Beyond the baby blues: A spectrum of postdelivery conditions

Asking the right questions is central to diagnosing and treating postpartum disorder.

By Kathleen Phalen Tomaselli, AMNews correspondent. Feb. 18, 2008.

Katherine Stone, a successful marketing executive, felt as if she was in a bubble, watching a world she once knew pass in strange, sometimes frightening ways.

Within six weeks after her son's birth, her behavior became unfamiliar. She would drive through stop signs and think, "Oh my God, what am I doing?" She felt disconnected from friends and family -- as if her brain no longer worked. "I didn't even know who I was."

And her thoughts -- "What if I take this burp cloth and smother him?" or "What if the knife slips and I stab him?" -- repulsed her. Still, she tried to rationalize the irrational, telling herself she was a well-educated woman who loved her baby, who could handle motherhood. "And to be sure I prevented any harm to my son, I made a pact with myself: If I make any real move toward hurting him, I will either run into the neighborhood screaming for help or I will get my husband's gun and shoot myself in the guest bedroom."

Stone experienced postpartum obsessive-compulsive disorder, a form of postpartum mood disorder. But a lack of knowledge and a profound fear that social services would remove her son pushed her further into this foreign world.

"In our society, the stigma about depression and an idealized picture of motherhood make asking for help very difficult," said Marlene P. Freeman, MD, director of the Women's Mental Health Center and associate professor of psychiatry, obstetrics and gynecology at the University of Texas Southwestern Medical Center. "Sometimes these mothers experience obsessions which are intrusive and disturbing thoughts about hurting the baby. These are different from psychotic thoughts a mother with postpartum psychosis might experience."