When Motherly Love Fails a Mother, on Postpartum Depression

Here comes those baby blues, from The New York Times that came with today’s Chinese papers, written by P. Belluck.

Postpartum depression isn’t always postpartum.  It isn’t even always depression.  A fast-growing body of research is changing the very definition of maternal mental illness, showing that it is more common and varied than previously thought.

Scientists say new findings contradict the longstanding view that symptoms begin only within a few months after childbirth.  In fact, depression often begins during pregnancy, researchers say, and can develop any time in the first year after a baby is born.

Recent studies also show that the range of disorders women face is wider than previously thought.  In the year after giving birth, studies suggest, at least one in eight and as many as one in five women develop symptoms of depression, anxiety, bipolar disorder, obsessive-compulsive disorder, or a combination.  In addition, predicting who might develop these illnesses is difficult, scientists say.  While studies are revealing clues as to who is most vulnerable, there are often cases that appear to come out of nowhere.

But a large analysis of thirty studies estimated that about a fifth of women had an episode of depression in the year after giving birth, about half of them with serious symptoms.

Jeanne Marie Johnson, 35, of Portland, Oregon, had a happy pregnancy, but she began having visions right after her daughter, Pearl, was born.  She said she imagined suffocating her while breast-feeding, throwing her in front of a bus or “slamming her against the wall.”

She said she was horrified at the idea of hurting her baby, and did not carry out the acts she envisioned.  Yet while overlooking a shopping mall skating rink, “I pictured myself leaning over the bridge and letting her fall and bust like a watermelon,” she said.

Most women experience such “intrusive thoughts,” as experts call them, never hurt their children.  Some take extreme measures to protect their babies.  One woman “scooched downstairs on her butt for months because she’d imagined throwing her baby downstairs,” said Wendy N. Davis, the executive director of Postpartum Support International.

But studies indicate that maternal stress may undermine women’s ability to bond with or care for their children, and that children’s emotional and cognitive health may suffer.

A complex interplay of genes, stress and hormones cause maternal mental illness, scientists say.  “Hormones go up a more than a hundredfold,” said Dr. Margaret Spinelli, the director of Women’s Program at Columbia University in New York.  After birth, hormones plummet, a roller coaster that can “disrupt brain chemistry,” she said.

Some women are genetically predisposed to react intensely to hormone changes.  And some are more sensitive to stresses like difficulties with family, finances, childbirth or parenting.

Maternal mental illness was recognized as early as the fifth century B.C., when Hippocrates proposed that fluid from the uterus could flow to the head after childbirth and cause delirium.

The latest version of Diagnostic and Statistical Manual of Mental Disorders, the established reference for psychiatric illnesses, said symptoms often include “severe anxiety and even panic attacks,” and estimated that half of what is considered major postpartum depression actually begins during pregnancy.

In a 2013 study, the largest screening of women for postpartum depression to date, Dr. Katherine L. Wisner of Northwestern University in Illinois and colleagues found that fourteen percent of ten thousand women had depression four to six weeks after birth, but that for a third of them it started during pregnancy.

Other research indicated that symptoms could emerge any time in the first year.

Another 2013 study assessed 461 women at two weeks and six months postpartum, and it found each time that eleven percent had obsessive compulsive symptoms, about four times the rate for the general population of women.  But it was “not the same eleven percent,” said an author, Dr. Dana Gossett, the chief of gynecology and obstetrics at Northwestern.  “Half got better by six months, and another half developed O.C.D.”

Emily Guillermo, 23, of Horizon City, Texas, had a smooth experience with her first child, even though her husband was deployed with the Army in Iraq and watched Christopher’s birth on Skype.  Then, despite using contraception, she conceived again.  She said she and her husband agreed to abort but considered after learning she was 20 weeks pregnant.  She said she descended into depression, feeling “like my body had been invaded.”  When Benjamin was born, Ms. Guillermo recalled thinking, “You were not supposed to be made.”

During several baths, “I held the water over his face until he started to flail, he could not breathe,” she said, “I was hearing a voice saying, ‘Do it and he will stop crying.  He’s not going to wake Christopher from his nap.’”

Something would make her stop.  But for a few seconds, she could not remember “if I had killed him, or if he had drowned, or what I had done,” she said.

Benjamin became frightened.  “When I’d walked into his troom, he’d burst into tears.”

Ms. Guillermo once tried to jump from a car as her husband drove but she said he stopped her, telling her: “You will love Benjamin.  We just need to get you on the right medication.”

Finally, a combination of drugs, plus the help of Postpartum Support International, worked when Benjamin was nine month old.

In Ms. Johnson’s case, she said she felt suicidal and escaped emotionally by drinking.  She finally agreed to take medication.  That, combined with a support group, helped.  Now, he relationship with two-year-old Pearl is loving an untroubled, said Ms. Johnson, who sees a therapist, but no longer takes medication.

She said: “There are still times at the end of the day where I don’t have energy left.  But even at really big stressful times, I haven’t felt panicky feelings or intrusive thoughts.  It’s just a whole world of difference.”

And so, Postpartum Depression AND Postpartum Psychosis is NOT something that we women make up at all, it’s how our hormone ran out of whack after we give birth, and, so, dudes, DO show some kindness to your wives (one at a time), after all, we are still the ones, carrying YOUR babies, and, do NOT call us crazy if we get in a bad mood either!!!

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Filed under Cause & Effect, Despair, Downward Spiral, Issues on Gender, Postpartum Depression/Postpartum Psychosis & Other Problems from After Birth

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