In "Delivery Form Darkness" (Feldheim Publishers 2009), the Jerusalem-based authors, Rabbi Baruch Finkelstein and his wife Michal along with certified nurse-midwife and therapist, Doreen Winter, present a most sensitive yet pragmatic guide to prevention and treatment of post-partum depression.
The authors make it abundantly clear that PPD and its related disorders are in no way reflective of a mother's general mental state, nor does it serve as any ominous indication of her abilities to nurture her child. They show that PPD needs to be cogently understood in terms of concrete intervention.
The taboo surrounding this most enigmatic of ailments often causes families a great deal of shame and guilt. In the forward to this book, psychiatrist and author, Rabbi Avraham Twerski says, "Because the symptoms of postpartum depression are behavioral, many people think of them as being due to a mental abnormality. Given the stigma that this carries, the symptoms are often overlooked or explained away."
In some cases women might be genetically predisposed to PPD, the authors point out, but thyroid and adrenal hormones are the major culprits. Support from family and friends and the help of compassionate and educated health care professionals can make all the difference.
The book also focuses on the turmoil and pain that husbands often experience as a result of their spouses' PPD. Several tell their stories in their own words, giving a personal face to the potential tragedy that can result if PPD is left untreated.
With an estimated 80 percent of all new mothers experiencing some degree of "baby blues" and 15 to 20 percent being beset with PPD -- and in one in a thousand women being diagnosed with postpartum psychosis -- the authors sound a clarion call to reach out with urgency to those suffering. Mothers often experience daily bouts of anger, irritability, sadness, and moodiness, and feel terribly frightened, agitated and distraught. An intense fear of dying or going crazy, and a profound loss of control combined with suicidal thoughts are also prevalent in some cases, since the feelings of helplessness and hopelessness can be all encompassing.
In salient detail, the authors describe the origins of hormonal shifts in pregnancy and the post-partum period while also emphasizing environmental causes such as daily-life or financial stress. In some cases, anti-depressants have proven effective, but the authors suggest holistic approaches as well, including Traditional Chinese Medicine, the use of herbs, vitamins and minerals as well as establishing a regime of the highest standards in nutrition and exercise. They also encourage keeping a healthy spiritual mindset.
The authors conclude their very helpful book with the advice of Rabbi Nachman of Breslov who viewed depression as "very damaging" but also as a growth stage.
“All falls are necessary for the ascent,” he said.
