When Depression Strikes After a Baby’s Birth


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Gina Wilcox was blindsided by postpartum depression. Within days after the birth of her son in June 2008, the Cary mother felt weepy, exhausted and overwhelmed. While many new moms experience brief "baby blues" after delivery, Wilcox's feelings kept getting worse instead of better. Soon, she knew she needed some professional help.

"About five weeks after my son was born, I was almost completely unable to function due to my depression and high levels of anxiety," Wilcox recalls. "I remember being in the grocery store and wanting to buy enough groceries for a month so I wouldn't have to go out of the house with my son."

Wilcox is just one of an estimated 10 to 15 percent of new mothers who experience postpartum depression (PPD), according to the UNC Center for Women's Mood Disorders. Recent research has shown that some fathers can experience postpartum depression, too.

For most new mothers, symptoms can start right after delivery, especially during the first six weeks.

"Postpartum depression is much more common than most people think," says Dr. Samantha Meltzer-Brody, director of the Perinatal Psychiatry Program in the UNC center, where Wilcox received help on an outpatient basis. "The most important thing is for women to recognize they need professional help and get it."

Open for treatment

Today, area obstetricians and pediatricians are more open to checking women for symptoms of the illness. At their six-week postpartum physician visit, new mothers typically are asked to complete a questionnaire on possible symptoms.

Dr. Darlene Esper, an obstetrician at WakeMed in Raleigh, says women with a history of being depressed are at a greater risk of PPD. These new mothers usually come two weeks after delivery for a postpartum visit.

"We work to keep a closer eye on these women," she says. "Many women just feel like they are losing control and not being good mothers. We want to make sure we get prompt treatment for all postpartum women who need the care."

The UNC Mood Disorders Center offers an outpatient clinic for women with PPD at UNC in Chapel Hill and Raleigh's Rex Hospital. Rex is part of the UNC Health Care System.

In September 2008, a six-bed inpatient unit for women with the illness opened at UNC Hospitals in Chapel Hill. It is the first of its kind in the country to treat women with PPD in a hospital setting. The program has extended visiting hours, so patients have regular contact with family and their babies.

UNC's Meltzer-Brody says other countries have similar inpatient clinics for women with the most severe symptoms. The vast majority of women are seen in outpatient clinics.

Wilcox improved over time with physician treatment, medications and talk therapy. She had a great deal of support from her husband, family and friends. Wilcox also attended Moms Supporting Moms, a decade-old support group at Rex.

"It was great to be in a group with other mothers who were having the same feelings," she says.
Getting professional help is most important for new mothers with PPD, according to the experts.

Records of women with postpartum depression go back centuries, but it still can be difficult for women to find adequate treatment. The stigma of mental illness keeps them from seeking help, Meltzer-Brody says.

Wilcox certainly agrees seeking treatment is the key to improvement. "I knew I would not do any better without professional help," she says. "I was fortunate to have had such strong support and excellent treatment in this area."

Recent national legislation now requires the National Institutes of Health to expand its research efforts on depression during and after pregnancy and increase funding for a national public awareness campaign.

Fathers can suffer too

While it's been known that some mothers suffer from postpartum depression, a series of studies over the years suggest that new fathers also may become depressed after childbirth. One in 10 new fathers has some prenatal or postpartum depression, according to a recent analysis of dozens of earlier studies.

The men were at higher risk for depression three to six months after the birth of a child, and their depression often corresponds with depression in the mother, the study found. The paper on fathers and depression related to childbirth was published in the May 19, 2010, issue of The Journal of the American Medical Association. Researchers at Eastern Virginia Medical School conducted the analysis.

The research analyzed 43 studies involving 28,004 fathers observed during the period between the first trimester of pregnancy until one year after the birth. Researchers concluded that the overall estimate of paternal depression was 10.4 percent, more than double the 4.8 percent prevalence among men in the general population.

"It is surprising and novel that the rate is much higher than most people would guess or expect," says study author James Paulson. "This is a condition that is not recognized by many folks. Postpartum in men is an alien concept to most people."

American fathers were at greater risk for depression than fathers in other countries, with rates of 14.1 percent compared with 8.2 percent elsewhere.

Fathers are just as susceptible to factors that tend to trigger PPD in mothers, especially for first-time parents. Fathers experience the same stresses and the same overwhelming emotions that accompany the life-changing event of becoming a parent, Paulson says.

Disputing myths about male depression

National psychologist Will Courtenay makes a career of helping men with depression and maintains the website SadDaddy.com.

"There is a cultural myth that men don't get depressed and this communicates to men that they shouldn't get depressed — or at least, not express it," he says. "And so they don't. They're more likely than women to try to hide their depression or to talk themselves out of it."

But there's help for new fathers who are hurting. Treatment options include talk therapy, group counseling and drug treatment. It also is important to have an open and frank discussion with family members.

The important thing to know about these symptoms, and about men's depression, is that they're treatable, he adds. Men don't have to continue suffering from them. And although it's a very serious — and sometimes life-threatening — condition, men can recover from depression. According to Courtenay, the key to recovery for men is the same as for women: getting professional help.

Jane Paige is a Triangle-based freelance writer.

 


SYMPTOMS OF POSTPARTUM DEPRESSION

 

* Loss of interest or pleasure in life
* Feeling sad, guilty and hopeless
* Not feeling hungry
* Less energy and desire to do things
* A hard time falling asleep or staying asleep
* Sleeping more than usual
* Crying a lot
* Feeling restless, tense or anxious

If any of the above symptoms last longer than two weeks, seek help from a physician, nurse, therapist, counselor or social worker.

If you are having any of the following feelings, seek help right away from your health care provider, clinic or an emergency room:

* Fear of hurting the baby
* Fear of hurting yourself
* Hallucinations/delusions or thoughts that break from the real world

Source: UNC Center for Women's Mood Disorders

WHERE TO GET HELP

Local Resources

* Duke University Pregnancy and Postpartum Support – Call 919-681-6840 for information.
* UNC Center for Women's Mood Disorders – The center offers an outpatient clinic in Chapel Hill and at Rex Hospital in Raleigh. Call 919-966-5217 for an outpatient appointment. There also is an inpatient unit in Chapel Hill for women suffering from postpartum depression.
* Wake County Moms Supporting Moms – The group offers support group meetings at Rex Hospital in Raleigh. For information on when and where, call 919-454-6946.

Online Resources

* Postpartum Depression Online Support Group – www.ppdsupportpage.com
* Postpartum Depression Online Support Group for Dads – www.postpartumdads.org
* Postpartum Support International – www.postpartum.net
* Telephone and online support, international directory and information – 800-944-4773

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