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Madison, WI 53719-1179
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UW Healthlink Article


Published: Summer, 2002

Like the rest of the nation, Dr. Roseanne Clark was deeply saddened by the tragic case of Andrea Yates, the Houston mother who drowned her five children last summer six months after the birth of her last child. Known to be severely depressed, Yates may have suffered from postpartum psychosis, an illness that lies on the far end of the spectrum of mood disorders occurring in women following childbirth.

“The Yates case was an extreme and rare example, but it’s not at all unusual for mothers to experience some sort of depression in the months after childbirth,” says Clark, UW Health psychologist and director of the UW Department of Psychiatry Postpartum Depression Treatment Program.

Mental health professionals believe that several factors—biological, social and psychological—may contribute to postpartum mood disorders. Some women are at greater risk, including those with a personal or family history of depression, those who were depressed during pregnancy and those who had mood problems following a previous birth.

Between 50 percent and 80 percent of new mothers experience the postpartum blues. Symptoms can include tearfulness, irritability, fatigue and a feeling of being overwhelmed. The problems usually occur within the first 10 days after delivery and generally go away in less than two weeks. If they last longer, women are urged to contact a mental health professional.

Approximately 8 to 15 percent of mothers experience the more serious postpartum depression sometime during the first year after childbirth. Symptoms can include extreme fatigue, an inability to sleep, loss of interest in pleasurable things, panic and hopelessness. Some women report that they have trouble taking care of their new baby; they may be concerned that they aren’t feeling happy with their new infant.

“It’s important that the problem be quickly recognized and addressed, as postpartum depression can significantly affect a woman’s feelings about herself, her functioning as a mother and her family’s functioning,” says Clark, who is also a faculty member in the UW Medical School Department of Psychiatry. “The longer a woman is depressed and goes without treatment, the more likely she is to feel less competent as a mother, which consequently contributes to symptoms of depression.”

Meanwhile, she adds, longer exposure to a mother’s depression is associated with more problems in young children’s social, emotional, behavioral and language development, which can result in relationship and other psychological difficulties later in childhood.

“Typically, postpartum depression is a major depressive episode that may last from two weeks up to six months or longer,” says Clark. “It is a serious condition that may not get better without treatment.”

But the good news is that postpartum depression generally can be treated successfully.

Dr. Clark and her UW psychiatry department colleagues recently began a large-scale study that will compare a family-focused mother-infant group therapy program with standard individual psychotherapy.

“Both treatments may be useful in helping women who are experiencing symptoms of postpartum depression,” notes Clark. “The purpose of the study is to determine which approach would be more effective for which women.”

The study involves assessments and 15 weeks of therapy at no cost for women who are depressed and have infants under six months of age. The five-year, $2.75 million study is funded by the National Institute of Mental Health. For more information, call (608) 263-5000.

Maternal depression is considered a major public health problem. Dr. Clark is among a group of professionals involved in a statewide initiative to raise public awareness. The program also aims to increase understanding among medical professionals about the importance of early identification and referral of women with depressive symptoms during the postpartum period.

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