The document discusses Brooke Shields' experience with postpartum depression (PPD), detailing its symptoms, potential causes, and impacts on motherhood. It highlights the historical context of depression, the influence of societal expectations on women, and notable treatments for PPD. Additionally, it emphasizes legislative efforts, such as the Mothers Act, to raise awareness and provide support for PPD among women.

1. Postpartum Depression:Not just “Baby Blues”Brooke Shields

2. Biography: Brooke Shields, born May 31, 1965 in New York City; has been in the public eye since before her she reached age 1

3. Mother—Teri Shields—small time actress

4. Father—Francis Shields (deceased in 2003 from prostate cancer 3 weeks before the birth of Rowan)

5. Parents divorced

6. Only child

7. Model, actress, wife, mother

8. Graduate of Princeton University—French literature

9. Married Chris Henchy (TV writer/producer) in 2001

10. First born daughter—Rowan Francis—born May 15, 2003

11. Second Daughter—Grier Hammond—born on April 18, 2006One big happy family…Above: Brooke and her daughters, Rowan and GrierMiddle: Brooke and mother Teri ShieldsAbove: Brooke and her husband Chris Henchy

12. In the public eye…Movies/TV: most well-known movies include: “Pretty Baby” (1978)“The Blue Lagoon” (1980), “Endless Love”(1981). Star of the sitcom “Suddenly Susan”(1996) and appeared on “Nip/Tuck Season 4” (2006)

13. Magazines: has been featured on over 300 magazine covers between 1980-1985

14. Model: Calvin Klein (6’0”)

15. Broadway:Grease, Cabaret, Chicago

16. Media icon—named one of the 50 most beautiful people in the world by People Magazine (‘96 and ‘00)First record of Depression:Hippocrates in the 4th century provided the first description of depressionHe called it “melancholia”Believed it was caused by excess black bile in the brain(Areti & Bemporad, 1978)

17. What is Postpartum Depression?Postpartum depression: a mood disorder that commences after giving birth. It can occur anytime within the first year after childbirth; it usually occurs within the first couple weeks and adversely affects the mother’s ability to function.Many suffer for up to 6 months and about ¼ of sufferers still experience symptoms after a year if left untreated.

18. Symptoms: How do I know?Anxiety component: Anxiety

19. OCD symptoms

20. Sometimes these occur with little depression Be aware of suicidal ideations, and also fantasies about injuring the baby.

21. --”…I sat holding my newborn & could not avoid the image of her flying through the air & hitting the wall in front of me. I had no desire to hurt my baby & didn’t see myself as the one throwing her…the wall morphed into a video game, and in it her little body smacked the surface & slid down onto the floor…the image all but destroyed me…” (Shields, 71)Typical depressive features: Sadness

22. crying

23. insomnia

24. a lot of sleeping,

25. low mood/energy

26. loss of appetite

27. agitation

28. self-critical thinking (p. 47)LOSS: major issue in PPD(Nicholson)Loss of Autonomy

29. Loss of Time

30. Loss of Appearance

31. Loss of Femininity

32. Loss of Sexuality

33. Loss of Occupational identity“In my mind, having the baby had made my life hopeless and meant that nothing would ever be the way it used to be” –Brooke Shields “Down Came the Rain”

34. Loss of Autonomy & TimeAutonomy—personal freedom

35. The women feel that they just can’t pick up and leave whenever they wish (vacation, hanging out with friends)

36. They have to tend to the baby instead of just themselves

37. Being a parent is a “24 hour, full-time job”

38. In a case study done, several women were interviewed on this subject. One woman said that the “new baby’s arrival eliminated time for her and her husband to be on their own together for at least 18 [more] years.

39. “I longed for the freedom to pick up and go to the movies or on a hike or on a trip out of the country…” (Shields, 70)Loss of AppearanceAnxiety about the loss of their former appearanceTime plays into trying to keep up personal looksThey don’t feel comfortable with the changes in their bodies after having a babyThey don’t like the fact they can’t wear the same clothes or the same type of clothes as they once did before being pregnant. Developed anxiety about their appearance—saw the changes as negative“You think you’ll never get your body back together really” (Hilary, interview 2)

40. Loss of Femininity & SexualityBecause of the anxiety about their appearance and the shape of their body after pregnancy they do not feel that their spouse would be attracted to them as much. Worried about body size/shapeSelf-image changedHad to think of themselves are more motherly beings than sexual beings“Like on Saturday---I wanted to wear my leather mini-skirt. But I had second thoughts…I’m a mother now” (Natasha, interview 3)

