refer her to a psychiatrist and therapist who
specialized in treating postpartum mood disorders.
"I was immediately put on antidepressants and mood stabilizers that
were safe to take while breastfeeding," she recalls. "I started feeling
better within a week, but my recovery was lengthy because I had been
untreated for so long." Her treatment eventually allowed her to safely
deliver her second child.
The suicide of Seattle mother Carol Soukakos several years ago led
her husband, Thomas, to launch a crusade for awareness. Soukakos, who
owns the Capitol Hill restaurant Vios, helped push for the state
legislation that is providing start-up money for the campaign
The Washington Council on Child Abuse and Neglect is leading the
effort. Director Joan Sharp says the $25,000 will be used primarily to
launch a new Web site and try to make a big media splash this winter.
An existing resource is PSI of Washington's telephone number,
1-888-404-PPMD (7763). Any woman can leave a message that will be
returned by a trained volunteer, and the organization promises to call
back within 24 hours. Volunteers can refer women to community health
professionals who specialize in this issue.
One of those helping to raise national awareness is celebrity mother Brooke Shields, author of Down Came the Rain: My Journey Through Postpartum Depression.
The book, which debuted last summer, gets a good review from
Koss-Nobel. She sees the publicity as a great vehicle for drawing wider
attention to a public health issue that relatives, neighbors and
friends of pregnant women should know about.
Koss-Nobel and others are working with health professionals to organize
a conference on postpartum depression next spring. One of their goals
is to get more material about PPD in waiting rooms and examining rooms,
where a mother may read a poster or pick up a handout. They also hope
to convince professionals to ask a series of screening questions of
mothers.
Pediatricians, family-practice physicians and obstetricians all see
women with new babies, but most attention during these short visits is
focused on specific medical questions. During a baby's first year, for
example, pediatricians have more contact with new mothers than any
other physician. While some are already on the lookout for postpartum
depression symptoms, adding a PPD screening to well-baby routine visits
would benefit mothers in Washington state, Sharp says.
Sally James is a Seattle freelance writer and mother of three.
Resources
- www.ppmdsupport.com: Washington chapter of Postpartum Support International
- www.postpartum.net: National Web site
- www.naps-doulas.org Seattle-based Northwest Association for Postpartum Support offers referrals for postpartum support doulas.
- Beyond the Birth: What No One Ever Talks About,
booklet by Abby Myers, ARNP, Dawn Gruen, MSW, Rex Gentry, M.D., and
Sandra Jolley, Ph.D., ARNP. Available for $6 from Washington's PSI
chapter. - Women's Moods: What Every Woman Must Know About Hormones, the Brain, and Emotional Health, by Deborah Sichel, M.D. and Jeanne Watson Driscoll, M.S., R.N., C.S. (Quill)
- The Postpartum Husband: Practical Solutions for Living with Postpartum Depression, by Karen Kleiman, MSW (Xlibris)
- This Isn't What I Expected, by Karen Kleiman, MSW, and Valerie Raskin, M.D. (Bantam Books)