There's a new nonfiction book about maternal depression on the scene, written by a colleague who is practically my neighbor (she lives and works in the Washington, DC area)!

Former Washington Post reporter, freelance journalist, and author Tracy Thompson's The Ghost in the House: Motherhood, Raising Children, and Struggling with Depression deals with longer-term depression that goes well beyond PPD, and how it affects our families and our experience of mothering. It was released by HarperCollins earlier this month, so the book is hot off the press.

My friend and fellow author Devra Renner says this in her review of The Ghost in the House:

"As a clinical social worker who has worked with hundreds of mothers, this is a book I recommend to clients, as well as mental health professionals. Thompson's ability to explain complicated medical/physiological/pharmacological information while simultaneously using commonly understood language - without watering down the information one iota - is a true gift. The stories Thompson shares from her own experience as a mother struggling with depression, in adddition to the compelling interviews she has conducted with hundreds of mothers (all backed by excellent research relating what is happening currently in the field of depression) set this book apart."

Also check out Thompson's previous book, The Beast: A Journey Through Depression and her website, TracyThompson.com.

Posted by Sarah M. at 08:15 PM | Permalink | Comments (22) | TrackBacks (3)

Well, well, well.

Uber-actor Tom Cruise gets dropped by his film studio for losing money at the box office, and within 24 hours his business partner is speaking to the media about the "deep regret" Tom feels in the wake of his well-publized tirade against PPD survivor and author Brooke Shields, the use of psychotropic medications for postpartum depression, and the entire profession of psychiatry. Amazing what can happen when the dollar signs get pinched!

People magazine was the first of many national publications to quote Cruise co-producer and business parnter Kathleen Kennedy on this point, followed by MSNBC and a bazillion others around the world.

Too little, too transparent, too late? You be the judge.

In the meantime, try a little comic relief at my favorite Cruise-spoofing site, TomCruiseisNuts.com. And, if you haven't already, be sure to read Brooke Shields' op-ed rebuttal in the New York Times.

Posted by Sarah M. at 07:33 PM | Permalink | Comments (955) | TrackBacks (9)

A basic and useful Q&A from the May Clinic was published last week, featuring psychiatrist Dr. Daniel Hall-Flavin:

"Defining 'Mental Illness': An Interview with a Mayo Clinic Specialist"

This piece should be required reading for all members of the media who cover or provide commentary related to "mental health"!

Posted by Sarah M. at 01:00 PM | Permalink | Comments (3) | TrackBacks (3)

Advocate Katherine Stone has posted an important entry on her (fabulous!) blog, Postpartum Progress, regarding the effectiveness of the widely-used Edinburgh Postnatal Depression Scale (EPDS) in diagnosing women who have postpartum anxiety disorders:

"Edinburgh Scale May Not be Broad Enough to Identify Women with Postnatal Anxiety"

Posted by Sarah M. at 12:46 PM | Permalink | Comments (0) | TrackBacks (1)

Doesn't exactly come as a surprise, but...

A new study published in the journal General Hospital Psychiatry suggests that two-thirds of the pregnant women who have depression are not being treated for it with either medication or talk therapy. The research team notes that depression during pregnancy is often overlooked and undertreated - and that this situation puts both mother and baby at risk.

In addition, this study - which looked at a sample of 1,800 women - reaffirms that approximately 10 to 15 percent of pregnant women experience depression, and that it is THE strongest risk factor for PPD. Take-home message: Recognizing and treating depression during the pregnancy is a proven method for preventing PPD in new moms!

Posted by Sarah M. at 04:46 PM | Permalink | Comments (2) | TrackBacks (4)

A Q&A I did with Dr. Bill Beardslee for one of my consulting clients, the National Healthy Mothers, Healthy Babies Coalition (HMHB), is now live on their website. Check it out!

Not Just the Baby Blues:
An Interview on Postpartum Depression with William Beardslee, MD

The Q&A was intended to address an audience of professionals, advocates, and journalists in maternal-child health, but it also has cross-over appeal as a resource for expectant and new parents.

Posted by Sarah M. at 01:23 PM | Permalink | Comments (0) | TrackBacks (1)

Anybody had a chance to read Adrienne Martini's new book, "Hillbilly Gothic: A Memoir of Madness and Motherhood"?

The book, which was released in late June, has been described as "a Girl, Interrupted for the new-mother set." And I was interested to read author Marion Winik's (love her!) review:
"Adrienne Martini has had a tough time as both a daughter and a mother, yet she brings back from the wretched edge of the maternal endeavor a book of liveliness and companionability, full of the wit and the will and even the anger that got her through the experience. This post-hillbilly madwoman knows how it is. She slips around your defenses and whispers her jokes and stories in your ear until you can't help but feel less isolated. I found her very good company."

Martini is a journalist, college professor, mother, and now nonfiction author who shares her first-hand account of postpartum depression, and how it ultimately led her to revisit and heal the skeletons in her family closet - including her own mother's depression.

