A CLINICAL DEFINITION<\/strong><\/p>\r\n\r\n\r\n\r\nLeba was suffering from postpartum depression (PPD), a form of maternal mental illness affecting at least one in eight\u00a0\u2014 and as many as one in five\u00a0\u2014 women across the world.<\/p>\r\n\r\n\r\n\r\n
In the past, researchers referred to any post-birth mood disorder as \u201cdepression,\u201d but today the medical world talks about postpartum reactions, acknowledging the range of conditions that can result from wildly fluctuating hormones: anxiety, bipolar disorder, obsessive-compulsive disorder (OCD), post-traumatic stress disorder (PTSD), or a combination.<\/p>\r\n\r\n\r\n\r\n
Not to be confused with baby blues, a short-lived bout of irritability affecting 90 percent of mothers for the first two weeks after birth, postpartum reactions generally do not go away without medical or therapeutic intervention\u00a0\u2014 or an integration of both.<\/p>\r\n\r\n\r\n\r\n
What\u2019s more, a fast-growing body of research indicates that maternal mental illness does not always wait for delivery:<\/p>\r\n\r\n\r\n\r\n
33 percent of women diagnosed with PPD developed the condition in their third trimester. Symptoms can also develop anytime in the baby\u2019s first year of life\u00a0\u2014 not just the first few months.<\/p>\r\n\r\n\r\n\r\n
\u201cWith each child, the depression hit later and later,\u201d Sari, a Baltimore mother of four relates. \u201cWith my youngest, I was fine until he was five months old. Then it hit.\u201d<\/p>\r\n\r\n\r\n\r\n
What causes maternal mental illness? A complex interplay of genes, stress, and hormones. \u201cHormones go up more than a hundredfold\u201d during pregnancy, says Dr. Margaret Spinelli, director of the Maternal Mental Health Program in Columbia University, as quoted in the New York Times. After birth, hormones plummet, causing a crash that can \u201cdisrupt brain chemistry.\u201d<\/p>\r\n\r\n\r\n\r\n
Some primary risk factors are biological: Women whose moms had postpartum (PP) reactions are highly susceptible, and women who once experienced pregnancy-related depression have a 50 to 62 percent risk of recurrence.<\/p>\r\n\r\n\r\n\r\n
Environmental factors also play a big role: the more stressors in a woman\u2019s life\u00a0\u2014 from financial strain to shalom bayis issues\u00a0\u2014 the more likely she is to get a PP reaction. Experiencing a scare during pregnancy\u00a0\u2014 even if it never materialized\u00a0\u2014 can also trigger PPD.<\/p>\r\n\r\n\r\n\r\n
Internal stressors impact a woman\u2019s risk as well. A woman from a family of high achievers, for example, is at high risk. \u201cShe had a baby, she\u2019s more limited, she can\u2019t cope as well\u00a0\u2014 but she\u2019s expecting the same output of herself,\u201d says Dr. Shula Wittenstein, a seasoned psychologist who works at Nitza, the Jerusalem Postpartum Support Network.<\/p>\r\n\r\n\r\n\r\n
Perfectionists are more likely to fall into depression when their birth or after-birth experience does not go as planned, because they aim for \u201cperfect\u201d even in areas they can\u2019t control. \u201cMany women are brainwashed not to take an epidural, or told that a C-section will negatively affect the baby for life,\u201d Dr. Wittenstein notes. \u201cThey\u2019re also told nursing is a must. And they feel the powerful societal pressure to have many children in close succession, regardless of circumstance that warrant rabbinic instructions to the contrary.\u201d<\/p>\r\n\r\n\r\n\r\n
The result, asserts the psychologist, is that women aim for these goals even when they don\u2019t have the capacity for them. And when they don\u2019t succeed, they feel like failures.<\/p>\r\n\r\n\r\n\r\n
