Emily Dryer, a former obstetrics nurse, has seen postpartum depression in real life. In the novel “The Memory Child” by Steena Holmes, Dryer said she saw it accurately portrayed in fiction.
“As an avid reader, I recommend this novel because it is a page-turner,” said the Hingham resident, who is the mother of two grown children. “But as a former OB/GYN nurse, it really sheds light on postpartum depression, and just how serious this condition can be.”
“The Memory Child,” a psychological thriller published this year, is told in the alternating voices of Brian and Diane, a professional couple about to have their first child after 12 years of marriage. Diane has been ambivalent about motherhood as she vividly remembers her mother’s depression after the birth of Diane’s baby brother.
Then Diane finds herself pregnant as she receives a long-awaited promotion, while Brian must leave to head a new office in London.
As the narrative jumps back and forth in time in the novel’s complex structure, Diane’s troubled childhood clashes with the anxiety typical of any new mother.
“It’s very clear right from the very beginning of this story that Diane is not well,’’ Dryer said, “but readers will need to wait to the twisted end to understand Diane’s true predicament.”
She added, “After a birth, women everywhere struggle with the baby blues, full-blown depression, and in rare instances, even psychosis — and there is still much embarrassment, shame, and secrecy about it.”
As a psychologist, I think it’s important to understand the distinctions between these three postpartum psychiatric conditions.
New mothers will often say to me, “I know this is supposed to be the happiest time of my life, and I love my baby, but I don’t understand why I am feeling so down.”
The baby blues are totally normal, and between 60 and 80 percent of women experience them. Baby blues almost always begin in the first few days following delivery, but disappear in about two weeks.
While new mothers expect to feel bliss, they may instead have symptoms that include teariness, mild anxiety, sadness, exhaustion, irritability, and feelings of vulnerability. These symptoms are likely triggered by hormonal changes, and are no cause for alarm.
In contrast, postpartum depression is a disorder, and is distinguished by how long the symptoms last. If the baby blues continue beyond two weeks, it is diagnosed as postpartum depression, and may peak around three months after the baby’s birth.
Difficulty sleeping may worsen, as can anxiety, hopelessness, irritability, low self-esteem, and frequency of crying. In addition to emotions spiraling downward, there may be changes in appetite, difficulty concentrating, and even suicidal thoughts.
If the symptoms disrupt the woman’s ability to function or care for her baby, the condition should be considered serious, and a woman should seek professional help.
Postpartum psychosis is a disabling illness, and typically occurs in one out of 1,000 births, according to the group Postpartum Support International. Though rare, it can prove to be life-threatening to both the mother and infant.
Symptoms usually appear suddenly within the first four weeks after birth, and can include delusions, hallucinations, hyperactivity, decreased need for sleep, paranoia, and rapid mood swings. Women who have a postpartum psychosis are experiencing a break from reality, and while the delusions make sense to the woman, they may take the form of violence toward herself or the infant.
While it is a dangerous condition, psychosis is temporary and treatable, but requires immediate help and hospitalization.
According to Dryer, “ ‘The Memory Child’ can serve as a reminder that every woman needs support following birth, and that we should be paying more attention to the warning signs of depression in ourselves, our friends, and our daughters.”Nancy Harris can be reached at firstname.lastname@example.org. Follow her on Twitter @DrNancy_Globe.