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Book Reviews   |    
Down Came the Rain: My Journey Through Postpartum Depression
Reviewed by Carol C. Nadelson
Psychiatric Services 2006; doi:
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by Brooke Shields; New York, Hyperion, 2005, 240 pages, $23.95

Dr. Nadelson is affiliated with Brigham and Women's Hospital in Boston.

In this inspiring and readable memoir Brooke Shields relates the history of her infertility and its treatment, with a resulting in-vitro-fertilization pregnancy, a difficult delivery by C-section, and a postpartum depression. She is frank, realistic, and informative. She details the procedures and the emotional trial she experiences. As her story unfolds one can understand many of the complex elements that contribute to her psychiatric symptoms. These elements, often risk factors for postpartum depression, include her history of depression and the death of her father shortly before she delivered her baby. Her story invites consideration of the potential for prevention of serious postpartum disorders.

Her forthright presentation of the experience of a daughter and wife becoming a mother movingly portrays the changing of identity with this life event. It also teaches us about her vulnerabilities and every woman's vulnerabilities at this time of life.

She provides an important account, which must awaken everyone involved with the care of pregnant and postpartum women to take very seriously the early symptoms of depression as they evolve into a serious illness. Depression affects a substantial number of postpartum women, about 10 percent.

It is clear from Shields' accounts that the combination of psychotherapy and medication were instrumental in her recovery and in her ability to experience the joy of mothering her newborn daughter. The combination allows her to again be able to be part of the lives of her husband and her family and to reinvest in her career.

Shields also identifies and discusses the conflicts that she and many other women experience with work and motherhood, gender roles and parenting, and the complex restructuring of family relationships that occur when a child is born. These conflicts are compounded in her experience by her celebrity status, which adds to the stress as well as the excitement. This excellent book should to be read by those of us in the field of mental health and by our students and patients.

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