Chaviva, who suffered from classic PPD, says, \u201cI made myself insane trying to nurse, but it simply didn\u2019t work. It took having three kids and consulting seven lactation consultants for me to accept that this is the way Hashem made me.\u201d<\/p>\r\n\r\n\r\n\r\n
Another internal stressor is the guilt felt when seeking a husband\u2019s help. \u201cThe mother is drowning, but she doesn\u2019t want to take away from her husband\u2019s Torah,\u201d describes Dr. Wittenstein. \u201cShe valiantly tries managing alone, pushing herself deeper into depression.\u201d<\/p>\r\n\r\n\r\n\r\n
Sari, an almost ten-year-veteran kollel wife, remembers feeling like a horrible Jew. \u201cHow could I ask him to stay home? I must have no chashivus haTorah, I\u2019d think. Then I\u2019d get angry at him for not offering to stay, thereby relieving me of the inner turmoil.\u201d<\/p>\r\n\r\n\r\n\r\n
A GLIMPSE INTO DARKNESS<\/strong><\/p>\r\n\r\n\r\n\r\nDepression, the most common postpartum reaction, varies significantly in severity. Many affected women report a constant state of sadness and irritability.<\/p>\r\n\r\n\r\n\r\n
Naturally upbeat and optimistic, Chaviva couldn\u2019t find it in herself to smile. \u201cEverything was wrong,\u201d she remembers. \u201cI couldn\u2019t shake the anger.\u201d Chaviva was unable to react to normal life challenges in a balanced way. When minor things went wrong, she would stew in a negative headspace\u00a0\u2014 for days. \u201cIf my husband didn\u2019t take out the garbage, he didn\u2019t love me, my marriage was falling apart,\u201d she says.<\/p>\r\n\r\n\r\n\r\n
Other mothers paint a picture of perpetual \u201coverwhelmedness.\u201d<\/p>\r\n\r\n\r\n\r\n
\u201cTaking care of my kids just didn\u2019t end. I felt I was being buried,\u201d says Mindy. \u201cMy toddler whining, my baby crying\u00a0\u2014 anything would set me off.\u201d Mindy\u2019s black feelings were exacerbated by a massive cloud of guilt: She had struggled with infertility for years. \u201cG-d gave me these two amazing gifts after all these years\u00a0\u2014 how could I not be happy?\u201d<\/p>\r\n\r\n\r\n\r\n
Rivka, who felt similarly submerged by routine responsibilities, says that in hindsight, she realizes her depression began in pregnancy. When she and her husband would read about their unborn baby\u2019s weekly development, the soon-to-be-Tatty would get excited and emotional. Rivka, in contrast, would be completely detached.<\/p>\r\n\r\n\r\n\r\n
\u201cI kept telling myself: You can\u2019t see the baby, that\u2019s why you\u2019re not feeling anything.\u201d Months later, Rivka had no difficulty loving her sweet infant\u00a0\u2014 she just couldn\u2019t handle even life\u2019s tiniest curveballs. \u201cIf I was in a rush and the baby had a dirty diaper, I\u2019d lose it,\u201d she recalls. \u201cI couldn\u2019t make decisions or problem-solve. I felt like I was about to crash \u2014 all day long.\u201d<\/p>\r\n\r\n\r\n\r\n
Most difficult to diagnose are cases of milder depression. Here, the woman functions outwardly\u00a0\u2014 cooking and laundering, caring for the baby \u2014 but her inner world is in tatters.<\/p>\r\n\r\n\r\n\r\n
\u201cI put on a Broadway show. No one in the neighborhood could have known,\u201d Leba says. \u201cAt home, though, I was in a fog. I wasn\u2019t relating to my husband, my kids.\u201d<\/p>\r\n\r\n\r\n\r\n
For Shira, who held a high-powered finance job through several babies\u00a0\u2014 and years of untreated depression\u00a0\u2014 the farcical charade was the scariest part of it all. \u201cI was having awful, awful thoughts: What\u2019s the point? Why am I living? I knew I could do something really bad to myself, and no one would even know to prevent it.\u201d<\/p>\r\n\r\n\r\n\r\n
