A gutsy memoir of postpartum breakdown
A gutsy memoir of postpartum breakdown By Carole Goldberg The Hartford (Conn.) Courant Endless tears flow like a rushing mountain stream through Adrienne Martini's memoir, a frank exploration of how nature, nurture, nerves and numbness sent her to a mental hospital after the birth of her first child. But just as sunlight can make even troubled waters sparkle, Martini's wisecracking humor glimmers throughout, making this painful story more tolerable. Postpartum psychosis is back in the news after the second trial of Andrea Yates, who horrified the world when she drowned her five children in the grip of severe delusion. First found guilty in a flawed trial, and subsequently found insane, Yates is a terrifying example of the havoc this insidious affliction can unleash. Martini's condition, which put down ugly roots during her not-so-happy childhood, was postpartum depression. More serious than the "baby blues" that temporarily derail some exhausted and hormonally overwhelmed mothers, yet not as disastrous as psychosis, it nevertheless can endanger mothers and their babies. Martini, a writer and teacher whose voice is that of the sardonic journalist she once was, describes her emotionally fraught reaction to motherhood: "It's like getting the best Christmas gift ever, but Santa decided to kick the crap out of you before you unwrapped it." To explain what happened to her and why, she gives a history of the condition - "crazy mothers are nothing new," she deadpans - and her family story, ridden with manic depression, suicide, breakdowns and other ills going back generations. This information had to be pried from proud, close-mouthed people not given to sharing details of their infirmities, even with family. She's Italian on her father's side, but her mother's people are from Appalachia - West Virginia, to be exact - a region long unfairly mocked by others, where, she writes, "isolation has long been the hallmark." In its mountains and hollows, "deep suspicion ... of new faces and ... new ideas still thrives." Whether this closed-off area attracted people who already had this emotional makeup or engendered it, no one can say. Martini, who grew up in Pittsburgh, accepted her mother's crying jags and post-divorce bitterness as normal, as she did her own bouts of unwarranted sadness and anxiety attacks. She and her husband, Scott, finding themselves not hip enough for Austin, Texas, and not religious enough for Knoxville, nevertheless make a go of it in Tennessee, until she learns she is pregnant. Spoiling that good news is her escalating fear she will never be a good mother, based on her emotional fragility. With her difficult labor, inability to nurse and nights without sleep, Martini breaks down. Supported by her husband, family and friends and enduring her mother's mix of scolding, quarreling, baby-sitting and demanding love, she enters a Knoxville hospital, where a counselor, hearing her family history, marvels, "So it was really just a matter of time before you wound up here." She is diagnosed with "a disorder of mood rather than a disorder of thought." As if that hurts any less. With drugs, therapy, love and her body's gradual healing, Martini attains an at-first precarious reality and eventually the stability to have another child. It's a difficult journey, well told. The telling includes journal excerpts whose blunt honesty someday might shock her daughter: "Part of the problem is that I'm not really sure if I love you yet. I mean, I love the idea of you and the you you will become, but right now you're just a crying, pooping ball of need that threw my life out of control." Such wrenching words take guts to share, but they show the clear-headedness Martini knows she will need if someday her daughter should follow family tradition and "fall into her own emotional hell." http://www.myrtlebeachonline.com/mld/myrtlebeachonline/living/15264130.htm?source=rss&channel=myrtlebeachonline_living

Post Partum depression is a real mental condition which needs more research and attention by the medical profession and the public. Education for medical personnel for early diagnosis and intervention measures put in place for the patient. There should be information given to each pregnant female and family member on signs and symptoms to observe for. To inform all there is a possibility of post partum depression occurring. This is not done. Many times the female does not understand or recognize her slip into post partum depression. She feels guilty and can not explain (even to self) where or why the thoughts and feeling she is having comes from. In my opinion > this is another area where women's health is put on the back burner just as heart disease of a female was for years.

