DEFINITION: Postpartum depression is the first occurrence of a defined set of symptoms, which occur after childbirth and before the return of menstruation. Symtoms include exhaustion, irritability, sleep disturbances, anxiety, appetite changes, hopelessness, memory loss or changes, uncontrollable crying, guilt, feelings of inadequacies and worthlessness, exaggerated highs and lows, low libido, fear of harming yourself or the baby and depression. While many new mothers experience temporary ''baby blues'' after giving birth, more serious postpartum depression occurs in about one in every ten mothers. For most mothers it is limited to a single episode, in others the change in personality and lifestyle may persist for twenty or more years.

CAUSES: It is not known for sure what causes postpartum depression but it may be caused by rapid changes in hormone levels, stress, anxiety or history of mood disorders. However, researchers are directing more attention to the role of hormones since so many aspects of the body and how it functions are interdependent with hormone levels. Three hormones are the primary focus of current research: estrogen, progesterone, and thyroid stimulating hormone or TSH.

STANDARD TREATMENT: The good news about postpartum depression is that it is typically treatable. The sooner it is detected and treated, the better the outcome for the patient and the family. If you believe that you suffer from postpartum depression, it is important to contact your health care provider immediately. Typically your provider will perform a medical exam to rule out any other conditions, and run some laboratory tests to include a thyroid panel. (The thyroid is your hormone regulator).

Traditional treatment options include antidepressants, anti-anxiety medications and even birth control pills. If breast feeding, these may not be an option. Non prescription options include vitamin B complex, psychiatric therapy, psychotherapy and support groups.

PROGESTERONE REPLACEMENT THERAPY: Many women and health care providers have contacted WOMEN'S HEALTH AMERICA Inc., for additional treatment options. Because postpartum depression is often related to a sharp drop in progesterone levels after delivery, we suggest practitioners may want to consider prescribing natural progesterone replacement to help return new mothers, even those breast-feeding, to symptom-free, healthy lives with their new babies and families. The pharmacists at Women's Health America, Madison Pharmacy Associates, Inc. are available to work with health care providers to determine appropriate dosing protocols for attaining hormone levels within the therapeutic range.

Madison Pharmacy Associates is the only pharmacy able to fill prescriptions for natural, micronized progesterone as a Progesterone Even Release Tablet designed specifically to help avoid the peaks and valleys of traditional oral dosing and maintain more constant hormone levels.

WHEN SYMPTOMS TURN CYCLIC: Many women who experience postpartum depression following childbirth notice that as their bodies return to the pre-pregnancy state, their symptoms become cyclic. For these women, ongoing progesterone therapy two weeks out of the cycle may be appropriate.

As with other health conditions, educating yourself about postpartum depression and understanding your treatment options is important. Although it does not happen to every woman, when it does, it can be a serious health concern. Since not only the mother but the baby and whole family are often affected, being prepared or having a family member prepared can be helpful.

For more about postpartum depression, click here.