Years later, in a discussion about that bleak period, Shira\u2019s husband remarked: \u201cIf you had stayed in bed for three days straight, I would have done something, gone for help. But you were totally functioning\u00a0\u2014 I assumed you were just in a really bad mood.\u201d<\/p>\r\n\r\n\r\n\r\n
BEYOND DEPRESSION<\/strong><\/p>\r\n\r\n\r\n\r\nOther widespread postpartum reactions include anxiety, obsessive-compulsive disorder (OCD), and post-traumatic stress disorder (PTSD).<\/p>\r\n\r\n\r\n\r\n
\u201cPeople don\u2019t associate anxiety with birth, but it\u2019s very, very common,\u201d notes Dassy Gordon, coordinator at Nitza. She\u2019s worked with mothers who were suddenly scared to leave the house, enter an elevator, or stay home alone. It\u2019s a vicious cycle: If the anxiety deteriorates into a full-blown panic attack, the woman starts feeling anxiety about having another attack.<\/p>\r\n\r\n\r\n\r\n
Anxiety often centers on the baby: Is she healthy? Happy? Developing right? In severe cases, a form of OCD may develop, where the mother constantly checks her baby\u2019s breathing. Sometimes it manifests only in thought: The mother has to keep telling herself\u00a0\u2014 again and again\u00a0\u2014 \u201cEverything will be okay.\u201d<\/p>\r\n\r\n\r\n\r\n
\u201cWomen suffering from OCD know it\u2019s illogical,\u201d Dassy says. \u201cBut they feel out of control. Their brains are being manipulated.\u201d<\/p>\r\n\r\n\r\n\r\n
Mindy, whose mother passed away suddenly when Mindy was in her eighth month of pregnancy, suffered from a mix of anxiety and PTSD. Coursing through every diaper change, bath, and bedtime was an underlying worry that she\u2019d die too\u00a0\u2014 leaving her children orphans.<\/p>\r\n\r\n\r\n\r\n
\u201cI was terrified. I was sure I would die, and who would take care of them?\u201d<\/p>\r\n\r\n\r\n\r\n
Birth is a particular trigger for PTSD: Studies suggest that the delivery process revives old stresses. What\u2019s more, many women experience birth itself as a trauma, especially if there are complications.<\/p>\r\n\r\n\r\n\r\n
\u201cBirth can be very frightening,\u201d Dassy observes. \u201cIt\u2019s understandable that many mothers have to process this trauma.\u201d<\/p>\r\n\r\n\r\n\r\n
Using hormonal contraceptives after birth may exacerbate\u00a0\u2014 or impersonate\u00a0\u2014 maternal mental illness. While some gynecologists gloss over the side effects, many women experience radical mood swings and mistakenly assume they\u2019re having a postpartum reaction. For others, hormonal treatment aggravates a preexisting condition, introducing new levels of despair.<\/p>\r\n\r\n\r\n\r\n
\u201cI had low-grade PPD for years,\u201d shares Shira. \u201cBut it was only under the influence of hormonal treatment that I started having suicidal thoughts.\u201d Shira found viable alternatives quickly.<\/p>\r\n\r\n\r\n\r\n
PPD\u00a0 AT HOME<\/strong><\/p>\r\n\r\n\r\n\r\nMaternal mental illness of any kind has a profound effect on the family. \u201cAkeret habayit is not just a cute catchphrase,\u201d says Dassy Gordon. \u201cIt\u2019s reality.\u201d<\/p>\r\n\r\n\r\n\r\n
In extreme cases, the household stops functioning: Kids wear dirty clothing to school, hygiene falls by the wayside, the supper table remains empty.<\/p>\r\n\r\n\r\n\r\n
In milder cases, the cogs keep turning, but the inner damage is acute. A mother with a postpartum reaction cannot attend to her children\u2019s emotional needs. Her marriage is severely compromised. And her relationship with her baby can be frighteningly flawed.<\/p>\r\n\r\n\r\n\r\n
\u201cIt was the worst at night,\u201d Chaviva remembers. \u201cShe\u2019d wake up, again, and I thought I would hurt her.\u201d<\/p>\r\n\r\n\r\n\r\n
Sari remembers thinking, I don\u2019t want to look at this baby.<\/p>\r\n\r\n\r\n\r\n
