TMC PULSE

t m c » p u l s e | m a y 2 0 1 8 35 can do," Puryear said. Sherman said taking medication during pregnancy made her nervous at first because she didn't want to hurt the baby, but she was reassured by Puryear's prediction that the postpartum depression symptoms would improve. "That was hard for me because that is a long time to be feeling bad or like I can't do this," Sherman said. "It took a while for the medicine to turn me around." By her second pregnancy two years later, Sherman was fully pre- pared for another bout of depression if the symptoms returned. "I had been off the medication for years at that point, but when it happened it was almost the same," Sherman said. "It just wasn't as scary because I knew what it was and I knew Dr. Puryear would help." Today, Sherman's daughter, Dylan, is 5, and her son, Zachary, is 3. Sherman's postpartum depression is safely in the past, though she still wonders what caused it. Researchers are trying to find the answer. Although Puryear and others have been able to treat postpartum depression successfully and track its progression, its cause remains elusive. "When you are pregnant, right from the beginning, your hormones just start rising and they keep rising throughout the entire pregnancy. They are at their highest of any time during a woman's life," Puryear said. "What happens immediately postpartum is all of those really high hormone levels fall. They don't fall gradually. They rise gradually, but postpartum, they just fall off a cliff. There is something about that rapid drop in hormones that for some women triggers symptoms and nobody yet has quite figured out what is going on there." To help solve that mystery, Puryear has made it her mission to expand screening services through- out the Texas Children's system by administering the Edinburgh Postnatal Depression Scale ques- tionnaire to women at various stages of pregnancy and after deliv- ery in multiple care settings. "One of my goals was to make sure that all women who were seen by the obstetrics and gynecology practices in this hospital were screened for postpartum depres- sion and then my second goal was to have the pediatrics practices screen," Puryear said. "As of now, if you are seeing one of the OBs who practices in this hospital, you are screened at the first prenatal visit, again at 34 to 36 weeks, before deliv- ery and then at six weeks postpar- tum. All of the pediatric clinics are screening at the first well child visit, usually around two weeks, and then again at two, four and six months." Although any pregnant woman can get postpartum depression, some women are at a higher risk than others. "What is so surprising about it for women and their families is that in lots of instances it is just totally unexpected," Puryear said. "If you have had any history of mental health issues, any previous episode of depression at any time in your life, if you have any stressors in your life, a difficult support system or come from a lower socioeconomic status, you are at a higher risk." Knowing your risk of postpar- tum depression and creating a plan for support after the birth of your child can help pregnant women and new mothers reduce its likelihood, Puryear explained. "Our culture is so transient, so a lot of moms I see in Houston have no family here at all. They are isolated and I think that increases the risk for postpartum problems," Puryear said. "Who is going to help and who is going to bring meals? Who is going to do laundry? Who will help with the other kids? It is called a postpartum plan." Just as expectant mothers should develop a birth plan that details who they want in the delivery room and whether or not they want an epidural, they should also devise a blueprint for postpartum depression—whether it hits during pregnancy or after. "As soon as you leave the hospital and they put a baby in your arms and you go home, there is not a lot of support or help or reaching out going on unless you've set something up ahead of time," Puryear said. Relax in Luxury. Whether you are looking for a weekend getaway or a place to call home, choose Quality RV Resorts, and experience the best in RV resort living! With 11 locations throughout Houston, San Antonio, Baytown, and Brazoria, Texas – you're sure to find a resort and amenities that will fit your needs. Don't own an RV? No problem. We have onsite rentals available. *Pads only. Not valid for existing customers. Offer expires August 31, 2018. Code Word: TEXAS To redeem, use code word at the time of reservation. www.QualityRVResorts.com 50% OFF First Month's Rent *

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