BY BRENDA RINDGE
The Post and Courier
Originally Published on: 3/20/03

The fall of 1999 should have been a happy time for Ruth Rhoden Craven.

Craven, 33, gave birth to son Andrew on Sept. 20.

A graduate of Wando High School and the College of Charleston, Craven had an outgoing personality and a reputation for being talkative.

"Ruth had many, many friends," says her mother, Helena Bradford. "Before Andrew was born, she was given five baby showers. She was a sensitive, loving, thoughtful, caring young woman who was excited about the upcoming birth of her baby. She loved her husband, family and friends passionately."

But instead of being joyous, the days after Andrew's birth turned dark for Craven as she sunk deeply into postpartum depression.

"Before this, she never had a day of depression in her entire life," says her mother.

In the weeks after Andrew's birth, Bradford made several trips from her Mount Pleasant home to her daughter's house in Lexington. She was worried and felt helpless as she watched her daughter slip away.

"Ruth was somewhat of a perfectionist and wanted everything done right and just the way she wanted it done, and she was exceptionally strong-willed," Bradford says. "These characteristics contributed greatly to her severe depression because she was unable to chill out and let go of insignificant chores to relieve her stress level."

The first two weeks of Andrew's life, Ruth had problems breast-feeding.

"I tried and tried and tried to convince her to stop," Bradford says emphatically. "Finally after two weeks of struggling, the doctor told her to stop right away."

Craven's postpartum depression was diagnosed over the telephone. The physician also phoned in a prescription for the new mother.

This, Bradford now knows, is not the way to diagnose or treat postpartum depression.

"Before Ruth was stricken, I had never even heard of postpartum depression," Bradford says. "There is precious little information available about PPD, and it is normally skimmed over in birthing classes."

As she watched her daughter struggle, Bradford clamored to find information on the illness.

"Before our experience with PPD, I was one of those who thought 'baby blues' was merely a matter of attitude," Bradford says. "Nothing could be farther from the truth. Unfortunately, I would venture to say, the vast majority of medical caregivers all too often make the mistake of not taking the complaints of PPD women seriously and assume what they are experiencing is 'baby blues,' which will only last about two weeks."

As Bradford learned, postpartum depression has much more severe symptoms than the "baby blues." It is a temporary illness but can last months or even years.

"It strikes women who are young, not so young; women who have had a history of depression and women who have never experienced depression; well-educated women as well as poorly educated ones; women who have a strong social support system and those who do not," she says. "There are women who have all the risk factors and don't get it and some who have none of the factors and do get it."

Postpartum depression is thought to be the result of a chemical imbalance caused by large doses of hormones rushing through the body at the time of birth. Normally, the hormones level off on their own, but when they do not regulate themselves, they severely impair the ability of the mind to function properly.

Recently, some high-profile cases of postpartum depression have been in the news. In fact, at the same time Craven was suffering, entertainer Marie Osmond also went through it. She has written a book chronicling her saga, "Behind the Smile: My Journey out of Postpartum Depression."

In June 2001, Houston mother Andrea Yates, who suffered severe postpartum depression, drowned her five children. That same summer, four women in Chicago killed themselves in the months after the births of their babies, among them Jennifer Mudd Houghtaling (see accompanying story).

But three years ago, these cases were not in the news, and postpartum depression, which strikes about one in 10 women, was not as well-known.

Bradford, like many others, even doubted its existence.

"Before I went through this with Ruth, my impression of depression was 'Get a grip!'" she says.

'SHE COULDN'T COPE'

As she stood by helplessly, her daughter's condition continued to deteriorate.

"She stopped talking and became uncharacteristically quiet," Bradford says. "Also, she adored her three cats. They were her babies, but within a week after Andrew's birth, she didn't seem to care whether they got fed or not. She also quit petting and loving them as she normally did. And she couldn't cope with the thought of taking care of Andrew."

Craven's medication and dosages were adjusted repeatedly. Every time the cloud lifted, it would come back again.

"PPD comes and goes," Bradford says. "It can leave for as little as several minutes or as much as several hours, but then suddenly without warning, it returns. When this happens, it is extremely discouraging to the suffering mother. She begins to feel she is finally over it, only to have it pop back up out of nowhere."

Craven attempted suicide twice. One time, her mother, stepfather Buzz Bradford, and husband Joey were in the house when she took an overdose of prescription medication.

Then, when her baby was one day shy of 11 weeks, Craven sneaked out of the house on a Sunday afternoon, climbed into her husband's car, took a gun and ended her life. Just hours before, over the phone, she had told her mother she was starting to feel better.

