Buffalo author urges: Address postpartum depression

Nov. 06--Jessica Smock and her husband, Adrian Quackenbush, were in the midst of packing for a move from Boston to North Buffalo when their first child was born.

Smock, a former English and history teacher, also was trying to finish her dissertation for a Ph.D. in educational policy and development from Boston University.

During labor, she underwent an emergency C-section because her son's heart stopped as he neared delivery. Little Gavin was born colicky, with acid reflux and a milk protein allergy.

"It was a very stressful, anxiety-ridden time," Smock recalled. "Then I moved here and I was away from all the friends I'd made in Boston, and I literally didn't even know how to get to the grocery store. I had a baby who just cried all day and all night. He was inconsolable, and didn't sleep at all. I had trouble sleeping."

The big changes and parental challenges morphed into postpartum depression as the weeks, then months, moved along. As she struggled, Smock scoured parenting books and websites looking to fix what seemed so impossibly broken. Exhausted, she wondered whether she was fit to be a mom. Friends and family members encouraged her to go on more walks to try to clear her head and work through her despair. Little seemed to help.

It wasn't until she saw a specialist, and received treatment, that she began to emerge from a condition that is far more common than many moms -- and their loved ones -- understand.

An estimated one in six women suffer with a perinatal mood disorder during or after pregnancy, according to the Centers for Disease Control and Prevention. The most severe cases are rare -- psychotic forms that strike two of 1,000 women affected, but more often make headlines -- leaving many women with more typical cases unaware they have a medical condition that can be addressed with either medication, behavioral therapy, or both.

As her awareness grew, Smock was amazed at the number of myths that prevent women from getting help. She also learned that her writing partner in an online business, The Her Stories Project, also had suffered from postpartum depression. The connection led to an anthology by Smock and Stephanie Sprenger, of Denver, published this week -- "Mothering Through the Darkness: Women open up about the postpartum experience." ($16.95; herstoriesproject.com)

"I tell women, 'It's not your fault,'" said Dr. Wendy L. Weinstein, a Buffalo psychiatrist who met with Smock during work on the book and who specializes in women's reproductive and relationship issues. "You're suffering from a real illness, just like any other illness in the body. Just because you can't see it doesn't mean it doesn't exist. With treatment, you will get better and you will feel like yourself again."

Both women talked this week about the myths that come with postpartum depression.

1. All postpartum depression is the same More than 200 women sent essays to Smock and Sprenger for consideration in their latest book. Many wrote that their friends and family members were surprised they were suffering. "It was, 'Look at you in your Christmas pictures, you look so happy with your baby," Smock said. "And look at all your pictures on Facebook."

Smock and Sprenger's symptoms varied, as did those of the 35 essayists they feature in their book.

"People think of depression as people not being able to get out of bed, with the covers pulled over their head," Weinstein said. "It's such a myth. This is partly because of the media and how it's portrayed. You only hear about the sickest patients. The shock value is there. But there are different gradations."

Perinatal mood disorders run from mild to severe. They may or may not include the worries and racing thoughts that come with anxiety; the tears, irritability and ambivalence that come with depression; the racing heartbeat and obsessive, compulsive fear that you might harm or can't protect your baby. The experience also might dredge up unresolved past traumas that can bring the nightmares and panic attacks that often accompany post-traumatic stress.

Milder cases include moms who are sad and struggling to bond, Weinstein said. More serious cases involve severe anxiety, depression or OCD, she said, and should be dealt with promptly with help from an OB/GYN or mental health professional.

2. Many women are immune Two primary care doctors Smock saw during her first six months in Western New York assured her that too much time had passed since her son's delivery for her to be dealing with postpartum depression -- and besides, she was too bright to suffer from it. This week, a CNN piece on the subject tells the story of an African-American woman who once suffered and was told by friends, "That's a white woman's disease. We don't get that."

"Postpartum depression does not discriminate," Weinstein said. Women at greater risk, however, include those previously diagnosed with mood disorders, who have stressors in their lives outside the stress of having a baby, whose relationship with a spouse or partner may be shaky, or who have undergone a C-section, Weinstein said. A 2010 University of Rochester Medical Center study also suggests that poor women who live in urban areas have a significantly higher risk.

3. Pregnant women don't get it "That's not true at all," Weinstein said. Depression can set up during pregnancy, she said, in part because of hormonal shifts but also because of other risk factors or exaggerated fears that an expectant mom will be completely unprepared for motherhood. Adopting mothers and those who lose a baby to miscarriage or stillbirth also can suffer from postpartum depression, Weinstein and other experts said.

4. It won't last long and will go away on its own Depression can take weeks or months to develop and it takes time to recover. "Sometimes, this is part hormonal and recovery can come a little quicker," Weinstein said, "but I've seen women who've been struggling with postpartum depression for about a year who finally come in to see me."

The normal course of an untreated depressive episode runs from nine months to a year, she said, while Smock pointed out that while you suffer with a treatable condition, the first year also is a critical time for a baby's development.

5. This is a sign you're a bad mother "That's an awful myth," Weinstein said. "A lot of postpartum moms blame themselves. That's part of being depressed. The guilt is overwhelming and so too can be the sense of hatred and the sense of shame. When I tell them, 'It's not your fault,' if they can start to change their thought process, take a deep breath, that can help."

Weinstein often finds herself telling new moms it's normal for babies to cry. It helps when an authority figure can underline assurances often given by close friends and family -- another reason why professional guidance can be useful.

Treatment helped Smock get through the rough patches after her son was born 4 1/2 years ago. Gavin now deals with sleep apnea and seasonal allergies, but the colic long ago subsided. Smock has her doctorate degree and her husband, in-laws and part-time child care have helped her find time to write and carve out more time for herself.

Daughter Eliza was born a year ago last Wednesday. Five days afterward, Smock felt a hormonally charged feeling wash over her. She cried inconsolably for a while, but the feeling passed. Life these days is mostly good.

"Don't be afraid to ask for help as early as possible," she advised any mom who finds herself in a place like she was four years ago. "And don't be afraid to ask for more help from family and friends so you don't feel so overwhelmed in the first place."

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