51
You don't want to experience postpartum depression
What he was thinking of, in
fact, was the whales' songs. In the past the whales had been able to sing to
each other across whole oceans, even from one ocean to another because sound
travels such huge distances under water. But now, again because of the way in
which sound travels, there is no part of the ocean that is not constantly
jangling with the hubbub of ships' motors, through which it is now virtually
impossible for the whales to hear each other's songs or messages. So fucking
what, is pretty much the way that people tend to view this problem, and
understandably so, thought Dirk.
Douglas Adams, The Long Dark
Tea-Time of the Soul
At The Farm in Tennessee, where
nearly 2,000 home births have taken place, postpartum depression is virtually
nonexistent. The rate is 0.03 percent. This incidence is 300 times less
frequent than similar sized populations experience after typical hospital
births.
John
Robbins, Reclaiming Our Health
One investigator points out
that, while postpartum depression afflicts 10% to 25% of mothers who give birth
in the hospitals of industrialized countries, it is unknown in preliterate
societies.
Anne
Oakley, "Cross-cultural practices"
Ay, in the very temple of Delight
Veil'd Melancholy has her sovran shrine . . .
John
Keats, "Ode To Melancholy"
I have heard the mermaids singing, each to each.
I do not think they will sing to me.
T.S.
Eliot, "The Love Song of J. Alfred Prufrock"
"Your self-esteem is a notch below Kafka's."
Woody
Allen, Manhattan
"Paging Dr. Freud!"
Mike
Meyers, Austin Powers: The Spy Who Shagged Me
a mini-play
MOTHER: I don't love my baby.
PHYSICIAN: You have puerperal psychosis.
MOTHER: I'm sorry?
PHYSICIAN: You have puerperal psychosis.
MOTHER: "Purr-purr" . . .
PHYSICIAN: You have puerperal psychosis.
MOTHER: What is "puerperal
psychosis," Doctor?
PHYSICIAN: You have puerperal psychosis.
MOTHER: What is "puerperal
psychosis," Doctor?
PHYSICIAN: You have puerperal psych– What?
Oh. Puerperal psychosis is a very mysterious mental illness. We know nothing
about it.
MOTHER: Nothing?
PHYSICIAN: Nothing. All we know for sure is that
nature is at fault. Fortunately, we have drugs at our disposal.
MOTHER: Drugs?
PHYSICIAN: Drugs!
MOTHER: But if you don't know anything about
the disease . . .
PHYSICIAN: When nature sends you curveballs, you
get out the pharmaceutical bat! To the moon!
MOTHER: So it's nature's fault that women become mentally
ill after childbirth?
PHYSICIAN: Right.
MOTHER: Why do you think that's so?
PHYSICIAN: I just write the prescriptions.
MOTHER: My girlfriend who gave birth at home
never got depressed. She was happy.
PHYSICIAN: That's because she's crazy.
MOTHER: What?
PHYSICIAN: Home birth hippies like your friend are
already
mentally ill. You'd have to be crazy to give birth at home! Your friend's
"nondepression," her so-called "happiness," as you put it,
is a delusion.
MOTHER: My friend doesn't seem delusional . . .
PHYSICIAN: That's because you're delusional too! You've just
gone through childbirth, baby! There's nothing more confused than the maternal mind after
creating new life! Let's prescribe you some anti-depressants, sugar-tits.
MOTHER: Doctor, did you just call me
"sugar-tits"?
PHYSICIAN: You're not against breastfeeding, are you?
MOTHER: Uh . . .
PHYSICIAN: Your baby will never have a sweeter
meal than your
breastmilk! Breastmilk is full of the best sugars around – except for Aspartame,
which isn't really a sugar, although stockholders in the FDA, I mean Monsanto,
sure like to think so, ha ha. Anyway, breastmilk is full of a whole bunch of excellent substances –
MOTHER: What substances?
PHYSICIAN: Couldn't say. But it doesn't matter,
because infant formula is just as good as breastmilk! I have some free infant formula
coupons for you, for the betterment of your baby's life . . .
MOTHER: No, thanks.
PHYSICIAN: You never know when you might need 'em!
