Screening urged for postpartum depression.

Byline: Karen Mellen

CHICAGO _ Despite increased attention on postpartum depression over the last few years, the number of women screened and then referred for treatment has not increased significantly, according to a national expert on the disorder.

That's why it is so important for all social workers, nurses and doctors to be trained to look for symptoms of depression among women who have recently given birth, said Dr. Laura Miller, associate professor of psychiatry at the University of Illinois at Chicago.

"The frustrating thing is it's difficult to have time to do the screening," Miller said. "Clinicians have to screen for everything."

Miller spoke to about 60 clinicians in DuPage County, Ill., recently.

Miller emphasized that, although postpartum depression is highly treatable, untreated depression can have long-lasting negative effects on mother and baby. The severity of the symptoms increases with time and can lead to problems for the baby, she said.

Women whose depression is not treated can become suicidal or suffer recurring bouts of depression later in life. Children can end up with lower IQs and depression because of the neglect, either physical or emotional, from mothers who suffer from a mental disorder, she said.

As a result, everyone who comes into contact with a family must look for signs of depression, Miller said. But she cautioned that the symptoms of postpartum mental illnesses are often different from mental illness in the general population.

For instance, in the case of the more serious postpartum psychosis, women can appear to be lucid for long periods of time, which can lead to their being released from inpatient facilities or otherwise not being treated aggressively enough, she said.

"(We need) the involvement of family and significant others," said Miller, adding that clinicians should not rely only on the woman for information.

Martha Stouffer, a program coordinator for DuPage County, said cases in which new mothers kill themselves or their children rally mental health advocates. This year, a few high-profile cases were reported.

A Houston mother accused of killing her five children is said to have been suffering from postpartum psychosis, and two Chicago mothers are believed to have killed themselves because of the disorder.

"It's sort of a call to action," Stouffer said. "Those cases remind us when postpartum (depression) isn't treated in the early stages, it can move to psychosis."

Kathy Sheridan, a program supervisor for Metropolitan Family Services DuPage in Wheaton, Ill., said she was pleased to hear more about the science behind postpartum depression.

Scientists theorize that hormonal changes during pregnancy and soon thereafter can trigger a chemical change that leads to depression. About 10 percent of mothers will become depressed, they say.

When such information is relayed to patients, they feel less alone and less guilty about their emotions, which often include feelings of inadequacy, Sheridan said.

"It's good to be able to explain it to the patients," she said. "(They) think everybody else does this (parenting) so well."

Carol Stolte, a mental health coordinator for the DuPage County Health Department, said the discussion on postpartum depression is only one of many programs to give information to local clinicians and residents on mental illnesses, which are underreported and undertreated.

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