It is common, Bradford now knows, that suicidal women carry through with their plans when they are medicated and beginning to feel better.

"The reason for that is when a person is severely depressed, she normally doesn't have the energy to follow through with suicidal thoughts, but after being treated and regaining her energy is when she is most likely to follow through," she says.

When she should have been preparing for her grandson's first Christmas, Bradford was burying her only daughter.

"Although she pulled the trigger, Ruth did not commit suicide," Bradford says. "Postpartum depression killed my child. She had no more control over what she did than anyone suffering from MS, polio or any other crippling disease can control their paralyzed or partially paralyzed bodies. Ruth's mind was literally paralyzed by postpartum depression, which made it physically impossible for her to think clearly or rationally.

"I think her husband has put it best by saying that postpartum depression took a piece of steel and twisted it into nothing."

IN RUTH'S MEMORY

Three months after Craven's death, her friend, Elaine Earl, suggested starting a nonprofit foundation in her memory. The result is the Ruth Rhoden Craven Foundation Inc. for Postpartum Depression Awareness.

Bradford devotes her life to it. She has formed a support group, has a Web site with a message board, has done several speaking engagements, has planned special events and is trying to persuade doctors to screen all pregnant women and new mothers for the illness.

"I am not a leader," says Bradford, a former church organist who worked at several jobs before her retirement. "Organization is not my forte, and I don't have a medical background."

She has become an expert on postpartum depression.

"I feel not that God caused Ruth's death, but that he didn't step in and stop it so this foundation would come about," she says. "He used Ruth because she had so many friends. She'd be the last person you would expect to have something like this. I don't like it one bit, but it's what I believe."

She feels that mistakes were made in the diagnosis and care of her daughter but prefers not to dwell on them.

"I prefer using my energy in the way I'm doing it," she says. "I'm not out for revenge."

She wants all pregnant women screened when they first become pregnant, at six months gestation, at their baby's birth and several weeks after.

"Doctors don't always pick up on it," she says. "We'd like to see all pregnant women screened, just like they are screened for gestational diabetes or pre-eclampsia."

Around the time Bradford's grandson turned 1, his grandmother held her first postpartum support group meeting. The group has met the first and third Thursday of every month since that day in September 2000 even though sometimes the only people in attendance are board members.

"That's OK," Bradford says. "I'd rather be there and have nobody show up than not be there and have someone come looking for us. That's why we meet even if it's a holiday, because we want to be there if someone needs us. These women are so ashamed. They are scared, they have a lack of energy. It's hard to get them to come to meetings."

Bradford likens the feeling to being in a room full of doors, but the suicidal person can only see one exit.

"Some of these women have awful visions of harming themselves or their baby," she says. "For them to meet someone who has been there and survived gives them hope. The support group could be so healing and powerful. They need to realize that this is temporary. They are going to get well. They won't feel like this the rest of their life."

Bradford still sees her grandson as often as possible. Joey Craven lives in Aiken and has remarried and has a baby daughter. Craven and his family, Bradford's son Mark Rhoden, Joan Mudd, the mother of Jennifer Mudd Houghtaling, and PPD survivor Randy Berman will participate Saturday in the Postpartum Depression Awareness 5K walk/run. Mudd and Berman also will attend the group's support group meeting tonight.

"Postpartum depression is not a character flaw nor is it an indication of weakness," Bradford says. "There is no reason for these tragedies."

PPD SUPPORT

The Ruth Rhoden Craven Foundation can be reached at 881-2047 or ppdsupport.org.

-- Support group meetings are held at Lutheran Church of the Redeemer, 714 Riverdale Drive, West Ashley, on the first and third Thursday of each month, even if the day falls on a holiday. The meetings are 7 to 8:30 p.m.

Joan Mudd, whose daughter, Jennifer, took her life as the result of postpartum depression, and Randy Berman, who suffered from postpartum depression, will be at today's meeting.

Child care is not provided but Bradford says anyone needing child care should call ahead, and she can arrange it.

-- The group also meets at The Center for Women, 531 Savannah Highway, at 10:30 a.m. on the third Saturday of the month. For information, call 763-7333.

-- The foundation also is sponsoring a 5K walk/run at Hampton Park at 8 a.m. Saturday. The cost is $20 per person and includes a T-shirt. Registration will be open before 8 a.m.

-- On May 3, Jane Honikman, founding director of Postpartum Support International, will lead a training session for the medical community and the public.