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Campaign to spotlight signs of postpartum depression

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.


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