41. Loss of Occupational Identity The women have feelings of loss concerning:

42. --loss of power

43. --loss of opportunity

44. --loss of relationship w/ partners, friends

45. --loss of finances

46. “I feel I’m not contributing to the finances” (Sylvia, interview 3)

47. Debate whether or not to go back to work or to stay at home with the child

48. Many have feelings of guiltMotherhood:Most people would think of having a child and becoming a mother to be a “happy event”.Motherhood has, is, and will be central to the female identity and role in society.Society/culture portrays this happy, healthy, perfect family of the American Dream/Pleasantville society—places a lot of pressureIf the women don’t feel this way right away they feel like failures and wring in their feelings.Brooke felt that people would see her only now by the role of being a mother and not by being an actress anymore--Defined herself and identity through her work and success.

49. The Perfect Candidate:Parents divorced at very young ageDealt with alcoholism on both sides of her familyFather diagnosed with prostate cancer and died 3 weeks before the birth of her childHer dear friend David committed suicide a couple years priorDefined herself by her success in her jobPhysical problems in terms of being able to get pregnant—short cervix, In vitro fertilization, miscarriage; Had an emergency C-SectionHer health was in danger after giving birth—herniated uterusRowan had to wear a harness for her jaundiceTraveling back and forth from NY to LA—new apartmentDidn’t have a baby nurseHer and Chris were inexperienced parents

50. Possible Causes:Emotional/Biological Changes: --Hormone fluctuations (drop in estrogen levels)Physical Changes: --sleep deprived, exhausted –Lifestyle Changes: --having the responsibility for this little, fragile baby --added stress of routines changing –financial shifts –difficulty breastfeeding –lack of family/social support

51. Potential Risk Factors:Previous history/predisposition to depressionExperienced Premenstrual Distress Disorder (PMDD)Stressful events occurring during pregnancyDifficulty in marriageFeelings of loss (occupational, physical, social)Child was unplanned/unwanted

52. More Risk Factors:Caesarian birthHistory of infertility/fertility treatmentsIllness in the infantIsolation from family and friends, a poor match in temperament between mother and child.Thyroid problems

53. Levels of PPD:1.) Postpartum “Baby Blues—less severe, most common. 2.) Postpartum Depression—moderately severe--affects app. 8%-20% of women3.) Postpartum Psychosis—most severe

54. Level 1—”Baby Blues”Few days after childbirthSadnessTearfulnessIrritabilityHormonal changes (like PMS)If persistent can develop into PPD --Affects app. 80% of women

55. Level 3—Postpartum PsychosisPostpartum psychosis – not PPD

56. Loss of reality testing

57. Delusions and/or hallucinations

58. Much less prevalent than PPD

59. Requires prompt consultation

60. Also institution of anti-psychotic meds, and sometimes hospitalizationPossible TreatmentsPsychological:

61. --Cognitive-Behavioral Therapy—trying to get rid of the negative thoughts of self, world and future and adding reinforcement (Craig & Dobson 1995) (Beck, Rush, Shaw, Emery, 1979)

62. --Family Therapy

63. --Interpersonal therapy

64. “Talk” Therapy/Social Support GroupsMedical:--Drug Therapy—anti-depressant drugs (i.e. SSRIs such as Paxil or Prozac and other Tricyclic medications)

65. --Hormone therapy—Estrogen reaplacement

66. --Sleep aids

67. Antidepressant drugs are less expensive than psychotherapy (Beck, 1979)

68. “Can’t stop cold-turkey!” –Brooke did at one point.Paxil: Anti-depressantBrooke Shields personally takes the anti-depressant Paxil to help her postpartum depression.The drug Paxil has been controversial in terms of the side effects and long term effects once someone decides to stop taking the drughttp://www.youtube.com/watch?v=hfQUTHrWnRk

69. Personal Help/Self-Management TreatmentsRegulation and management toward a long-term goal/change

70. Many focus on the negative events rather than the positive

71. --spend time alone with husband/partner and the baby before having visitorsTreatment Effectiveness:With adequate treatment, PPD generally leaves after a few months.Some women, however, may have chronic symptoms.Most effective treatment combines the medical, psychotherapeutic, and social support aspect of treatment.Pharmacotherapy—Medication paired with therapyMedication has side effects and sometimes requires a change/termination--still having the therapy maintains progress

72. Q: True or False-- PPD is just for mothersA: FALSE—fathers can also develop a form of PPD because they also have to adjust to a new lifestyle with the addition of a new baby into the family. They are affected by the emotional state of the mother and also have an added responsibility to care for the child while the mother is suffering.