Adrienne Martini currently blogs at www.martinimade.com (where she chronicles, among other things, my beloved former home of 10+ years, Austin, Texas! For the recent Austin American-Statesman's piece on former hometown gal Martini and her book, click here.)

I'm anxious to read this memoir, and I'd love to hear from those of you who already have. Hit the "comments" link below this entry, people - don't be shy! Or send me an email: smasterson (at) perinatalproject (dot) com.

Posted by Sarah M. at 07:13 PM | Permalink | Comments (1) | TrackBacks (4)

The Women's and Children's Health Policy Center at the Johns Hopkins University Bloomberg School of Public Health has released a new policy brief, "Considering Interventions for Depression in Reproductive-Age Women in Family Planning Programs."

This brief explores family planning programs as a possible site for incorporating interventions around depression, including screening and treatment, and looks at opportunities to reach women who otherwise may have little contact with the healthcare system. Included is a list of potential interventions and recommendations that can be used by family planning programs, state and local public health agencies, as well as mental healthcare providers.

To check out this resource, click here.

Posted by Sarah M. at 10:11 AM | Permalink | Comments (0) | TrackBacks (4)

Recently featured in ACOG Today, the members-only newsletter of the American College of Obstetricians and Gynecologists:

A new recommendation, "Committee Opinion, Psychosocial Risk Factors: Perinatal Screening and Intervention," advises that ob/gyns should do a psycho-social screening on all women receiving prenatal care at least once per trimester, "because problems may arise during the pregnancy that were not present at the initial visit." They affirm that identifying psycho-social stressors in expectant moms' lives may help "reduce poor birth outcomes."

Thankfully, the committee also notes that "For screening to be effective, physicians should have a process for referrals in place. . .since developing a list of community resources helps physicians develop a referral network." The committee opinion continues, "Constructing a resource list is as straightforward as contacting local hospital social services departments and community centers. Office practice staff can compile this information and be assigned to keeping it up to date. It is also important to obtain feedback from patients and staff on their experiences with the various resources." (This would've been a prime opportunity for ACOG to build a few bridges, save physicians and their staff a lot of time, and serve their patients by mentioning local and state PSI coordinators, who volunteer their time to keep up-to-date resource lists, as well as in many cases leading peer support groups!)

This committee opinion was published in the August issue of the journal Obstetrics and Gynecology. And the document includes a well-regarded screening tool developed by the Healthy Start Program administered by Florida's state health department. (Questions from the tool are now included in ACOG's "Obstetric Medical History Form," for use by ob/gyns.)

Posted by Sarah M. at 11:15 AM | Permalink | Comments (0) | TrackBacks (2)

Like moths to the flame, a number of media outlets have picked up on the recent "dads-get-postpartum-depression-too" study, which was published in this month's journal Pediatrics.
Among those who ran a story in today's news:

from WebMD

from ABC News

from Fox News

from Yahoo! News and Reuters Health

from CBS News

The Virginian-Pilot

from MedicineNet

Veeery interesting indeed to notice the subtle spin that some media outlets present this research with. . . Even the sub-headers hint at socio-political agendas and stereotypes. However, in the end only good things can come from this study, the publicity it generates, and the public discourse it provokes. The more, the better!

Posted by Sarah M. at 07:10 PM | Permalink | Comments (0) | TrackBacks (3)

Thanks to the editors of the South Florida Sun-Sentinel, who have been brave enough to publish an educated, insightful response to the verdict in the Andrea Yates case.

In doing so, this (relatively) small news organization has taken a stand in a bloodthirsty public debate - which, sadly, the editorial boards of some of the nation's larger and more influential media outlets have declined to do. The Sun-Sentinel's op-ed will help to educate its readers about mental health in a way that defies stigma and sensationalism.

"Yates Verdict: Humane End to Horrific Case of Postpartum Psychosis"

Posted by Sarah M. at 11:22 AM | Permalink | Comments (0) | TrackBacks (5)

An article from the American Pyschological Association has been distributed by the Newswise service, shedding light on the longer-term experiences of the thousands of individuals displaced by Hurricane Katrina - many of whom are, of course, mothers, fathers, and young children.

Among the APA's findings...

To date, two studies. . . of children affected by the hurricane have found high rates of depression, anxiety, behavioral problems and post- traumatic stress disorder (PTSD).

According to New Orleans mental health and school officials, the issue for many of these children is not just the storm, but the dislocation from a parent, a home. . . According to these officials, programs that help these families get back on their feet and return to a sense of normalcy are often the most helpful to the psychological health of the children.

The take-away message: At this stage, we can can best contribute to emotional healing for these families by helping the parents to help themselves - Not just through healthcare or psychiatric services, but in terms of the bricks and mortar of everyday existence... rebuilding, economic growth and job development, nondiscriminatory socioeconomic opportunity, and public infrastructure. All of which must be understood as part of mental health advocacy.

For the full article: "One Year After Katrina, More is Known About its Mental Health Effects"

Posted by Sarah M. at 10:35 AM | Permalink | Comments (0) | TrackBacks (7)

An interesting new study on PPD was published in the July 2006 edition of Maternal and Child Health Journal: "The Role of Social Networks and Support in Postpartum Women's Depression: A Multiethnic Urban Sample."

