The Need to Screen for Postpartum Depression

Despite agreement that screening for depression should occur during prenatal care, ob-gyns don’t routinely ask about their patients’ mental health, says Shari Lusskin, M.D., a clinical assistant professor of psychiatry at New York University’s School of Medicine. And women don’t like to tell their doctors about their mental health, especially when they’re pregnant and postpartum.

Bridget Kane fell into an at-risk category for postpartum depression because she has a history of anxiety disorders. She also had a high-risk pregnancy, which can also trigger PPD, so her doctors had some clues.

Terri Denton tells a different story. She took antidepressants after her mother died in 1997 and went off her medication when she tried to conceive. But her depression was never monitored during her pregnancy, she says, probably because no one asked and she didn’t volunteer the information. And no one at the hospital spoke to her, even in general terms, about the possibility of the baby blues or worse.

One summer night, about three month’s after giving birth, Denton went to the emergency room. “All I wanted to do was see a doctor who would do something for me,” she recalls. Instead of finding someone to listen, she was driven by ambulance to another hospital’s psychiatric ward and nearly committed.

The fear that there was something terribly wrong with her, coupled with the shame and embarrassment of not bonding with her baby, isolated Denton from her family and friends. “I didn’t want to talk about it with anyone,” she says. “You’re supposed to be deliriously happy and I was far from it.”

Like Denton, Kane withdrew physically and emotionally. When co-workers doted over 1-month-old Charlotte, Kane could barely speak. “They were all saying she’s so beautiful, you’re so lucky, you must be so happy,” Kane recalls. “And I was just dying inside, wanting to tell them to please take her home with you, I can’t take care of her.”

But you can’t say how ashamed you are that you don’t want to mother the baby you dreamed about for so long, Kane says. You can’t talk about the dread that invades your every thought. “I felt like I had to hide from 95 percent of the people in my life,” she says.

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