March 21, 2008

Scientific American's solid article on postpartum depression epidemic

There's an extremely comprehensive article on PPD on the Scientific American web site, including data from a number of current PPD-related studies from around the world. The article, written by Katja Gaschler, includes an in-depth look at the impact of PPD on the nascent bond between a mother and her baby.

Here's an excerpt:
"The consequences of depression inevitably reach beyond the mother. In a fog of sadness, a mother often lacks the emotional energy to relate appropriately to her baby. Overwhelming grief prevents her from properly perceiving a child’s smiles, cries, gestures and other attempts to communicate with her. Getting no response from mom, the child quits trying to relate to her. Thus, three-month-old infants of depressed mothers look at their mothers less often and show fewer signs of positive emotion than do babies of mentally healthy moms.

"In fact, infants of depressed mothers display something akin to learned helplessness, a phenomenon University of Pennsylvania psychologist Martin E. P. Seligman and his colleagues described in the 1960s. In Seligman’s experiments, an animal would conclude that a situation was hopeless after repeatedly failing to overcome it—and then remain passive even when it could effect change. A similar passivity characterizes depression. “Sometimes the infants mirror their mother’s depressive behavior,” Reck says.

"Such reciprocal withdrawal can start to fray the critical emotional bond between mother and child, especially if the depression occurs early in the baby’s life. Other work has shown that infants develop essential social skills in months two through six, building relationships with their mothers as well as other people. In a 2006 study of 101 new mothers, psychiatrist Eva Moeh­ler, Reck and their Heidelberg colleagues found that maternal depression strongly diminished the quality of a mother’s bond with her child at two weeks, six weeks and four months postpartum—but not at 14 months. Thus, depression during the first few months after birth may be particularly perilous for a child’s social development."

So .... in addition to treating a woman for PPD, it's equally important to treat the relationship that she has with her baby as well. Apparently, there are some really ground-breaking therapies happening around the world, such as at the Clinic for General Psychiatry in Heidelberg, Germany. This personally fills me with so much hope. How great to know about the good work being done out there!! Here's another excerpt:

"Tabea, a mother in her early thirties whose depression was severe enough to warrant hospitalization for several weeks after she gave birth, is still having difficulty interacting with her four-month-old son. At the Heidelberg clinic, a psychologist asks Tabea (which is not her real name) to sit in front of a video camera with her baby. Tabea speaks loudly to him. She raises her eyebrows and laughs. Her infant makes eye contact, and a smile flits across his face. His mother feels reinforced. But then the infant turns his head away. And Tabea says, “Well, what’s the matter now? Sulking again, are we? Did mommy leave you by yourself too long?” Tabea feels guilty for having had to leave her baby to be treated for depression.

"But it is normal for infants to turn away after a social interaction. That is how they regulate stimuli. It is not, as Tabea sees it, a personal affront or a sign that she is a bad mother. Nevertheless, Tabea’s misinterpretation of her baby’s actions can prompt a vicious cycle in which the child’s apparent rejection hurts Tabea, making her feel insecure and sad, which in turn has a negative effect on the baby.

"The therapist’s job is to break that cycle, large­ly by correcting a mother’s misimpressions and emphasizing what she has done well. Tabea’s wide-open eyes, for example, signaled that she was paying attention to her child. The psychologist points out that Tabea’s expressive face and melodious speech are similarly appropriate and helpful. Then she encourages Tabea to wait for her child to take the initiative, which will be her signal to respond.

"Some hospitals have mother-infant treatment centers for postpartum depression so that the mother can remain with her infant during treatment. There hospital personnel help the mother feed, diaper and bathe her child while also providing behavior therapy. Fathers can play an important part, too. Assuming he is not depressed, a father can significantly ameliorate the effects of a mother’s depression by building a close relationship with his son or daughter.

"Meanwhile a mother can take steps to ease her emotional burden by asking for help from family and friends, sleeping more, spending time with her spouse, getting out of the house and putting less pressure on herself. In the end, most mothers who receive adequate treatment—often a combination of psychotherapy, medication and self-help—usually recover completely within about two months of starting treatment, according to psychiatrist Ricardo J. Fernandez of Prince­ton Family Care Associates in New Jersey. Some mothers even emerge from their cloud of sadness with a new sense of clarity. As one mother said of her depression, 'It gave me the impetus to change my life.'"

I just love that last quote. I can totally relate to that "new sense of clarity" feeling that comes from rising up from the pit of despair. There is actually so much positive that you can take away from overcoming a devastating nightmare such as PPD. And it's gratifying to know that there are those in the scientific community who are working hard to contribute to what has truly become an epidemic among mothers.

1 comment:

Beth said...


Yet another good post. You give lots of good information.

I don't know why it didn't let you post, but I thank you for coming by and hope you will again.