Researchers explored the relationship of social support and social networks to symptoms of depression in a multi-ethnic sample of new moms.

The team randomly sampled women at community health centers in a Northeastern city were from groups stratified by race/ethnicity (African American, Hispanic, and white) and by postpartum interval. The used each mother's score on the Center for Epidemiologic Studies of Depression Scale (CES-D) as the dependent variable. The main independent variables included the Medical Outcomes Study (MOS) Social Support Survey and a social network item. They looked interactions between race and social support, race and social networks, and social support and social networks.

Findings:

* The authors conclude that both low or absent social support and social networks were statistically significant and independently related to depressive symptoms.

* Having two or more friends or family members available was associated with a 13.6-point lower mean score on the Depression Scale, compared to women reporting none or only one available person.

* The multivariate models with MOS Social Support scale indicated that each 10-point increase in the MOS Social Support Survey was related to a 2.1-unit lower score on the Depression Scale.

Hopefully new research will continue to look at factors such as race/ethnicity, class, socio-economic status, and social support, and the extent to which they influence PPD and other perinatal mood disorders. There's so much we still don't know!

Posted by Sarah M. at 08:01 PM | Permalink | Comments (0) | TrackBacks (2)

A lawsuit was filed against pharmaceutical co. GlaxoSmithKline on July 28, on behalf of two-year-old Adrian Vasquez of Bedford, Texas, who was born on April 19, 2004 with birth defects.

The suit alleges that Adrian's birth defects are the result of his mother's prenatal use of Paxil, a GlaxoSmithKline antidepressant drug in the SSRI class (selective serotonin re-uptake inhibitor).

The FDA recently upped the Paxil warning from a category "C" to a category "D," warning pregnant mothers that taking Paxil more than doubles the risk of a heart defect in newborn babies. As the FDA officially puts it, "Category D means that studies in pregnant women (controlled or observational) have demonstrated a risk to the fetus. However, the benefits of therapy may outweigh the potential risks to the fetus."

As always on this issue, we're left pretty much where we started. Some antidepressants during pregnancy = potentially bad for baby. Untreated depression during pregnancy = definitely bad for baby (with plenty of research data to back it up). As always, defer to an individual risk-benefit analysis suited to your history and your needs, in private consultation with your healthcare provider. And if you are a woman who is not convinced that your healthcare provider is up to date on the latest research in this area, or if the provider blows off your concerns or won't sit down for a sustained conversation, get a new doctor, pronto!

Posted by Sarah M. at 08:01 PM | Permalink | Comments (0) | TrackBacks (1)

The National Institutes of Mental Health (NIMH) at the NIH (National Institutes of Health) in suburban Washington, DC is in the midst of three long-term studies on postpartum depression, and they have an ongoing need for research subjects.

If you are a mom who fits the profile to participate and you would like to contribute to cutting-edge knowledge of perinatal mental health, check these links for more details:

1) "Women with a History of Postpartum Depression: The Effects of Hormones in Postpartum Mood Disorders"

2) "Women with Postpartum Depression: A Treatment Study"

3) "Women with PPD: An Observational Study"

To find out if you qualify to participate or to get more info, send email to: nimhcore (at) mail (dot) nih (dot) gov or call 301.496.5645.

Posted by Sarah M. at 02:47 PM | Permalink | Comments (0) | TrackBacks (19)

Did you know about the findings from the most recent Kaiser Women's Health Study? It's not pretty.

Women and Health Care: A National Profile, is based on a survey of 2,766 women age 18 and older, conducted in 2004 and released in 2005. Here's what it reveals:

* 23 percent of women have been diagnosed with depression or anxiety, over twice the rate for men (11 percent).

* Nearly four in 10 women (38 percent), have a chronic condition, such as diabetes, asthma or hypertension that requires ongoing medical attention, compared to 30 percent of men.

* Two-thirds of women without health insurance report that they delay or go without care that they believe they need, because they cannot afford it.

* 20 percent of women said they did not fill a prescription in the past year because of the cost.

* 14 percent of women report skipping or taking smaller doses of their prescribed medications in the past year, to make them last longer.

* Eight in 10 mothers have primary responsibility for choosing their children’s doctors (79 percent), taking them to appointments (84 percent), and ensuring that they receive follow-up care (78 percent).

* Pap testing rates among women ages 18 to 64 have fallen since 2001 - currently only 76 percent.

* One in 10 women (12 percent) care for a sick or aging relative. Among this group, forty percent are low-income, 46 percent have a chronic health condition of their own, and 29 percent provide more than 40 hours of care per week.

This data should serve as a stark reminder to advocates, policy-makers, and practitioners that there is much work yet to be done. Not only is women's health suffering, but the children (and elders) whose care they provide may be at risk, too.

Let's get busy!

(For more about the survey's methodology and findings, click here.)

Posted by Sarah M. at 02:54 PM | Permalink | Comments (0) | TrackBacks (1)