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    Britney and Postpartum Depression

    When radio-marketing specialist Sandra Poulin first heard reports linking Britney Spears' recent erratic behavior to postpartum depression, she was skeptical.

    The partying, the strip-club photo ops, the head shaving—none of that spoke to the experience of Poulin, who battled the disorder after the birth of her daughter, or to those of the women she interviewed for her book, The Mother-to-Mother Postpartum Depression Support Book.

    "If she has the energy to party, that is very suspect to me that she in any way would have postpartum depression," says Poulin, who endured months of anxiety-driven sleepless nights.

    But then Poulin did the math: Spears' youngest son, Jayden James, was born six months ago last September; postpartum depression is often diagnosed four to six months after the birth of a child.

    "That's when it hits the hardest, because you are not sleeping well, and you really are not well," Poulin says. "People often think it's immediate, it hits you right away—no way."

    According to Postpartum Support International, a California-based support and advocacy group, one in eight women will experience overwhelming helplessness, sadness or even anxiety after giving birth.

    Brooke Shields and Marie Osmond belong to this not-at-all-exclusive club. Insiders in Spears' camp suggest she does, too.

    Postpartum-depression experts don't disagree.

    "I think it could definitely be a factor," says Susan Dowd Stone, a licensed clinical social worker and president of Postpartum Support International. "Quite frankly, I don't see how it could not be a factor."

    "It isn't, 'Wow, isn't it weird Britney Spears had postpartum depression?' It's, 'Well, that's what was going on.' "

    To Stone, Spears' acting out is in sync with a postpartum-disorder diagnosis, as well as potentially tied to classic risk factors such as marital problems and substance abuse.

    Spears filed for divorce from husband Kevin Federline last November, en route to notching headlines for coast-to-coast clubbing, collapsing and vomiting.

    "People think of depression as being in bed all day, or crying all day," Stone says. "But in manic states, [women] can engage in risk-taking behavior."

    On Friday, and barring an early discharge, the 25-year-old Spears will mark her first full week in Promises, a Malibu clinic renowned for its alcohol- and drug-treatment programs.

    Spears' camp has not expressly said what ails the singer—although paparazzi shots of Spears attending a not so anonymous Alcoholic Anonymous meeting on Wednesday night left a little less to the imagination.

    Though short on public pronouncements, Spears' insiders are talking up reporters—and talking up postpartum depression, even if some incidents, such as her 55-hour marriage to Jason Allen Alexander, occurred prior to either of her pregnancies.

    A source close to Federline told Tina Dirmann of E! Online's Planet Gossip show that Spears was "never the same after she had their kids," sons Jayden James and one-year-old Sean Preston.

    "Even after the first baby, she had wild mood swings and her temper would go off at the drop of a hat," the source said. "After she came home the second time, she just seemed really unhappy all of the time."

    If Spears has a postpartum disorder, Poulin says, it's possible she doesn't, or didn't, know it.

    "A lot of these mothers," Poulin says, "they look back and go, 'What was I doing, what was I thinking?' "

    Spears is also getting support from one of the most public faces of postpartum, Shields. The actress and model, who documented her own bout following the birth of first daughter, Rowan Francis, in the book Down Came the Rain, tells Access Hollywood, "If she wants to talk to someone, I'm available."

    Katherine Stone (no relation to Susan Down Stone) is an Atlanta-based mother of two who suffered obsessive-compulsive thoughts following the birth of her eldest child. On her blog, Postpartum Progress, the online discussion has begun to include Spears and whether her behavior is linked to what even the hairstylist who finished off the singer's infamous buzz cut labeled "hormonal."

    "A lot of people have said, you know, I was wondering that myself," the blogger/writer says.

    Watching Spears from the outside, Katherine Stone sees a woman who went from appearing, in photographs anyway, to be very close to her first child, to not being anywhere near either child following the latest birth.

    "When you're suffering from postpartum depression, you really have this crushing fear you should never be a mother," Katherine Stone says. "That you just can't do it...Some mothers will pull away."

    Add public scrutiny to the mix, and, well, actually don't add public scrutiny to the mix...

    "It's hard enough for people to come forward and admit it [a mood disorder] because of our society's view of mental illness," Katherine Stone says. "I can't imagine being Britney Spears."

    Medication and therapy helped Katherine Stone along a yearlong road to recovery. For Sandra Poulin, it took 18 months, medication and the invaluable introduction of a fulltime nanny.

    Susan Dowd Stone says the prognosis is excellent for any woman suffering from a postpartum disorder, provided the problem is diagnosed and treated.

    "If she's got this," Poulin says of Spears, "I hope she will get help.

    "I hope Britney's okay. That's all I can say. Everybody hopes she's okay."


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