The psychosis that reportedly drove Texas woman Andrea Yates to drown her five children is rare, but afflicts a percentage of all new mothers, mental health experts say. Officials at Magee-Womens Hospital are starting a support group for mothers with postpartum depression that they hope can relieve their suffering and avert a similar tragedy here. 'I've had women who have told me they questioned if they and their children would be better off dead,' said Dr. Roger Haskett, chief of psychiatry at the Oakland hospital. 'There's a large percentage of women out there who wouldn't do something like that, but they're suffering.' Yates is the Houston mother accused of drowning her five children in a bathtub on June 20. It's been reported that she was suffering from postpartum psychosis. That condition is a severe variation of postpartum depression, which experts estimate afflicts 10 percent to 20 percent of all new mothers. Symptoms can include loss of appetite and loss of sleep, mood changes and detachment from the baby and other family members. Researchers at the hospital are studying methods to detect depression during pregnancy. Women with a family history of depression are most at risk. Until recently, progress in understanding and treating postpartum depression has been almost glacial in the United States, said Laurence Kruckman, a professor of anthropology at Indiana University of Pennsylvania and the president-elect of Postpartum Support International, a group that coordinates support efforts. Media reports on the Yates case, as well as four well-publicized suicides in Chicago earlier this summer, have placed postpartum depression under the spotlight. 'If anything comes out of the tragedies in Chicago and Houston, I hope that House Bill 2380 passes and mandates postpartum education in medical college,' Kruckman said. The bill, under consideration by the U.S. House of Representatives, is named for Melanie Stokes, the wife of a Chicago pediatrician. She was diagnosed with postpartum psychosis this summer and later jumped to her death from the 12th story of a hotel. Experts like Haskett said the attention accompanying these deaths doesn't mean postpartum depression and psychosis are more prevalent, only that society is starting to notice. 'This has been happening for centuries,' he said. As many as 80 percent of new mothers get what's known as the 'baby blues,' a highly emotional period believed to be spurred by hormones that surge through the body around the time of delivery. In most cases, the tumultuous feelings last a week or two after birth and then fade. 'One of the things we have to educate women and their families about is that after two to four weeks, it's no longer the baby blues,' Haskett said. Only one in 500 to 1,000 new mothers develop postpartum psychosis, according to Kruckman. Some of them have reported hearing voices telling them to kill their children. About 200 infants die in the United States every year at the hands of mothers suffering postpartum depression, according to Kruckman. He had no estimate of the number of mothers who commit suicide because of mental illness. But the more subtle effects of postpartum depression can be costly as well. 'I would say it's associated with child abuse, learning problems in children, relationship problems with a high rate of divorce...' he said. 'We ought to be concerned about the mother's pain.' Kruckman says the United States could learn a lesson from postpartum care in England, where nurses visit new mothers as many as a dozen times following birth. That can be beneficial, considering symptoms of depression can show up as much as a year after birth. For now, he pushes for more education in medical colleges and universal screening for depression among all new mothers, something that happens at Indiana Hospital where he is a consultant. Dr. Adam Duhl, associate residency director for the obstetrics department at Allegheny General Hospital, teaches residents to look for signs of postpartum depression. He questions, however, how financially feasible and effective universal screening would be. Postpartum psychosis, he said, is even more of an unknown. 'Most people might see that once in their career,' Duhl said. He said he had one such patient. 'She just said, 'I hear these voices, and I want to kill the baby.'' Because signs of postpartum depression aren't always immediate, mothers can go undiagnosed and spend weeks or months languishing at home. They may feel too guilty or ashamed to admit they're feeling depressed or considering harming themselves or their babies, and unaware that treatment is available. Haskett said either a regimen of medication, like anti-depressants, or psychotherapy - or a combination of both - can alleviate the depression. 'I think it's a process that's evolving,' Haskett said. 'We obviously aren't doing enough yet.' And support groups - like the one Magee plans to start - let new moms get together and help each other through early parenting. 'We're hoping to develop these groups and implement them this fall,' said Pam Dodge, director of ambulatory care at Magee. The hospital has produced a video and brochure recently about postpartum depression. 'We want to raise awareness and we want to erase the stigma.' Marc Lukasiak can be reached at mlukasiak@tribweb.com or (412) 320-7939.

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