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June 4, 2004 - Subscribe - Contact Us - Rate Card - Place an Ad Valley&State Backpage O&E Sports Archives Classifieds Faith&Beliefs Obituaries Revels May 21, 2004 Post-partum depression is a treatable affliction By Steve Zimmerman Ashland Daily Tidings The birth of a baby can be one of the happiest moments in a couple's life. It can also trigger stresses that can overwhelm the strongest of relationships. Postpartum depression is a situation where stresses and sad, anxious feelings overwhelm a new mother to the point that, untreated, it can progress to crisis proportion like happened in the Andrea Yates case in Texas. Yates suffered deep and severe PPD but had no support mechanism to help her through. Having no support group, coupled with an unsympathetic husband whose only concern was for her to be home with the kids and continually pregnant, led Yates to snap and drown two of her children. Her depression had progressed into psychosis. But it did not have to happen. Early treatment of the disease would have saved Yates and her children from the tragedy that befell them. Jani Rollins, Ashland Obstetrician and Family Care physician, talked about what postpartum depression is and when it occurs. "It occurs after delivery and peaks at about the third postpartum week," she said. "Although it can occur or be diagnosed anytime during the first year. About 10-15 percent of pregnancies have true postpartum depression." Rollins said there is no true way to predict who will suffer from postpartum depression but there are some factors that can predict the disease. "People who are at greater risk have higher stress in their life," she said. "Women who do not have a lot of support or who have preexisting emotional problems are certainly at risk. People who have had a history of postpartum depression during previous pregnancies are also at higher risk." The biggest concern for those suffering from PPD is the relationship between the mother and baby and the bonding process. Martha (not her real name) has had two children (ages 5 and 2 1/2) and has suffered PPD with both pregnancies. She is done having babies because of the trauma of postpartum depression. Martha found herself becoming depressed after the birth of her first child. "My biggest problem was insomnia and anxiety," she said. "After we came home, I felt like I didn't want anything to do with her. I was overwhelmed and not prepared." Martha had a support system to help her through the depression. But it didn't help. "I felt alone," she said. "My husband was there and his family was there helping so I had that kind of support system. But I felt like I didn't have anyone to talk to. I didn't have anyone to relate to who had gone through it." Martha recognized the problem and sought medical help quickly. "My OB (Cynthia Olson) actually recognized what was going on," she said. "I was in denial at first that I was even depressed. She put me on antidepressants and I went off them right away. I finally went to see a counselor for a year and that helped. She helped me recognize that it is not my fault and there is nothing to be ashamed of." Martha said her husband also did not know what was happening to her. She said he felt helpless because he could not help her and didn't know what to do. She finally felt released from the PPD after the birth of her second child. "My doctor put me back on Zoloft and I am doing pretty good with that," she said. "I went off the medication during my second pregnancy and after my son was born all the symptoms came back." After the second child, Martha and her husband talked about what he went through during her depression. "He said he felt overwhelmed, helpless and exhausted because he had to take on most of the baby care at night so that I could sleep," she said. Martha wants people to know there is not a stigma about having depression. "I felt that way the first time around but I don't anymore," she said. "It is not your fault. It is a chemical imbalance and something that needs to be treated, just like if you had a cold or pneumonia." When Rollins sees signs of impending depression in one of her patients, she uses specific medications to treat the illness. "Generally speaking, the SSRI's (selective seratonin reuptake inhibitors) are the accepted medications," she said. "Welbutrin is a class B in pregnancy so that is a safe medication. Prozac, Zoloft (and) Paxil are also the more well-known medications used to treat postpartum depression." Breast-feeding women need to be careful about which medications they should take. Paxil and Zoloft are the two most recognized as being safe for breast-feeding mothers. Rollins also suggests that couples deal with the depression together and find ways to remove the stressors together. "They need to find time for themselves," she said. "That can be hard to do depending on how many kids they have. The other issue is sexual dysfunction. With hormone changes and fatigue for the woman, a lot of times sexual dysfunction can be an issue for the men. Finding time to do things together, finding someone to watch the baby and having date nights are very important." Leaving the baby is very hard for most mothers. But it is something they must do. "Everybody's a little different but first-time moms are more anxious because they are trying to do everything right," Rollins said. "People tend to be a little more relaxed with the second child. "But it depends on their support. If they have relatives in town it is easier to leave the baby when grandma is around. And you have been in the baby-sitting loop because it is the second child." 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