While most women experiencing such intrusive thoughts never hurt their children, writes Pam Belluck in an extensive New York Times piece on the subject, some take extreme measures to protect their babies. One woman\u00a0 slid down the stairs in a sitting position for months because she\u2019d imagined throwing her baby downstairs, reported Wendy N. Davis, the executive director of Postpartum Support International.<\/p>\r\n\r\n\r\n\r\n
Maternal stress may cripple a woman\u2019s ability to bond with or care for her child, studies indicate. As a result, the child\u2019s emotional and cognitive health may suffer.<\/p>\r\n\r\n\r\n\r\n
Dassy Gordon says passivity is a common fallout. Baby is developing a relationship with this world. When he smiles or cries and doesn\u2019t get reactions, he subconsciously thinks, \u201cWhy should I smile or cry? What effect do I have on my surroundings?\u201d<\/p>\r\n\r\n\r\n\r\n
\u201cThese babies can become apathetic, lying in the crib for hours each day,\u201d Dassy says. \u201cThey may grow into children who recoil from emotional attachment, who can\u2019t build healthy relationships.\u201d<\/p>\r\n\r\n\r\n\r\n
Older siblings can also sustain long-term effects. Struggling with typical new-child jealousy and insecurity, they need extra love and attention. Instead, they might receive copious amounts of screaming and yelling, or feel obliged to take on a protective role, propping up a fragile mother who cries endlessly.<\/p>\r\n\r\n\r\n\r\n
But, Dr. Wittenstein stresses, children are very resilient. If a woman seeks help in a timely manner, her kids will likely make a full recovery.<\/p>\r\n\r\n\r\n\r\n
Beyond the children, the marriage relationship is obviously undermined. Many men\u00a0\u2014 especially first-time fathers\u00a0\u2014 are unfamiliar with postpartum reactions, and their ignorance adds insult to an already difficult dynamic. \u201cYou have a young boy who married a beautiful, charming wife,\u201d Dassy Gordon says. \u201cThen she\u2019s sick for nine months straight. When she gives birth, he\u2019s thinking, \u2018Finally, I\u2019ll have my happy wife back!\u2019 But the opposite happens.\u201d<\/p>\r\n\r\n\r\n\r\n
Some husbands brush it off as \u201cnormal moodiness.\u201d Then the wife starts making demands, and he gets resentful. \u201cHe doesn\u2019t understand that he needs to stretch beyond his normal schedule to help her get past this,\u201d Dr. Wittenstein says.<\/p>\r\n\r\n\r\n\r\n
Sari blamed her husband for everything. Unwilling to admit another factor was at play, she attributed her never-ending upset to him: \u201cIf only you helped more, I wouldn\u2019t feel this way.\u201d The anger predictably intensified during high-pressure times like Yamim Noraim or Pesach. One Succos, she remembers not speaking to him all Yom Tov.<\/p>\r\n\r\n\r\n\r\n
Shira, whose depression went undetected for years, felt deeply betrayed: She was in a dark pit, and her husband wasn\u2019t pulling her out of it. \u201cEvery woman wants her husband to take care of her,\u201d she says. \u201cBut I didn\u2019t realize what was happening myself, and my husband didn\u2019t pick up the cues.\u201d<\/p>\r\n\r\n\r\n\r\n
A CULTURE OF COPERS<\/strong><\/p>\r\n\r\n\r\n\r\nWhether they suffer from depression, anxiety, or PTSD, frum women experiencing postpartum reactions face unique challenges. In a community that prides itself on large families and masterful juggling skills, mommies who are not managing feel enormous shame. And because of the emphasis placed on the beauty of motherhood (\u201cEim habanim semeichah!\u201d), the woman who finds herself resenting\u00a0\u2014 even hating\u00a0\u2014 the role feels completely inadequate.<\/p>\r\n\r\n\r\n\r\n
