Summary

Depression affects women almost twice as often as men, with about one in four women suffering from it at some point in her lifetime. While depression may strike at any time, studies show that women appear to be particularly vulnerable during their childbearing years. This comprehensive and empathetic book confronts the seldom-talked-about issue of pregnancy-related depression, identifying symptoms, treatments, and cures for this constellation of serious, underdiagnosed, and surprisingly common emotional conditions.Topics covered include the emotional repercussions of infertility and miscarriage, depression during pregnancy, postpartum depression and anxiety, and the impact of maternal depression on spouse and family. Also addressed are the many aspects of a woman's life -- career, education, marriage, and a host of other factors -- that may increase her stress during the span of her childbearing years and make her especially susceptible to emotional difficulties.Straightforward, honest, and sensitive,A Deeper Shade of Bluespeaks directly to women at risk of or suffering from depression within the context of childbearing and provides the information they need to get the best care, during pregnancy and beyond.

Author Biography

Ruta Nonacs is the associate director of the Center for Women's Mental Health at Massachusetts General Hospital and an instructor in psychiatry at Harvard Medical School Ruta Nonacs, MD, PhD is the associate director of the Center for Women's Mental Health at Massachusetts General Hospital and an instructor in psychiatry at Harvard Medical School

Foreword	p. xi
Introduction
A Neglected Problem: Depression During the Childbearing Years	p. 3
Hormones and Mood: Understanding What Causes Depression in Women	p. 3
The Ripple Effect: How Depression Affects the Family	p. 31
Pregnancy
Modern Technology Meets Mother Nature: Getting Pregnant	p. 55
Unexpected Tragedies: Coping with Pregnancy Loss and Other Complications	p. 84
A Not-So-Rosy Blush: Depression During Pregnancy	p. 109
The Postpartum Period
Crying for No Good Reason: Baby Blues and the Transition to Motherhood	p. 127
Beyond the Blues: Postpartum Depression and Anxiety	p. 148
No Sense of Reality: Postpartum Psychosis	p. 171
Minimizing the Impact of Depression
Life After Children: Partners As Parents	p. 189
Helping Yourself: Practical Techniques for Managing Stress and Depression	p. 208
Seeking Professional Help: Treatment of Maternal Depression	p. 228
Understanding Your Options: Treating Depression During Pregnancy and the Postpartum Period	p. 260
For Families and Friends: How You Can Help	p. 301
Author's Note	p. 309
Edinburgh Postnatal Depression Scale (EPDS)	p. 311
FDA Pregnancy Categories	p. 313
Women's Mental Health Programs	p. 314
Resources	p. 317
Recommended Reading	p. 320
References	p. 323
Index	p. 351
Table of Contents provided by Ingram. All Rights Reserved.

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Excerpts

Foreword

The last decade has brought great advances in our understanding of depression and the ways to treat this serious illness. Nonetheless, a majority of patients who suffer from depression do not get appropriately diagnosed or treated. These individuals suffer the significant consequences of untreated mood disturbance. In addition, the impact of depression on others, including partners, friends, and family members who surround those suffering from this illness, is too often underestimated. Despite the consistent finding from well-conducted studies that depression is more common in women than in men and that it is particularly common during the childbearing years, it has really only been during the last fifteen years that attention has been paid to treatment of depression in women during critical times such as pregnancy, the postpartum period, and the interval following miscarriage.

A Deeper Shade of Bluetakes great steps to provide us with a clear road map to a more complete understanding of depression during the childbearing years, its recognition and treatment, and indeed the extent to which it is treatable. The information found here will empower those who require treatment to work with those who can provide it.

We have yet to completely understand what underlies women's vulnerability to depression during critical times in their reproductive years. Meanwhile, too few sources of information on what is presently known have been available thus far. The Internet has vast potential, and yet it can sometimes incompletely inform or even misinform us when we search it for answers. Nor should we have to rely on magazines for discussion of a problem as serious as depression. InA Deeper Shade of Blue,readers will find full explanations regarding a wide range of mood disorders that appear to be linked in some fashion to female reproductive biology. For example, they will find a discussion of PMS, and particularly the more severe form of PMS known as premenstrual dysphoric disorder (PMDD), which used to be a pejorative term but has evolved over the last decade into a more clearly understood problem of mood. They will read a demystifying description of infertility treatments and an honest discussion of the range of experiences associated with pregnancy loss, for which there is not only helpful information but encouragement to follow a woman's own intuitive feelings, rather than an expectation to "move on" after so significant a loss. They will read straightforward descriptions of what women actually experience during pregnancy, from normal mood swings to clinically significant depression in need of professional evaluation and treatment.

Postpartum depression remains one of the most common complications in modern obstetrics, and yet it remains largely undetected and frequently untreated. Just as the general range of feelings experienced by postpartum women varies widely -- ambivalence, joy, confusion -- postpartum depression may be very different for the single mom, the older mom, the mom managing a fussier baby, the mom caring for a newborn in an unfamiliar culture with a level of support different from her native one.

From PMS, to depression during pregnancy, to postpartum mood disorders, women need to be able to distinguish what is normal from what is more serious and in need of definitive treatment. Perhaps the most critical message of this book is that a failure to recognize and treat depression during the childbearing years cannot be an option. With the publication ofA Deeper Shade of Blue,women are given a valuable resource that offers them a way to better understand depression as they collaborate with family, friends, and care providers in the process of treatment and recovery.

Lee S. Cohen, MD

Boston, Massachusetts

February 2006

Excerpted from A Deeper Shade of Blue: A Woman's Guide to Recognizing and Treating Depression in Her Childbearing Years by Ruta Nonacs
All rights reserved by the original copyright owners. Excerpts are provided for display purposes only and may not be reproduced, reprinted or distributed without the written permission of the publisher.