Brooke Shields has it all: Flawless beauty (she looks better in real life than she does on screen, if that's possible), a successful career as an actress and model, a glamorous life, wealth, talent, brains, a great husband and now a darling, much-wanted daughter, Rowan, 2. Even though Shields has been in the public eye since infancy, she has avoided the drug/alcohol/legal problems that have derailed so many former child stars.

So why is this articulate, level-headed Princeton grad now struggling for composure as she describes what she calls her year of hell on Earth? What should have been the most joyous event of her life, the birth of her daughter, led to her struggle with one of society's major taboos: postpartum depression.

Shields always wanted to be a mother. She and her husband, comedy writer Chris Henchy, struggled very publicly with infertility treatments and were elated when Shields finally became pregnant. "I had a blissful pregnancy," Shields says. So it was all the more shocking to her when she sank into depression and despair after giving birth.

We caught up with Shields at a recent press conference at Good Housekeeping magazine in New York to publicize her book, "Down Came the Rain: My Journey Through Postpartum Depression" (Hyperion, $26.98). She describes her ordeal: "I felt worthless and couldn't stop crying. I knew something was horribly wrong but to express what I was feeling was impossible. I tend to power through things, soldier on, so to admit to what I thought was weakness was horrific to me. I felt so ashamed and guilty."

Often misunderstood, postpartum depression is the mental illness no one wants to talk about. In today's society, where mothers are expected to be supermoms, PPD is often considered a luxury afforded to only whiny, pampered women, like Shields. In fact, PPD is biological, affecting 10 percent of new moms. This is not the normal "baby blues," that 80 percent of women encounter after giving birth.

The difference is severity and duration, says Norma Kirwan, director of outpatient behavioral health services at the Dorothy Bennett Behavioral Health Center at Stamford Hospital. "Many women have a mild depression after delivery. These symptoms generally go away after two to three weeks and don't require treatment. The symptoms of postpartum depression are similar but with greater intensity and may last up to a year. It really gets in the way of the mother's ability to function."

Symptoms include crying, irritability, exhaustion, mood swings, changes in appetite and difficulty concentrating. The mother sometimes fears she will harm her baby or herself. The most extreme -- and very rare -- form, postpartum psychosis, is a medical emergency signaled by agitation, bizarre behavior, insomnia, hallucinations and delusions. Andrea Yates, the Texas woman convicted of drowning her five children, suffered from an untreated case of PPP.

Postpartum depression is caused by a variety of factors: the drastic decrease of progesterone and estrogen, lack of sleep, lack of social supports and stress. Women with personal or family histories of depression are at greater risk. "The most important thing that a woman and her family needs to know is that this is not within the woman's control to get better without help. Something chemical is happening in the woman's body that she can't just reverse by willpower," says Dr. Devra Braun, a psychiatrist with Integrative Medicine and Psychotherapy in Greenwich.

And here's the rub: Help can only come if the woman knows what to ask for, who to go to, how to find the words to describe the maelstrom within. She must rise above paralyzing shame and name the unnamable -- not easy considering the ways in which motherhood is glorified. To admit depression can make affected mothers feel weak. "People tend to look at postpartum depression as a moral or character flaw rather than a biological illness or disorder than needs to be treated," says Kirwan.

As Shields says, "If you had asked me if I was depressed, I would have said 'no.' Nothing gets me down, I can soldier on." She was too ashamed to ask for help or to admit even to herself what was happening. Shields was in the position that so many other women face. And no matter their position, most women don't talk about it, don't seek help, suffer needlessly and get worse.

The tragedy? PPD is treatable. "Assessment must be done on an individual basis but there are many options such as antidepressants, psychotherapy, support groups, education and lifestyle changes," says Kirwan.

When Shields finally sought help after a year of terrible struggle, she responded immediately to psychotherapy and antidepressants. Hence, Shields' mission to educate women. "Don't be ashamed and don't disregard what you are feeling. It is better to be proactive," she writes. "I recovered only because I got help. Now I'm back, I'm me again and I am staggered by the immensity of my love for my daughter. Now I get what everyone is talking about when they talk about a mother's love. Now I understand it."

Symptoms:

* Crying

* Irritability

* Exhaustion

* Mood swings

* Changes in appetite

* Difficulty concentrating

* Sometimes the mother fears she will harm her baby or herself.

* Very rare: postpartum psychosis, a medical emergency signaled by agitation, bizarre behavior, insomnia, hallucinations and delusions.

Resources:

* Depression After Delivery, www.depressionafterdelivery.com.

* Dorothy Bennett Behavioral Health Center at Stamford Hospital, 325-7560.

* National Woman's Health Information Center, www.4woman.gov/faq/postpartum.htm.

* Postpartum Assistance for Mothers, www.postpartumassistance.com.

* Emergency hotline: (800) PPD-MOMS (773-6667)

 

Stamford (Connecticut) Advocate, May 20, 2005