Carol--
I didn't see your original posting about ppd either--perhaps I'm missing a
digest. But following is some information from one book on PPD ("Postpartum
Depression: A comprehensive approach for nurses," Kathleen A.
Kendall-Tackett with Glenda Kaufman Kantor, SAGE Publications, 1993). I
haven't read the entire book, but it appears to understand the need for
support for women in the postpartum period, and how a lack of this increases
the risk of PPD. In the chapter on Physiological Factors, hormones are
reviewed, as are the factors of pain and fatigue.

Leslie Ayre-Jaschke, BEd, IBCLC
Peace River, Alberta, Canada

The authors reviewed the information they found about a relationship between
prolactin and ppd. Some research has apparently found a correlation between
high levels of prolactin and depression, anxiety, and hostility in the
peurperium. An article by Kellner, Buckman et al (1984) "reviewed the
research on prolactin to date, but they only included studies that used the
"Symptom Questionnaire." All four studies (N=approximately 10) found that
higher prolactin levels were associated with higher hostility ratings (as
indicated by scores on the Symptom Questionnaire). Depression and anxiety
levels also were associated with high levels of prolactin. Two studies
compared hyperprolactinemic women with amenorrheic women who had normal
prolactin levels, or hyperprolactinemic women with normal controls.
Hyperprolactinemic postpartum women were more hostile than either
nonpostpartum hyperprol. women or normal controls. When bromocriptine, a
prolactin-lowering drug, was administered to hyperprolactinemic women in a
double-blind study, a decrease in hostility, depression, and anxiety
occurred that corresponded with the decrease in prolactin. No such change
occurred with the placebo. The authors of the review postulated that
hostility associated with high prolactin levels may be a vestige of an
evolutionary advantage for women protecting their young. This idea is highly
speculative however, and runs counter to the common notion that prolactin
increases maternicity (Sears, 1991). Finally, an in-depth study of four
women (Susman & Katz, 1988) also noted a connection between weaning and
postpartum mood disturbance. The authors of this study pointed out, however,
that three of these four women also had family histories of affective
disorders."  p. 24

The authors conclude, about hormones in general and their relationship to
PPD:
"Researchers to date have not established that peurperal hormonal changes
causes the blues, depression, or psychosis (Stern & Kruckman, 1983), in fact
even consistent correlational evidence is missing, with several studies
finding that hormones levels are correlated with depression, and other
studies finding no such relation (O'Hara, 1987). Many of the existing
studies that have found differences used small samples of women, and some of
the studies had serious methodological difficulties, including lack of
control groups and lack of a double-blind design...
"Future research should move beyond examining the effects of individual
hormones and should examine these effects within the context of the entire
endocrine or limbic systems. Further, depression should be examined in
relation to key neurotransmitters such as serotonin and norephinephrine.
Clearly more comprehensive and carefully controlled studies must be
conducted before we can declare that hormones are a major cause of
postpartum depression. In conclusion we should proceed with caution about
our use of hormone replacement therapy and should be aware that current
evidence does not support prophylactic use of hormones for preventing or
treating postpartum depression."