Wednesday, March 24, 1999

Tristate women tackle postpartum depression




BY SUE MacDONALD
The Cincinnati Enquirer

        It was supposed to have been a time of great joy and happiness. Maternal satisfaction at its highest. Warm-and-fuzzy hoopla over the arrival of a life-affirming bundle of joy. The birth of Rachael Bowling's second son was anything but.

        Three days after Grant was born in May 1997, Mrs. Bowling thought she caught the flu. Twenty-one days of vomiting and diarrhea followed. Then came three trips to the emergency room for panic attacks and uncontrolled feelings that she was dying.

        Some days she wouldn't get out of bed, wouldn't shower, wouldn't eat. Once, her husband Scott had to force her to suck water from a straw. She remembers lying in bed, holding her son after nursing him and crying uncontrollably until Scott came home from work. Breast-feeding was the only thing she did that made her feel like a mother; frankly, it was the only thing she could do.

        She knew something was wrong. She just didn't know what.

        “I called suicide hot lines. I called my obstetrician. I called my primary-care physician,” the 28-year-old Fairfield woman says. “Nobody had an answer to help me.”

        Five months after Grant was born, the answer finally came, and Mrs. Bowling now wants to help other with postpartum depression.

        So strong is her commitment that she and Maria Korengel, of Madeira, have formed a support group and phone counseling service, A Lighter Shade of Blue, to be able to tell other mothers what no one told them for weeks or months after their babies arrived: Your feelings and unhappiness have a name, and there's help for postpartum depression. You are not alone. You are not crazy.

        It's the first time the Tristate has had a postpartum depression support group since one folded four years ago.

GETTING HELP
  Sometimes it's up to a woman's husband, friends or family member to step in and arrange help for postpartum depression, because the anxiety, lack of interest and overwhelming sense of helplessness associated with the disorder make it difficult for women to help themselves.
  Among the services available, in the Tristate and nationally:
  • A Lighter Shade of Blue, the Cincinnati chapter of Depression After Delivery (DAD), is a phone counseling and monthly support group offered by Rachael Bowling of Fairfield, who suffered from postpartum depression after the birth of her second child. 860-4394.
  • Depression After Delivery, a national non-profit support organization and hot line for women suffering from postpartum depression, based in Morrisville, Pa., (800) 944-4773.
  • Some women find help online through message boards and chat rooms for mothers and new mothers.
  • Talk to your doctor, nurse, midwife, obstetrician, psychologist or psychiatrist. If health-care professionals do not believe or seriously consider your symptoms, keep talking until you find a sympathetic ear.
        “It just helps if you have one person who agrees with and believes you,” says Mrs. Bowling, praising her husband for his persistence and help during the five difficult months she struggled with her depression. “All we had was each other.”

        A Lighter Shade of Blue is the Cincinnati chapter of a national self-help group called Depression After Delivery (DAD).Robin Egbert, breast-feeding consultant and childbirth educator at the Franciscan Hospital MOM Center in Mount Airy, is glad to have a local chapter after the previous group folded.

        “We have all felt the absence of the Depression After Delivery group that folded about four years ago,” she says. “When I've received phone calls for postpartum depression, either from providers or women themselves, it has been difficult recently to match them up with a health-care provider or other mothers who've been through this situation.”

        Doctors, nurses, midwives and childbirth educators try to use class discussions, brochures, in-hospital videos and send-home materials to alert women to the possibility of depression and blues after the birth of a baby, she says.

        “Once the mother is at home, many times she will be seen by a home-health nurse one to two days after her discharge,” Mrs. Egbert says. “She is going to be seen by her physician or midwife at six weeks. But we stress to the fathers that they may be the one who sees the fog that the mother is in.”

        It's a definable fog, but not always easy to work through.

        For five months, Mrs. Bowling underwent digestive and blood tests that came back normal. Doctors told her she was fine, yet she felt miserable inside. Finally, she cornered her family physician and said, “Wait a minute. You're not getting this. Something is not right.” Then she cried for 90 minutes.

