Diane writes:

<< The mom wants very much to continue breastfeeding, but she also feels that
 her current state of depression and anxiety is interfereing with her ability
 to function.  After fighting the depression off for seven months in an effort
 to continue breastfeeding her daughter and getting no relief from Zoloft,
 she's at the end of her rope. >>

While I've recently beat my drum on this topic, it seems to demand repeated
percussion:

After 7 months, I'm not so sure that we are looking at PPD.  My DSM IV is at
my office, but I believe that the parameters are narrower than that.

Whether it is or is not PPD, one also needs to look at the stressors and
other issues in this mother's life.  As attractive as we have made it become,
taking a pill will not resolve those things.  And though a significant amount
of depression is, in fact biochemical, it is a mistake to assume that all
etiology will be found in the brain/hormones, etc.  The fact that she isn't
responding to Zoloft makes me suspicious.  Further, no matter what the
problem is, the hormonal chaos of weaning and loss of this exquisite intimate
experience with her baby may precipitate a larger crisis.

The vast majority of the women who come to me to address their "PPD" issues
have no such diagnosis.  With exploration, we determine that most of the
things bothering her have been there for a while, or are totally unrelated to
her birth or supposed maladjustment to baby's arrival, or even to her
hormones.  Methinks we may be in danger of overdiagnosing.........

Regardless, this woman could use the services of a good therapist.

Nancy Williams, MA, MFT, IBCLC

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