Dr Linda Helps - If you’ve ever dealt with a postpartum mood disorder, you know what a frightening and sometimes shameful experience it can be. One moment, you are happy, the next crying. Some days are great. Other days are met with confusion and hopelessness. You may have thoughts about hurting your baby or have panic attacks that feel like you are dying. You may have bizarre fantasies like throwing your baby out the window or toasting her in the oven. Maybe you feel obsessed and check your baby’s crib every 15 minutes.

Symptoms vary and range from mild blues to a severe form of the disorder called postpartum psychosis. It is rare but occurs in about one in a thousand women. Symptoms include hallucinations and delusions that sometimes place the safety of a baby in danger. Therefore, quick intervention is needed.

Since the disorder has a psychological component as well as hormonal and biochemical ones, what should a mother do who finds when gripped by this condition? In the past, women have suffered in silence, feeling horrible and ashamed. Others have been given advice like, “Drink a glass of wine or take a tranquilizer.” Today, although we don’t completely understand the causes of this disorder, we have treatment options.

Support groups can help women deal with the psychological issues related to the disorder and possibly prevent recurrence. Group meeting provide a place for women to tell their stories and discharge guilt related to feeling less than ideal mothers. Hearing other women talk who experience similar symptoms is reassuring. You soon realize you are not alone. Group members usually share strategies to cope with negative thoughts, depression and anxious feelings.

Physicians can offer antidepressants and mood stabilizers. According to Dr. Rex Gentry, a Bellevue hospital psychiatrist, research has not found any heightened risks for birth defects when pregnant women take Prozac, Paxil or older tricyclic antidepressants. He believes that if you weigh the developmental risks of a mother’s depression on the fetus, careful drug prescription used to stabilize mood disorder during pregnancy may be a safe prevention strategy.  

But breast-feeding women are not usually prescribed Prozac because it is metabolized more slowly and can accumulate in the baby’s liver. Also Lithium, often prescribed for bipolar disorder, is not prescribed for nursing women.

A group of English and now American doctors are experimenting with progesterone and /or estrogen treatments given immediately following birth. The intent is to stabilize hormonal changes that might precipitate the disorder. Estrogen and progesterone rise to many times their normal levels before birth and then drop after delivery.

Hormones changes are not the only explanation for these mood disorders since fathers and adoptive parents can also develop them. Researchers continue to look at factors like sleep deprivation, lack of social support, family history of depression, expectations and attitudes about new parenting and the baby’s temperament. The more we know, the better we can prevent the problem.