After The Stork: The Couple’s Guide to Preventing and Overcoming Postpartum Depression is an essential resource for anyone expecting a baby.  Dr. Rosenquist, a Board Certified Clinical Health Psychologist has written a meticulously researched and immensely helpful book.  Her language is understandable.  Her stories, amalgams from real life, are engaging.

Estimates of how frequently mothers and/or fathers become depressed after the birth of baby vary, in large part because each study defines and measures depression differently.  Still, the estimates vary within a small range. Rates of postpartum depression among mothers range between 7% and 15% and these figures are the same for birth mothers and for adoptive mothers.  Meanwhile, about 10% of fathers experience postpartum depression, and, again, it doesn’t matter whether the father is biological or adoptive.  If the hormones related to pregnancy and birth told the whole story, this wouldn’t happen.  Similarly, if hormones were the main cause of postpartum depression, then we would expect to find evidence of postpartum depression among women in every culture and throughout history.  But it just ain’t so.   

 Meanwhile antidepressants have become the most widely prescribed medication for women in the United States replacing psychotherapy as the front line treatment for depression, and we now have very good evidence that both the effectiveness and the safety of these medications has been exaggerated.  More importantly, the increased use of SSRIs during pregnancy has not resulted in happier moms and healthier babies.  Just the opposite appears to be true.  While more than 25% of pregnant women in the United States are taking antidepressant medications, the rates of postpartum depression continue to climb.

So if hormones aren’t causing postpartum depression, what is?  The answers are complex and nuanced.  Dr. Rosenquist documents the results of several decades of psychological research: cognitive style variables—habits of thought, and interpersonal style variables—habits of relating,  mediate between stressful life events and depression.  These are the targets that psychotherapy needs to address in order for treatment to really be effective and for results to be lasting.  After The Stork explains the habits of thought and habits of relating that give rise to depression and shows the reader just how to approach therapy in order to make meaningful changes that will last a lifetime.

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