Sandra Galle waited as long as she could to have kids. In fact, she never really wanted them in the first place. But as her 40th birthday was approaching, she realized her biological clock loomed over her like a black cloud. In November of 2004, at the age of 39, Sandra gave birth to Jack and Layne, her fraternal twins.
Her first two months after bringing her two bundles of joy home from the hospital in Huntington Beach, Calif., were a blur.
"The best way I can describe it is a lack of interest in everything going on in the world and in my life, even the stuff that previously made me happy," Galle said. "I didn't care to go shopping, cook, wear nice clothes, or even spend time away with my husband. I felt like a robot in my own life, just going through the motions and having guilt for feeling that way."
Galle swears she never thought she was suicidal but recalls wondering why she did not feel like most new mothers, especially with two healthy babies.
"I tried hard to put up a front and pretend that I was enjoying my kids and being a mom," she confessed.
Two months into the post-natal period, Galle assumed her feelings must be caused by the natural fatigue from recovering from her Caesarean section and her hormones going haywire.
"I figured I was a strong enough woman to recover on my own," said Galle. "I needed the color back in my life."
Galle waited but the days turned into weeks and still nothing but the same old feeling. Finally, Galle's husband, Bob, encouraged her to go see a specialist. Gathering all the strength she had left, Galle dragged herself to her OBGYN, sitting silently in the exam room before breaking into tears upon her doctor's entrance.
"That was the light at the end of my tunnel," said Galle. "The visit was cathartic. I felt relief just knowing that I faced the situation and it had a name, and others suffered from it too."
Galle was prescribed to Zoloft for eight months and eventually weaned herself off.
"All I can say is that postpartum depression is equivalent to a terrible doomsday, like when you witness the space shuttle explode, or the World Trade Center crumble, or the first casualties of war," she said. "You have this incredible guilt for having such rotten feelings about life, knowing there's no good reason for the way you feel. After all, shouldn't motherhood be blissful in the beginning?"
New research, beneficial non-pharmacological treatments
For many women, the transition into motherhood is anything but smooth. Instead of basking in the glow of being a new mother, vulnerability, helplessness and depression start to set in.
Health psychologist at the University of New Hampshire and researcher at the UNH Family Research Lab, Kathleen Kendall-Tackett says there are countless treatments available to new mothers experiencing postpartum depression. She is the author of a new monograph, "Non-Pharmacological Treatments for Depression in New Mothers."
May 2008 has been designated Postpartum Mood and Anxiety Disorders Awareness Month by New Hampshire Governor John Lynch.
Postpartum mood, anxiety and thought disorders, often referred to simply as postpartum depression, affect 10 to 20 percent of pregnant and postpartum women as well as their children and partners. Kendall-Tackett's research shows that in high-risk populations, or women with low income and low social support, risk for depression can be as high as 40 to 50 percent.
Kendall-Tackett warns the consequences of postpartum depression are simply too serious to ignore, especially with harmful effects for the babies. Children of depressed mothers have more social, behavioral and cognitive difficulties than their counterparts with non-depressed mothers. Additionally, women often do not even realize that it is depression.
"They just feel that coping with new motherhood is hard," she said. "They just assume that what they are experiencing is part of a normal beginning phase."
Depressed mothers may avoid medications because they worry about how it will affect their unborn babies or that they will become addicted. But concerns about taking medications while breastfeeding may keep others from seeking treatment altogether. There is a wide range of non-drug treatments that are effective, even with major depression, and all are compatible with breastfeeding. In her new monograph, Kendall-Tackett reviews evidence supporting Omega-3 fatty acids, bright light therapy, exercise, social support, psychotherapy and St. John's Wort.
"The good news is that there are several medications that are undetectable in infant plasma, even if they show up in the milk, so babies are getting very low exposure to the medications that their mothers are taking," she said.
"Depression in new mothers needs to be treated promptly. For mothers who refuse antidepressants, or for whom antidepressants may be inappropriate, we have more evidence-based, non-pharmaceutical options than ever before," Kendall-Tackett said. "And because all of these choices are compatible with breastfeeding, mothers are never forced to choose between their mental health and breastfeeding their babies, a choice no mother should have to make.
"Since depression has devastating effects on both mother and baby, it's vital that it be identified and treated promptly. Depressed mothers are also more likely to stop breastfeeding with negative health effects for each."
More importantly, Kendall-Tackett said the first step for preventative measures involves empowering women through knowledge.
"Women should be given much more specific information about what the transition to motherhood will entail, preferably while they are still pregnant."
The second step, Kendall-Tackett recommends, involves giving women more power and autonomy during their labors and deliveries.
"It does not require great social programs or even piles of money. It does require some planning and coordination of efforts. Effort in this area will yield rich rewards by improving the quality of mother-infant relationships and ultimately the relationships of entire families."
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