Go ahead! Take a few! Your milk could dry up at any time, and then where would
you be?
MOTHER: Doctor, have you ever been to a home
birth?
PHYSICIAN: I'd rather cut my throat with a laser
knife. Home birth is for freaks. Here's your prescription for a very strong
anti-depressant, hippo-buns, ha ha. I called my wife "hippo buns"
after our third baby, and we always got a big laugh out of it. Hippos are very
friendly animals, unless they decide to eat you. Anyway, it's important for you
to understand that this drug will make you a better mother. And if it doesn't make you a better
mother, it will definitely make you happier. In fact, I'd wager it will make
you so happy, you'll want to go on Star Search! I can just see you singing like
Britney Spears! Of course, you could never fit your ass into her leather pants, ha
ha!
MOTHER: I, uh, guess I should thank you,
Doctor.
PHYSICIAN: Of course you should thank me! That'll
be $225.
MOTHER: $225?
PHYSICIAN: The road to stardom is not cheap.
MOTHER: But I've been here for less than three
minutes.
PHYSICIAN: Medical school bills, my dear. Medical
school bills.
MOTHER: But you're 60 years old.
PHYSICIAN: They've still got me by the cajones.
MOTHER: Does it hurt?
PHYSICIAN: Only when I don't charge $75 a minute!
ha ha! I'm just glad to be of service to the procreating masses. Go forth and
multiply! But for God's sake, next time your friends decide to get knocked up,
tell 'em to get their butts to the hospital! It's all about safety, sweet
cheeks.
MOTHER: Thank you, doctor. You've been a great
help.
PHYSICIAN: Whatever! Now get out of here, or I'm
going to have to charge you $300! Can you hand me my putter on the way out?
* * *
The Men in White Coats
by Jock Doubleday
They laughed and said I hadn't died.
I said, "What do you mean?"
"The blood is just the way it goes,"
they said.
"It's just routine."
I held the creature in my arms.
"Was this thing part of me?"
"Oh, yes," they said. "We took it out
–
for the usual fee."
They handed me the bottle, then:
"It beats the breast," they grinned.
I plucked my nipple from his gums
and stuck the bottle in.
The sky was dark when we went home –
I didn't know his name.
But what the hell, the thing was done,
And kids, they're all the same.
* * *
In modern Western culture, and not in other cultures, childbirth and maternal
depression are linked.
Why this is so, is a
spellbinding story. That is, it is a spellbinding story to those who have not
heard exactly the same story, again and again, ad nauseam, sounding like a dirge behind each
and every one of the queer and chronic maladies of Western culture.
To researchers whose business
it is to ferret out the truth behind modern civilization's health-related
discontents, the story of postpartum depression is, well, just business as
usual.
And the answer
is . . .
The
story behind our high rates of postpartum depression is reducible to one
mind-numbing concept.
What is the answer to 99 out
of 100 questions? You guessed it. Money.
Modern-day birth technology
creates postpartum depression (for a fee), and then modern-day pharmaceutical
technology attempts to remedy it (for a fee).
The
medical literature divides postpartum mood disorders into three categories.
Let's look at these categories – which for the sake of truth we'll call
"cash-cow categories" – one by one.
Postpartum
blues
The clinical
definition of postpartum blues (also called "maternity blues" or
"baby blues") is: "depression lasting up to eight days after
childbirth."
Symptoms
of postpartum blues include depressed mood, irritability, anxiety, confusion,
crying spells, sleep and appetite disturbance, and something called "mood
liability." These symptoms typically peak between three and five days
postpartum and typically resolve spontaneously between 24 and 72 hours after
peaking.
Today,
postpartum blues occurs in an astonishingly large number of Western women. It
is estimated that up to 85 percent of birthing women suffer from it. Because
the numbers are so large, postpartum blues is considered to be a normal
phenomenon, something that "just happens" to women who give birth. Presumably,
the act of giving life is an inherently traumatic process, a gauntlet of
sorrow. Nature is culpable, and the tear-jerking show goes on.
