Baby and the bathwater

Overcoming baby blues: a comprehensive guide to perinatal depression

Gordon Parker, Kerrie Eyers, Philip Boyce. Sydney: Allen and Unwin, 2014 (256 pp, $27.99). ISBN 9781743316771.

THIS BOOK, part of the Black Dog Institute series, illustrates the misery, struggle and survival of parents during pregnancy and the baby's first year. It is written by authors with internationally acknowledged clinical and research expertise in mood disorders and perinatal depression. The particular strength of this book is its use of patient stories (from the Institute's annual writing competition). More than being about just “baby blues”, it covers anxiety and depressive reactions, adjustment disorder, melancholic depression, psychosis and bipolar disorder.

In the preface, the authors write:

This is occasionally uncomfortable because the book struggles to find a coherent voice.

The early chapters provide an excellent overview of perinatal mood disorders, risk factors, screening, diagnosis and treatment options. There is a clinical feel to this section and regular reference to the particular Black Dog approach to mood disorders. Perhaps it is intended to empower parents, but some sections read more like a useful introductory text for clinicians, than a book for women with depression. From Chapter 5 onwards, the book is a useful, accessible resource for families, including the appendix on medication use in the perinatal period.

There is a chapter on fathers and the extended family, and an acknowledgement that they are often overlooked despite mounting evidence that their support influences both a woman's risk of illness and her recovery.

One significant concern is the statement: “it takes a pretty high and constant level of abuse to have a marked negative effect on infant psychological development” (p 40). This may be an attempt to protect parents from guilt, but it is inaccurate. It is not adequate to think about the wellbeing of new parents, without also acknowledging the experience of their little one. The infant is potentially affected by parental depression and protective factors for the whole family need to be identified. Remember, don't forget the baby!

Overall, this is a useful book containing a great deal of information and that is eloquently illustrated by personal stories that bring it to life. Clinicians would do well to read it themselves before deciding how best to use it with their clients.