\u201cWe are raised with expectations about how happy we\u2019ll be as mothers,\u201d says Rebbetzin Michal Cohen, LCSW, a kallah teacher, social worker, and rebbetzin of Congregation Adas Yeshurun in Chicago. \u201cThen you have a woman who can\u2019t get out of bed, or has thoughts of hurting her baby. What is she supposed to think?\u201d<\/p>\r\n\r\n\r\n\r\n
\u201cI lost my bren for Yiddishkeit,\u201d Chaviva recalls. \u201cLife was about keeping my head above water instead of becoming close to Hashem. I felt like a terrible Jew. I\u2019d been so passionate in seminary, I had so many dreams\u2026 what happened?\u201d<\/p>\r\n\r\n\r\n\r\n
Chaviva\u2019s pain was magnified by the fact that no one\u00a0\u2014 not even her husband\u00a0\u2014 validated her pain. When she reached out to mentors, they pooh-poohed her feelings, telling her it was normal to be overwhelmed after birth.<\/p>\r\n\r\n\r\n\r\n
\u201cThat was the hardest part: not feeling heard,\u201d Chaviva says.<\/p>\r\n\r\n\r\n\r\n
When she finally went to the psychiatrist, who told her, \u201cYou have textbook PPD,\u201d the relief was profound.<\/p>\r\n\r\n\r\n\r\n
Denial of postpartum reactions is unfortunately not the exception. This flawed approach to mental health illness\u00a0\u2014 resulting from community stigma or plain lack of awareness\u00a0\u2014 can cause years of needless suffering, sometimes irrevocable emotional damage.<\/p>\r\n\r\n\r\n\r\n
For Leba, it took six children and ten years of strained shalom bayis to seek help. Her refusal to face reality was part stigma, part ignorance. \u201cMy husband had a wife every other year,\u201d she says sadly, adding that he was nothing short of a tzaddik for putting up with her. \u201cI used to tell people: \u2018It takes eight full months to recover from birth, you\u2019re supposed to feel yucky!\u2019 Looking back, I realize how abnormal that sounds.\u201d<\/p>\r\n\r\n\r\n\r\n
When Leba\u2019s husband would show concern, wondering why she snapped so frequently at the kids, she\u2019d say, \u201cThis is not medical, it\u2019s avodas hamiddos.\u201d When Leba finally made the trip to the doctor\u00a0\u2014 at her husband\u2019s insistence\u00a0\u2014 she put up a tough fight.<\/p>\r\n\r\n\r\n\r\n
\u201cThe doctor\u00a0\u2014 who I\u2019d already decided was a quack\u00a0\u2014 recommended a mild antidepressant, and I was like, \u2018Are you out of your mind? Do you know who you\u2019re talking to? I\u2019m Leba Katz, I\u2019m normal!\u2019\u00a0\u201d<\/p>\r\n\r\n\r\n\r\n
\u201cIf your eyes weren\u2019t working well, would you not get glasses?\u201d the doctor matter-of-factly stated. \u201cYou\u2019re missing some serotonin. That\u2019s the whole story.\u201d<\/p>\r\n\r\n\r\n\r\n
The shame associated with therapy and mental health meds causes many frum women to delay treatment until the situation becomes untenable. \u201cWe have to be crawling on the floor, gasping our last breaths, in order to seek help,\u201d rues Rebbetzin Cohen. \u201cWhy do we do that to ourselves? I wish therapy were one of the Aseres Hadibros: Thou shalt seek help.\u201d<\/p>\r\n\r\n\r\n\r\n
Another factor possibly aggravating PPD incidence in our community is the fact that there isn\u2019t much emphasis on mothers taking care of themselves. Rebbetzin Cohen shares a telling incident: At the first session of a newly launched parenting class, she asked each woman to introduce herself. The questions included name, age, and range of children, and what each woman does to relax or unwind.<\/p>\r\n\r\n\r\n\r\n
\u201cMost of the women could not respond to the last question,\u201d Rebbetzin Cohen reports. \u201cI was floored. If you don\u2019t outfit yourself with the oxygen mask first, your entire family will be comatose!\u201d<\/p>\r\n\r\n\r\n\r\n
