The early weeks of pregnancy are fragile—and confusing. Here, the answers to your questions.
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Everything seemed normal during Sherryl HartmanÂs 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. ÂI just started bawling like a baby,Â she says. Late-night panic attacks soon followed: HartmanÂs heart would race and she would feel anxious and overwhelmingly emotional. It was difficult to control her strong urge to leave the houseÂand her newborn. Hartman called her midwife and explained what was happening. ÂShe said it was just the baby blues. She told me to find a hobby and IÂd feel fine,Â Hartman says. But it wasnÂt 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 sonÂs birth and feels a sense of loss. ÂThings were supposed to be so happy with a new baby in the house,Â she says, Âand I feel like I missed it.Â The unrecognized illness Symptoms of postpartum depression include irritability, apathy, lack of appetite, insomnia, irrational behavior, fear of hurting oneself or oneÂs 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 & Infants Hospital of Rhode Island. ÂThe women who have PPD think theyÂre the only ones, but 10 to 20 percent of women get it,Â Howard says. ÂItÂs vastly underrecognized, and as a result, itÂs vastly undertreated.Â 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 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. Sidestep your shame New mothers may be afraid to admit that they are depressed and need treatment, says Ronald Rosenberg, M.D., a psychiatrist and OB-GYN on the faculty of Wayne State University School of Medicine in Detroit and co-author of Conquering Postpartum Depression (Da Capo, 2004). ÂThereÂs guilt, thereÂs shame, thereÂs a feeling that the baby will be taken away from them,Â Rosenberg says. Despite the self-imposed stigma, PPD can strike any woman, regardless of age, economic status or cultural background. However, a new motherÂs risk might be elevated if she has a personal or family history of depression; anxiety or depression during pregnancy; a more difficult than usual labor; little or no social support; marital problems; or a baby with a birth defect or disability. DonÂt postpone treatment New mothers can benefit from talk therapy or programs such as those offered at the Day Hospital in Providence, R.I. Many new moms feel overwhelmed because they think they have to be perfect mothers, and therapy can help them develop more realistic expectations. That was the case with Hartman, who was able to work through her feelings of inadequacy and her tendency to be a perfectionist. About 10 months after her son was born, Hartman no longer needed medication. She was worried that her depression would prevent her son from bonding with her, but it turned out not to be the case. Today, she says, Âmy son and I couldnÂt be any closer.Â