http://www.nytimes.com/2005/07/01/opinion/01shields.html?ei=5090&en=7189d307fdb5772d&ex=1277870400&partner=rssuserland&emc=rss&pagewanted=print
July 1, 2005
War of Words
By BROOKE SHIELDS
London
I WAS hoping it wouldn't come to this, but after Tom Cruise's
interview with Matt Lauer on the NBC show "Today" last week, I feel
compelled to speak not just for myself but also for the hundreds of
thousands of women who have suffered from postpartum depression. While
Mr. Cruise says that Mr. Lauer and I do not "understand the history of
psychiatry," I'm going to take a wild guess and say that Mr. Cruise
has never suffered from postpartum depression.
Postpartum depression is caused by the hormonal shifts that occur
after childbirth. During pregnancy, a woman's level of estrogen and
progesterone greatly increases; then, in the first 24 hours after
childbirth, the amount of these hormones rapidly drops to normal,
nonpregnant levels. This change in hormone levels can lead to
reactions that range from restlessness and irritability to feelings of
sadness and hopelessness.
I never thought I would have postpartum depression. After two years of
trying to conceive and several attempts at in vitro fertilization, I
thought I would be overjoyed when my daughter, Rowan Francis, was born
in the spring of 2003. But instead I felt completely overwhelmed. This
baby was a stranger to me. I didn't know what to do with her. I didn't
feel at all joyful. I attributed feelings of doom to simple fatigue
and figured that they would eventually go away. But they didn't; in
fact, they got worse.
I couldn't bear the sound of Rowan crying, and I dreaded the moments
my husband would bring her to me. I wanted her to disappear. I wanted
to disappear. At my lowest points, I thought of swallowing a bottle of
pills or jumping out the window of my apartment.
I couldn't believe it when my doctor told me that I was suffering from
postpartum depression and gave me a prescription for the
antidepressant Paxil. I wasn't thrilled to be taking drugs. In fact, I
prematurely stopped taking them and had a relapse that almost led me
to drive my car into a wall with Rowan in the backseat. But the drugs,
along with weekly therapy sessions, are what saved me - and my family.
Since writing about my experiences with the disease, I have been
approached by many women who have told me their stories and thanked me
for opening up about a topic that is often not discussed because of
fear, shame or lack of support and information. Experts estimate that
one in 10 women suffer, usually in silence, with this treatable
disease. We are living in an era of so-called family values, yet
because almost all of the postnatal focus is on the baby, mothers are
overlooked and left behind to endure what can be very dark times.
And comments like those made by Tom Cruise are a disservice to mothers
everywhere. To suggest that I was wrong to take drugs to deal with my
depression, and that instead I should have taken vitamins and
exercised shows an utter lack of understanding about postpartum
depression and childbirth in general.
If any good can come of Mr. Cruise's ridiculous rant, let's hope that
it gives much-needed attention to a serious disease. Perhaps now is
the time to call on doctors, particularly obstetricians and
pediatricians, to screen for postpartum depression. After all, during
the first three months after childbirth, you see a pediatrician at
least three times. While pediatricians are trained to take care of
children, it would make sense for them to talk with new mothers, ask
questions and inform them of the symptoms and treatment should they
show signs of postpartum depression.
In a strange way, it was comforting to me when my obstetrician told me
that my feelings of extreme despair and my suicidal thoughts were
directly tied to a biochemical shift in my body. Once we admit that
postpartum is a serious medical condition, then the treatment becomes
more available and socially acceptable. With a doctor's care, I have
since tapered off the medication, but without it, I wouldn't have
become the loving parent I am today.
So, there you have it. It's not the history of psychiatry, but it is
my history, personal and real.
Brooke Shields, the author of "Down Came the Rain: My Journey Through
Postpartum Depression," is starring in the musical "Chicago" in London.
* Copyright 2005 The New York Times Company
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