news item: “study finds genetic prediction of postpartum depression”

I don’t discuss it much, but I went through a Very Bad Time after my first son was born. When he was about 4 months old, my husband realized that I was no longer doing things like leaving the house, showering, eating, sleeping, etc. He took me to the emergency room. A psychiatrist, social worker, mental health nurse doing home visits, support groups, and months of medication later and I was semi-human again.

Postpartum depression is FOR REAL. It is not the “baby blues” nor is it “regular” depression, something I have struggled with as well. Without going into much detail (as this is something I still struggle greatly with sharing) I was not myself. And on top of it all, I was debilitated with guilt and shame. How could I feel this way when I just won the lottery?

In hindsight, I had many risk factors for PPD all lined up neatly in a row. A history of anxiety and depression, suffering back to back miscarriages, infertility, an extremely stressful pregnancy, traumatic birth experience, lack of support after birth, and so on. However something I had never considered was whether I was genetically predisposed to it. Yesterday on Twitter I came across an article (thanks KeAnne, you re-tweeter you) that has me thinking…

Study Finds Genetic Prediction of Postpartum Depression

It is not clear what causes postpartum depression, a condition marked by persistent feelings of sadness, hopelessness, exhaustion and anxiety that begins within four weeks of childbirth and can last weeks, several months or up to a year. An estimated 10 to 18 percent of all new mothers develop the condition, and the rate rises to 30 to 35 percent among women with previously diagnosed mood disorders.

The researchers later confirmed their findings in humans by looking for epigenetic changes to thousands of genes in blood samples from 52 pregnant women with mood disorders. The women were followed both during and after pregnancy to see who developed postpartum depression.

The researchers noticed that women who developed postpartum depression exhibited stronger epigenetic changes in those genes that are most responsive to estrogen, suggesting that these women are more sensitive to the hormone’s effects. Specifically, two genes were most highly correlated with the development of postpartum depression. TTC9B and HP1BP3 predicted with 85 percent certainty which women became ill.

“We were pretty surprised by how well the genes were correlated with postpartum depression,” Kaminsky says. “With more research, this could prove to be a powerful tool.”

Without going off on a tangent about study size, sample population, and commentary on methodology, I will say that this study is very interesting. It is general assumed (even by mental health professionals) that PPD can be attributed to “wacky hormones being all out of whack.”  More specifically, that a drop in estrogen levels affects mood significantly in some women, but not others. Although, that reason doesn’t answer the question of why this woman and not that one?

This study suggests that certain woman are more sensitive to changes in estrogen. What is interesting about this research is that it could potentially lead to a blood test performed in the third trimester to determine whether these changes are taking place and raise a potential red flag for the woman, her family, and her healthcare provider.  The lead researcher, Zachary Kaminsky, an assistant professor of psychiatry and behavioral sciences at the Johns Hopkins, hopes that this could help HCPs and mothers make informed decisions about treatment for depression during and after pregnancy, including the appropriate use of medication when weighed against other risks. In other words, if you knew you higher risk, you could better prepare for the possibility that it might be more likely to happen.

I have been chewing on this all morning, and will likely continue to for a while. I felt that I had no choice but to go on medication or risk not being able to parent my child. Curiously, I have not remotely had the same experience after the birth of my second son, despite life (and life events) being more stressful now. I attribute this to a a different pregnancy, and empowering birth, and experience as a mother, but also to being on the lookout for The Very Bad Time – Part 2. I have written here before that I lied to my HCP about feeling depressed during pregnancy. So as I read this over and over this morning, I can’t help thinking that normalizing mental health issues before and after pregnancy is a good thing. Yes, a blood test like this raises moral and ethical questions and could be used for all sorts of nefarious purposes. But what if it is used for good?

I’m chewing on it.

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If you or someone you know is struggling with postpartum depression, an excellent resource is Postpartum Progress. Click on GET HELP for more information.

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What do you make of this research? Can you see this being added to the battery of available pregnancy testing?

If this test were available, would you choose to take it? Why or why not?

Prior to giving birth did you discuss mental health issues (relating to pregnancy and the postpartum period) with your healthcare provider? 

Did you have adequate emotional support (or access to resources) after bringing your child home? 

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SRBSarah is a former high school teacher, turned medical writer, turned SAHM to two boys. She enjoys beer, knitting, gardening, and cheese, and is striving to raise boys who can will do their own laundry and cooking. This urban mama parents with an ever-evolving mix of natural, attachment and RIE principles with a dash of by-the-seat-of-her-pants for good measure. She blogs about her life at a sausage party at Little Chicken Nuggets.

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