Brooke Shields urges psychiatrists to help raise public awareness of postpartum depression

By Paula Moyer
MedWire – APA (San Diego, California, USA) – 23 May, 2007

In an exclusive interview with MedWire, Hollywood actress Brooke Shields talked about her personal experience of postpartum depression. As a result of her own struggle, Shields is committed to raising public awareness of the disorder, so that other women can relate to her experience and get help sooner than they would otherwise.

Ms Shields applauded the efforts that have been made so far to raise public awareness of postpartum depression, but added that she hopes that physicians will begin to screen for the disorder much earlier than they currently do.

“I would have wanted to be asked to focus on the fears that I had about being a mother. What happens is that you get pregnant and then it’s like planning a wedding. You focus on whether it’s a boy or girl, the baby furniture, and the color of the nursery.”

Physicians can help women prepare effectively for the anxieties that accompany new motherhood, even without the additional layer of postpartum depression, if they help them to expect some emotional chaos while convalescing from childbirth and getting acquainted with the new baby, she explained.

“I wasn’t racked with sobs and thrashing around… It was more like one continuous, quiet sob.”

She told MedWire of the crisis that led to her diagnosis, and then discussed the ways that psychiatrists can help women be diagnosed sooner, so that they and their families can recover from this debilitating illness.

“I wasn’t racked with sobs and thrashing around,” she said. “It was more like one continuous, quiet sob.” The troubling thoughts, the sense of distance from her daughter, and the haunting images of her daughter being harmed were compounded by the shame she felt at having these emotions.

“If you feel this way about your baby, you must be a bad mother,” she said, summarizing the sense of judgment that kept her from getting help.

The catalyst for her to seek help was a visit from the friend who had been her agent, and was also the baby’s Godfather. “He had always fixed things for me,” Shields recalled. “I said to him, ‘You’ve got to help me, get me out of this.’” His response, “I’ve never seen you like this before, you’re not yourself,” influenced her to seek help, a move that led to her diagnosis and successful treatment.

Therapy offered her the opportunity to admit to her negative feelings about motherhood and her infant daughter in a safe environment - a process that was critical to her healing. In that setting, she was able to understand that the feelings she had were symptoms of a treatable illness.

Interestingly, Shields had no risk factors in her family history that would lead a physician to suspect that she had postpartum depression. There was no history of depressive disorders, and she had never had a previous depression. However, she had struggled with infertility and miscarriages before giving birth to her daughter. A complicated obstetric history is now known to be associated with an increased risk of depression. [1]

“Once I understood that it was a treatable condition, I could remind myself that the feelings were temporary,” she commented.

Ms Shields believes that if physicians are more open to discussing the less-than-glamorous aspects of motherhood, as well as the enormous hormonal shifts involved in the post-pregnancy transition, even healthy women may enter parenthood with less stress, and women who do have postpartum depression would have a better understanding of the biological underpinnings of their disorder.

“I just wish I had had someone to talk to at that time,” she stated. When she was finally diagnosed and received medical therapy for the depression, talking and sharing her fearful thoughts and feelings helped her to feel less ashamed of them. As with most affected women, the condition was treatable and eventually resolved. “Once I understood that it was a treatable condition, I could remind myself that the feelings were temporary,” she commented.

Family members are typically not able to fill that role, she said. In her case, even though her family could see that she was preoccupied and not connecting with her baby, they themselves were preoccupied with the day-to-day logistics of helping out. This meant that they were unable to step back and recognize that she and they could all benefit from professional help.

As a result of being diagnosed with postpartum depression with her first daughter, Ms Shields said that the management of her pregnancy and postpartum period with her second daughter was handled much differently.

“I was prepared [this time] for the possibility of postpartum depression,” she said. She took several measures to reduce stress. For example, since she had had a cesarean birth with the first daughter, she scheduled a cesarean with the second rather than undergoing the trial of labor. Although some women might want to attempt a vaginal birth after cesarean (VBAC), in Ms Shields’ case knowing that the cesarean had been scheduled was less stressful.

Preparation for the transition, knowledge about the risks and benefits, and the freedom to voice her fears were key contributions that put her on better footing when she carried and gave birth to her second daughter, Venetia, she said.

Reference

1. Peindl KS, Wisner KL, Hanusa BH. Identifying depression in the first postpartum year: guidelines for office-based screening and referral. J Affect Disord 2004; 80:37-44.