Although
postpartum blues is considered normal in Western culture, it is at the same
time considered a "disorder." Because it is normal, there is no need
to look for a cause. Because it is a disorder, doctors can legally prescribe
pharmaceuticals to alleviate its symptoms. Your neighborhood medicine man,
fixer of disorders, hero of the sad, is allowed, even encouraged, to sell you
drugs (don't worry – they're legal!) to help you recover from the
"normal disorder" called postpartum blues. If motherhood doesn't make
you happy, pharmaceuticals will.
Postpartum depression
The clinical definition of
postpartum depression is: "depression during and after the first eight days after
childbirth."
Symptoms
include – get ready – dry mouth, blurred vision, urinary hesitancy,
constipation, drowsiness, orthostatic hypotension (low blood pressure when
standing), arrhythmia (irregularity in the rhythm or force of the heartbeat),
weight gain, fatigue, feelings of worthlessness, feelings of guilt (especially
"failure at motherhood"), sleep and appetite disturbance,
"dysphoric mood" (hopelessness), loss of interest in usually pleasurable
activities, negative feelings toward the new baby, and recurrent thoughts of
death or suicide.
Postpartum
depression complicates 10 to 15 percent of all hospital deliveries. (Women who
suffer postpartum blues are not exempt from postpartum depression.) Most women who suffer from
postpartum depression suffer from it for more than six months.
(Side
note: Because
mothers suffering from postpartum depression often show a more negative
attitude toward their children, social service workers and doctors who
prescribe drugs feel justified in "monitoring," and indeed
interfering in, the mother-child relationship. In a post-nature,
hyper-technology world, abusive mothers in potentia are identified (no one knows how
– no standards have been devised) and prescribed one or more
pharmaceuticals to prevent new mothers from hurting, maiming, or killing their
children. Precautionary or preemptive maternal sedation (like the Precog Crime
Unit in the popular movie, Minority Report) is the perfect answer to crimes that haven't
happened yet. Preemptive maternal sedation is perfect, as far as pharmaceutical
companies are concerned, because there is no way to know for certain that the
crime wouldn't have happened without the drug. So women who have committed no crime against
their children are left in the position of assuming that the drugs they are
taking probably did some good, even though the drugs may in fact have had no
positive effect at all and may even have had negative effects. Preemptive
maternal sedation is perfect for doctors because it gives them more control
over their patients and over their patients' bank accounts. New mothers left
with the nagging feeling that drugs are the only sure route to peaceful, loving
motherhood will genuflect, cash in hand, to the doctor-priest till kingdom
come, literally begging him for the magical, child-saving potions that he, and
only he, is empowered to dole out. Low rates of child abuse are attributed by
medical researchers to high maternal pharmaceutical use. If rates of child
abuse are high, such abuse is labeled an aberration, a glitch in the
pharma-system, and an increased use of pharmaceuticals is recommended "to
curb the trend." Everybody wins – if you don't count women, babies,
fathers, and society.)
Puerperal psychosis
Puerperal psychosis is
comparatively rare, occurring in "between one and two out of a
thousand" birthing women. This rate is 12 to 14.5 times the prenatal incidence of maternal psychosis.
That is, you stand a 12-to-14.5-times-greater chance of suffering from
psychosis after giving birth than before giving birth. In other words, one
might say, "there's just something about giving birth that makes women
psychotic." What is that something? Read on.
Symptoms
of puerperal psychosis generally manifest within the first 4 weeks postpartum
but can occur up to 90 days after delivery. Patients suffering from puerperal
psychosis have hallucinations and delusions that frequently focus on the infant
dying or being divine or demonic. These hallucinations seem to place mothers at
high risk of committing suicide and/or infanticide.
Just say yes
Whichever type of postpartum
depression you find yourself the victim of after your hospital birth, you'll
almost certainly be prescribed one of the following seven drugs: amitriptyline,
desipramine, imipramine, nortriptyline, fluoxetine, paroxetine, or sertraline.
