Postpartum Depression is a Serious, but Treatable Illness On June 20 Andrea Yates drowned her five children in the bathtub and then called her husband, a computer expert at NASA, telling him, "You need to come home." The story of Yates and her unthinkable crime is horrifying to us all. Articles about the Yates family paint a domestically oriented picture: a set of parents with five children under the age of seven who choose to home school the children. Both parents were high achievers in school, held to high religious principles, and chose to forego two incomes so their children could have a full-time mother. Andrea's father suffered from Alzheimer's disease and, in addition to the demands of motherhood, she also helped care for him. Andrea's mother, quoted in Newsweek, said: "She was the most compassionate of my children. Always thinking of other people, never herself. She was always trying to care for everybody." Russell Yates has said his wife suffered from postpartum depression after the births of their two youngest children, and her condition worsened after her father died. The explanation for the Yates tragedy includes the mention of a diagnosis: postpartum psychosis. This brain disorder is a treatable condition related to the less severe postpartum depression. Because of hormone fluctuations during pregnancy and delivery, 50 - 75% women experience the "baby blues" after giving birth. Symptoms include: crying for no apparent reason, impatience, irritability, restlessness and anxiety. Usually such feelings disappear quickly and don't require treatment. Symptoms include: Nervousness, anxiety, panic Sluggishness, fatigue, exhaustion Sadness, depression, hopelessness Appetite and sleep disturbances Poor concentration, confusion, memory loss Over concern for the baby OR lack of interest in the baby Uncontrollable crying, irritability Guilt, inadequacy, worthlessness Fear of harming the baby and/or yourself Exaggerated highs and/or lows
A woman suffering from postpartum depression may experience one or a combination of the above symptoms, ranging from mild to severe. They may be changeable, with alternating good and bad days. Postpartum psychosis, the diagnosis given to Andrea Yates, is the most severe but least common postpartum reaction. It occurs in about 1 in 1000 new mothers. Symptoms are exaggerated and severe and may include insomnia, hallucinations, agitation, and bizarre feelings or behavior. Yates was previously treated with anti-depressants and a strong antipsychotic medication, but was not in therapy or taking antipsychotic medication when she murdered her children.
The causes of postpartum depression and psychosis are not fully understood but we know that they are caused largely by physiological factors. Other stressors such as isolation, sleep deprivation, and increased stress in other areas of life contribute to the onset of depression after childbirth. Women who have already experienced depression or psychosis are at greater risk for a recurrence. Marie Osmond has written a book about her experiences after childbirth, titled Behind the Smile: My Journey out of Postpartum Depression. She says shame and immobilization kept her from seeking help, although she had supportive family, friends and other resources. She blames the "motherhood myth" for her initial denial of the problem, the idea that the days after giving birth are always a time of joy and fulfillment for the new mother. In fact, this time is quite emotionally and physically difficult for many. New mothers need a great deal of support in the days following delivery and sometimes for months afterward. In the past, extended families and neighbors helped mothers care for small children, and the expectations heaped upon today's mothers are often compounded by loneliness and isolation. It is important for any woman experiencing mood problems following childbirth to seek help. Depression of all kinds is treatable. If you suspect that you or someone you know might have postpartum depression, urge them to seek help from their doctor. Support groups, educational programs, home visits, and informal networks that support mothers are all important to the health and well being of both mothers and children. The Andrea Yates tragedy is a reminder that such support might even be a lifesaving intervention.