The Postpartum Effect
contains some interesting information that might possibly be useful but it is
not a book I'd recommend to pregnant women, especially those prone to
depression. The book itself is quite well-written, although parts of it are
merely summaries of some recent research papers on the topic, and there's an
uneven pacing to the chapters, since some are very short and others are much
longer, and two are authored by medical professionals. It's not very clear at
which readership the book is aimed: much of the book seems to be for the
general reader who wants information and help concerning postpartum depression,
while the rest of it concerns the failure of the medical and psychological
professions to adequately address this common phenomenon. An editor who
insisted on more unity in the aims and writing style would have improved the
book. But the main problem is that it strongly emphasizes the danger of
mothers with postpartum depression killing their own children. Of course, this
is a serious issue, but it happens very rarely, and to highlight the problem in
a general book about the common phenomenon of depression in new mothers is
needlessly alarming and somewhat sensationalist.
There are various estimates of the
prevalence of postpartum (also known as postnatal) depression (PPD). The back
cover says that it affects 400,000 women in the US annually. It affects
between 10 and 15 percent of new mothers, but in women over twenty-five years
of age with a history of mood instability, 30 to 40 percent will be affected. Huysman
states vaguely that those with a family of mood instability, which she equates
with being "genetically predisposed," are also prone to PPD. Huysman
is clearly sympathetic to a biological conception of mental illness, and places
strong emphasis on the role of hormonal changes in PPD, as well as referring to
bipolar disorder as a genetic illness. She laments the fact that PPD has not
been deemed a separate mental disorder in the diagnostic manual DSM-IV-TR.
Nevertheless, Huysman herself does not provide a clear definition of the
disorder; rather she lists some of the "most recognizable signs" of
the illness such as severe anxiety, panic attacks, spontaneous crying long
after the first week after birth, lack of interest in the new baby, and
insomnia. She also lists other associated signs such as complains by the
mother of not being well, of not sleeping or having nightmares, or being
irritable, family conflict, thoughts of suicide, hyperactivity, and neglect or
abuse of the baby. Of course, with such a vague list, it is not surprising if
this is a difficult phenomenon to identify and study scientifically.
There are chapters on treating the
condition, which go through the usual lists of forms of medication with brief
mention of psychotherapy and counseling. There is an additional chapter tagged
on to the end of the book, written by Paul Goodnick, which mostly repeats
information found elsewhere in the book, adding information about some of the
newer medications that have become available since the first edition of the
book. Another chapter by Ilyene Barsky provides some brief information about
how to get help along with a slightly dated list of books on the topic.
In the middle of The Postpartum
Effect are two chapters that seem out of place. A chapter on
"Partners" starts out telling the reader, "Research shows that a
significant number of mothers who kill their children do so with the help of a
partner." This is hardly what a woman at risk of PPD or who is suffering
from the condition needs to know. The chapter goes on to list the ways in
which men have colluded in child abuse or murder, giving special attention to
the case of "Cheryl Stone." The longest chapter of the book is on
"Mothers Who Kill," and it goes into a great deal of detail
concerning individual stories. It is depressing reading.
The back cover claims that author
Arlene Huysman as done pioneering work in mood disorders which is widely cited
in the field. However, no articles or books by her are listed in the
bibliography or in the notes. It is hard to tell what exactly she has
contributed to the field of knowledge on the topic. Most of the information in
the book could have been collected by a journalist. Ultimately, The
Postpartum Effect seems ill-conceived and badly edited. I recommend
readers seek out other books on the subject if they are looking for a guide to
depression in new young mothers.
© 2004 Christian Perring.
All rights reserved.
Ph.D., is Academic Chair of the Arts & Humanities Division and Chair of the
Philosophy Department at Dowling College, Long Island. He is also editor of Metapsychology Online Review.
His main research is on philosophical issues in medicine, psychiatry and