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Postpartum Depression

© John McManamy

"I began to feel as though I was sinking, under the ground, not of this world."

"A few weeks after I gave birth to my son," wrote Pamela Gerhardt in the Washington Post, "I rocked him gently to sleep, lay him in his crib, walked down the stairs, grabbed the vacuum cleaner and hurled it out onto the front lawn. It sat there all day, broken, the hose hanging from the blue spruce, the plastic pieces scattered on the lawn like tree limbs after a hurricane."

Welcome to postpartum depression, a condition that can ambush hopeful new mothers at the time when they least expect it and turn their dreams of parenthood into the worst of nightmares. The term postpartum merely refers to the triggering event. This is major depression, pure and simple, but with this cruel twist: A combination of ignorance and misplaced expectations - both on the part of the new mother and those who should know better - conspire to cause far more suffering than necessary.

"Bookstores file postpartum depression under psychology," Pamela Gerhardt notes in her article. "And how many women, giddy with the thought of becoming a mother, are perusing the mental illness section of Barnes & Noble?"

One guidebook offers this advice: "Treat yourself to a dinner out ... put on makeup." Another recommends a little mascara.

Weeks of mental anguish for Pamela followed, so she decided to consult a psychologist, who advised her to "shop at Nordstrom." Her obstetrician recommended she and her husband make more time for sex.

"A few weeks after demolishing that vacuum cleaner," she wrote, "my violent eruptions abated, only to be replaced by something far darker. I began to feel as though I was sinking, under the ground, not of this world, a feeling very similar to the one I'd had when my mother died ten years earlier."

Postpartum depression affects more than ten percent of mothers, with biology and environment contributing to its cause.

During weeks eight to 38 of pregnancy, progesterone levels increase seven-fold, estadiol 130-fold, and prolactin 19-fold, then drop sharply following delivery to pre-pregnancy levels. Also implicated are adrenal steroids, which affect cortisol which regulates the metabolism of food, and the thyroid.

Many women get better when their hormonal levels soon return to normal, but others can suffer for months or even years.

Women with a history of depression are at greater risk, as are those who react negatively to their weight gains and those with low self-esteem. Poverty and family upheavals also play a role, and studies have linked postpartum depression to traumatic birthing experiences, such as C-section or early hospital discharge.

The copyright of the article Postpartum Depression in Depression is owned by Kathy Brewis. Permission to republish Postpartum Depression in print or online must be granted by the author in writing.