Postpartum depression affects 13 percent of mothers By Karin Grunden Everyone expects a woman to be happy after giving birth. “It’s the social norm,” said Joanne Goldbort, director of maternal health services at Union Hospital in Terre Haute. However, for some new moms, the reality is far from smiling over that so-called “bundle of joy.” About 13 percent of women experience postpartum depression, Goldbort said. Different from the “baby blues,” a more common short-term period of sadness associated with hormonal changes and exhaustion, postpartum depression begins about two weeks after delivery. Signs and symptoms include fatigue, withdrawal, insomnia, severe mood swings and a new mom’s lack of concern for herself or her baby. “Most women suffer in silence,” for at least a while before seeking help, said Goldbort, who while completing her doctorate researched the depression women experience after unexpected birth experiences. Later this month, Union Hospital’s Maternal Health Clinic will host educational sessions on postpartum depression. Sara Wheeler, dean of the Lakeview College of Nursing in Danville, Ill., is scheduled to present information on the subject during two sessions Aug. 31 at the Landsbaum Center for Health Education in Terre Haute. Wheeler will be joined by Margaret M. Pike, an associate professor at the Indiana University School of Nursing. An afternoon session will be offered for nurses, nurse practitioners, respiratory therapists, chaplains and social workers who care for women postpartum. An evening session will be open to the public. A grant is covering the cost of the program. Risk factors for postpartum depression include a history of depression after a past birth, a family history of depression, social stresses and a lack of social support, Goldbort said. In the extreme, some women experience postpartum psychosis, which is marked by confusion, disorientation, hallucinations, delusions, paranoia and fear of harming oneself or the baby. The case of Andrea Yates, a Texas woman who was retried last month after drowning her children in 2001, has brought the issue of postpartum depression to the forefront. The defense has said Yates suffered from severe postpartum psychosis after the birth of her fifth child. Goldbort said it’s important for women who are experiencing any form of postpartum depression to have support and to get intervention, for the health of the new mom, as well as her baby and other family members. Karin Grunden can be reached at (812) 231-4257 or karin.grunden@tribstar.com. If you go What: The Many Faces of Postpartum Depression, an informational session sponsored by Union Hospital Maternal Health Clinic. When: Aug. 31. A session from 7 to 9 p.m. will be open to the public. A session from 1 to 4:30 p.m. is for nurses, and other professionals who care for women postpartum. Where: Landsbaum Center for Health Education auditorium at 1433 N. 6½ St. in Terre Haute Cost: Free For more information, or to register for either program, contact Mary Huffman at (812) 238-7301 or mhuffman@uhhg.org. http://www.tribstar.com/news/local_story_225235220.html

Understanding postpartum psychosis Rare condition in spotlight following verdict The Daily Press Monday, August 14th, 2006 09:09:47 AM By UZMA YUNUS, MD For The Daily Press The Andrea Yates trial made headlines last month, when a Texas jury found her not guilty by reason of insanity in the tragic deaths of her children five years ago. Organizations like the National Alliance on Mental Illness praised the verdict, saying the decision is raising more awareness about the impact of severe mental health problems. But the trial also pointed out the need for more understanding about postpartum psychosis, a rare and severe psychiatric condition that affects some women after childbirth. The cause of postpartum psychosis is unknown, but has been linked to various factors including the change in hormone levels after pregnancy, the stress of caring for a newborn, and psychological factors like negative thinking patterns. Psychosis is a term that can be used for any mental health illness when a person loses touch with reality. It may be characterized by hallucinations (hearing voices or seeing things that aren't there), delusions (fixed beliefs) or paranoia (pathological suspiciousness). With postpartum psychosis, the onset of the condition usually occurs within four weeks of delivering the baby. It can be an outcome in women who suffer from a pre-existing mental health condition like bipolar disorder or severe depression. Symptoms can include delusions and hallucinations, along with anxiety, serious insomnia, disorganized thinking, confusion, mood swings and irritability. The women may be hearing voices, or feeling urges to hurt themselves or their babies. Studies have shown that postpartum psychosis runs in families. Women are at higher risk if a first-degree relative (like a sister) has the condition. And patients who have a history of severe postpartum depression are also at higher risk for psychosis. This illness is considered a psychiatric emergency that typically requires hospitalization for intervention. The patient needs to be evaluated and, if necessary, removed from the stressful environment. Treatment can also include anti-psychotic medications and sleep aids, and in some cases, electroconvulsive (shock) therapy. This type of therapy can be a safe option, especially for mothers who want to breastfeed, as it doesn't affect the baby. Another important part of the treatment involves the patient's family — helping them to understand this illness through supportive family and individual counseling. Postpartum psychosis occurs in about one in 1,000 women. But the rate of postpartum depression is much higher — about one in 10. Postpartum depression is a mood disorder. Unlike pyschosis, a mother suffering from this type of depression is still in touch with reality. She understands what's going on around her, but can't enjoy anything. The mother may experience crying spells, be unable to sleep, and feel guilty about not being able to care for or bond with her new baby. On rare occasions, very severe depression can cause symptoms of psychosis. It's important that women speak with their health care providers if they're exhibiting signs of postpartum depression or psychosis. While it can feel like an embarrassing subject, many women have thoughts of guilt or doubt about their newborns — and physicians are ready to help, not judge, their patients. In fact, 85 percent of new moms experience the postpartum blues — the mildest form of a postpartum disorder, which generally resolves itself. But if the feelings persist, women should get help. They can start by calling their primary care doctor. Patients may also seek an appointment with a psychiatrist or a therapist. If the symptoms are rapidly worsening or are accompanied by suicidal thoughts, go to the nearest emergency room. Postpartum psychosis doesn't occur very often, but the tragic outcomes of this illness can garner a lot of media attention, as was demonstrated by the Andrea Yates case. Yet mothers and their families can take comfort knowing that resources are available — and that postpartum depression and postpartum psychosis are treatable. Uzma Yunus, MD, is a psychiatrist at the Duluth Clinic-Ashland, where she's worked for almost five years. Dr. Yunus is especially interested in women's mental health issues. She has completed training at the University of Illinois in Chicago, which is nationally recognized for treating mental health problems affecting women. http://www.ashland-wi.com/dailypress/index.php?sect_rank=5&story_id=210536