iving birth is a time of joy, perhaps the greatest joy, in life. For many women, however, the period after the birth of a child, is a time of agony. Instead of experiencing the transport of happiness that society, their friends and family, and they themselves expect to feel, they are sunk in gloom, overwhelmed by feelings of grief and loss, tormented by alarming thoughts of harming the tiny being they brought into the world.

The condition is called postpartum depression and it is suffered by as many as 15 percent of women who give birth. It is a phenomenon which is the special interest of Cheryl Beck, a professor of nursing, who has written numerous articles based on her extensive studies of the subject.

In addition to her own qualitative studies during the past 10 years, based on research she conducted at St. Francis Hospital and Medical Center in Hartford, Beck, who joined the UConn faculty in 1997, has performed in-depth analysis of other research studies on the topic.

Through a grant from The Patrick and Catherine Weldon Donaghue Medical Research Foundation, Beck and Robert Gable, a professor of educational psychology, also have formulated an attitude survey, the Postpartum Depression Screening Scale, for use by health care professionals to identify those suffering from postpartum depression, a condition that often goes unrecognized. And the Donaghue Foundation recently awarded Beck a further three-year, $180,000 grant to translate the screening scale and the manual that accompanies it into Spanish.

Beck, a certified nurse-midwife, became interested in the problem when she observed "the struggle some women go through after birth. Because everyone expects them to be happy, they suffer in silence." Compounding the problem are feelings of guilt about their depression and shame at their lack of "normal" feelings of happiness in having a new baby. Although for many the condition may be short-lived, for others the depression is severe and long-lasting and may lead to suicide or infanticide.

"Postpartum depression is a complex phenomenon," she says, "it has a bio-chemical basis, but other factors can play a part as well, such as stress, marital problems, and previous experiences of depression."

One of the most frightening aspects of postpartum depression can be its sudden onset. A woman in one of Beck's studies says "I was on cloud nine through my whole pregnancy. I was very happy in the hospital. Then it hit me when my baby was 14 days old. One night I had my first severe panic attack. I felt like everything was closing in on me. Something just snapped in me and there was no going back."

Another compared herself to the cartoon character Wile E. Coyote, always hanging on to the edge of a cliff by his fingernails.

In fact, "teetering on the edge" is a term Beck often uses in speaking and writing about the condition. Though there are many aspects or "themes," as Beck calls them, in postpartum depression, loss of control, she has discovered, is what underlies most of them. "Women lacked control over their emotions, thought processes, and actions," she says.

Other themes include relentless, obsessive thinking; loss of a sense of self; isolation; and contemplating and attempting acts of self destruction. Many women experience alienation from the baby: "I had these really weird feelings toward my baby. I couldn't be around him. He gave me anxiety as if he were something bad," one mother said.

Adding to the alarm is a woman's fear that her baby may be taken from her or that in her out-of-control state she may harm the child.

Postpartum depression may also have a negative effect on the all-important mother-infant bonding that greatly influences how a child will develop. In one of Beck's studies, she cites research showing that "significant cognitive deficits were reported in the children whose mothers had suffered with depression during the first year of their children's lives." A mother with depression, she says, "doesn't respond to the cues of her infant to the degree others do."

Beck has found that "recovery depends on how quickly they (the new mothers) get help." As with other kinds of depression, treatment may include therapy with a mental health professional and anti-depressa nt medication. But first there must be recognition of the disorder. There are, she says, still too many health care professionals who tell women suffering from postpartum depression, "don't worry ... it's just your hormones ... go shopping, you'll feel better."

Beck says support groups are an important factor in recovery, as the new mothers receive assurance that they are not alone.

Even as women recover from the depression, they may mourn for the time they lost with their babies. One woman repeatedly visited the infant department of stores in the mall, grieving that that period of her child's life had been lost to her because of depression.

Beck's studies have brought her two honors this year, the Distinguished Researcher Award from the Eastern Nursing Research Society and a Distinguished Alumni Award from her alma mater, the Yale School of Nursing.

Diane Cox