Part of being a mother, says Rebbetzin Cohen, is making sure you are mentally and emotionally capable of caring for your kids. A 45-minute exercise routine is just as important\u00a0\u2014 if not more so\u00a0\u2014 than making a fresh supper.<\/p>\r\n\r\n\r\n\r\n
\u201cAfter all these years, I finally started treating myself to facials,\u201d says Shira. \u201cIt sounds silly, but the emotional impact is real. Someone is taking care of you.\u201d<\/p>\r\n\r\n\r\n\r\n
Precisely when families are large, it\u2019s critical that women stay on top of their emotional wellbeing. The larger the family, the more children are affected each time Mommy lapses into a postpartum reaction.<\/p>\r\n\r\n\r\n\r\n
GETTING HELP<\/strong><\/p>\r\n\r\n\r\n\r\nTreatment for postpartum reactions involves a multipronged approach of physical support, emotional support, therapy, and medication.<\/p>\r\n\r\n\r\n\r\n
The first stop for a woman who suspects PPD is her obstetrician, who might refer her to a psychiatrist to evaluate if medication\u00a0\u2014 usually in the form of antidepressants\u00a0\u2014 is necessary. Next, the woman might call a postpartum support network like Nitza, who would refer her to a qualified therapist, hook her up with a support group, or arrange for a \u201cphone friend\u201d\u00a0\u2014 based on her preferences.<\/p>\r\n\r\n\r\n\r\n
Fearful of side effects to their unborn or nursing babies, many women are wary of taking medication (though research indicates the risk is minimal). But the damage of not taking it might be far more serious.<\/p>\r\n\r\n\r\n\r\n
Mindy, whose psychiatrist prescribed a low-dose antidepressant, says the impact was immediate. \u201cWithin a week, I saw a difference,\u201d she says. \u201cI was reluctant to take it, but eventually I realized: You take Motrin for a headache, antibiotics for an infection, and antidepressants for mental illness.\u201d<\/p>\r\n\r\n\r\n\r\n
Leba\u2019s results on medication were so positive that she\u2019s continuing to take them, even though her baby is now pushing two. \u201cI\u2019ll get off of them one day. In the meantime, I have to be an effective mother.\u201d<\/p>\r\n\r\n\r\n\r\n
For Chaviva, landing on the right medication and dosage took time. \u201cIt\u2019s not an instant happy pill,\u201d she says. \u201cBut it did allow me to become grounded again. Life\u2019s ups and downs kept coming, but the downs didn\u2019t send me flying down a staircase anymore.\u201d<\/p>\r\n\r\n\r\n\r\n
Therapy is another critical treatment piece. It often comes in the form of cognitive-behavioral therapy (CBT), a structured, present-oriented psychotherapy focused on solving current problems and recasting negative patterns; or of psychodynamic therapy, a more analytical approach that examines the client\u2019s past to reveal the unconscious intent of his actions or choices,<\/p>\r\n\r\n\r\n\r\n
Therapeutic healing is also essential. This refers to a woman sharing her experience: letting go of the guilt, shedding feelings of inferiority, and internalizing that postpartum reactions could happen to anyone.<\/p>\r\n\r\n\r\n\r\n
These feelings are facilitated when mothers speak openly with each other, normalizing the condition.<\/p>\r\n\r\n\r\n\r\n
\u201cInstead of pretending you have the perfect life,\u201d Dr. Wittenstein urges, \u201cshare your story. For every person who courageously shares, so many others are affected.\u201d<\/p>\r\n\r\n\r\n\r\n
Alternative healing methods like reflexology or massage may be beneficial. But, warns Esther Gross, author of You Are Not Alone and moderator of a Williamsburg-based support group, these alone cannot be effective. \u201cIt\u2019s like using an ACE bandage for a broken foot,\u201d she says. \u201cI meet women who spend $30,000 a year on alternative healing. I tell them: \u2018Stop sabotaging yourself. Go to a doctor.\u2019 \u201d<\/p>\r\n\r\n\r\n\r\n