Let's
take a look at these drugs one by one, paying special attention to their
so-called "side" effects, which, when they happen to you, probably
won't much feel like side effects. On the subject of side effects, Tim O'Shea,
in his splendid expos, Conventional Medicine vs. Holistic: A World of
Difference,
writes:
Side effects . . . Just
another Medspeak term. Chemicals don't have side effects in the human body;
they just have effects. Using the term "side effect" is pretending
that the drug actually had the one main effect it was supposed to have, and all
these other responses are just extraneous, minor reactions. The body doesn't
think like that. All its systems work together in a complex symphony of
sophisticated chemical reactions and defenses. When a drug comes in, everything
happens at once: most of the energy is expended trying to neutralize the drug
and to isolate it and get rid of it. The reason for this is simple: drugs don't
cure disease. No matter what you read, diseases are not drug deficiencies. In
the body, drugs are simply toxic, foreign chemicals.
"Diseases are not drug
deficiencies" . . . What a brave new world opens up when one groks those
five simple words.
Amitriptyline
Amitriptyline, which goes under the
brand names Elavil and Endep, is a tricyclic antidepressant.
"Tricyclic" means having a molecular structure containing three
rings. It is a word used by doctors to make you feel that their education was
worth your paycheck.
Common
"side" effects of amitriptyline use include blurred vision,
constipation, drowsiness, dry mouth, low blood pressure, increased sensitivity
to sunlight, increased sweating, sleepiness, and weight gain. Less common side
effects include insomnia, confusion, racing heartbeat, heart palpitations,
seizures, skin rashes, "sexual problems," and allergies.
Amitriptyline
makes its way directly into the breastmilk of nursing mothers. No infant safety
studies have been performed, but pharmaceutical companies admit that there is a
potential for a serious adverse infant reaction to amitriptyline.
Desipramine
Desipramine, known to
marketing people and their public as Norpramin and Pertofrane, is a tricyclic
antidepressant. Common side effects of desipramine use include dry mouth,
constipation, urinary retention, blurred vision, drowsiness, dizziness,
headache, nausea, insomnia, stomach pain, and loss of appetite.
No
studies have been performed on the safety of this drug during pregnancy and
nursing.
Imipramine
Imipramine, otherwise known as
Tofranil, is a tricyclic antidepressant.
Common
side effects of imipramine use include dry mouth, constipation, urinary
retention, blurred vision, hallucinations, muscle spasms and tremors, seizures
and convulsions, disorientation, confusion, worsening glaucoma, and sensitivity
to bright light or sunlight. Less common side effects are anxiety,
restlessness, numbness and tingling in the extremities, poor coordination,
itching, fluid retention, rash, fever, allergy, blood pressure changes,
abnormal heart rate, heart attack, stomach cramps, changes in sex drive,
changes in liver function, flushing, drowsiness, dizziness, weakness, headache,
loss of hair, nausea, vomiting, loss of appetite, diarrhea, black discoloration
of the tongue, insomnia, nightmares, and feelings of panic.
The
manufacturer states that "Imipramine should never be taken by pregnant or
nursing mothers. Birth defects have been reported. Nursing mothers should
bottle-feed their babies."
Nortriptyline
Nortriptyline,
marketed as Pamelor and Aventil, is a tricyclic antidepressant.
Common
side effects of nortriptyline use include dry mouth, drowsiness, weakness,
fatigue, anxiety, insomnia, stomach upset, constipation, difficulty urinating,
blurred vision, increase in skin sensitivity to sunlight, severe skin rash,
yellowing of the skin or eyes, irregular heartbeat, excessive sweating, jaw
spasms, neck spasms, back spasms, changes in sex drive, slowing speech,
shuffling walk, persistent fine tremors or inability to sit still, fever,
nightmares, difficulty breathing, and difficulty swallowing.
As
a consumer of nortriptyline, you are warned that you should "tell your
doctor if you are pregnant, plan to become pregnant, or are breast-feeding. If
you become pregnant while taking nortriptyline, call your doctor
immediately."
Fluoxetine
Fluoxetine, otherwise
known as Prozac, is an SSRI antidepressant. (SSRI stands for "selective
serotonin reuptake inhibitor." Your brain creates the natural hormone serotonin to regulate your
mood. SSRIs block the reuptake of serotonin, making the hormone available for
mood regulation for longer periods of time.)
