A light in the fog: caring for women with postpartum depression

It is estimated that at least 1 in 10 women will experience postpartum depression, yet systematic screening for it in clinical practice is too often neglected. The foggy unreality of this affective disorder leads women to believe they are losing their minds, and their efforts to find help can be elusive. Women with postpartum depression who go undetected and untreated are at risk for immediate harm and potential lifelong sequelae for themselves and their families, and especially for their children. This article provides 1) an understanding of the woman's experience of postpartum depression, 2) a review of two instruments, developed through a focused program of research to screen for the disorder, 3) triage in clinical practice, and 4) an overview of the three dimensions of treatment: psychopharmacology, psychotherapy, and psychosocial care. Practical guidance and client information are provided to assist midwives and primary care providers to incorporate systematic screening into clinical practice, to identify effective interdisciplinary treatment teams, and to muster family and community resources to help with this commonly hidden childbearing crisis.