"This was a sadness of a shockingly different magnitude. It felt as if it would never go away." That's how actress and former model Brooke Shields described postpartum depression in her tell-all book, Down Came the Rain, (H.B. Fenn & Company, 2005).

Shields' struggle with postpartum depression (a clinical depression that sets in after the birth of a child) began as common moodiness, which she describes in the book as feeling "embarrassment to stoicism to melancholy to shock, practically at once. I didn't feel at all joyful." Those emotions intensified, until her worried husband and friends persuaded her to seek treatment. There's a happy ending to her story -- she got better and went on tour to promote the book about her struggle.

The ideals of motherhood
In that book, Shields admitted to resenting her daughter and entertaining thoughts of self-harm (often, mothers suffering from postpartum depression have thoughts of harming themselves or their children, but rarely act upon them). These feelings are so contrary to commonly accepted ideas about motherhood -- such as the idea of mother's unconditional love -- that they are rarely discussed. This, even though at least 1 in 10 mothers suffer from postpartum depression, according to Dr. Mark Berber, a psychiatrist and specialist in postpartum depression.

While many praised Shields' book for helping to personalize, bring attention to, and legitimize those feelings, a high-profile celebrity took issue with her means of treatment. In an interview for the entertainment news show Access Hollywood, movie star Tom Cruise was on a promotional tour for his new movie The War of the Worlds when he talked about his Scientology-based belief that psychology is destructive. Shields' recovery was aided by the antidepressant medication Paxil, which Cruise described as "dangerous", explaining that instead of taking the drug "you can use vitamins" to help women deal with the hormonal imbalances that are associated with postpartum depression. Shields, in return, suggested that Cruise "stick to saving the world from aliens."

Celebrity stories revealed
More celebrity women added their opinions to the mix; actress Courtney Cox revealed she took the hormone progesterone to overcome her postpartum depression, but songstress Lisa Marie Presley (also a Scientologist) says she has battled the illness and won, using vitamins. All of a sudden celebrities, reporters, doctors and mothers were discussing the benefits and drawbacks of medication, and sharing their own experiences involving their children and depression.

All of this attention on postpartum depression is an outcome Shields seems to favour. In an interview for The New York Times, she said: "If any good can come of Mr. Cruise's ridiculous rant, let's hope that it gives much-needed attention to a serious disease."

Symptoms of postpartum depression
Part of the blame for the silence surrounding postpartum depression can be put on the baby blues, which leave approximately 80 per cent of new mothers moody for up to a week and a half after giving birth. Postpartum depression is a more severe version of this sadness. Use Dr. Berber's "Face is sad" acronym to remember the following nine symptoms of postpartum depression:

Fatigue
Anxiety
Concentration loss
Esteem loss

Interest loss
Sleep disturbance

Suicidal thoughts
Appetite change
Depressed mood

Mothers suffering with postpartum depression suffer at lease five symptoms on this list for over two weeks. In addition, they have "impaired functioning": trouble keeping up with the demands of motherhood, work, housekeeping, or their relationships. Often, their marriages suffer. In fact, many husbands, friends or family encourage women to see the doctor. Once there, a patient may receive talk therapy, couple's counselling, take part in support groups, learn stress management strategies, or be prescribed anti-depressants. And they feel better, Dr. Berber says, right away. Hopefully leaving every mother like Brooke Shields, who, recovered, is now busy adoring her toddler.

A hopeful outlook
The fact that postpartum depression is a real disease -- in need of real treatment -- is a message that Dr. Berber is happy to have Shields shouting from the pages of everything from The Times to People magazine to the The New York Times. He's happy to have a celebrity help dislodge the stigma associated with any mental illness and start conversations that will help spread his advice to mothers in need of comfort: "This is an illness, you're not alone, and you will be a good mother."

For more information about postpartum depression, contact the Pacific
Post Partum Support Society (www.postpartum.org), Our Sister's Place
(www.oursistersplace.ca) or Motherisk (www.motherisk.org).