The tragic suicide of Deborah Thomas, the 33-year-old pregnant woman from Atlantic Beach who recently took her life and that of her baby even as she was being treated for a mental illness, will have a positive side if her husband and family are successful in publicizing the depression that they believe ultimately killed her.
One reason Thomas’ story became big news is that we like to think of pregnancy as a joyous time. But for too many women, that’s a myth. Extreme mood disorders, known as postpartum depression, can set in during pregnancy, and shortly after birth as well, and last for a year or longer.
Although psychosis is rare (one to two cases per thousand) and infanticide even more rare, studies show that the number of women suffering from depression or mood disorders during a pregnancy is about 10 percent, the same rate that the illness occurs in the general population. The rate rises to about one in five women experiencing a mood disorder after giving birth. For mothers facing poverty, or who may be teens or single parents, the numbers go up to more than two in five.
Hormones, stress, severe sleep deprivation and previous histories of mood disorders all seem to be factors. Each is a treatable condition, but the women in emotional pain tend to underreport or stay silent about how badly they feel. The stereotype of a woman overjoyed with the prospect or reality of new motherhood leaves them worrying about what’s wrong with them.
The shame, guilt and sense of failure from being unable to act motherly toward their babies, of having scary, intrusive thoughts about harming themselves or their babies and, ultimately, the isolation that grows from this secret life - all keep many pregnant women and new mothers from getting help.
The intense anxiety or depression that these women experience is often so crippling that basic self-care, such as eating or bathing, let alone care for an infant, becomes overwhelming and nearly impossible. The desire to not burden others - particularly husbands, partners and other relatives - may also be strong.
Frequently, women convince themselves that any slight improvement is a sign that recovery is around the corner. When the black clouds of despair return hours or days later, or another medication seems to prove ineffective, they feel like failures.
A friend or family member who suspects something is wrong will need the courage to ask the first simple and revealing questions and make statements that can give us more clues about how pregnant and new mothers may be feeling - and tolerate really listening to the responses: Do you feel like yourself? Are you sleeping at all? You look as if you have been crying. You look uncomfortable holding the baby. You don’t seem to be eating. When the baby cries, do you wish that you could just disappear?
This kind of conversation can lead a woman to seek help. Increasingly, new research is informing treatments, including medications, talk therapy and support from women and families going through similar issues. Often a sense of relief will accompany the discovery of a shared experience.
In Washington, legislation recognizing the seriousness of postpartum mood disorders has been introduced in the House and Senate, calling for funding for education and research. The text of the House bill, named the Melanie Blocker-Stokes Postpartum Depression Research and Care Act, named for an Illinois mother who committed suicide, estimates that more than 400,000 women a year suffer from mood changes ranging from mild to severe.
As Congress works to pass this legislation, we need to develop a coordinated network of care on Long Island, so that frightened and isolated women can know that help is available.
Pediatricians and obstetricians, social workers and psychiatrists, midwives and nurses are the care providers women use. All of us in these fields will have to work closely together to challenge the stigma of emotional disorders, to inform women and their families that there is help and to assure them that they need to get that help quickly.
It is the silence and shame that does far more damage than the disease.
BY SANDRA R. WOLKOFF
Sandra R. Wolkoff is director of the Diane Goldberg Maternal Depression Program of North Shore Child & Family Guidance Center.
