Chicago suicides refocus spotlight on depression

Associated Press, various newspapers in Canada and the U.S.A., By LINDSEY TANNER. July 20, 2001

CHICAGO -- A mother of quadruplets flees home and drowns herself in Lake Michigan less than a week after their births.

Another new mother disappears from her house several months after her baby is born and jumps to her death from a 12th-story hotel window.

Aracely Erives, whose body was found in the lake on Wednesday, and Melanie Stokes, who died June 11, were among four new mothers to commit suicide in Chicago over the past two months, authorities say.

The women could have met pushing strollers in the park, sharing stories of sleepless nights, first smiles and favorite lullabies. Instead, at a time that is supposed to bring wondrous joy, they were all struck by postpartum depression.

The condition has been in the spotlight recently because of Andrea Yates, a Houston woman said to have been afflicted with the most severe form of the illness. She is accused of drowning her five children in the bathtub June 20.

Authorities believe the recent cases do not mean there is any surge in postpartum depression-linked violence, but rather reflect a slowly growing awareness of the baffling disorder.

Experts admit they know frustratingly little about postpartum depression and its causes. And some say not enough is being done to detect it before tragedy strikes.

"People dismiss it and say that you can just snap out of it, that you've chosen to feel this way. That is totally wrong," said Lisa Anderson, a Tacoma, Wash., shipping company auditor. She went to several doctors before finding one who took her seriously when she developed postpartum depression after the birth of her third child last year.

Anderson, 33, said she thought her family was better off without her and contemplated suicide. But medication and counselling helped her, and she said women should know "they shouldn't blame themselves for this illness."

Postpartum depression happens in about 10 percent of pregnancies and typically develops within the first few weeks after childbirth, according to the National Institutes of Health.

It is often blamed on the dramatic drop in estrogen and progesterone, pregnancy-sustaining hormones, that occurs with childbirth. But there is little scientific evidence to support that theory, said Dr. Valerie Davis Raskin, a University of Chicago psychiatrist.

An NIH study is seeking to test the theory by using drugs to create a "scaled-down" hormonal state of pregnancy in non-pregnant women and then measuring their mood after immediate withdrawal of the synthetic hormones.

One problem is trying to figure out which women are susceptible, since all women experience a hormone crash after giving birth but only a fraction develop postpartum depression, Raskin said.

The condition is known to run in families, and women who had had previous mental ailments, including an extreme form of premenstrual syndrome, also face an increased risk, she said.

Women with difficult pregnancies, such as 27-year-old Erives, who spent more than a month on bedrest, are also at risk.

Carol Blocker, Stokes' mother, said her daughter's symptoms began soon after her baby's birth in February. "She stopped eating, she couldn't sleep, she was very agitated," Blocker said Thursday. "She told me that she felt like a walking zombie. She she told me she was a living corpse."

Stokes, 41, was eventually hospitalized and diagnosed with postpartum psychosis, an extreme variation that affects one in 500 to 1,000 women. But she was later sent home.

Stokes' mother is promoting legislation Rep. Bobby Rush, D-Ill., introduced in her daughter's name that seeks more research and services for postpartum depression victims. "I'm not going to let her die in vain," Blocker said.

The U.S. government does not track postpartum depression-related violence, but estimates that up to 200 U.S. infants a year are killed and many more suicides are committed by afflicted mothers, said Laurence Kruckman, a medical anthropologist at Indiana University in Pennsylvania.

Kruckman said the United States lags behind places like Britain, where all new mothers are evaluated for postpartum depression before they are sent home, and nurses make at least two mandatory home visits to check for symptoms within 40 days of childbirth.

At Indiana Hospital outside Pittsburgh, where Kruckman works as a consultant, all new mothers are screened for postpartum depression and are offered free support-group sessions with their babies where experts look for symptoms.

New York and New Jersey are the only states that require hospitals to give mothers information on postpartum depression, said Sonia Murdock, president of Postpartum Support International, a Santa Barbara, California., group.