ROANOKE TIMES
Copyright (c) 1996, Roanoke Times
DATE: Tuesday, August 6, 1996 TAG: 9608060032
SECTION: EXTRA PAGE: 6 EDITION: METRO
SOURCE: LYNN BULMAHN COX NEWS SERVICE
The first months of a baby's life is supposed to be a joyous time for its parents.
But it's not always.
Sometimes mothers can get in the doldrums after giving birth. Often it's a temporary, minor thing - a case of the ``baby blues.''
In some cases, however, it can be more serious.
While about half of all mothers experience baby blues, postpartum depression affects an estimated 10 percent of new mothers. The latter condition occurs long after the baby's birth - usually three to six months after delivery - and is more severe than baby blues. In contrast, the common baby blues hit within three to five days of giving birth.
Psychiatrist Dr. Gayle Rowell discussed the maternal mental health conditions at a Brown Bag luncheon at Providence Health Center.
Baby blues usually go away within a week and are thought to be biological, she said.
Yet, Rowell explained, baby blues are not considered to be an illness. No treatment is needed other than the mother's getting good support from her family.
The mystery of why women get the baby blues is just now being discovered, Rowell told her audience. New medical research is finding links between the hormone oxytocin and maternal depression.
Oxytocin is the hormone responsible for uterine contractions during labor and for milk production, she said. Scientists have found receptors for oxytocin in areas of the brain that regulate one's emotions.
It is believed that mothers who breast-feed may not have as many problems with the baby blues as those who use formula.
A possible biological link between oxytocin and depression is further evidenced by some laboratory experiments, Rowell said.
Lab rats injected with oxytocin displayed maternal behavior even if they hadn't given birth. Mother rats given chemicals to suppress the oxytocin in their systems rejected their babies, she told the group.
Rowell said there are differences between simple baby blues and more serious psychiatric conditions.
Both the baby blues and postpartum depression have symptoms in common: feelings of guilt or inadequacy, feeling overwhelmed by the responsibility of caring for a baby, mood swings and crying. These symptoms are more severe in the postpartum depression, considered an illness.
With postpartum depression, a woman may experience obsessive worries about the baby, suicidal thoughts, panic attacks, low energy and an inability to experience pleasure. Sometimes intrusive thoughts about harming the child may be experienced - although mothers rarely follow through on them.
It is important to treat postpartum depression, Rowell said, because the mother's inability to provide emotional nurturing or to interact with the child could adversely affect the baby's development.
One way to prevent postpartum depression is to alter the risk factors. Rowell prescribes having a stable life and being financially sound before attempting to start a family.
Ideally, she said, a new mother needs to have a solid relationship in place with her partner so marital conflict won't add to the stress of having a baby.
A pregnant woman also needs easy access to caring professionals, such as her obstetrician. If there is history of mental illness present in her or her biological relatives, the woman should also have a psychiatrist to turn to, Rowell said.
Antidepressants can be prescribed, although it is not a good idea to take them and breast-feed. A choice may have to be made between the medications and nursing the infant.
``While breast-feeding is important in enhancing the bonding between mother and child ... the mental health of the mother is an even more important factor to consider in the health of the baby,'' Rowell said.
An even more severe mental illness is postpartum psychosis. This rare condition is considered a psychiatric emergency, Rowell said.
``This kind of problem ends up in the newspaper, when the mother severely abuses or murders her baby,'' she said.
All the symptoms of postpartum depression are present in postpartum psychosis. In addition, the mother may have hallucinations or be delusional.
In cases of postpartum psychosis, the mother needs to be identified and hospitalized before she can cause harm to her infant, Rowell said.
Maternal mental health problems are more likely to occur with the first baby, because of the adjustments a first time mother must make.
Also, younger mothers, such as teen-agers, may be especially prone to depression because they are more vulnerable and have to deal with more stress.
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