The importance of a solid support system in treating PPD cannot be overemphasized: Research indicates that proper social support (regular phone calls, home visits, offers of help, empathy) can reduce symptoms by 50 percent.<\/p>\r\n\r\n\r\n\r\n
Husbands especially must be on board, offering extensive technical help and showing support for the interventions. Chaviva\u2019s husband\u2019s rosh yeshivah unilaterally directed her husband to make himself available both physically and emotionally.<\/p>\r\n\r\n\r\n\r\n
\u201cIt\u2019s funny\u00a0\u2014 now that I know he\u2019s available, I don\u2019t need his help as much,\u201d she says. \u201cKnowing he\u2019s there physically is so important to me emotionally.\u201d<\/p>\r\n\r\n\r\n\r\n
In contrast, Sari\u00a0\u2014 who\u2019s endured PPD four times\u00a0\u2014 has developed some coping mechanisms, but she still hasn\u2019t gone for professional help. \u201cI wish my husband would put his foot down and tell me: I\u2019m going to watch the baby and you have to go,\u201d she says. \u201cHe\u2019s just not that type.\u201d<\/p>\r\n\r\n\r\n\r\n
But whether or not Husband \u201cgets it,\u201d women like Sari must realize they deserve to take care of themselves. The short-term babysitting technicalities pale in comparison to the potential fallout of non-treatment.<\/p>\r\n\r\n\r\n\r\n
A narrow slice of PPD cases resolve spontaneously within three years. Most untreated cases deteriorate or become chronic. And because depression often occurs with comorbidities like anxiety or PTSD, the depression may diminish while the comorbidity remains.<\/p>\r\n\r\n\r\n\r\n
\u201cA 45-year-old woman may still be suffering from postpartum depression,\u201d says Dr. Wittenstein. \u201cWith each year, the impact becomes progressively more severe.\u201d This means that at first, PPD struck an otherwise healthy family. Now, after years of abstaining from treatment, the mother must deal with PPD along with a host of marital and parenting issues that developed as a result.<\/p>\r\n\r\n\r\n\r\n
What\u2019s more, Dr. Wittenstein tells mothers, even if the condition fades away, \u201cTwo to three years is a long time to live like this. For you and your family.\u201d<\/p>\r\n\r\n\r\n\r\n
PREPARATION AND PREVENTION<\/strong><\/p>\r\n\r\n\r\n\r\nWomen who endured postpartum reactions are generally determined to use every means at their disposal to avoid a repeat experience.<\/p>\r\n\r\n\r\n\r\n
\u201cNext baby, I will not leave the hospital before going on medication,\u201d Mindy says. \u201cI will pursue therapy before birth, while I\u2019m pregnant.\u201d<\/p>\r\n\r\n\r\n\r\n
\u201cI will get more help,\u201d Chaviva says resolutely. \u201cNo one else can mother my kids, but lots of people can wash dishes, fold laundry, and cook supper.\u201d<\/p>\r\n\r\n\r\n\r\n
\u201cI\u2019m open to bottle-feeding,\u201d Rivka says, recalling the physical pain that plunged her further into depression. \u201cI wanted to nurse so badly, but I\u2019d do anything\u00a0\u2014 anything\u00a0\u2014 to avoid this again.\u201d<\/p>\r\n\r\n\r\n\r\n
On a communal level, reducing the rate and severity of postpartum reactions requires greater awareness and open discussion. Dr. Wittenstein feels strongly that childbirth education classes should include more emphasis on \u201cnot-dream births\u201d and associated feelings of inadequacy and shock. Expectant mothers must learn more about PPD and its red flags, in a clear, non-alarming way.<\/p>\r\n\r\n\r\n\r\n
