Answers to Your Questions About Postpartum Depression

Thank you for the strong interest in our story about motherhood and mental illness. The ABC News Medical Unit asked Dr. James Potash, co-director of the mood disorders program at Johns Hopkins Hospital, to answer some of your questions. Here are his responses to a selection of your questions from the "World News" message board.

Question: My baby is 6 months old, and I still catch myself crying for no reason. Am I still suffering from having her?

Potash: Women can certainly become depressed soon after having a baby and continue to be depressed six months later. We don't have a lot of certainty about why this is, but it may be that once depression starts, it takes on a kind of life of its own. Depressions in general last on average five to six months.

Question: Is it possible for the hormonal or physical changes that cause postpartum depression to affect the mother before she delivers?

Potash: Women can develop depression while they are still pregnant. In fact, one-third to one-half of postpartum depressions begin during pregnancy. It is not clear if the causes of depressive symptoms during pregnancy are the same as those in the partpartum period.

Question: How long before postpartum depression shows up?

Potash: It can start immediately after birth, or during pregnancy. Our "official" way of categorizing in psychiatry says that postpartum depression starts within one month of giving birth. But we know that depression in the second or third month after giving birth is also not uncommon.

Question: I have not been diagnosed with depression, but after seeing the show I now know that's what I am going through. Is there any way to deal with depression without taking medication? And how can my husband help me through this?

Potash: Serious depression does require medication, along with talk therapy, also called psychotherapy, but milder depressions may improve with talk therapy alone. Your husband can help in a number of ways. He could learn more about depression so that he has a clear idea of what kinds of signs indicate a worsening of depression. He could provide support to help you understand that depression is typically transient, that you will be yourself again. He may need to remind you that you have more going for you than you may realize while you are depressed. He also might be able to help you navigate the process of finding the psychiatric care you will need if your depression is serious.

Question: My son is now 2½. After having him I suffered from postpartum psychosis. I was hospitalized for about a month. I am wondering what my chances are of having it again with another child? Is there anything I can do to prevent this from happening again?

Potash: Postpartum psychosis is a severe form of psychiatric disturbance that often resembles a manic episode. Women who have had this experience have about a one-in-three chance of having it happen after subsequent deliveries. Given the similarity of postpartum psychosis to the mania of bipolar disorder, use of bipolar disorder medications such as lithium have been tried as a preventive measure. Lithium has been shown to reduce the risk of having another postpartum psychotic period.

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