Fragile beginnings: identification and treatment of postpartum disorders.

The transition to parenthood has long been recognized as a normal developmental crisis. However, 7 percent to 10 percent of all new mothers experience serious postpartum disorders that lie beyond the realm of the common "maternity blues." Postpartum depression and psychosis are hormonally based psychiatric illnesses that pose risks to the new mother and the family system. Too often, they are misdiagnosed as exclusively psychological and are undertreated by health care professionals. Early detection, assessment, and treatment are critical for the health and safety of both mother and child. Aggressive treatment may include individual and family therapy as well as medication. Women at particular risk for these illnesses should be identified during pregnancy. Efforts also should be made to prevent recurrence after subsequent deliveries.