\u201cI assumed every woman with PPD was suicidal,\u201d says Rivka, who suffered from milder depression. \u201cIf I\u2019d only known to get help, I could have avoided two years of misery.\u201d<\/p>\r\n\r\n\r\n\r\n
Husbands must be especially prepared, since they are often the only ones in a position to help. Dr. Wittenstein\u2019s dream is for every rosh kollel or rebbi to check in with new fathers every few weeks after birth, asking, \u201cIs your wife getting enough sleep? Is she back to herself? Is there anything you\u2019re concerned about?\u201d Rabbanim should be supportive, lightening the pressure of husbands who may need to spend more time at home. Neighborly nurturing after birth is far-reaching. Besides meals and babysitting, women should try to tune in to the emotional needs of kimpeturin mothers. \u201cInstead of only asking, \u2018How are you managing?\u2019 try asking, \u2018How are you feeling? Are you happy with the baby?\u2019\u00a0\u201d suggests Dassy Gordon.<\/p>\r\n\r\n\r\n\r\n
Most of all, mothers must validate, validate, validate, scratching out the stigma with every conversation\u00a0\u2014 so that women like Sari feel comfortable seeking help. \u201cEven after experiencing depression many times, it\u2019s so hard to face it,\u201d says Sari. \u201cI\u2019m still convincing myself: If I ignore it, it will go away.\u201d<\/p>\r\n\r\n\r\n\r\n
Meanwhile, women like Leba\u00a0\u2014 who have found relief through medication and support\u00a0\u2014 are continually stunned at how joyful and manageable motherhood can be.<\/p>\r\n\r\n\r\n\r\n
\u201cI am beyond crazy about my baby,\u201d Leba says. \u201cHe\u2019s 24 months; I\u2019m still nursing him; I\u2019m hopelessly attached. I feel like he\u2019s my first kid.\u201d<\/p>\r\n\r\n\r\n\r\n
DEPRESSION IN DADS<\/strong><\/p>\r\n\r\n\r\n\r\nA little-known cousin of maternal mental illness, paternal postnatal depression (PPND) affects as many as 14 percent of fathers in the US. Experts dub it the \u201cunderscreened, underdiagnosed, and undertreated condition,\u201d contending that real incidence is probably much higher, since men are less likely to report symptoms.<\/p>\r\n\r\n\r\n\r\n
Depression in fathers presents differently than in their female counterparts: while men exhibit more traditional symptoms like fatigue, loss of appetite, or low motivation, they are less inclined to cry or show sadness.<\/p>\r\n\r\n\r\n\r\n
Which men are vulnerable? Researchers have found a strong link between maternal depression and PPND, likely due to poor marital satisfaction. Some studies even propose that maternal depression causes PPND. But regardless of the mother\u2019s condition, first-time fathers, unemployed fathers, and fathers of kids with special needs are associated with the highest rates of PPND.<\/p>\r\n\r\n\r\n\r\n
And while the effects of PPND are milder than those of maternal depression, normal child development can still be hampered. Research indicates that children whose parents are not depressed have a 6 percent rate of emotional or behavioral problems. In homes where only the father was depressed, 11 percent of children will develop problems; where only the mother had symptoms, the rate among children was 19 percent.<\/p>\r\n\r\n\r\n\r\n
Alarmingly, a child with two depressed parents has a 1 in 4 chance of having emotional or behavioral problems later in life. So both mothers and fathers should be on the lookout for the telltale signs of depression\u00a0\u2014 and deal with them swiftly.<\/p>\r\n","protected":false},"excerpt":{"rendered":"
What happens if your new baby brings you anxiety and depression, instead of joy and delight? How to recognize \u2013 and recover from- postpartum reactions.<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[8,1],"tags":[],"yoast_head":"\n
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