Can pregnancy intensify a mood disorder? I suspect my daughter-in-law suffers from a mood disorder. She is 4 months pregnant and her behavior is out of control. Her anger is irrational, explosive, overwhelming and it is escalating to violence. Lately, she is always angry, depressed, and at times mentions suicide. She works herself up so much that she becomes ill. My son is extremely frustrated and is feeling helpless because her anger is directed at him and she does not respond to logic or calmness. Her outbursts are very much affecting my four year old grandson. She refuses to seek medical advice or attention stating that she will not take drugs and there is nothing that can be done. In rational moments she realizes that she is disrupting the family but cannot control herself. My son and his family live in Calgary and I live in Vancouver so I cannot be there to help. They are not in a financial position to consider counseling. I do not know where to turn. Do you have any suggestions that can help my family? I would appreciate it if you could respond as soon as possible. Thank you.

Sandy Simpson

Dear Sandy,

I can't comment on the medical effects of pregnancy on mood disorders, as I'm not a doctor. But my experience is that hormone changes do influence moods.

It's near to impossible to convince someone to get help when they don't believe they need it. I have three suggestions. When your daughter in-law visits her doctor for 'baby check-ups' have your son go with her. Don't have your son surprise her with accusations at the doctor's appointment about her behavior. Instead let her know ahead of time that he'd like to talk about his concerns with her and the physician, if only to help him understand what's going on. Reassure her that discussing the issue doesn't mean she's admitting she has a mood disorder, nor does it mean medication will be the answer.

And if a mood disorder is discovered, be encouraged: many women have healthy pregnancies while living with such illnesses. But I believe it means being proactive and working with a doctor whom you trust. The courage rests in not doing this alone, but being willing to face reality, ask the right questions and listening to the answers, even if they're not what you want to hear. And have your son discuss going to the doctor with her together when she is feeling less emotional.

Second suggestion: If she refuses to have him join her, have him visit the doctor on his own. Have him emphasize the seriousness of the situation. Mention of suicide should always be taken seriously and when behavior is escalating to rage and violence this must be communicated to the physician in order to discern what the cause is. Please have him do this as soon as possible -- better to have him go on his own and start finding help.

Thirdly: please connect with the groups listed below. Although this is not post partum, these societies should be able to help and/or suggest other avenues of assistance.

1. Calgary Post Partum Support Society
   310-707 Tenth Ave., SW
   Calgary, Alberta T2R 0B3 CANADA
   Phone: (403) 266-3083
2. Pacific Post Partum Support Society
   #104 - 1416 Commercial Drive
   Vancouver BC V5L 3X9 CANADA
   Phone: (604) 255-7999
   Fax: (604) 255-7588
   Website: www.postpartum.org