research offers new insight on depression
Postpartum depression isn't always postpartum. It isn't even always depression. A fast-growing body of research is changing the very definition of maternal mental illness, showing that it is more common and varied than previously thought.
Scientists say new findings contradict the long-standing view that symptoms begin only within a few weeks after childbirth. In fact, depression often begins during pregnancy, researchers say, and can develop any time in the first year after a baby is born.
Studies also show that the range of disorders women face is wider than previously thought. In the year after giving birth, studies suggest, at least 1 in 8 and as many as 1 in 5 women develop symptoms of depression, anxiety, bipolar disorder, obsessive-compulsive disorder or a combination. The Affordable Care Act contains provisions to increase research, diagnosis and care for maternal mental illness.
Sometimes cases are mild. But an analysis of 30 studies estimated that about a fifth of women had an episode of depression in the year after giving birth, about half of them with serious symptoms. Studies indicate that maternal stress may undermine women's ability to bond with or care for their children, and that children's emotional and cognitive health may suffer as a result.
A complex interplay of genes, stress and hormones causes maternal mental illness, scientists say. "Hormones go up more than a hundredfold," said Dr. Margaret Spinelli, director of the Women's Program in Columbia University's psychiatry department. After birth, hormones plummet, a roller coaster that can "disrupt brain chemistry," she said. Some women are genetically predisposed to react intensely to hormone changes. And some are more sensitive to stress.
new york times