Kathy D., I don't think we *do* disagree on treatment of depression...  and
I didn't mean my comments to sound like "either-or" or drug-bashing;  I am
personally very appreciative of the efficacy of SSRIs.....

My concerns about this discussion on Lactnet, where we are talking about
nursing moms and the postpartum period (see Kathleen B I'm trying to stay on
topic! :D) are several:  is postpartum depression an "altered brain
chemistry" or a situational stress?  Or both?  Who is diagnosing postpartum
depression, and what treatments are they proposing?  Do they have any
science to back up these proposed treatments?  Do OBs, GPs, etc. know what
they are doing when they prescribe antidepressants?  <slight irony>  Do
psychiatrists?  <not sure sometimes>  I think my main reaction of serious
concern to the increased number of incidents being related here on Lactnet:
"Mother has postpartum depression, doctor wants her to take a medication,
but she has to wean," is that postpartum depression is being treated as if
it were an ear infection or mastitis - oh, here, just take a pill and you
will feel better.  I dare say that the situation is likely to be MUCH more
complicated than that and it does outrage me that new mothers are treated
with so little respect for the difficult challenges that they are struggling
with in their lives.  Maybe Zoloft *will* help them feel better, but will
they have learned anything about why they had difficulty with this
particular challenge in their life?  Will they have gained any insights that
will perhaps help them to meet a future challenge without getting depressed?

In fact, having mentioned mastitis, it seems to me that treating postpartum
depression with ONLY an antidepressant prescription would be like treating
mastitis by writing an Rx for an antibiotic without assessing the
breastfeeding relationship to see if there were contributing factors, or
reviewing good nursing practices to help avoid mastitis in the future.

On a more general note, here's a question that I don't think has been
satisfactorily answered yet:  what is the *effect* of situational stress on
brain chemistry?  I'll use my own experience with depression as an example:
Maybe my threshold for depression - that is, the brain chemistry "setting" -
is actually fairly low most of the time, but I encountered a whole string of
problems and ended up in major depression.  Prozac helped a LOT.  Therapy is
helping MORE.  (Both provided by the same MD; my "pill-pusher" remark wasn't
meant to connote "anti-pills.")  I wouldn't have wanted to do without either
of those treatments for awhile!

Finally I'll add to the "were you breastfed?" survey on this topic by noting
that I was breastfed for the incredibly long time of six months in 1956.

Mary Renard
Vienna VA  USA
where it is snowing, sleeting and *definitely* not fit for an outing on
crutches.