After car-chase tragedy in D.C., questions about driver's mental health

The death of Miriam Carey, shot by police after leading them through a chase in downtown Washington, D.C., Thursday with her 1-year-old child in the car, is drawing new attention to post-partum depression.

While authorities haven’t officially linked the incident to mental illness, Ms. Carey's mother told news outlets that her daughter had post-partum depression. CNN reported Friday morning that Carey’s boyfriend told police she was delusional when the child was four months old, and that investigators found medication for depression, bipolar disorder, and schizophrenia in her Connecticut home.

The Monitor turned to Cindy-Lee Dennis at the University of Toronto, an expert on post-partum depression, to explain the medical research on the condition, as well as some possible interventions that look promising to researchers. The following questions and answers are based on a phone interview with her Friday morning.

What do researchers estimate is the prevalence of post-partum depression?

About 13 percent of women develop post-partum depression, often within the first 12 weeks after giving birth.

Are children at risk of being harmed because of it?

Most mothers with post-partum depression do not harm their children – often they’re overprotective. However, some mothers, less than 1 percent, experience a condition called post-partum psychosis, and it sometimes overlaps with bipolar disorder or schizophrenia. It can involve hallucinations and often requires hospitalization, because of the risk that the mother will harm herself or the child.

How long can these conditions last?

In a study of more than 6,000 women in Canada, 8 percent were found to have depressive symptoms a year after the birth.

What kind of support can prevent or reduce post-partum depression?

Screening and home support by a nurse or midwife are very helpful in the early weeks after the birth. Sometimes women are referred for psychotherapy.

Even support over the phone from a local peer – a mother who has recovered from postpartum depression and has received some basic training – can make a major difference. A randomized-trial study in Ontario looked at what happened when mothers, found to be at risk through a screening, received such calls – on average eight calls of about 14 minutes each. At 12 weeks after the birth, the risk of post-partum depression was cut in half, compared with a control group that did not receive the calls.

What are some barriers to women receiving such help?

Screening is not done routinely except in some states, and the women themselves or their family members often don’t recognize that help is needed. Just as other forms of mental illness are stigmatized, the society doesn’t understand post-partum depression and often stigmatizes mothers who experience it.

If the problem is identified, often there’s a long wait for treatment, or it’s not conveniently located, or it’s difficult to find child care. That’s why innovating with Internet and phone support is important.

Does it affect only women?

No. About 10 percent of men experience post-partum depression, and if the mother is experiencing it, the risk is greater than the father will as well.