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Some Urge Routine Screening for Postpartum Depression

Postpartum depression affects about 15 percent of women in the weeks and months after giving birth. As Leta Hong Fincher reports, some health professionals and advocates are urging routine screening of new mothers for mental health problems.

Adrienne Griffen quit her job seven years ago to stay at home and fulfill her dream of raising children. But after the birth of her second baby by emergency Caesarean section, that dream went terribly wrong.

"I knew from the moment he was born that something wasn't right, because I remember lying on the operating table and feeling no connection whatsoever with this baby that just had been born, and it just continued to get worse from there," she recalls.

Griffen says she felt so desperate and depressed that she screamed at her baby whenever he cried. At her six-week postpartum medical exam, she said her obstetrician did not ask about her emotional problems, so her depression continued.

"I was just so angry, so irritable,” says Griffen. “My husband would walk in the door and I would just hand him the baby and walk out. I'd call him at work and say, 'I'm losing it, I'm screaming at the children, I can't get it together, what is wrong with me, I think I'm having a nervous breakdown.' "

Griffen is not alone. A recent study in Denmark shows that just 10 to 19 days after giving birth, women with newborns are seven times more likely than women with older infants to suffer severe mental illness. The study is outlined in the Journal of the American Medical Association. It says that problems range from anxiety and depression to bipolar disorder and schizophrenia.

Rapid hormonal and physiological changes after childbirth can trigger mental illness, especially if the mother is sleep deprived and lacks social support. But doctors say postpartum depression is consistently undertreated.

Jennifer Grosman is a clinical psychologist in Washington. She says that typically only one in five mothers suffering from depression is diagnosed. And only one in five of those women actually receives treatment.

"Women with postpartum depression are very ashamed of the problems that they're having,” she says. “They think that they're supposed to be happy and enjoying being a new mother and if they're not, then they really feel very guilty about that. So they may go to great lengths to hide how they're really feeling and sort of put on a happy face."

Grosman says she became interested in postpartum depression after she herself suffered from the illness with the birth of her first child. She says too few doctors screen for postpartum depression in new mothers, and that a routine questionnaire would be an effective way to catch many of the cases that otherwise go undetected.

"Obstetricians are reluctant to ask questions about a woman's emotional state because they're afraid of opening a can of worms that they don't know how to deal with,” says Grosman. “But if they were properly educated and informed and given the proper referral sources, then they would be better equipped to help serve their patients."

More and more health professionals agree that new mothers should routinely be screened for postpartum depression. Last April, New Jersey became the first U.S. state to pass a law that requires doctors to question new mothers about their emotional state before they leave the hospital---and again weeks later.

Adrienne Griffen says her depression lasted six months before it was finally diagnosed and she was treated with antidepressant medication and talk therapy. She says her problem could have been resolved earlier if her doctor had simply asked her how she felt.

"Throughout all this I just kept looking for somebody to give me this big verbal hug and for somebody to say, ‘You know what, it's O.K. People have felt like this, it's O.K., here's what's going on, here's what we can do to help you,’ and there was none of that. It was just sort of like this hands-off kind of thing."

Griffen now has three children and volunteers for a Washington branch of Postpartum Support International, a group that advocates congressional legislation to mandate screening for new mothers.