        He diagnosed postpartum depression on the spot and referred her to a psychiatrist who offered counseling and prescribed antidepressant medicines that eased the depression in a matter of weeks.

        It was as if a light bulb went off, she says, because her thoughts and feelings finally had a name, a treatment and the hope of recovery.

10 percent affected
        The “baby blues” is a very mild form of depression that can occur for a few days after the birth of a baby, and it affects up to 75 percent of mothers.

        Postpartum depression is a longer-lasting, deeper form of depression that affects about 10 percent of mothers. It can occur any time within the first year after a child's birth, and it can occur with any child — not just the first.

        “Many times, it can be treated similarly to depression at any other stage of your life, and treatment is very effective,” Ms. Egbert says.

        But that assumes someone diagnoses it and knows how to treat it.

        Postpartum depressionoccurs at a time when many women are already overwhelmed — physically, emotionally and hormonally. Their bodies may be recovering from labor and delivery. They may be sleep-deprived because there's a new baby in the house or exhausted from taking care of other children. Hormones can remain unstable for months. Many simply don't know what's going on, and the depression instills a hopelessness about asking for help.

        Sometimes, anxiety and obsessive-compulsive behaviors accompany postpartum depression. Women worry constantly about their babies or themselves. They feel completely drained of willpower and energy. They don't care. Then they feel guilty that they don't care.

        Many are afraid to air their deepest, darkest secrets and feelings. They don't want to admit they're not thrilled about a new baby. They're afraid of losing custody if they do divulge their unhappiness.

        “When you can't see the light at the end of the tunnel, you forget that there's even a tunnel there,” says Mrs. Korengel, an office manager whose postpartum depression was diagnosed four weeks after the birth of her daughter in 1996.

        “That was my biggest problem. I kept looking for it to get better — I kept saying to myself it would get better after she started sleeping through the night or after she turned one and started walking. But those aren't the things that make it better, and I didn't know that.”

        “It's a long struggle,” adds Mrs. Bowling, a 1989 graduate of Cincinnati Christian Schools in Fairfield. During her worst months, Scott and Rachael's grandmother took care of the Bowlings' older son, Zachary, now 3.

Hard on dads, too
        And postpartum depression can be equally hard on fathers, says Mr. Bowling, 30, a customer service and inside sales rep for Orflex Printing in Forest Park.

        “There were days when I could see that she didn't have the will to do anything,” he says of Rachael's struggles. “There were lots of things that were hard, and not finding anyone who could help was a big one. Nobody gave it a name for so long. There was nobody we could trust at that point.

        “Men need to understand that their wives can't do everything alone,” he says. “They need to be there for their wives.”

        Ms. Egbert says getting help means women have to let others know that something is wrong, husbands/partners have to be willing to step in and help, and health-care providers have to pick up on the symptoms, feelings and cues and offer immediate help.

        Her advice for new mothers experiencing postpartum symptoms:

        • Seek medical help. If no one believes you, get a second opinion and keep talking until someone does. Write down a list of symptoms, behaviors, feelings and day-to-day activities so you have a clear way of explaining what your life is like when you do see a doctor, nurse, midwife or other professional.

        • Get emotional and physical support from family members, friends and other mothers who understand your needs.

        • Try relaxation techniques and exercise.

        • If you live in an area without a support network, try to find help online. (America Online, for example, offers a 9 p.m. Wednesday chat on mothering and postpartum depression at keyword “MO”).

        • Be vocal about your feelings. Mrs. Korengel says her ability to talk about her unhappiness and obvious lack of maternal joy tipped off friends to the possibility of postpartum depression.

        Mrs. Bowling just wants to make sure other women have the help and advice she desperately wanted but couldn't find easily.

        “I want the mom who's in bed and so scared to take care of herself or her children to call so I can say, "I've been there and I'll do whatever I can to help you through this,' ” Mrs. Bowling says. “You're not going nuts. This is so real. I don't want people to suffer the way I did.

        “I want postpartum depression to be something that moms are to afraid to talk about. They need to know that they will get out of this and be normal again.”

Symptoms of postpartum depression



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