A woman who led DC police on a car chase from the White House to the Capitol suffered from post partum depression, according to her mother.
Miriam Carey, 34, of Stamford, Conn. drove her car through a barrier at the White House, ramming a Secret Service agent onto the hood of her car, and then led police to the Capitol, according to the Associated Press (AP). Police began firing at Carey’s car after she drove into a Secret Service vehicle and escaped down Constitution Avenue, where she hit a median and was shot to death by police. Only then did they discover Carey’s infant daughter in the car, who was unharmed and placed in protective custody.
Carey’s mother, Idella Carey, told ABC News that her daughter gave birth last August, and became depressed several months later. Carey was fired from her job as a dental hygienist about a year ago, and had experienced a head injury following a fall, her employer Dr. Brian Evans told the AP. A federal law enforcement official also told the publication that based on interviews conducted with Carey’s family so far, she showed signs of “serious degradation in her mental health.”
It may take many months before more is known about what drove Carey to act as she did, and to determine whether her behavior was the result of post partum depression, as her mother suggested, or a different mental illness, or even a combination of both. Recent studies suggest that about half of all new mothers experience post partum depression after childbirth, with about 10% to 15% showing symptoms of sleep problems, apathy, and obsessive worry about their parenting skills. An even smaller percentage develop more severe conditions of post partum psychosis, which can include hallucinations, paranoia and extreme anxiety. But these are only estimates, since experts say there are few comprehensive studies on post partum depression and minimal understanding of what makes women vulnerable.
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To address the knowledge gap, some scientists have recently used brain imaging to identify patterns of activity that may pinpoint new mothers who might be at greater risk of developing post partum symptoms. These scans showed that the condition may result from dulled responses in the regions that regulate empathy and emotion.
Some early investigations have also revealed potential genetic clues to the condition; Johns Hopkins researchers have connected increases in estrogen levels during pregnancy with changes in genes that regulate mood. Some women, they say, may have genetic makeups that make them more sensitive to the drop in the hormone after birth, which could make them more vulnerable to depression. Even more encouraging is the fact that these genetic changes can be detected in the blood with about 85% accuracy.
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Other studies have suggested a link between geography and post partum depression; about 10% of mothers living in urban areas developed the condition compared to 6% of women in rural areas. Despite the fact that more people tend to live in smaller spaces in cities, mothers may feel less connected to a supportive network of close family and friends in these settings.
But without a more coordinated understanding of the condition, questions about whether more women should be screened — and defining the criteria for diagnosis — are still lacking. Congress recently took action on the matter, passing the Melanie Blocker-Stokes Postpartum Depression Research and Care Act, or the Mothers Act, as part of health care reform to require the National Institutes of Health to expand research into the condition and improve ways of diagnosing and treating its symptoms. The law also calls for a study into whether screening all mothers for post partum depression could lead to earlier interventions to help mothers cope better with their symptoms and potentially avoid tragic outcomes like Carey’s and Blocker-Stokes’, a Chicago mother who jumped to her death in 2001 after being hospitalized three times for post partum psychosis.
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Early detection of the hormonal and genetic contributors could help the most vulnerable mothers take advantage of drug or behavior-based therapies to manage their symptoms. At the University of North Carolina at Chapel Hill, doctors run the country’s first stand-alone inpatient psychiatric unit for expectant and new moms with depression. The program provides 24-hour care, including stress management skills and treatment for depression, all while allowing the mothers to spend time with their babies.
Whether Carey would have benefited from such a dedicated treatment program will never be known. Her mother said that her daughter had been hospitalized for her depression, but most programs aren’t focused specifically on issues that women with post partum face.