Print

Email story

Comment

Email editor

Pulse

The postpartum debate

The sniping between actors Tom Cruise and Brooke Shields has put this illness, which affects up to 10 percent of women who have given birth, in the spotlight.

By SHARON GINN
Published June 28, 2005

The recent public tiff between actors Tom Cruise and Brooke Shields about postpartum depression was delightful fodder for the entertainment media, from Cruise's opening shot ("Look at where her career has gone") to Shields' response that Cruise "should stick to saving the world from aliens."

Less attention has been paid to Cruise's main assertion: that Shields was "irresponsible" for taking the antidepressant Paxil after being diagnosed with postpartum depression following the birth of her daughter, Rowan, in 2003. Cruise, who as a Scientologist believes that all psychiatry is "junk science," claimed in an Access Hollywood interview that "those drugs are dangerous," and "you can use vitamins to help a woman get through those things." (Scientology maintains its spiritual headquarters in Clearwater.)

Cruise, talking to Matt Lauer on the Today show last week, said the drugs ". . . mask the problem, Matt. . . . You're not getting to the reason why. There is no such thing as a chemical imbalance."

The research doesn't back up Cruise's statements, said Dr. Zachary Stowe, a leading researcher in postpartum depression and director of the Emory Women's Mental Health Program in Atlanta. Stowe, who has spent 15 years exclusively treating women who are suffering from postpartum illness, said vitamins are not what works.

Four main approaches to treating women with postpartum depression have been studied, Stowe said: hormonal therapies; amino acids and so-called natural remedies; psychotherapy; and medications such as antidepressants. Results for the first two approaches have been "less than impressive," Stowe said, while "therapy and medicines appear to be the most effective interventions."

Stowe said postpartum depression seems to get attention only when a star such as Shields writes a book about it (her Down Came the Rain was published in May) or when someone suffering from the far more severe postpartum psychosis kills her baby. The more common postpartum depression affects 8 to 10 percent of women who have given birth, Stowe said, and should be treated. It is different from the "baby blues," a general moodiness and irritability that peaks a few days after delivery and quickly resolves itself.

Ilyene Barsky, a licensed clinical social worker, founded the Center for Postpartum Adjustment in Coral Springs two decades ago, after recovering from postpartum depression following the birth of her first child. Barsky said Cruise has done a disservice to women suffering from the illness.

"This is the kind of condition you want to go after with a double-barreled gun," she said. "Medication and psychotherapy. This is not something you want to play around with. . . . You want to knock it out of her system ASAP."

That's because more than the health of the mother is at stake.

"This isn't a one-person thing," said Glenn Catalano, a professor of psychiatry at the University of South Florida in Tampa who specializes in depression. "If you're depressed and you're trying to muddle through using vitamin therapy - which is not held up by research - not only are you allowing yourself to suffer longer, you're taking time away from your child and not being an effective mother. . . . (The child doesn't) need a mom who's locked up in a room and unable to function."

The most effective way to deal with postpartum depression, Stowe said, is to identify women who are at risk.

Risk factors include a history of depression, a family history of depression or signs of depression during pregnancy. Some studies are looking at genetic markers that can aid in diagnosis, he said.

But many, if not most, sufferers are not singled out for preventive treatment. When postpartum depression appears, usually two or three weeks after delivery, some know enough to ask for help. But some, Barsky said, cope by smiling and hoping it will go away. Usually, it gets worse. That's where friends, family, the baby's pediatrician and, most important, the woman's partner need to look for signs, Barsky said.

"Sometimes it takes a little questioning and a little probing," she said.

The quicker it is caught, the easier it is to treat. But even when caught early, it can take six months to a year of psychotherapy and/or medication to resolve, Barsky said.

Researchers are getting closer to understanding what triggers postpartum depression, Stowe said. A study by his own group has noted changes in serotonin, while another recent study cites abnormalities in dopamine. Both are neurotransmitters, chemical substances that transmit nerve impulses across a synapse.

But "it's not hormones," Stowe said. "There is no confirmation from any research study that (it's caused by) any abnormality in any hormone."

[Last modified June 28, 2005, 07:09:03]