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What To Do If You Feel Down

If you think you are experiencing depression while pregnant or after your baby is born, get help immediately: 

• Call your primary-care physician or OB-GYN for an immediate appointment. If your doctor doesn’t take you seriously, be persistent or call a different doctor.
• Ask your doctor or your baby’s pediatrician for a referral to a psychiatrist, psychologist or therapist with experience treating prenatal or postpartum depression.
• Request help from friends and family before and after giving birth. They can be especially useful if you need child-care assistance. Take any and all offers of support.
• Try to eat right and get plenty of rest. n Get out of the house; join a Mommy & Me exercise or play group. Take your baby for a stroll down a pleasant street. Stop into shops and interact with other adults.
• Visit websites such as Depression After Delivery, Postpartum Support International, the Center for Postpartum Health and the National Association of Postpartum Care Services for information, support-group contacts, resources for fathers, reading lists and other help.
•Pick up a copy of Beyond the Blues: A Guide to Understanding and Treating Prenatal and Postpartum Depression by Shoshana Bennett and Pec Indman (Moodswings Press, 2003).

Find Out More
After giving birth to her daughter, Rowan Francis, actress Brooke Shields suffered a severe case of postpartum depression. She tells her story in her book, Down Came the Rain: My Journey Through Postpartum Depression (Hyperion, 2005).

When Mama Sings the Blues

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Everything seemed normal during Sherryl Hartman’s pregnancy and labor five years ago. Her son was born healthy, and she had plenty of support from family and friends in her town of Elkridge, Md. A few days after delivery, however, the then 26-year-old Hartman began to feel depressed. “I just started bawling like a baby,” she says. Late-night panic attacks soon followed: Hartman’s heart would race and she would feel anxious and overwhelmingly emotional. It was difficult to control her strong urge to leave the house—and her newborn.

    Hartman called her midwife and explained what was happening. “She said it was just the baby blues. She told me to find a hobby and I’d feel fine,” Hartman says. But it wasn’t simply the blues. Hartman had a severe case of postpartum depression (PPD).

   Her crying jags and panic attacks continued. Soon she began to self-inflict pain by hitting herself on the head. Visits to her doctors and a psychological counselor at her local hospital brought no solutions.

    Finally, Hartman found a psychiatrist who prescribed both an anti-depressant and an anti-anxiety drug in addition to weekly visits with a psychologist. After two months of the combination therapy, her depression lifted, but she looks back at those first months after her son’s birth and feels a sense of loss. “Things were supposed to be so happy with a new baby in the house,” she says, “and I feel like I missed it.”

PPD: common yet undertreated
 Other symptoms of postpartum depression include irritability, apathy, lack of appetite, insomnia, irrational behavior, fear of hurting oneself or one’s baby and an inability to make decisions or to concentrate, according to the American College of Obstetricians and Gynecologists. And it is far more prevalent than most people realize, says psychologist Margaret Howard, Ph.D., clinical assistant professor at Brown University in Providence and director of the Day Hospital at Women and Infants Hospital of Rhode Island.

   “The women who have PPD think they’re the only ones, but 10 to 20 percent of women get it,” Howard says. “It’s vastly under-recognized, and as a result, it’s vastly undertreated.” But PPD can be treated with psychotherapy and anti-depressant medications such as Zoloft and Paxil. Studies suggest that babies of moms who breastfeed while taking Zoloft or Paxil do not behave or develop any differently than babies who are breastfed by unmedicated moms.

    Patients at the Day Hospital, a specialized treatment facility for pregnant and postpartum women who are suffering from depression, anxiety or other mood disorders, can receive group and individual therapy, lactation consultation, drug therapy and more without ever having to disrupt breastfeeding or separate from their newborn.

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Alice Lesch Kelly is a health and psychology writer and co-author of Conquering Infertility: Dr. Alice Domar’s Mind/Body Guide to Enhancing Fertility and Coping With Infertility (Penguin Books, 2004).