I have appreciated the discussion about family violence and depression.
Please add to the list of potential reasons for depression the issue of
untreated alcoholism and drug abuse.  Though widespread, these are "secret"
diseases.  Women who are married to alcoholics often protect them and the
rest of the family from shame  by not revealing that they are struggling
with the illness.  Alcoholism tends to worsen over time, and symptoms may
worsen during pregnancy, putting the wife at higher risk for abuse.
Physical abuse during pregnancy is very common, and being pregnant is, in
fact, considered to be a risk factor for abuse.

When I encounter depressed women, I always ask if the drinking of anyone in
her family (currently or in her family of origen) has affected her.  This
question then gives me an opportunity to refer the woman to Al-Anon or to
counseling, where she can begin to explore the effects of the disease on her
life, and discover some options.

Barbara Wilson-Clay BSEd, IBCLC
Austin Lactation Associates
http://www.lactnews.com

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