Psychotherapist Karen Kleiman, founder and head of the Postpartum Stress Center in Rosemont, Montgomery County, said, "I haven't evaluated her, but from my experience and what I'm hearing, it's more characteristic of psychotic behavior than postpartum depression."
Postpartum depression affects an estimated 20 percent of new mothers, yet it remains shrouded in misunderstanding and shame because having a baby is supposed to be a joyful, fulfilling event.
Postpartum depression is often confused with the "baby blues," the emotional roller coaster - fueled by hormonal changes and sleep deprivation - that most women ride for a few days after giving birth.
Full-blown postpartum depression is more serious and persistent. Symptoms include feelings of guilt, fear, loneliness, helplessness and failure; crying jags; insomnia; loss of appetite; and withdrawing from friends and family. Some women have panic attacks or suicidal thoughts, or both.
"After two or three weeks, if the symptoms persist, it's postpartum depression," Kleiman said.
Kori Beer, 34, of Malvern, Chester County, was a classic case. An outgoing, workaholic corporate communications executive before her daughter was born five years ago, Beer became increasingly weepy, distracted, withdrawn and fearful after giving birth. Her husband, she says, "had no idea how to handle it or what to do"; her obstetrician-gynecologist said it was hormones and advised her to stop breast-feeding.
Finally, when the baby was 6 weeks old, Beer's pediatrician recognized the signs of depression and referred her to Kleiman.
"Karen listened and validated my feelings. I really needed that," said Beer, who also needed - and soon felt relief on - a serotonin-boosting antidepressant prescribed by a psychiatrist who collaborates with Kleiman.
With medication, counseling - and, in some cases, continuing psychotherapy to explore such underlying factors as marital or mental health problems - most women fully recover from postpartum depression, Kleiman said.
"The longer the depression, the harder it is to treat," she said.
Psychosis, suffered by an estimated 1 in 1,000 new mothers, is more mysterious. The woman may have periods when she acts - and even feels - calm and clear-thinking, but then she suddenly becomes delusional and impulsive. She may have bizarre fears or urges to kill herself or her baby, or both.
"She'll say things that make no sense, like: 'The baby's the devil. I have to save the baby from the devil,' " Kleiman said.
In contrast, a dangerously depressed mother could be susceptible to killing herself, thinking that doing so would make her baby's life better.
In any case, women who feel "something is wrong" should discuss their feelings - with their husbands, doctors or friends - and seek help.
"If you think something is wrong, it is," Kleiman said.
Contact staff writer Marie McCullough at 215-854-2720 or firstname.lastname@example.org.
The Postpartum Stress Center Web site ( www.postpartumstress.com ) has tips for talking about depression with a doctor, things that women can do to feel better, and a list of helpful resources and Web sites.