73. Dads cry too…In Shields’ book, she recounts of a moment that he husband Chris broke down: “Chris went out to the store to buy a changing table…He came back sooner and without the table…He looked up at me, his eyes filled with tears, and broke down…’There were women in the store who were happy, Brooke! They were smiling and happy to have their babies! What’s wrong with you? Why aren’t you happy? You don’t look at Rowan or sing to her or talk to her. Why? What’s happening?”

74. Q: True or False: The child of a parent with PPD is unaffected.A: False—Some studies have shown that the child/children of parents who have or are suffering from PPD are directly affected.An infant of a PPD mother can have irregular sleep, more depressed affect, higher norepinephrine levels, and a lower vagal tone (which indicates that the infant is undergoing stress and the body is reacting by releasing norepinephrine and the heart rate actually is slower in order for the body to deal with stressful activities—heart rate decreases and sympathetic activity increases.

75. When toddlers these children are associated with having delays in verbal skills, having behavior problems, and the school-readiness skills lack. When the children get older they tend to develop some behavioral/emotional problems—this puts them at a higher risk for developing depression themselves. (Clark, Tluczek, Wenzel 2003

76. Public CriticismOne of the major players in the criticism of Brooke’s treatment for her PPD has been Actor and recent Scientologist Tom Cruise. http://www.youtube.com/watch?v=cc_wjp262RYHowever, on August 31, 2006, Tom Cruise went to Brooke Shields’ home and personally apologized to her for his remarks.

77. Public SupportMany other celebrities have extended their support for Brooke Shields. For instance, Oprah Winfrey, comedian Tom Arnold, Rosie O’Donnell, and Matt LauerRosie says, “After watching Tom on Oprah and then everything else in the free world, I think I may need to up my meds. Shout out to Brooke. You saved a lot of women by telling the truth.” Tom Arnold says, “I just think he’s [Cruise] is ignorant…I thought that Brooke Shields is very brave, because celebrities, we want to look cool, and (admitting) you wanted to kill yourself and maybe your baby is a very vulnerable thing for her to do…I think Tom is a little out of touch.”

78. “Down Came the Rain” “At long last, her dream of being a mommy had come true. But instead of being relieved and happy, all she could do was cry.: “At first I thought what I was feeling was just exhaustion, but with it came an overriding sense of panic that I had never felt before. Rowan kept crying, and I began to dread the moment when Chris would bring her back to me. I started to experience a sick sensation in my stomach; it was as if a vise were tightening around my chest. Instead of the nervous anxiety that often accompanies panic, a feeling of devastation overcame me. I hardly moved. Sitting on my bed, I let out a deep, slow, guttural wail. I wasn't simply emotional or weepy (pg.65)

79. Taking ActionPress Conference for Mother’s Act on May 11, 2007Sen. Robert Mendez & Brooke ShieldsAbove: from left to right) Former First Lady Mary Jo Codey, Senator Menendez, Brooke Shields, Sylvia Lasalandra and Susan Dowd Stone

80. New LegislatureMothers Act: The Moms Opportunity to Access Help, Education, Research and Support for Postpartum Depression Act (S. 1375) Endorsed by Senators Menendez and Durbin (NJ)“M. President, in the United States, ten to twenty percent of women suffer from a disabling and often undiagnosed condition known as postpartum depression. Unfortunately, many women are unaware of this condition and often do not receive the treatment they need. That is why I am introducing the MOTHERS Act, so that women no longer have to suffer in silence and feel alone when faced with this difficult condition” --Senator Robert Mendez--NJThis new act will require hospitals to educate the parents and families before they leave the hospital on the possibility of developing PPD after childbirth & give screenings for symptoms.

81. Further Progress and Recent NewsOctober 15, 2007—Melanie Blocker Stokes Act passed in US House by a vote of 382 to 3! Postpartum Research and Care Act.On October 20, 2007, Postpartum Support International (PSI) will be holding a fundraiser in New Jersey—which has also been designated as Postpartum Depression Awareness Day in NJ (Both Sen. Menendez and Brooke Shields will be honored)October 24, 2007 is BlogHers Day to support the MOTHERS Actwrite a blog or call your local senator to show support.

82. “Out Came the Sun…”“Rowan remembers every motion to every portion of the song. I stare in amazement as her chubby baby hands with their dimpled knuckles intertwine while she pretends to be the spider climbing up the water spout. I can’t help myself and, plopping myself down in front of her, I quickly join in the song…With tears filling my eyes, we both reach up our hands and float them down like raindrops in front of us. As our fingers touch, I whisper, ‘Down came the rain and washed the spider out. Out came the sun and dried up all the rain, and the itsy bitsy spider went up the spout again.’” (Shields, 222)