Months after the birth of her son in 1997, Catherine Hunter visited her physician, telling him she felt depressed. She felt anxious, had trouble sleeping at night, felt exhausted during the day, and found herself crying often.
Her doctor's response: "How can you be depressed? Look at you. You are good looking and you have two beautiful children."
Hunter left the doctor's office dismayed, without a plan for treatment or hope for recovery. She didn't know her symptoms pointed to postpartum depression, a debilitating but treatable condition.
The condition is widespread, experts agree, but it's difficult to pinpoint just how prevalent it is.
While the U.S. Department of Health and Human Services says that 13 percent of pregnant women and new mothers experience postpartum depression, experts such as Hunter claim that as many as one in four women suffer from PPD.
Speaking of her doctor, Hunter said: "His lack of knowledge increased my depression because he made me feel ungrateful."
"When women are told that they are not grateful or not happy or healthy, they feel bad," said Hunter, now an expert on the problem that once caused her so much pain. A licensed clinical social worker, she includes postpartum depression among her specialties.
In the past decade, the medical profession has made significant advances in diagnosing postpartum depression - health professionals call it PPD - and taking preventive measures.
While PPD was once a condition not discussed among health-care providers, awareness has grown markedly in the past decade.
"It's been totally de-stigmatized due to families coming forward and talking about it happening in their family," said Nancy Molitor, a clinical psychologist in Wilmette.
Since depression is an hereditary disease, women are routinely screened during pregnancy to evaluate their risk of developing it. Illinois state law now requires the use of the Edinburgh Postnatal Depression Scale, a simple test used to assist primary-care health professionals detect whether mothers are suffering from postpartum depression.
Experts agree that PPD is most often caused by a shift in hormones in a woman's body after childbirth, usually within the first four weeks after delivery. However, specific factors can contribute to postpartum depression, such as the transition into parenthood or unrelated situational stressors, said Chrissy Anderson, staff therapist at the Family Institute.
Hunter says such outside stressors triggered her PPD. She had only experienced minor depressive symptoms and the so-called "baby blues" after the birth of her first child, but was never compelled to seek treatment.
Following the birth of her second child came an onslaught of problems that included the loss of her father, a move into a new house, the death of her dog, and the financial struggles of her husband losing his job. Hunter began to experience a much more severe depression than ever before.
According Anderson, the "baby blues," are experienced by as many as 85 percent of women and are "due in large part to the change in hormones, the sleep deprivation and the magnitude of the transition."
While the symptoms of baby blues can be confused with PPD, baby blues usually go away within one to two weeks after delivery. Baby blues usually begin from three to seven days after a birth, and do not require medical treatment.
Symptoms of PPD can last for months, however, and recovery is often dependent on treatment, such as medication or therapy.
Having a proper support system is the best way to combat the blues, said Anderson. It is important that someone ensures the woman gets enough sleep, cares for the child properly and has someone to talk with in the first few weeks.
After experiencing PPD with the birth of her first child, Laura Spencer underwent therapy and began taking medication. When it came time to have her second child, Spencer, a Chicago-area labor and delivery nurse, felt ready and confident about taking a proactive approach to her condition.
"I felt different, even the day my second daughter was born," said Spencer, "I knew I could talk to people about it if I felt anxious. Also, I knew if I did start to feel bad that I had someone to talk to and I could get help."
Women who have experienced depression prior to pregnancy are at greater risk for postpartum depression, said Anderson.
Women are now, more than ever, getting the care they need while suffering from this illness. Most hospitals offer support groups. In Chicago, The Jennifer Mudd Houghtaling Postpartum Depression Foundation, established in 2004, seeks to educate health-care providers and the public about the symptoms, dangers and treatments for postpartum depression.
"Women need to realize there are options for treatment and support so that they don't feel alone," said Anderson.
"It can also be very isolating if you don't know that other women feel this way. It's important to talk to someone who can normalize the situation and provide some support," said Anderson.
A recent study published in the British Medical Journal expressed concern for the use of antidepressants during pregnancy, linking antidepressant use to increased risk of pulmonary hypertension in infants.
Many experts agree that a woman's decision to continue antidepressant use during pregnancy depends on the severity of the depression.
"Someone with severe depression is usually recommended to stay on it, particularly if they have had postpartum psychosis," said Molitor.
Some medications have been approved by the FDA for use during pregnancy and postpartum period. Before stopping any medication for depression, it is recommended that a woman consult her physician.