Unfortunately, there is a
risk of "serious adverse reaction" to all SSRI antidepressants. This
adverse reaction is termed Serotonin syndrome. Notice that, as with SIDS, the
name of the syndrome is formulated to implicate nature, not culture. Somehow it
becomes the natural hormone serotonin's fault that women taking SSRIs develop
high blood pressure, fever, rapid heart rate, and "altered mental
status."
Common
side effects of fluoxetine use include dry mouth, upset stomach, nausea,
vomiting, diarrhea, stomach gas, rash, itching, anxiety, headache, drowsiness,
and fatigue. Less common side effects include difficulty concentrating,
increased appetite, acne, hair loss, dry skin, abnormal heart rhythms, blood
pressure changes, chest pain, urinary pain, eye pain, ear pain, double vision,
and changes in sex drive.
The
manufacturer states that "Pregnant or nursing mothers should not take this
medication unless the benefits significantly outweigh the risks. No serious
adverse reactions in babies have been reported, but pregnant or nursing mothers
on this medication should be very closely monitored."
Paroxetine
Paroxetine, marketed as Paxil, is
an SSRI antidepressant.
Common
side effects of paroxetine use include nausea, increased sweating, tremors,
weakness, dry mouth, constipation, dizziness, decreased sex drive, blurred
vision, headache, and weight gain. Less common side effects include flushing,
increased saliva, cold and clammy skin, dizziness when rising, blood-pressure
changes, swelling around the eyes, fainting, rapid heartbeat, muscle pain,
joint pain, teeth grinding, menstrual cramps, double vision, facial swelling,
weight changes, lymph swelling, breathing difficulty, memory loss, fatigue,
apathy, delusions, aggressiveness, a feeling of detachment, abnormal thinking
patterns, hallucinations, neurosis, paranoia, and suicide.
The
manufacturer graciously admits: "Pregnant or nursing mothers should not
take this medication, as adverse effect to the fetus or baby can occur."
Sertraline
Sertraline, otherwise known as
Zoloft, is an SSRI antidepressant.
Common
side effects of sertraline use include (take a deep breath . . . ready? Go!) dry mouth, sweating, heart
palpitations, chest pain, headache, dizziness, tremors, tingling or numbness in
the hands or feet, twitching, muscle spasms, confusion, rash, nausea, diarrhea,
constipation, upset stomach, stomach gas, appetite change, abdominal pains,
muscle aches, sleeplessness or sleepiness, sexual dysfunction, agitation,
nervousness, anxiety, loss of concentration, menstrual disorders, sore throat,
runny nose, vision changes, ringing or buzzing in the ears, urinary frequency
changes or disorders, fatigue, hot flashes, fever, back pain, thirst, and
weakness. Less common side effects include flushing, increased saliva, cold and
clammy skin, dizziness when rising, blood pressure changes, swelling around the
eyes, swelling of the arms or legs, coldness in the hands and/or feet,
fainting, rapid heartbeat, loss of coordination, migraines, hair loss, nose
bleeds, dry skin, acne, difficulty in swallowing, joint pains, cramps,
aggressiveness, menstrual cramps and pain, bleeding between periods, breathing
difficulty, double vision, sensitivity to bright light, weight changes, lymph
swelling, memory loss, apathy, delusions, a feeling of detachment, worsened
depression, emotional instability, hallucinations, neurosis, paranoia, and
suicide.
The
manufacturer states, in something less than good English: "Pregnant or
nursing mothers should not take this medication as adverse effect to the fetus
or baby can occur."
Happiness vs. breastfeeding?
If you find yourself on amitriptyline
(Elavil or Endep), imipramine (Tofranil), nortriptyline (Pamelor or Aventil),
fluoxetine (Prozac), paroxetine (Paxil), or sertraline (Zoloft), you will have
to decide between taking the drug and continuing to breastfeed your baby. If
you're taking desipramine (brand names Norpramin or Pertofrane), remember that no
studies have been
performed on its safety during pregnancy and nursing.
Thus,
as a taker of tricyclics or SSRIs, according to the pharmaceutical companies,
the only thing between you and drug-induced happiness is your breastfeeding
baby. Like so many other aspects of modern-day "medicine," postpartum
antidepressants pit family members against family members and weaken and
endeavor to break family bonds. Robert S. Mendelsohn, M.D. writes: