FROM THE NEW YORK TIMES

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.
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